A recent study, published in the journal Nutrition, demonstrated the effect of broccoli and blueberries on bowel inflammation in an animal model of inflammatory bowel disease (IBD).¹ Researchers fed IBD mice either a control diet, or a diet with 10 percent broccoli or ten percent blueberries. Both the broccoli- and blueberry-fed mice exhibited similar changes in gut microbiota with one exception: the broccoli-fed mice had lower levels of the bacteria Faecalibacterium prausnitzii. Both diets also increased the size of colon crypt cells and number of goblet cells per crypt. (Intestinal crypt cells are located in the “valleys” of the intestinal villi.)

Differences between the broccoli- and blueberry-fed mice were also observed. Higher concentrations of butyric acid and lower concentrations of succinic acid were found in the broccoli-fed mice; the only diet to reduce inflammation in the colon was the broccoli-fed diet; and broccoli-fed mice exhibited less translocation of microbes to mesenteric lymph nodes than the blueberry-fed or control mice. (This means in the broccoli-fed mice gut bacteria stayed in the gut rather than translocating through a leaky gut into gut-associated lymph nodes.)

One reason the blueberry-fed mice may not have had as beneficial an impact as the broccoli-fed mice could be the high fructose content of blueberries. Foods high in fructose can produce fermentation in the gut.² Inflammatory bowel disease involves a gut sensitivity to the microbes residing there. Increased fermentation may further disrupt an already sensitive environment.

Blueberries have been found to benefit microbial metabolism in the colon, likely due to the anti-inflammatory effects of blueberry’s phenolic compounds.³ Broccoli is also well known for its protective effects in the large bowel, mostly attributed to the sulforophane and indole-3-carbinol (I3C) bioactives.⁴

This study is helping to prove that whole foods absolutely affect the microbial population. The moral of the story? Well, more studies need to be done to confirm the effects in humans, and to elucidate the mechanisms at work, but in the meantime, eat more broccoli! In fact, eat more vegetables (and fruits if you aren’t sensitive) in general. The thousands of phytochemicals found in vegetables and fruits have more beneficial effects in our guts—and our entire bodies—than we will ever know.

References

1. G. Paturi, et al., “Influence of dietary blueberry and broccoli on cecal microbiota activity and colon morphology in mdr1a(-/-) mice, a model of inflammatory bowel diseases.” Nutrition. 2011 Nov 22. [Epub ahead of print]
2. P.R. Gibson, et al., “Review article: fructose malabsorption and the bigger picture.” Aliment Pharmacol Ther. 2007 Feb 15;25(4):349-63.
3. W.R. Russell, et al., “Availability of blueberry phenolics for microbial metabolism in the colon and the potential inflammatory implications.” Mol Nutr Food Res. 2007 Jun;51(6):726-31.
4. E.H. Jeffrey and M. Araya, “Physiological effects of broccoli consumption.” Phytochem Rev. 2009;8:283-9.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Belly fat, or visceral adipose tissue (VAT), is the fat that accumulates around the organs in the abdomen. It is strongly related to metabolic disorders including insulin resistance, fatty liver and inflammation. Because of the close proximity of belly fat to the intestines, and the ability of gut bacterial toxins to affect inflammation outside the gut, the relationship of increased intestinal permeability, or leaky gut, to increased abdominal fat has been investigated. 

Indeed, previous studies in animals and in people with illnesses like Crohn’s disease¹ and non-alcoholic fatty liver disease (NAFLD), have found a link between leaky gut and belly fat. Until recently, however, no studies had been done in healthy humans. Now the picture is all coming together nicely, as a new study highlights.

In 55 healthy women, intestinal permeability was estimated by measuring urinary excretion of ingested nonmetabolizable sucralose and mannitol. (They measure the ratio of excreted sucralose to mannitol—if the sucralose level is high, it means it leaked through the gut, even though it shouldn’t.) Further, imaging was performed of subcutaneous fat (fat just under the skin) visceral fat, and liver fat. The researchers found that increased leaky gut was associated with increases in both visceral fat and liver fat content in healthy women.² This is important because previous studies have found this in people with illnesses, but it was not known if leaky gut could was associated with belly fat in healthy individuals. Now we have a better picture of this gut connection.

The women in the study had no history of gut disorders, yet some of them still had leaky gut, and those with the worst leaky gut also had the most belly and liver fat. The researchers stated, “The current findings suggest that even without pathologically compromised gut function, intestinal permeability still appears to play a role in visceral adipose and liver fat accumulation.” Importantly, they go on to mention the role that the gut microbiota plays in this picture. Alterations in gut bacteria composition has been associated with metabolic dysfunction,³ and gut bacteria help regulate gut barrier function,⁴ they mention.

They conclude, “Our data suggests that intestinal permeability may be an important part of the link between diet, gut microbial balance, inflammation, and metabolic disorders. The present findings are consistent with the emerging role of gut in metabolic health.”

Abdominal fat has even been considered an organ of its own, due to the many chemicals and hormones it produces, just as organs do. The role of VAT as a contributor to metabolic diseases is possibly the most important factor to consider when trying to reduce disease risk. That the accumulation of this belly fat is related to the gut, and might even originate in the gut, takes our search into the prevention of diseases yet one more step closer to the source. A healthy gut is truly the foundation of total body health.

References

1. Desreumaux P, et al., “Inflammatory alterations in mesenteric adipose tissue in Crohn’s disease.” Gastroenterology. 1999 Jul;117(1):73-81.
2. Gummesson A, et al., “Intestinal Permeability Is Associated With Visceral Adiposity in Healthy Women.” Obesity (Silver Spring). 2011 Aug 18. [Epub ahead of print]
3. Cani PD and Delzenne NM, “The role of the gut microbiota in energy metabolism and metabolic disease.” Curr Pharm Des. 2009;15(13):1546-58.
4. Sharma R, et al., “Molecular modulation of intestinal epithelial barrier: contribution of microbiota.” J Biomed Biotechnol. 2010;2010:305879.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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The immune system is a complex organization of coordinated responses to “foreign” invaders in the body. Foreign invaders include microbes—bacteria, fungus, parasites and viruses—as well as toxins and even food. As a matter of fact, one major role of the immune system is to not respond to food. As is seen with food allergies, however, the immune system is not always successful at this. Food allergies involve an overactive immune response to certain foods, which would normally be recognized as harmless. 

The immune system is comprised of two main branches: the innate immune system and the adaptive immune system. The innate immune system, also known as cell-mediated immunity, involves an immediate non-specific immune response, often against pathogens. The adaptive immune system, also called humoral immunity, involves a delayed, specific, organized response involving the production of antibodies that later recognize invading microbes so that a more effective immune response can be mounted. The innate immune system involves the production of cells called T helper 1 (Th1) cells, and adaptive immunity involves the production T helper 2 (Th2) cells. T helper cells are lymphocytes, a type of white blood cell. They are like the messengers of the immune system, sending signals that stimulate various immune responses.

Th1 and Th2 responses are joined by another type of T helper cell known as Th17. Th17 and Th1 responses are both associated with over-active immune responses, as is seen in autoimmune conditions, in which the body mistakenly attacks its own tissues. Both these responses produce inflammation by way of cytokines, the immune equivalent of hormones. These three types of T helper cells are all regulated and balanced by cells known as T regulatory cells, or Tregs.¹

Are you confused yet? Think of all these T cells as a four-way seesaw.  Th1 and Th17 are on two prongs of one end, and Th2 and Tregs are on two prongs of the other. When all is well, this seesaw is in balance, like a harmonized symphony responding appropriately to that which the body comes into contact.  If out of balance, you may see higher levels of Th1 and Th17, an indication of underlying autoimmunity as is seen with type 1 diabetes, celiac disease, rheumatoid arthritis, psoriasis, multiple sclerosis and systemic lupus erythematous. In contrast, higher levels of Th2 and Tregs are characteristic of allergic conditions like asthma, food allergies and hay fever, and with immune suppression.

How can we balance immunity? Well, probiotics are one solution. Since over 70 percent of the immune system is in the gut, probiotics are in the right terrain for immune system communication. Probiotics help balance immune response.  Gut bacteria essentially “prime” the immune system,² educating it so that it responds appropriately to what passes through the digestive tract—and to what may ultimately pass through the small intestine and into the body.

Omega-3 fatty acids also affect immunity, largely by helping to balance the inflammatory response—an important aspect of immunity. You see, inflammation is a necessary physiologic occurrence.  But too much inflammation spells trouble.  The omega-3 fatty acids EPA and DHA found in fish oil help to quell inflammation at the right time.  They help stimulate the production of resolvins, chemicals knows to help “resolve” inflammation—or end it at the appropriate time.³ 

Further, the proper digestion of food is necessary so the immune system doesn’t have to work too hard.  When food is not broken down properly, undigested food particles can aggravate the gut, causing inflammation and even leaking through a permeable intestine (also known as leaky gut) and entering circulation where yet more inflammation is triggered, in a downward spiral of excess inflammation (which is at the basis of most, if not all, chronic disease).

Also important is regular bowel elimination, which can be attained by the consumption of dietary fiber—at least 35 grams per day. A diet rich in fruits, vegetables and whole grains is essential, and a fiber supplement can help reach 35 grams, which can be difficult to obtain through diet alone.

In essence, the HOPE Formula—High-fiber, Omega Oils, Probiotics and digestive Enzymes—can help improve digestive health and improve immune balance. Brenda and I have been recommending this formula for years for many good reasons. With the HOPE Formula, there is hope that your health will improve. 

References

1. Cooke A, “Th17 cells in inflammatory conditions.” Rev Diabet Stud. 2006 Summer;3(2):72-5.
2. Round JL and Mazmanian Sk, “The gut microbiota shapes intestinal immune responses during health and disease.” Nat Rev Immunol. 2009 May;9(5):313-23.
3. Serhan CN and Savil J, “Resolution of inflammation: the beginning programs the end.” Nat Immunol. 2005 Dec;6(12):1191-7.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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I’m really excited about a couple of new studies on gluten sensitivity. I have been talking about this condition for so long, knowing that it contributes to many different health conditions in the body. The science is only beginning to scratch the surface of what clinicians have been seeing for years in patients who suddenly feel better after removing gluten from the diet.

A new study published in the American Journal of Gastroenterology (yes, you heard me—gluten sensitivity is hitting the “big time” folks) has validated the fact that gluten sensitivity is not just “all in their heads.” This double-blind randomized placebo-controlled trial recruited people with irritable bowel syndrome (IBS) whose symptoms improved after following a gluten free diet. These patients, in whom celiac disease was ruled out, were then put into two groups: one group was re-challenged with foods containing gluten and the other group was given “placebo” foods that did not contain gluten.

The results? In the group receiving the gluten-containing foods there was a significant increase in bloating, abdominal pain, altered bowel pattern and fatigue. Surprise, surprise! This is something that I have seen in people for years, and that the natural health community has known for a long time. But to see it published in this prestigious journal gives me hope that we will be taken more seriously with regard to the knowledge we are spreading about the damage that gluten can cause in many people.

This study is only the beginning, and will surely trigger many new studies that seek to discover just what is occurring in gluten sensitivity and why. The study helps to not only put gluten sensitivity on the map, so to speak, but also to explain one of the triggers to the ever-elusive IBS. We have known that gut infections can trigger IBS, and now we know that gluten sensitivity may also be a trigger. Again, this is something that I have been saying for many years.

And that’s not all! Another study reported in the Wall Street Journal and published in BMC Medicine has determined that gluten sensitivity and celiac disease involve two different branches of the immune system. Gluten sensitivity involves the innate immune system, which is responsible for the initial inflammatory response that occurs when the body encounters a “foreign” invader—in this case, gluten. Celiac disease, on the other hand, was found to involve the adaptive immune system, which involves a more complex secondary immune response that identifies the foreign invaders so that they will be recognized each time they are subsequently encountered.

Very interesting is that the difference between these two conditions was related to intestinal permeability—leaky gut. Those people with celiac disease were more likely to have leaky gut, while those with gluten sensitivity had not developed leaky gut—YET! What I think they will find is that gluten sensitivity is the first, milder reaction that worsens, increases leaky gut, and becomes full blown celiac disease. It’s a progression, and if you don’t take control of it early, it can lead to many different health conditions.

If you think you are gluten sensitive, try a gluten-free diet (no cheating—I’m not kidding!) for at least six weeks (even up to 6 months or more depending on your condition) to see if you begin to feel better. Today, there are many gluten-free options. Be sure to include plenty of fruits and vegetables, lean proteins, good fats, and whole, gluten-free grains. You’ll be on your way to wellness.

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The title of this article has been taken directly from the journal Gut Pathogens January 2011, and can be accessed for free at www.gutpathogens.com. This article tells the story of the gut connection. As we have been preaching for years, there is good evidence of a connection between gut bacteria and most (if not all) of the body organs, including the skin and brain.  What’s more, the above article presents much new, refined information, but the basic information is included from published references from 80-90 years ago!

Read, and be informed of the following concepts presented:

1.  The regular consumption of fat, sugar and simple carbs low in fiber, will decrease the beneficial bifidobacteria and other probiotic species in the colon and terminal small intestine (the end of the small intestine).

2.  Low  bifidobacteria allows increases of other bacteria that may promote colonic lining (epithelium) inflammation, with increased free radical damage and oxidative stress that leads to increased intestinal permeability (IP), or leaky gut.

3.  Increased IP leads to the passage (or translocation) of partially digested food particles, bacterial toxins, and other bacterial byproducts including fat (or lipids) from dead bacterial cell walls. 

4.  Bacterial cell wall lipids known as lipopolysaccarides (LPS), or also bacterial toxins, are easily measured in the blood, and are important indicators of how much overactivity will occur in the immune system.  Elevated LPS is very likely to occur after eating your favorite ice cream, or even too much bacon and eggs with toast and jelly (high fat, high sugar, and low fiber).

5.  Elevated blood levels of LPS cause the immune system to increase production of inflammatory markers (pro-inflammatory cytokines). These markers can cause many negative reactions, including decreased insulin receptor sensitivity, and thereby elevate blood sugar and insulin levels.

6.  Chronically elevated blood sugar and insulin promote increase in blood lipids, and  increase in inflammation which can contribute to acne, anxiety and depression, among other conditions.

Here is the good news,  a  high-fiber diet found in vegetables, whole grains, legumes, seeds and nuts, with some low glycemic fruits (especially berries) will promote high-normal levels of bifidobacteria. Taking prebiotic fibers was also shown in this article to increase bifidobacteria, and supplementing with bifidobacteria probiotics or fermented foods will definitely have overall beneficial effects on the body, including the skin and the brain. 

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years.  In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe.  Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.   

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Most surgeons on call on Thanksgiving or Christmas Day are not surprised when they get called into the ER to see a patient with right upper abdominal pain and tenderness radiating through to the back. There are also no surprises when an abdominal ultrasound shows a dilated gallbladder, possibly with a thickened wall, and gallstones ranging from the size of a pebble to the size of a marble or even an egg. At this point, the appropriate next step would be laparoscopic cholecystectomy, or removal of the gallbladder. This is one of the most common surgical procedures in the Western world today.

So how does a person find themselves in the operating room on Thanksgiving night? First of all, it didn’t just happen all at once. Gallstone formation takes months or even years. It is believed that low-fiber, high-cholesterol diets high in processed starchy foods contribute to the formation of cholesterol stones. Over-consumption of fatty and fried foods and refined sugar, as well as inadequate intake of vitamins B, C and E, are also factors thought to contribute to gallstone formation. Inadequate water intake and lack of exercise also play a role.

With the above diet, a bacterial imbalance in the gut will develop. The effect in the gut of this imbalance will be increased intestinal permeability (also known as leaky gut). As a result of leaky gut, more toxins are delivered to and processed by the liver. These toxins are sent from the liver to the gallbladder, where they are stored and concentrated along with the bile, which can lead to gallstones.

So how do the holidays fit into this? Very simply – a large meal high in fat and sugar will release the hormone cholecystokinin (CCK) from the duodenum (upper small intestine). CCK triggers the gallbladder to begin contracting and may move the stones into the cystic duct (which drains into the common duct and then into the duodenum) causing gallbladder obstruction, swelling, more inflammation, and severe right upper quadrant pain.

Many people do not realize they have gallstones. They may go years without symptoms and only discover the gallstones in an emergency room visit such as I described above. Other people do experience periodic attacks and are able to recover from them and choose not to have surgery. In either case, it’s prudent to take extra care at major holiday meals. A combination of gravy, ham, buttery mashed potatoes, candied yams and alcohol, followed by pumpkin pie and ice cream is the perfect recipe for a gallbladder stress test. The following recommendations could help you avoid that ER visit this holiday season:

• Eat smaller portions of any high fat, high-sugar foods
• Chew thoroughly
• Eat slowly, taking the time to enjoy the meal and company
• Take digestive enzymes with the meal
• Limit alcohol consumption

Most importantly, as a preventative measure, follow a high-fiber, plant-based, antioxidant-rich diet low in processed foods and saturated fats, fried foods and sugar. In addition to getting regular excise and having regular bowel elimination to reduce toxins, it is important to have a healthy balance of intestinal bacteria. This can be achieved by eating fermented foods (which are naturally high in beneficial bacteria) and taking high-quality probiotic supplements every day.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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My assistant recently returned from the latest Institute for Functional Medicine conference in southern Florida. For those not familiar with Functional Medicine it is a personalized medicine that deals with primary prevention and underlying causes instead of symptoms for serious chronic disease. In other words, they teach Medical Doctors as well as all other specialties how to evaluate a person to get to the route of a problem or disease and treating the cause verses just treating the symptoms.

A big part of Functional Medicine includes the use of nutraceuticals in treatment.

This year’s conference centered on Mood Disorders, including depression, anxiety, and bipolar disorder as well as touching base on Alzheimer’s and Parkinson’s. Amazingly, one of the focuses of the lectures was the gut-brain connection in relation to mood disorders. More specifically, how reactions of our immune system and gut inflammation can directly affect our brain.

Remember that most of our immune system is in our gut.

Without getting too technical, the same type of cells and neurotransmitters found in our brain are also located within the digestive system. The development of an infection or inflammation anywhere in the body will set the immune system in action. Again, most of this reaction takes place first within the immune system of the digestive tract. Our immune system responds by the reaction of proteins called cytokines. These cytokines tell our body what type of reaction to have, such as swelling, stiffness, pain etc…It has now been shown that these cytokines will travel a very unique pathway and arrive at the brain, setting into motion a chemical reaction that results in the breakdown of the neurotransmitters involved in mood stability and inflammation within the brain itself.

Once this brain inflammation develops, it can remain for months even though the initial problem in the other part of our body gets resolved. This brain reaction can result in symptoms such as brain fog, memory problems, depression and anxiety. In addition, the influx of these cytokines to the brain can disrupt the lining of the brain called the blood-brain-barrier, causing what they now call “Leaky Brain” syndrome, making the brain more susceptible to other agents that do not normally pass this barrier. This is very similar indeed to what we know as Leaky Gut syndrome.

The more inflammation and irritation of the gut lining, as in Leaky Gut, will in turn send more of the cytokines to the brain, resulting in more inflammation and irritation there. In reverse, they are now seeing that healing the gut, reducing inflammation and supporting the immune system with the proper nutraceuticals can in turn reduce depression, anxiety and even reduce some symptoms associated with Alzheimer’s and Parkinson’s.

All the more reason to take precautionary measures by supporting your immune system with probiotics, as well as your vitamins and minerals. Taking a glutamine supplement such as IntestiNew will help keep your intestinal tract healthy, reduce inflammation and defer the development of leaky gut.

It is funny that years ago scientists and doctors treated the brain and mood disorders as a total separate entity from the rest of the body. It is nice to see that they now realize the brain is connected to the body, through something called the neck!

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