A new study, published in the European Journal of Clinical Nutrition, demonstrated a connection between diet, and stool pH and bacterial levels in adults.¹ The researchers studied stool samples from vegetarians, vegans, and omnivores. They found lower levels of potentially pathogenic bacteria, like E. coli, in people consuming the vegan or vegetarian diets. What they also found, in conjunction, was a decrease in stool pH level with decreases in consumption of animal proteins. Those on the omnivore diet had a stool pH of 6.9; those on the vegetarian diet (which included dairy and eggs) had a stool pH of 6.6; and those on a vegan diet (no animal proteins) had a stool pH of 6.3.

The higher pH in the omnivore diet is explained in part by an increase in the production of alkaline metabolites by enhanced growth of the protein-digesting putrefactive bacteria in the gut. That’s right—a diet high in animal protein promotes increased putrefying activity of gut bacteria, raising the pH of stool and making products like putracene, cadaverine, and nitrosamine, which could lead to colon cancer. Diets lower in animal protein and—this is key—higher in fiber promote gut bacterial activity that produces more acid via production of the beneficial short-chain fatty acids (SCFAs) butyrate, propionate, and acetate, promoting a more acidic environment in the gut.

The change in pH levels explains why potentially pathogenic bacteria were increased in the higher pH (more alkaline) stools of people consuming an omnivorous diet. Lower pH ranges do not support the growth of potential pathogens, which thrive in the higher pH range over 6.5.^2,3 So I say, stay alive under 6.5!  

Here is a major point. The lower pH may be mainly a biomarker indicating the production of the SCFAs, particularly butyrate. Butyrate is a major fuel for the colonocytes, and is critical for optimum colon health. Butyrate also affects nuclear transcription in a positive way. In other words, when colonic cells are under attack from absorption of free radicals from fecal material (more likely to happen with chronic constipation), the nucleus, under stress, sends a message to the cell: either commit suicide (apoptosis) or produce more damaged cells (cancer).  Butyrate is more likely to promote apoptosis, preventing cancerous cells and allowing new cells to come in and maintain a healthy colon lining.

However, we must always remember everything is a question of balance.  All of the SCFAs including butyrate come from the fermentation of soluble fiber from plants by commensal bacteria. Too much fermentation with too low of a pH (or too much acid) can damage the colonic lining creating increased permeability problems leading to numerous problems including immune imbalances which can have total body effects.

The researchers also found a decrease in levels of Bifidobacteria and Bacteroides in the people on a vegan diet. This is in contrast to other studies that have found increases in Bifidobacteria, and seems an anomalous finding, since high-fiber diets support the growth of Bifidobacteria, while suppressing the growth of potential pathogens. Perhaps a closer look at the diets would be in order. Many vegetarians and vegans eat high amounts of refined carbohydrates, and too much fats and oils which do not promote healthy Bifidobacteria levels.

The researchers state, “In addition to age, gender and diet, factors such as microbial interaction, food transit through different intestinal compartments with different bacterial colonization density, availability of nutrients, colonic supply, sulphate and bile acids, and bacterial adaptation may all be involved in the composition and activity of colonic microflora. This may help in understanding the lower abundance of Bifidobacteria and Bacteroides species in vegans and vegetarians, which was not linked to stool pH.”

At any rate, all diets—vegan, vegetarian, and omnivore—will benefit by adding probiotic-rich foods along with supplements to help replenish levels of the beneficial Bifidobacteria and Lactobacilli. These bacteria, along with a high-fiber diet high in vegetables and fruits, help to lower the pH in the intestines by producing the nourishing SCFAs.

Incidentally, this topic can confuse the message of the benefits of a high-alkaline diet. You may have heard that a diet high in animal protein, sugar, and refined carbohydrates creates acidity in the body. Yes, these foods do lower urine and salivary pH levels, which are thought to be associated with bone mineralization, a process that helps neutralize acidity by pulling alkaline minerals from bone.  Chronic low grade acidity (metabolic acidosis) also causes excess loss of calcium, magnesium and potassium in the urine. Diets high in vegetables and fruits, on the other hand, produce more alkaline urine and saliva levels, which is associated with reduced bone loss and reduced loss of minerals in the urine.⁴ These variabilities in optimum pH in different areas show the body’s ability to change based on local environment and physiologic and biochemical requirements.

The bottom line is, healthy pH levels, whether in the colon or systemic, are found when you eat a high-fiber diet, high in vegetables and fruits, healthy proteins, and healthy fats. Complement this with foods and supplements high in beneficial bacteria, omega-3 fatty acids, and digestive enzymes, and you will be supporting optimal health (which begins in the digestive system).

References

1.  J. Zimmer, et al., “A vegan or vegetarian diet substantially alters the human colonic faecal microbiota.” Eur J Clin Nutr. 2012 Jan;66(1):53-60.
2. J. Adler, “A method for measuring chemotaxis and use of the method to determine optimum conditions for chemotaxis by Escherichia coli.” J Gen Microbiol. 1973 Jan;74(1):77-91.
3. G.R. Gibson, et al., “Prebiotics and resistance to gastrointestinal infections.” Br J Nutr. 2005 Apr;93 Suppl 1:S31-4.
4. B. Dawson-Hughes, et al., “Treatment with potassium bicarbonate lowers calcium excretion and bone resorption in older men and women.” J Clin Endocrinol Metab. 2009 Jan;94(1):96-102.

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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Gastroenterologists from Johns Hopkins University are reporting something I don’t find surprising at all—kids are experiencing more serious and chronic bouts of constipation. Why? Lack of physical activity, inadequate water intake and fiber-poor diets are the biggest culprits.   

As I said, it’s not surprising. Traditional medicine defines constipation in children as three or fewer bowel movements per week, for at least three months (not necessarily consecutive) per year. They say that these children need to be treated early and aggressively. They also say, “no amount of fiber or prune juice will help a child with serious chronic constipation.”

Wanna know what I say? I say if children are not experiencing a bowel movement every day, they are constipated. If they miss a day, they are constipated and should be treated for it.  How’s that for early? Sure, if a child is only having three bowel movements per week for three months, fiber and prune juice might not be enough. But more importantly, we need to not let the problem get that far. In fact, it starts in infancy, with a proper diet (including plenty of breast milk!).

One bowel movement daily—that should be the norm, OK?

The researchers do recommend plenty of water intake, plenty of exercise, a high-fiber diet rich in fruits and vegetables, and a diet low in processed foods and foods that are high in fat and sugar. They also recommend the use of a stool or box to prop up legs into a more natural position.  They also stress the importance of teaching kids to never “hold” or ignore the urge to move the bowels.

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 Constipation is a common childhood condition, unfortunately. Even worse is the mainstream definition of constipation—less than three bowel movements per week. Say what! If you or little Johnny are only pooping three times a week, we’ve got a problem. Regular elimination helps remove toxins from the system. And the longer feces sit in the colon the more toxic it gets!

A recent study evaluated the effect of the probiotic Bifidobacterium breve in children with constipation. Twenty children between the ages of 3 and 16 took the probiotic daily for a 4-week period. Bowel movement frequency and stool consistency improved significantly in these children. That means their constipation improved. The results of this pilot trial are promising, and will lead to a larger randomized controlled trial.  

Bifidobacteria are the most prevalent probiotic bacteria in the large intestine, or colon, of children. Normal bifidobacteria colonization occurs when babies are born vaginally, and is improved during breastfeeding. Antibiotic treatment can interfere with colonization, especially during the first months and years of life. Maintaining a healthy balance of bifidobacteria is associated with intestinal health, which is the foundation of total body health.

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As you know from my previous post, April is IBS Awareness Month, and over the next few weeks I’m going to be talking a lot about IBS to help folks get a better understanding of just what it is, what causes it, and what you can do about it—so get ready to love your colon!

First things first, just what is IBS? Irritable bowel syndrome (commonly called IBS) is an intestinal disorder defined largely by its symptoms, which include abdominal cramping, abdominal pain, bloating, gas, and constipation or diarrhea (or both). Based on those symptoms, there are three main types of IBS:

• IBS-C is constipation-predominant IBS, which means it involves constipation-associated symptoms.
• IBS-D is diarrhea-predominant IBS, which means it involves diarrhea-associated symptoms.
• IBS-A, or alternating IBS, involves both constipation- and diarrhea-associated symptoms.

IBS is also one of the most commonly diagnosed disorders today, and as many as 20 percent of Americans have IBS symptoms. However, diagnosing it can be difficult since there are no “biological markers” to look for in a diagnostic test—which essentially means there are no indicators that help doctors distinguish whether you have IBS or something else. So then how do they know if you have it??

An IBS diagnosis is based on certain criteria called the Rome III Criteria, which state that a diagnosis can be made after six months from the first signs of IBS symptoms, with at least three months of recurrent abdominal pain or discomfort in association with two or more of the following conditions:

• Improvement of symptoms with bowel movement
• Onset of symptoms associated with a change in frequency of bowel movements
• Onset of symptoms associated with a change in form of stool

So now that we know a little more about what IBS is, next time we’ll talk about what causes it, so be sure to keep reading!

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Now I bet just the title of this post had you curious, didn’t it? That’s because poop is fascinating—take it from me! So before you start to chuckle about today’s Health Link, remember that investigating the look and consistency of your stool is one of the best ways to determine how healthy you are overall, so check out the Bristol Stool Chart and today and rate your poop!

Developed by experts at the University of Bristol in England, this helpful chart is an important tool for helping to study intestinal transit time (how long it takes your food to move through your digestive tract and out through your colon) and for learning more about how to keep your digestive system running smoothly.

Some quick tips—if your poop looks like a 3 or 4, you’re probably in good shape. But if you’re closer to a 1 or a 2, there’s a good chance you’re constipated, which means you need to get things moving! On the other hand, if your poops fall into the 5 to 7 range, things are moving too much!

It’s also important to consider how many bowel movements you have each day, and in case you haven’t heard me say it before, you ideally want to have 2 to 3 healthy bowel movements every day. And if you have accompanying symptoms like gas and bloating, or heartburn? There might be an underlying problem you really need to address—so take a little time to learn your poop score and give your digestive system the TLC it deserves!

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Believe it or not, at any given time one third of the U.S. population has parasites. And when I tell you it can happen to you, you better believe it! Keep in mind that parasites can range from bacterial types to microscopic amoebas and even larger worms. Remember Biology 101? Pretty gross. In a stool analysis study performed by Dr. Amin of the Parasitology Center in Tempe, Arizona, the most notable parasite, blastocystis hominus, was revealed—a microscopic intestinal little bugger that causes symptoms almost exactly like Irritable Bowel Syndrome (IBS).

I have seen many people who have been diagnosed with IBS, and when they have a stool analysis they find that they actually have blastocystis. This is one reason why some IBS sufferers, despite everything they try, never see any improvement. Not only that, but larger parasites such as tapeworms, hookworms and roundworms are no longer present only in third-world countries… beware, they are here!

 For some good information and moments that will make you squirm, just watch the show “Monsters Inside Me” on Discovery’s Animal Planet channel.

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