What’s In Your Gut Virome?
The gut microbiome is a hot topic these days. It seems like everywhere you turn someone is talking about gut health and bacteria. But is it all about bacteria? What is the gut microbiome? Let me break it down for you.
The gut microbiome is basically the ecosystem of trillions of microorganisms that live inside of our intestinal tract, mainly in the colon. Some have estimated that there are about 100 trillion microorganisms that live in the gastrointestinal tract. By the way, this is just the gut we are talking about; there are even more organisms on our skin, in our mouths, and in many other parts of our bodies. These little bugs make up an intricate network and ecosystem and are largely responsible for our health (or lack thereof). There are ten times more microorganisms in our digestive tract than there are human cells on our body. The DNA from these organisms outnumbers our human DNA by a factor of 100 to 1. This is definitely a force to take seriously!
We often think about the gut microbiome in terms of bacteria. In fact, it is predominantly bacteria. However, there are also fungi, yeasts, parasites (in some cases), and viruses. It’s the viruses I want to spend some time talking about. We are probably going to discover in the years to come that certain viruses alter the ecology of the gut microbiome and this can lead to certain conditions. For example, a recent study suggested that infection with the Reovirus could trigger an inflammatory response to certain foods and lead to the development of celiac disease (https://www.ncbi.nlm.nih.gov/pubmed/28386004). Another study suggested that infection with Rotavirus could lead to the development of non-celiac gluten sensitivity (https://www.ncbi.nlm.nih.gov/pubmed/29736406). Even a decade ago, in the literature, researchers described the Epstein-Barr virus (the virus that causes mono) as being associated with autoimmune diseases like Lupus, Rheumatoid Arthritis, and Sjogren’s syndrome (https://www.ncbi.nlm.nih.gov/pubmed/19028369).
What some of us biohackers are discovering is that there are viruses that are living in the gut. For the most part, these happen to be plant viruses. For example, some people may have a cucumber mosaic virus living in their gut. This is a virus that was first discovered in 1934 and it was found to infect cucumbers and a variety of other plants. We probably don’t think too much about plant viruses when we are eating vegetables but maybe we should. Humans make a good go-between for a plant virus and when we ingest them they could potentially change the ecology in the gut microbiome before they depart the gastrointestinal tract. Although we don’t know too much about all these different viruses yet, it is generally felt that the more viruses you have, the more issues with health you may have as well. Some bacteria in the gut can inhibit viral infections while other bacteria can promote viral infections, so there is definitely an interaction there (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373533/). Remember, 70% of the immune system exists in the gut. When you take a snapshot of your gut microbiome and get it tested, it is hard to know if the viruses that are being detected are related to food recently eaten or persistent infections. Either way, it could be a sign that you are not eating the best quality vegetables. While it is unclear if the viruses are a part of the picture when it comes to food sensitivities, it makes sense to try to avoid a particular plant if you know you are infected with a virus that infects that plant.
What is even more interesting are the viruses that infect the bacteria. These are called bacteriophages. One of the more common ones is referred to as crAssphage or cross-assembly phage (I love the name, don’t you?). This is a common phage in the gut, actually. It is felt to predict infection to the family Bacteroidetes. While the function of this virus in human health is not really clear, it does make one wonder about its role in human health if it can infect certain kinds of bacteria. It also makes one wonder about particular drug or therapy targets in certain diseases or conditions that involve a virus at the root of its cause.
In the meantime, here are a few things you can do to help protect your gut from viruses:
- Make sure your produce is organic and comes from a reliable source. If the vegetable looks infected or just doesn’t look right, think twice before eating it
- If you know you have a particular plant virus living in your gut, consider taking a break from that plant at least for a while.
- Work towards eating plenty of colorful fruits and vegetables that come from a reliable source so that you can build the diversity of your gut microbiome.
- Reduce stress, exercise, avoid toxins, have fun in life, avoid sugars and processed foods; basically, do all the things that help build a strong resilient gut microbiome
We don’t yet have enough information about the gut virome but it is clear that there are viruses that live in the gut as well. It is fascinating how a plant virus can settle down in the gut microbiome. It is even more fascinating to wonder about what it is actually doing. In some cases, these viruses may be doing nothing. However, in other cases, it is possible they could be shifting the balance of the microbiome and contributing to significant health effects. While I wouldn’t lose too much sleep over this, I would definitely try to be more aware that it exists and perhaps pay more attention to the quality of plants we are eating on a regular basis.
My Top 5 Tips on How to Detox Using Your Gut Microbiome
Detoxing is a big topic these days. Everyone wants to know how to detox. But what does it really mean to detox? Well, it means getting rid of the bad stuff and putting in the good stuff. It’s not entirely that simple but that is the basic concept to keep in mind. There are a few ways to help get the bad stuff out, besides not being exposed to the bad stuff. Three of the main ways that someone can flush the bad stuff out is via the digestive tract, urinary tract, and sweat. Of these three systems, the digestive tract is one of the most powerful. Why? Because the digestive tract is home to the gut microbiome, the ecosystem of trillions of bacteria, viruses, and fungi that live together with us, in sickness and in health.
The gut microbiome has been shown to have the ability to degrade chemicals and toxins such as pesticides (https://www.ncbi.nlm.nih.gov/pubmed/29072801). In humans, chemicals such as plastics, pesticides, fertilizers, electronic waste, and food additives that are endocrine disrupting chemicals are felt to be associated with the growing rate of diabetes and obesity. An endocrine disrupting chemicals is basically a chemical or substance that disrupts the normal hormone balance in your body and throws things off. As a result, you suffer negative health effects such as diabetes, obesity, and a whole number of other conditions. We know that the gut microbiome, metabolizes these toxins (https://www.ncbi.nlm.nih.gov/pubmed/28571659). This is such an important topic that I wrote a book chapter in the textbook of Integrative Environmental Medicine (https://global.oup.com/academic/product/integrative-environmental-medicine-9780190490911?cc=us&lang=en&) on this very topic: how the gut microbiome is involved and influenced by diet and environmental toxins.
Why should you care about all this? Well, what the gut is exposed to is very important. This is because when the gut microbiome gets imbalanced, various different diseases and conditions can occur such as Crohn’s Disease or Inflammatory Bowel Disease (https://www.ncbi.nlm.nih.gov/pubmed/27876802). When the detox capability of the gut microbiome is on point, then maybe we are ok. However, when the detox capability of the gut microbiome is off, as a result of an imbalance, then we may suffer negative health effects. It’s like having a well-oiled machine that doesn’t work as well as it could because the parts used to build that machine are lower quality. If our gut microbiome is bombarded with toxins, we may reduce the quality of our detoxification systems and we may alter the composition of the ecosystem that could subsequently leave us vulnerable to other changes, effects, and conditions.
So, what should we do? How can we maximize our gut’s detoxification capabilities? Here are my top 5 tips:
- It makes the most sense to try to reduce and avoid toxins. There won’t be as much stress on the system if the load is not as large. This means using clean cosmetic products, cleaning supplies, cooking tools, and most importantly it means eating clean.
- Eat plants. Plants have a lot of nutritional benefit, chemicals, vitamins, and anti-oxidants. This will help us in our never ending detoxification endeavors. Some of my favorites are dandelion greens, celery, swiss chard, cilantro, broccoli, green tea, oolong tea, turmeric, ginger, and berries.
- Eat clean foods. This means avoiding processed and packaged foods. These foods generally contain food chemicals that are meant to improve shelf life and make the product “look nice” for as long as possible. While these chemicals often accomplish the goal of the company, it exposes our microbiome to extra unnecessary chemicals.
- Avoid unnecessary antibiotics. Antibiotics can be life-saving. They should be used but in the appropriate setting. Often, antibiotics are over-prescribed and being given for viral infections or other self-limited conditions that do not require antibiotics. What happens is that we also kill the good bacteria when we take a broad spectrum antibiotic and some of these effects can be long lasting on our inner ecosystem.
- Ensure regular bowel habits. If we are not going #2 on a regular basis, we impair the gut’s detoxification abilities. Some of the bacteria can take a detoxified chemical and make it a toxin again if it sits around too long. We want to make sure we have at least one or two regular, soft, formed bowel movements every day. The saying “better out than in” never made more sense! If you eat cleaner, increase your fiber intake, drink plenty of water, and optimize your lifestyle choices, you will find that the bowel habits just come along as part of the process. For those of you who need a bit of a boost, that’s okay too; my only suggestion would be to work with someone who is well versed in digestive conditions to optimize your choices in things you can use. Sometimes a prebiotic and probiotic supplement can help; speaking to your health care provider about which ones may be best for you is important.
We live in a toxic world. That’s just a matter of fact. Everywhere we turn or look, I would bet you could find toxins. However, this is not something to fear. We have to live our lives in this modern world. So, the point is not to be scared of everything. The point is to learn how to maximize that detoxifying machine in our digestive tract and help it do the job it was meant to do, the job it wants to do. If we build a resilient and diverse gut microbiome with all the arsenal it needs to fight off the bad toxins, we will be ready (as best as we can) to handle the common threats that come into our everyday lives.
My top 3 mind healing herbs
Wouldn’t it be great if nature made some plants that could calm our nerves without making us feel like we were on drugs? Something to help regulate our stress while we learn how to meditate? Or just something to make it not so bad that your two-year-old broke another glass bowl again?
The truth is that we are able to self-regulate our feelings or responses to those feelings. It takes a lot of practice and it can be hard for some people, especially those who have never been introduced to mindfulness practice before. But don’t give up hope! Nature did indeed make some herbs that can help us get through the tough times and perhaps give us the opportunity to learn and practice mindfulness.
Adaptogens are herbs that help the body adapt to stress. It is important to regulate and control stress because it is the chronic low-grade chronic stress that can lead to hormone imbalance and inflammation. Stress is a risk factor for a number of diseases, including Alzheimer’s Disease (https://www.ncbi.nlm.nih.gov/pubmed/25178904). So, yes, reducing your stress can heal not only your mind but also your entire body! I’ve outlined my top 3 adaptogens and why I like them.
- Ashwagandha (Indian Ginseng). Ashwagandha is one of my all-time favorites. It is calming and relaxing and if you have troubles going to sleep it could be something to consider taking at bed time. Not only does this, nature’s valium, help you relax and reduce the stress response, it also has a bunch of other great health benefits. A recent study suggested that it has anti-tumor effect in colon cancer (https://www.ncbi.nlm.nih.gov/pubmed/29966656). Another recent study suggested that an extract from the leaves of ashwagandha can not only reduce brain inflammation but also reduce some of the behavioral problems that can occur as a result of that brain inflammation (https://www.ncbi.nlm.nih.gov/pubmed/29846872). This is part of the beauty of using natural alternatives; there can tend to be a number of other health benefits that come along with these things as a side effect.
- Rhodiola (Rhodiola Rosea). Rhodiola is another favorite. This herb has been used for a number of different things including anxiety, fatigue, and depression. Some people take it for increased energy and strength. I find that Rhodiola could be more uplifting as compared to ashwagandha. There are certain companies that actually make a blend of several different adaptogens so you get the benefit of a several different things. These can also be taken separately. Since Rhodiola can be a little more energy boosting, I sometimes suggest taking it in the morning. One study suggested that those who took rhodiola had reduced levels of self-reported anxiety, stress, anger, confusion, and depression just after two weeks (https://www.ncbi.nlm.nih.gov/pubmed/26502953). That’s pretty impressive if you ask me!
- Siberian ginseng (Eleutherococcus). Siberian ginseng has been used for ages as an adaptogen. It has been felt to help increase resistance to stress. It could be helpful in those experiencing fatigue or decreased energy, particularly from chronic disease. It has been demonstrated to have anti-oxidant capabilities as well and perhaps this is why it is a good choice in those with chronic illness (https://www.ncbi.nlm.nih.gov/pubmed/19051347). Not only does Siberian ginseng have immune stimulant properties, it is also felt that it might potentially have anti-tumor activity as well (https://www.ncbi.nlm.nih.gov/pubmed/26107240). One of the important things to remember with this one is that there are a lot of different kinds of ginseng. Others, like Panax ginseng, may also be considered adaptogens. Just be careful to read the labels and get a pure version of what you are intending to get.
There you have it! My top 3 adaptogens. These are great tools to carry in your toolbox. Herbs can carry a lot of power within them. We need to also remember that herbs are drugs too. Be sure to check on potential side effects as they may pertain to you and ensure that there are no drug-drug or herb-drug side effects that might affect you before you take anything new, just as you would with any other medication. If used properly, these can be great adjuncts to your stress-reducing regimen!
The information contained in this article and on www.thehealthygutmd.com is informational and not meant to be medical advice or replace the advice of a physician. Please consult your doctor with regards to your medical conditions and management.
Dr. Marv’s Gut Healing Smoothie
Smoothies are all the rage these days it seems. For good reason, though. Smoothies are one way to get a ton of nutrients into your body in a way that can be absolutely delicious and good for your gut. As an integrative gastroenterologist, people often ask me what sort of smoothie they can make that will be gut healing. Well, here is one of the many recipes I personally enjoy.
Organic Green tea (4 cups, cooled)
Half a bag of organic frozen blueberries
Half a bag of organic frozen cherries
4 generous handfuls of organic spinach
1 tablespoon of organic coconut oil
1-2 tablespoons of organic ground flax seed (or chia seed)
1 pinch of organic cinnamon
Optional: 1 organic banana (if you really need it sweeter)
Optional: 1 spoon of collagen protein powder
After I have all my ingredients in, I blend it all up in my Vitamix. What you get in the end is a wonderful and refreshing treat that will also give your DNA and microbiome a whole lot of love!
Here is a breakdown of some of the things that these ingredients can do for you:
- Green Tea is loaded with antioxidants. It can help with weight loss, reduces inflammation, and can improve brain function. EGCG (epigallocatechin gallate) is the main type of compound we often talk about that is found in green tea that is loaded with these health benefits. I often recommend drinking 2-3 cups a day in order to get the desired benefit. The smoothie is one great way to get a head start!
- Blueberries are probably one of my absolute favorites! They are a great source of fiber, potassium, folate, vitamin C, Vitamin B6, phytonutrients, and antioxidants.
- Cherries are a great source of antioxidants and they are also packed with anti-inflammatory phytonutrients. Cherries can help with post-exercise pain and also can help promote better sleep hygiene.
- Coconut oil gives a nice flavor the smoothies. It is a source of good fat. There is data supporting its benefit in brain health, cholesterol management, reduction of inflammation, and improved immune functioning. Coconut oil also contains lauric acid which we know has anti-bacterial properties and can reduce bad yeast like candida.
- Spinach is one of my favorite greens! I try to eat it every day. It is a great source of folate, vitamin K, iron, calcium, and a number of other vitamins and minerals. Your microbiome will love you for eating this!
- Flax and chia seeds are a great added fiber source to a smoothie. Fiber can act as a prebiotic to help the good bacteria in your gut flourish. This is also one way to get a dose of Omega 3s first thing in the morning with your smoothie! You can enjoy your delicious smoothie and know that you are improving your cholesterol at the same time!
- Cinnamon is one of my special tricks. I personally enjoy the flavor but make sure not to put too much in the smoothie because the flavor could be a bit strong if you did. Cinnamon has antibacterial properties, can aid in fat burning, and reduce bloating. It is loaded with anti-oxidants and has anti-inflammatory properties. It can also improve insulin sensitivity and reduce blood sugar.
- Banana is something I use to help sweeten it up if you feel like you need something else. I would rather you use a banana than some alternative sugar source. Banana has vitamins and minerals such as potassium, calcium, manganese, magnesium, iron, folate, among many others. If you get the banana a bit towards the greener side that is probably better for you and may serve as more of a prebiotic for your gut.
- Collagen protein powder is another great thing you could consider adding in for that extra boost. I use collage protein powder with people who are concerned about leaky gut, inflammation, arthritis, skin and bone health, among several others. This is definitely something that can make your gut healing smoothie even more powerful!
When you drink this smoothie, potential side effects could include euphoria, increased attention, a boost of energy, and a happy gut microbiome! I hope you all enjoy it!
4 Simple Ways to Regain Control of Your Health
Do you sometimes feel like you have no control over your health? Like you are in some downward spiral and nothing seems to work or help the problems you are going through? You are definitely not alone! There are so many people who are going through the same thing and have the same feelings. I often get asked about what someone can do to help regain control of the of their health. So, I decided to put together a simple jump start list to help you get started!
While there are a lot of moving parts to achieving optimal wellness, there are a few core principles that should always be at the forefront of your mind. Here they are!
- Sleep. Sleep is very important to our health, more than we give it credit for. Poor sleep can affect your memory, appetite, metabolism, mood, and behavior. Chronic sleep problems can result in changes in the gut microbiome which may be an underlying factor that sits at the core of chronic disease in general (https://www.ncbi.nlm.nih.gov/pubmed/27739530). Yes, not sleeping the right amount can make you overweight! The Journal of the American Heart Association published a study stating that inadequate sleep (either too much or too little) can give you an increased risk of death from any cause and cardiovascular events; they suggested we all aim for a target of 7 hours of sleep per night (https://www.ncbi.nlm.nih.gov/pubmed/28889101).
- Nutrition. This probably goes without saying. We all know that nutrition is key to optimal wellness. Did you know, though, that what you eat can influence the composition of the gut microbiome and how the various bacteria that live in our gut actually works? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303825/). This is a key concept because if we want to try to reverse chronic disease, one of the most important things to think about is what kind of fuel we are feeding our engines. Are you giving Diesel fuel to a body that needs Premium? By Diesel fuel I mean sugar, processed foods and meats, excessive alcohol, vegetable oils, trans-fats, fast foods, sodas, candies, and anything that is not “real food.” By “real food” and “Premium” I mean lots of plants and especially leafy greens, berries, nuts, seeds, healthy fats, cruciferous vegetables, and sources of Omega 3s. No matter what sort of diet you follow, these should be a key component of your nutritional plan. Try to keep things organic and non-GMO and don’t be afraid to try new things! It’s the variety of foods that is also important, not just the foods themselves. You can eat a broccoli diet everyday but just because we all know that broccoli is healthy for you does not mean that your diet is actually healthy.
- Stress Reduction. This may be one of the single most important elements of health and wellness. We are all busy, tired, and overworked. However, if we can find some time in the day to be still and enjoy the silence we will be doing our bodies a ton of good. I’m not talking about sitting and meditating for an hour a day. If you have the time to do that, then that is great. But if you start by giving yourself 5 minutes a few times a day you will start to see that it is highly beneficial. It would be nice to work up to 20 minutes twice a day but you have to start somewhere. Stress reduction techniques don’t have to be complicated. I’m not asking you to find a quiet spot in your office during lunch time so that you can do some downward dog poses. Start by just breathing and appreciating that you are here, you are alive, and life is good. While you do your breathing exercises, think about a few things that you are thankful for, whether it be the cup of coffee you had this morning or the fact that someone held the elevator for you when you got to work. Then think about how you give some of that good energy back to the world. We are, after all, connected to each other. Meditation can improve cell health, regulation of stress response, your immune system, and how your genes work. It can also reduce cortisol levels, inflammation levels, heart rate, triglycerides, and a number of other things (https://www.ncbi.nlm.nih.gov/pubmed/28863392). Can you think of a better drug that can do all these things?
- Have fun. You have to enjoy life. If we don’t enjoy life now, while we are living it, it will be over before we know it. Human beings are social creatures. We need that social connection. We thrive on our relationships. Having fun and doing things you enjoy with your friends, family, colleagues, or even strangers can have significant health benefit as well. Dan Beuttner wrote a fantastic book called “The Blue Zones of Happiness” and he outlines that one of the key concepts to attaining happiness is cultivating social interconnectedness and spending your money more on experiences rather than material objects (Buettner D. The Blue Zones of Happiness: Lessons from the world's happiest people. 2017). Go out and have some fun! You don’t have to do it with friends or anyone else, but it is always nice when you can share a great experience with someone. Your genes and your gut microbes will thank you for the dose of fun and excitement!
Yes, you need to exercise. And yes, you need to avoid toxins. There are a lot of things that need to be done to optimize your health. However, you can’t do it all at once so don’t worry about being perfect straight out of the gate. Take your time. Lifestyle changes can take a while to get down pat. You have to start somewhere. These 4 points include some elements of lifestyle that are often overlooked and under- appreciated. Starting to work on some of these things will help you push forward and allow you the opportunity to work on some of the other things. There is no race to the finish line here. You’ll get there. You just need to start!
Cheers to your (gut) health!
My Top 3 Choices For Treating Heartburn Naturally
As an Integrative Gastroenterologist, heartburn or acid reflux is one of the most common topics of discussion. There are all kinds of news reports that acid reflux medications like PPIs (Proton Pump Inhibitors) can cause anything from kidney failure to dementia. Is there any truth to this? Is there anything else that can be done? Well, yes, there is definitely something that can be done. And there are definitely some associations with some of these conditions.
Acid reflux and heartburn are basically the same thing; we use the term interchangeably. It basically means that stomach acid and bile can flow up from the stomach to the esophagus (food pipe). This can be a really uncomfortable feeling and can cause burning under the chest. The traditional go to medications have been things like TUMS or Zantac (ranitidine). Now that several proton pump inhibitors (PPIs) are over the counter, these have become much more readily used although they are still, and have always been, very widely prescribed. A proton pump inhibitor (PPI) reduces the production of stomach acid. They help us feel better, so we take them. End of story? Not exactly…..
We need the acid in our stomach. We were born to produce acid in our stomach so that we can digest and process the food we eat. So, what happens when you do something to counter that effect? Well, there have been a whole host of health effects noted or found to be associated with use of these PPI medications. These include: B12 deficiency, osteoporosis, kidney dysfunction, dementia, low magnesium levels, small intestinal bacterial overgrowth (SIBO), increased risk of getting a stomach bug, and increased risk of a potentially significant diarrheal infection from Clostridium difficile. There have been reports of low magnesium induced low parathyroid function (https://www.ncbi.nlm.nih.gov/pubmed/26069375). While there is no definitive consensus on the role of PPIs in dementia, there is some information to raise suspicion that PPIs could play a role in the development of dementia, perhaps as a result of drug-drug interactions and/or effects on electrochemical gradients in neurons, among other possibilities (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883984/). Risk of acute kidney injury and chronic kidney disease is also something well described. I have personally seen patients develop kidney failure and no other reason could be determined besides the use of a PPI. It is well established that an allergic kidney injury called acute interstitial nephritis can occur. Although we need more research to definitively establish that kidney failure and chronic kidney disease can result from use of PPIs, there are enough reports demonstrating association that should raise our eyebrows (https://www.ncbi.nlm.nih.gov/pubmed/29668562).
The literature and reports go on and on. I could probably write a book on it! The point, though, is that these medications may have a role in management of some things but they were not truly meant to be taken for long periods of time. However, many of us do take them for long periods of time. The problem is that we are now learning about things that could happen that we didn’t anticipate would happen. What we are likely doing is manipulating our gut microbiome. The gut microbiome is the ecosystem of over 100 trillion bacteria, viruses, and fungi that live inside of our gastrointestinal tracts. We know that they play a role in many chronic diseases. When we chronically reduce the acid in our stomach, which is there for a purpose, and also which is there as a line of defense for our GI tract, then we leave the doors wide open for all kinds of other bacteria to get into the digestive tract. This can lead to an imbalance in the ecosystem which could potentially be a set up for all of these things that we are discussing here. That’s my theory. And it is certainly plausible and worth consideration.
So, what do we do? Suffer? Absolutely not! While nobody would argue that you avoid a PPI if you are in the hospital with a life threatening GI bleed from an ulcer, we certainly do not need to take these medications for a lifetime, outside of potentially reducing risk of Barrett’s esophagus (a precancerous change in the lining in the esophagus) from progressing to esophageal cancer and a few other special circumstances.
Here are a few initial tips:
- See if there are any medications you are taking that could be correlated with your reflux symptoms. Perhaps there could be an alternative if you identify something.
- Keep a food log or get food sensitivity testing to see if there are any foods that are triggers for you (it is not always tomato sauce or spicy foods; it could be bread!).
- Stop smoking
- Reduce alcohol consumption
- Don’t eat 2-3 hours before lying flat
- Avoid heavy, fatty meals (you should be doing this anyway!)
- Don’t over-eat (you shouldn’t be doing this anyway!)
- Make sure you talk to your doctor; it is possible you may need an upper endoscopy (EGD) or other evaluation to evaluate the esophagus and upper GI tract, especially if there are concerning symptoms like difficulty swallowing, pain with swallowing, and/or weight loss.
Lifestyle interventions are excellent ways to reduce acid reflux. Losing weight, eating healthier, exercising, modifying your habits and routine can all be great ways to improve your symptoms. Remember, your symptoms are probably happening for a reason. I have a few favorite natural treatments that I use to help control symptoms while working on the above. Make sure you consult a doctor who understands how to use these natural alternatives when trying to taper or wean off your PPI. Here are my top 3 natural alternatives for acid reflux treatment.
- DGL (Deglycyrrhizinated licorice). This is a mainstay in my practice. It comes in a variety of forms. Many people like the chewable DGL tablets but I am not so fond of the fillers and sugars that are in some of those formulations. I tend to prefer a pure powdered DGL. We want to make sure you don’t take a pure licorice for long period of time because doing that may have some important health consequences; however, taking DGL is different and safer than taking regular licorice. As always, be sure to discuss this with your doctor and make sure there are no interactions with other things you could be taking.
- Ginger. This is another favorite. Ginger has many health benefits. It can help reduce inflammation, improve arthritis symptoms, and fight certain infections. I love it as a natural treatment for nausea. It also works as a prokinetic which means it helps move things forward. It can help with stomach emptying, bloating, and constipation. So, it is a great adjunctive therapy for acid reflux.
- Slippery elm. This is another natural therapy that I use as an adjunct to the other therapies. It is particularly good for those that have upper throat and esophageal symptoms. It acts as a natural cooling blanket and helps coat the esophagus. I tend to prefer the lozenge form for minor esophageal symptoms.
While there may be a lack of definitive evidence correlating acid reflux medications with chronic health problems and diseases, there is definitely an ever-growing body of evidence hinting that there could be an association with PPIs and these conditions. My take on all this is that if there is no underlying major problem that could justify use of PPIs (most of the time there is not), we should do everything we can to minimize and eliminate their use and replace them with more natural therapies and lifestyle changes. This is what is best for us in the short term and in the long term!
The information contained in this article and on www.thehealthygutmd.com is informational and not meant to be medical advice or replace the advice of a physician. Please consult your doctor with regards to your medical conditions and management.
My 5-minute gut healing meditation
Wait….what??!! How can a meditation be gut healing? Am I serious? The answer is a resounding YES!
Stress reduction is a cornerstone to obtaining gut healing, for people of all ages. Stress, even at an early age, can change the composition of the trillions of bacteria and microorganisms in our digestive tracts referred to as the gut microbiome. Infant monkeys (monkeys are quite similar to humans) who were separated from their mothers were shown to have reduced amounts of the key helpful bacteria such as Lactobacilli and Bifidobacteria. Instead, they had increased amounts of the Prevotella species; this is the species of bacteria that has been well established to be linked to imbalance in the gut microbiome and psychiatric disorders (https://www.ncbi.nlm.nih.gov/pubmed/28976454). There is evidence in the scientific literature that different kinds of psychological stress can affect the composition of the gut microbiome and these organisms are pertinent to controlling overall stress, anxiety, and cognitive function (http://www.jneurosci.org/content/34/46/15490).
Meditation is one of the most powerful medicines that I prescribe in my office. I consider meditation to be the forgotten magic potion to gut healing. There is an ever growing body of literature to support the health benefits of meditation. For example, meditation has been shown to improve cellular health, regulate stress response, improve immune function, reduce levels of cortisol (the stress hormone), reduce CRP (a marker of inflammation in the body), reduce blood pressure and heart rate, and reduce tumor necrosis factor alpha (another inflammatory marker that can play a role in a variety of diseases, including inflammatory bowel disease), among many others (https://www.ncbi.nlm.nih.gov/pubmed/28863392).
In my medical practice, I often see patients with chronic unaddressed stress who have abdominal pain, heartburn (acid reflux), bloating, constipation, diarrhea, and a number of other symptoms. They keep getting passed around from doctor to doctor and have normal work ups. Yet, the problems remain. Much of the time I find that stress plays a big role in how refractory these symptoms can be. The brain and the gut are connected to each other. Chronic stress can change pain circuits and alter motility in the gastrointestinal tract in addition to causing intestinal permeability (leaky gut) (https://www.ncbi.nlm.nih.gov/pubmed/26662472).
One of the main obstacles to meditating is time. People often say that they don’t have the time. Largely this is not true because there is always time. We often spend countless minutes flipping away on social media and other activities during our days and we don’t think twice about it. While there are tons of different meditative practices that you can use, I’ve created a quick 5-minute gut healing meditation for you to get you started and hopefully this will tune body in to the health benefits of meditation. I must say that it is most ideal to meditate for 20 minutes or more at a time. However, I always tell people that we have to get you there before we can keep you there; this means that we have to get you started before we can focus on the long term practice. Also, this is not a religious practice; it can be if you would like it to be but it absolutely does not have to be. This is often another misconception that I hear about. Meditation is a great way to give yourself a little break, focus your attention, and ground yourself.
If you are not meditating at this time, just the mere fact that you are reading this article and thinking about it is progress! Congratulations! Now, try this 5-minute meditation practice and start healing your gut!
Dr. Marv’s 5-minute gut healing meditation:
- First, find a nice quite place. Sit however you like (on the floor, on a chair, on a bed, it doesn’t matter although the bed is probably not the most ideal place since you may be more likely to fall asleep).
- Close your eyes. Rest your hands on your lap.
- I like to start my meditative practice by saying a positive affirmation in my head such as “May this be of benefit.”
- Start by taking a few deep breaths and just observe yourself breathing. Breath in through your nose and breath out through your mouth. If you notice your mind already wandering, it’s ok; just gently redirect your mind to the breath without any judgement.
- Once you have gotten into a rhythm, do 4 cycles of the 4-7-8 breath. Dr. Andrew Weil taught me this breathing exercise (https://www.drweil.com/videos-features/videos/the-4-7-8-breath-health-benefits-demonstration/) and it has changed my life personally! Make sure you are inflating your belly when you take these deep breaths. Take a breath in through your nose to a count of 4. Hold it in your belly to a count of 7. Breath it out through your mouth to a count of 8. Do this at least 4 times and no more than 8 times.
- After you have done the 4-7-8 breaths, then go back to taking nice gentle breaths in through your nose and out through your mouth at a comfortable pace.
- Next, imagine yourself inhaling the positive energy from the earth and your environment. On the inhalation, you are taking in all that positive energy and strength. On the exhalation, you are blowing out all of that positive energy and strength to everyone and everything in your immediate surroundings.
- After one minute of doing this, your inhalations will be for the same purpose (taking in all the positive energy). However, on the exhalation you will be blowing out all of that positive energy to the entire planet. Really truly imagine with every inhalation and exhalation that you are using yourself as a beacon of energy and that you are delivering that positive energy to the rest of the planet. Remember, that we are all human beings at the end of the day. We all want to be happy and healthy. Everybody needs kindness and compassion. That’s how we are built.
- Once you have reached the approximate 5-minute mark you can stop or feel free to continue as long as you want. When you are ready to finish, take a nice deep breath in and raise your arms over your head in the shape of a circle. Then slowly lower your hands as you slowly open your eyes. Sit there for a moment and note how you feel. When you are ready, you can quietly and slowly get up and enjoy the rest of your day!
I find that this is a nice way to start your day and a nice way to end your day. It will be guaranteed to be awkward and difficult when you first start. Some of you may even fall asleep. That’s no big deal! Don’t criticize yourself over it. Enjoy the rest and keep doing it! Keep trying. Once you get into a good rhythm with this, you can graduate to trying some of the other meditative practices. You can even make up your own meditations! If you find that you cannot remember the steps in this guided meditation, then read the steps out loud into a recording device (you can use your smartphone or tablet, for example) in a quiet gentle voice and play it when you are ready to sit down and do it.
There is a wealth of healing in mindfulness, meditation, kindness and compassion. Definitely do not forget this important medicine when putting together your gut healing protocol!
The Magic of Tea: How to heal your gut and boost your genetic potential with a delicious drink
If you are not much of a tea drinker, hopefully this article will make you think twice about it. Tea has been a popular beverage for ages and rightfully so! I drink tea often and I suggest it to all of my patients. Teas can have gut healing, anti-inflammatory, immune balancing, digestion boosting capabilities. It’s like magic!
Here are my top 7 tea recommendations:
- Green Tea (I especially like Jasmine Green tea but it’s nice to switch it up and try different flavors from time to time). Green tea owes its magical powers to its bioactive molecules such as epigallocatechin-3-gallate. This superfood has been associated with health benefits in those with obesity, diabetes, heart disease, and even cancer (https://www.ncbi.nlm.nih.gov/pubmed/24915354).
- Oolong tea. This is another anti-inflammatory tea that has great polyphenols and can help with weight loss, inflammatory conditions, obesity, and diabetes (https://www.ncbi.nlm.nih.gov/pubmed/25031332).
- Tulsi (Holy basil) tea. Holy basil has numerous health benefits from improved oral care and to relief from stress. One of the most exciting areas of research has been in how it can help improve memory and cognition. This magical tea may have brain-protecting properties! (https://www.ncbi.nlm.nih.gov/pubmed/25031332).
- Chamomile tea. This is an oldie but goodie. I often use and recommend chamomile tea. Just make sure you don’t have an allergy to this and any related plants such as daisy and ragweed. Chamomile soothes the digestive tract, reduces stress, promotes sleep, and can boost your immune system. I love it in my patients with Irritable bowel syndrome, especially if they have anxiety as well. This magical tea is packed full of health promoting phenolic compounds, flavonoids, quercetin, and a number of other chemicals. It can help relax your bowel spasms and potentially lower your cholesterol at the same time! (https://www.ncbi.nlm.nih.gov/pubmed/16628544).
- Lemon Balm tea. This is another favorite. A friend of mine described feeling like they were getting a spa treatment while drinking this tea; that’s how relaxed they were. I like it for those with anxiety, sleep disorders, and indigestion. It’s a great way to wind down a long stressful day. There is even science behind the claim that it has anti-stress effects (https://www.ncbi.nlm.nih.gov/pubmed/25360512). I guess my friend wasn’t too far off the mark!
- Ginger tea. Ginger is one of my favorites! It is great for nausea, heartburn, bloating, constipation, gastroparesis, inflammation, arthritis, and a whole host of other things. For those of you who don’t like to take pills, ginger tea is another great way to get in that dose of ginger and some of its health benefits. Ginger has even been used in nausea and vomiting of pregnancy (https://www.ncbi.nlm.nih.gov/pubmed/29614764). I would advise anyone using ginger or other herbs to make sure to consult with your doctor before trying anything to make sure the dose and quality of the product you are using is appropriate.
- Peppermint tea. This can be a refreshing and cooling beverage. Try it chilled! Peppermint is a great one for bowel spasms and those with Irritable Bowel Syndrome, perhaps more particularly with those who have diarrhea predominance (https://www.ncbi.nlm.nih.gov/pubmed/21389791). My kids love peppermint tea; it’s a refreshing way to cool them off after playing in the sun outside and preparing them for a gut healing snack such as carrots and cucumbers. The main thing to be aware of with peppermint is that it can make acid reflux or heartburn worse. So, for those of you with heartburn, peppermint tea may not be the best option for you, but don’t worry because you have many other choices to pick from!
If you are not a tea drinker or you never thought of drinking tea, try to switch it up a bit and experiment! Food really is medicine. Teas can be one of the greatest ways to get a nice dose of medicine that will make your mind and body happy! Just remember to source your tea from good, clean, reliable companies and try to stick with organic and loose leaf options whenever possible.
The Secret to Self-Empowerment
To become an Integrative Gastroenterologist, I had to spend 4 years in college, then 4 years in medical school, then 3 years doing an Internal Medicine internship and residency, followed by 3 years of a Gastroenterology fellowship. Then, when I thought I was done learning, I enrolled myself in a 2-year fellowship at the University of Arizona’s Center for Integrative Medicine which was founded by Dr. Andrew Weil. At that point, you would think I would be done, right? Well, not exactly. What I learned from the whole process of formal education is that learning doesn’t stop on graduation day. I found myself with more questions than ever.
I had to figure out how to get those questions answered a few years ago. At that time, I was an actively practicing full-time gastroenterologist who would be on call at nights, rounding in the hospital, and seeing patients in the office. At home, I have a wife and two little kids who I also want to spend time with when I’m not working. One day when I was driving to a meeting and I was stuck in traffic, I thought to myself, “man, what a drag; sitting here is such a waste of time.” I would always listen to music when I driving, and it was relaxing; but sometimes I just felt like I needed something else. That’s when the light bulb went off in my head….audiobooks! Yes, audiobooks! This was one way for me to learn about some of the questions I still had and use the time I had in the car more effectively. This was a big transition for me because I always read books. In the end, however, it doesn’t matter if you read or listen to the book…it’s the same book….and what is cool is that many of these books are actually read by the author which kind of makes it even more entertaining.
Wow, what a change it made in my life. In just under two years I read over 100 books! I got hooked and never turned back. After the first several months I was learning so much and sometimes found myself wanting to go run an errand just so I could listen to the next chapter of a book! What happened by reading all these books? Well, I was able to refine the solid knowledge base that I got from my formal education and add the extra layers I was looking for. Not only did this give me a sense of self-empowerment, it gave my patients the same because I was able to convey that knowledge and encouragement to them. I totally changed my life, health, and overall wellbeing personally through this change of mind frame in how to learn. Since I was able to read and learn more at a rapid pace, I was able to apply the knowledge I was getting to my own life. And that is when the magic happened. I started losing weight, feeling happier and more energetic, and I had a new way of looking at life. Yes, just from audiobooks!
I thought I would share with everyone my top 5 audiobooks. These are excellent choices to start your own journey of knowledge and self-empowerment with (in no particular order).
- The Code of the Extraordinary Mind by Vishen Lakhiani. This is an amazing eye-opening book that will help you understand how to look at things in life and get to the point where nothing can bother you.
- Mindsight by Dr. Daniel Siegel. Anything that Dr. Siegel writes is something you should read. This book was one of the first books of his that I read. It teaches you about how our minds work and how this can affect our health, lives, and sense of wellbeing.
- The Book of Joy by Douglas Abrams. This is mandatory reading for all human beings. This is a fantastic book that was written based on a series of discussions and conversations that His Holiness The Dalai Lama and Archbishop Desmond Tutu had. It will entirely change your perspective on life and what true happiness really means.
- The Telomere Effect by Drs. Elissa Epel and Elizabeth Blackburn. This book is fantastic and easy to read. Dr. Blackburn was awarded the Nobel Prize for her groundbreaking research on telomeres, which are the caps at the end of our chromosomes. Read this book and learn how to live a longer life free from disease!
- Food: What the Heck Should I eat? By Dr. Mark Hyman. This is a great book, breaking down the basics of health and nutrition in a super understandable manner. It will help you understand the science behind why we should and should not eat certain foods and help put you on a path towards revamping your own health.
Wow…making this top 5 list was actually really hard. There are so many awesome books that I have encountered and read. This by no means is a comprehensive list. However, these books are a great place to start. I encourage you all to read, read, and then read some more. Read about different topics. Read about things you always wanted to learn about but never had the chance to. Learn about subjects that you never even heard of. Just get the audiobook and pop it in your car and listen. Your life will change. You may not even know how it will change when you start doing it, but if you keep doing it, the change will be apparent. What you will find is that you have a newfound sense of confidence and wisdom. Human beings are very intelligent beings; we can learn an immense amount of knowledge from each other. It is great to read the research and literature that is published in peer-reviewed journals. It is also great to read about what people think and hear different viewpoints and philosophies. In fact, the better written books reference research and the literature so you get a dose of both. Then you will end up combining your own knowledge with what you are reading and develop your own opinions and viewpoints. When this happens, you will have achieved that sense of self-empowerment and it will only make you want to read and learn more and teach others! What a fantastic thing!
Five probiotic foods your kids will love (and thank you for later)
Everywhere you look these days it seems like there is some advertisement for probiotics or probiotic foods. A probiotic is a live microorganism that can have health benefits. The marketplace can make things challenging to figure out what is best with all the choices we have out there these days. We know that our adult gut microbiomes (the ecosystem of trillions of bacteria that live within our digestive tracts) are fully developed somewhere between 2 and 3 years of age and that there are a number of different things that can influence the gut microbiome of a child. These things can include the mode of delivery (c-section versus vaginal delivery), duration of pregnancy (term vs. pre-term), antibiotics, environmental exposures, among many others (https://ukm.pure.elsevier.com/en/publications/gut-microbiota-in-early-life-and-its-influence-on-health-and-dise). Don’t fret! There is definitely hope! I’ve put together a list of my top 5 probiotic foods that you and your kids can enjoy regularly. This way your whole family can heal their gut together!
- Kefir. Kefir is basically a cultured dairy product. Although, there are numerous amounts of non-dairy kefir products available these days (like water kefir or coconut kefir). Just be wary of the sugar content in some of these products because it may not be worth the extra probiotics if it means you are going to get 25 grams of sugar with it! Kefir has a whole host of health benefits. Some of them include improved cholesterol metabolism, antimicrobial activity, tumor suppression, help with speed of wound healing, and improvements in asthma and allergy (https://www.ncbi.nlm.nih.gov/pubmed/27199969). I can’t think of very many medicines that can do all of those things, can you? Kefir makes a good snack especially when you are on the go and if you want to go to the next level, you can make your kids a smoothie with kefir as the base and pump them full of other great antioxidants and phytonutrients at the same time! Their brains and microbiomes will definitely thank you!
- Fermented Pickles. My kids love pickles. The fermented ones may take some getting used to but they do make a delicious side note to a healthy meal. Make sure you get truly fermented pickles. If it isn’t refrigerated, that’s one clue that you are about to pick up junk food, not a fermented pickle. A recent study showed that three unique strains of a bacteria called Bacillus from a fermented pickle showed good potential as a probiotic. These probiotics showed protective effects against bad bacteria (pathogens) and also had anti-oxidant activity (https://www.ncbi.nlm.nih.gov/pubmed/29729063). I bet you never thought you could boost your kids’ immune system with a pickle, did you?
- Cultured ghee. Everything is better with butter isn’t it? Seriously, ghee is a form of butter that has great health benefits. When it is grass fed and organic, it is packed with even more nutrients. When you get a cultured product, you have the added bonus of a probiotic food that your gut will welcome! We know that grass fed butter has a higher Omega 3 content and it is higher in vitamin K2 which is great for the bone health of your growing children. Additionally, there is a beneficial fat called CLA or conjugated linoleic acid in grass fed butter; this healthy fat can help boost immunity and may have anti-inflammatory effects. In fact, some types of CLA have been suggested to show anticarcinogenic (or anti-cancer), antiobese, and antidiabetic properties (https://www.ncbi.nlm.nih.gov/pubmed/25434907). Mix that with some good bacteria and have a recipe for wellness! For those who may be concerned about dairy sensitivity or allergy, you may want to consider if this food is really for you, but keep in mind that ghee is a casein and whey free product and you may tolerate it unless you are extremely sensitive since very pure ghee is around 99% pure butter oil.
- Sauerkraut. This is another great one. It is pretty easy to make at home too. My kids love it. Since the name sauerkraut may not be the most appealing to a kid, we usually call it “shredded pickles” and since they love pickles, it’s almost a no brainer that they would like this one too! One of the main bacteria that is present in functional foods such as sauerkraut includes Lactobacillus. There is some data to show that these bacteria can degrade certain pesticides and can also provide antioxidant power, make the gut barrier stronger, and reduce inflammation (https://www.ncbi.nlm.nih.gov/pubmed/26123785). Even if you are already eating organic and non-GMO foods, pesticides are in our environment, parks, and other places. I’ll take an extra dose of detox anytime!
- Fermented carrots. This is another personal favorite. Fermenting your own carrots at home is super fun for the kids and the whole family. It is also incredibly healthy and pretty easy to do. All you do is dissolve salt in water and put carrot sticks in the jar and pour the liquid over the carrots. Then cover the jar with an airtight lid until they are ready to be eaten. Just make sure to release any excess pressure in the jar on a daily basis. We all know that carrots are full of Vitamin A, antioxidants, fiber, minerals, and other key nutrients. We can take this awesome food and turn it into a superfood with fermentation! Oh, and remember that it can be fun to mix it up with colorful carrots. It will make eating the carrots more fun for the kids and also give them a variety of other health benefits. For example, purple carrots have more anthocyanin and extra Vitamin A. And don’t leave out the white carrots just because they aren’t colorful; their health benefits come from their fiber content. As always, it’s good to eat the rainbow!
Side dishes and snacks can definitely be healthy and full of nutrients and vitamins. Helping your children (and whole family) build a diverse ecosystem of bacteria within their intestinal tracts can have long-lasting health benefits. Your kids will definitely thank you for this when they get older!
What is gut health anyway?
So, what is gut health? Is this just another fad? It seems like everywhere you turn there is some advertisement, article, or post about gut health (this one included!). Many of you may be wondering what the big deal is. Should you even be interested? The answer is an “absolutely, yes!”
Let’s first start off by talking about the gut. What is the gut? Well, the gut refers to our digestive tract. The second you put something in your mouth the process of digestion starts from the enzymes in your mouth to the chewing with your teeth. Digestion progresses as the food is transferred into your food pipe (aka, the esophagus) and then down into your stomach. From there, it will travel through the small intestines (or small bowel) and finally end up in the colon (or large bowel). The final product that is expelled from our rectum is what we fondly refer to as poop. This is an oversimplified explanation of how things travel down; there are a lot of things that happen in between. However, I wanted to at least give everyone an idea of what the different parts of the gut actually are. Did you know that if you were to remove your digestive tract from your body and lay it down on the ground it would be about as long as a doubles tennis court? That’s a lot of ground to cover!
One of the reasons why it is important to be concerned about our gut health (or the health of our digestive tract) is because it is home to one of the most powerful entities in our bodies—the gut microbiome. The microbiome refers to the approximately 100 trillion bacteria, viruses, and fungi that exist together in our digestive tracts. These little bugs are important because they do a whole host of things for us. They can also make us sick if things get out of balance. Protecting the gut microbiome and helping to grow a resilient ecosystem can go a long way in the management of chronic disease.
In those with obesity and fatty liver, we know that there are changes in the inflammation levels in our intestines and changes in gut permeability (or leaky gut). Along with these changes come alterations in the gut microbiome (https://www.ncbi.nlm.nih.gov/pubmed/29956210). There is also a suggestion that the gut microbiome can affect kidney function and play a role in acute kidney injury (https://www.ncbi.nlm.nih.gov/pubmed/29961049). Not only does the gut microbiome play a role in metabolism and immunity, it also can influence your risk for heart disease (https://www.ncbi.nlm.nih.gov/pubmed/29967639). The body of knowledge that we are accumulating regarding the gut microbiome is growing at a rapid pace and we are learning about associations with almost every medical condition, including diabetes, Parkinson’s Disease, Alzheimer’s disease, autism, ADHD, stress, depression, among many others. Just doing a PubMed (medical literature) search for the “gut microbiome” brings almost 11,000 articles.
We are still trying to figure out how it all works and which microorganisms do what but one of the clear messages is that a diverse and rich microbiome are key. It’s kind of like this….if you are the CEO of a major company, what kind of work force would you want? Would you want a bunch of people who have the same skill set, same educational background, identical cultural backgrounds, and same ideas? Or would you want a bunch of highly talented people that come from a variety of backgrounds, from different schools, different countries, and have their own unique personalities and ideas? I think the answer is obvious, right? So, as the CEO of your body (and your gut microbiome), it is our jobs to make sure that we have a diverse microbiome. This is another way of looking at the term “gut health.”
Here are a few basic tips on building a diverse, resilient gut microbiome:
- Eat a variety of (preferably organic, non-GMO) colorful vegetables and fruits, while avoiding processed foods, unhealthy trans-fats, fast foods, and excess sugar.
- Avoid toxins. This includes food toxins, environmental toxins (as best as possible), certain medications (if possible), tobacco, and excessive alcohol.
- Exercise. Movement on a regular daily basis is good for your gut too!
- Sleep. Shoot for 7 hours of sleep per night.
- Reduce stress. This is a big one. There is a direct mind-gut connection and stress can definitely weigh heavy on the gut and the gut microbiome.
- Social interconnections. Yes, this is definitely part of the program too. Our social connections, friendships, and relationships play a large role in our overall health and how we do, especially when we are sick. This is one of the keys to living a long healthy life. Our gut bugs can definitely feel the love!
I hope this helps clear up some of the confusion about gut health and what it is. At the end of the day, we should remember that gut health is important. It may actually be one of the most important parts of our bodies. We should be responsible CEOs to our gut microbiomes. In turn, they will help us be strong, healthy, and successful in many different ways!
Rebalance your health, mind, and family with this one simple concept
Do you ever find yourself exhausted at the end of the week? Sometimes the exhaustion starts in the middle of the week or even sooner. By the time the weekend comes, you just want to do nothing. Before you know it, it’s Monday again and you are going back to work tired, as if the weekend never even happened.
There are a lot of things that go into fatigue and stress. We all need to make sure we eat the right foods, avoid toxins, exercise, sleep enough, and meditate on a regular basis. However, one of the most important and forgotten things we need to do is work on our social connections. You may say, “what are you talking about? I have family. I have friends.” I know. You do. However, what are you doing with them? Are you just going through the mechanics of a relationship or are you truly and genuinely trying to connect with each other? Human being are social creatures. We thrive on our social connections. In fact, there is evidence that our social relationships can increase happiness (https://www.ncbi.nlm.nih.gov/pubmed/25641486). Having more social connections has also been associated with decreased odds of suicide or attempt (https://www.ncbi.nlm.nih.gov/pubmed/29349115). It’s not about how many relationships you have either. It is the quality of relationships. You could have one friend and be better off than someone with 100 friends if the quality of that relationship is solid.
What we often do is take these relationships for granted. We think we have them and we enjoy that we have them but at the end of the day, are we cultivating that meaningful relationship on an ongoing basis? One simple concept that my family discovered a few years ago has really helped us reconnect and rebalance: Hygge (pronounced “Hoo-Ga”).
Hygge is a Norwegian and Danish word which refers to a mood of coziness. To me, the word means warmth and love. The origins of the word hygge may even come from the word hug, which further supports the concept of coziness and comfort. Ok, so what does this mean anyway. Well, it can mean whatever you want it to mean for you and your circumstances. That’s my viewpoint. The concept is to create an environment of warmth and coziness for you, your friends, and your family. The weekends are a great time to do this because it can be hard to execute in the hustle and bustle of the work week. Vacations are also a great time to do this, but I definitely would not wait for a vacation to start. There are a few ground rules when it comes to hygge (The Little Book of Hygge by Meik Wiking). I’ve outlined them for you below:
- Create a good atmosphere. Dimming the lights helps.
- Have presence. Turn off the phones.
- Have pleasure. Favorite foods are always helpful.
- Treat everyone with equality. It’s more about we rather than me.
- Have gratitude. Soak in all the warmth and give thanks for the opportunity to be with your loved ones.
- Be harmonious. No need to compete when playing games; everyone is there to have fun.
- Make sure you are comfortable. Wear sweatpants, warm fuzzy socks, whatever you feel the coziest in.
- No drama. Leave the arguments and debates behind.
- Be together. Reminisce on things you have in common or adventures you have been on together.
- Be in a safe place like someone’s home. The people you are with are your tribe. Hygge is a place of peace and security.
It’s really not complicated. Hygge can be whatever you want it to be (https://www.visitdenmark.co.uk/en-gb/denmark-hygge). Pick one day out of the week that works for you and your family. Make this your family hygge time. My family likes Friday nights or Saturdays. It doesn’t necessarily have to be a whole day affair. The whole point is to just be present in the moment together and enjoy the company. If you have out of town friends coming over for a visit, have fun with them….have a picnic, go for a bike ride, sit around a campfire and tell stories. Yes, you can still go to Disney World if that is what they are there for, but don’t let the “good stuff” go so easily. Make sure you connect, truly connect. It’s the memories you make when this happen that are the ones that truly stay with you and keep you warm inside. That’s what hygge is! Having a friend and being a friend are two different things. Even having one friend earlier in life, as a child, can offer a reduced risk of psychological problems later in life, as an adult https://www.ncbi.nlm.nih.gov/pubmed/25316094).
Here is what we do on our hygge weekends:
- No electronics or phones (outside of music). Unplug the TVs. Put away the Iphones and tablets.
- Nice meals planned out (home cooked is the best, especially where everyone can contribute to the preparation)
- Board games with the kids
- Outdoor games with the kids (shoes off is even better so you can get some earthing in!)
- Funny stories, lots of jokes, and tons of hugs (of course!)
- Aromatherapy diffuser (rose and orange citrus are a few of our favorites)
- No drama
We know, and have seen, in the published literature that there are implications for gene expression and gut microbiome diversity in relation to our social interconnectedness. This means, that just by having fun and enjoying your social connections and relationships, you could be giving yourself a dose of one of the cheapest and most powerful medicines: love. Our human physiology responds to this. Oxytocin probably plays a large role in this process. Oxytocin is a chemical that has many different functions but is often-times referred to as the “love hormone.” Some of the effects it has includes parental behavior, social bonding, falling in love, friendship, and cooperation. The gut microbiome likely plays a role in how oxytocin is released because it appears that Lactobacillus reuteri, one of the bacteria that is found in the gut, can increase blood levels of oxytocin (https://www.ncbi.nlm.nih.gov/pubmed/27793228). I bet you would never have guessed that happiness could come from the gut!
The Danish are some of the happiest people in the world. They figured this out a long time ago. We can all learn from their example and bring hygge into our lives! The warmth and coziness of hygge will trickle down into the core of your being and deliver a dose of the best medicine to you, your genes, and your microbiome!
How earthing can heal your gut
What’s all the hype about earthing and grounding? Believe it or not, there is science behind it! So, what is it? Well, grounding and earthing refers to direct skin contact with the surface of the Earth, whether it be with your bare hands or feet. Another concept that is along the same lines as this is called forest bathing. Forest bathing was developed in Japan and is called Shinrin-yoku or “taking in the forest atmosphere.” These techniques are a way to reduce stress and calm the mind. They allow us the opportunity to enjoy the great Earth we all live on together.
Guess what? Earthing actually effects our human physiology and health! Grounding can influence changes in levels of our white blood cells, inflammatory markers, and immune response. It has also been demonstrated to reduce pain and change the number of immune cells floating around in your bloodstream which can then influence the downstream factors related to inflammation (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378297/). One very interesting study showed that grounding caused a reduction in a muscle enzyme called creatinine kinase (CK) after a series of muscle contractions (the people in the study did 200 half-knee bends). This means that grounding helped reduce muscle damage or irritation after these muscular contractions were performed (https://www.ncbi.nlm.nih.gov/pubmed/26443876).
One theory is that earthing can influence the electrical and chemical capabilities of the nervous system. This may help the nervous system to better adapt to the demands of the body and immediate surroundings. It may also help us restore our natural electrical status. These changes can even be seen on tests such as an EEG (electroencephalography) which measures brain wave activity (https://www.ncbi.nlm.nih.gov/pubmed/21856083). Fascinating, isn’t it?
Forest bathing has been shown to produce changes in our human physiology as well. One study showed that pulse rate, blood pressure, and heart rate variability were better in the forest than in the city when people were asked to walk for 15 minutes and then sit in chairs viewing the areas they walked in for 15 minutes (http://www.natureandforesttherapy.org/uploads/8/1/4/4/8144400/_physiologiceffectsurbanforest.pdf). Another interesting study showed that brain activity and cortisol (a key stress hormone) levels were significantly lower in those that spent time in a forest walking around and enjoying the scenery compared to when this was done in the city (http://www.natureandforesttherapy.org/uploads/8/1/4/4/8144400/_physiological_effects_of_shinrin-yokucortisol-2007.pdf). What is exciting is that these changes are noted in a very short period of time. You don’t have to do it for months before you can see the benefit.
We know that the brain and the gut are directly connected to each other and that the digestive tract has its own nervous system. There are more nerves in the digestive tract than in the spinal cord! It is also well established that the brain can influence activity in the digestive tract and can influence the gut microbiome. Additionally, the opposite is also true. The gut microbiome can also influence brain activity, emotions, feelings, anxiety, and depression. Earthing and forest bathing seem like a genius way to naturally reset and rebalance our human bodies and physiology. Not only can it help us reduce stress, it can influence brain activity, blood pressure, heart rate, and immune activity. Almost certainly, the gut microbiome probably plays a role in this process as well. A happy brain makes for a happy gut. It actually makes a lot of sense if you think about it. Dr. Daniel Siegel defines the “mind” as being within us and between us; our mind is within our body but also between our body and the environment. Therefore, in order to heal our mind and body we must also connect with and respect our environment and everything and everyone in it (http://www.drdansiegel.com/books/mind/).
Regardless of the science or anyone’s opinion, there seems to be enough evidence to support earthing and forest bathing. It is a free, simple, and fun way to not only heal your mind but also heal your gut! So, next time you feel like you need a break or a breather, take off your shoes and walk barefoot in a patch of pesticide-free organic soil! Make it part of your regular routine!
How many times have you heard people talk about good genes and bad genes? Even as a physician, I have had my own physicians tell me that I probably have a higher risk of heart disease because of my family history and genetics. Is this entirely true? Well, yes and no.
We do carry added risk for certain conditions that are inherited in our genes. However, we have the option to exercise control over those genes. Really? We can control our genes? Yes!
Our genes and our DNA are definitely an important part of our health. However, this is not the only factor that we need to consider. Our gastrointestinal tract or digestive tract starts from our mouth and goes all the way to rectum. Within these pipes lies a vast amount of power. There are approximately 100 trillion microorganisms that live inside of our inner pipes (Singh M, Mullin G. Diet and Environmental Chemicals and the Gut Microbiome. In: Vom Saal F, Cohen A, editors. Integrative Environmental Medicine. Oxford University Press. 2017). These can include bacteria, fungi, yeast, and viruses. We affectionately call these guys our gut microbiome. This basically refers to the ecosystem that lives within our gut. Not only are these little bugs responsible for making vitamins for us and helping us digest our food, they help control the immune system since 70% of our immune systems lies within the gut! Even more fascinating is that at least 90% of the serotonin in our bodies is stored in the gut as well. When we think of antidepressants we often think of increasing the amount of serotonin in our brains but this is only partially true. We have a whole pharmacy of antidepressants sitting in our gut. We just have to know how to open the door to get access to all this free medicine!
Our DNA and our gut microbiome work together and are influenced by our environment, exposures, stress levels, and hormones. One of these elements alone is not enough to control or manipulate our health. It is my belief that the human body was designed this way on purpose. Almost like checks and balances within the government. When everything works together nicely, our everyday challenges are dealt with effectively and problems are solved. When a few things start to get out of balance, the entire system can get out of balance. And if we have some underlying risk for a particular condition that is hidden within our DNA blueprint, our body may push the button to activate that condition when we don’t want it to.
Don’t get too worried, just yet! Our health is not that scary. The beauty of the whole system is that even if we have already started to walk down the path of sickness, we can do our best to get off that path. More importantly, we can do things to keep on a path of wellness!
Dr. Elizabeth Blackburn was awarded the Nobel Prize for her groundbreaking work on telomeres, which are the caps at the end of our DNA that help keep the DNA intact (almost like the plastic tips of your shoelaces that help keep the shoelaces from fraying). It turns out that we have an enzyme called telomerase that helps keep these caps intact and can even make them longer. This is important because once the caps get too short and the DNA starts to “fall apart” so to speak, the cell that contains that DNA starts to become senescent or senile and does things that you don’t want it to do such as send false signals that can be confusing to the other cells in your body. When I heard that The Telomere Effect by Dr. Elizabeth Blackburn and Dr. Elissa Epel was coming out I made sure I got a copy because I was very interested to learn about what their research showed regarding how we can live longer and be healthier. Guess what? The very same things I have been educating patients about in my practice about gut health are also important for telomere and DNA health! These include eating a balanced diet full of antioxidants, phytonutrients, colorful vegetables and fruits; exercising; avoiding toxins; reducing stress; sleeping the right amount; and having fun building friendships and relationships with people and the environment. Personalized lifestyle interventions are the cornerstone of optimizing our health (https://www.ncbi.nlm.nih.gov/pubmed/23878520), not only because they are good for our DNA but because they are good for our gene expression, our gut microbiome, hormone balance, and our environment.
So next time someone tells you that your chronic illness is “all in your genes,” tell them and prove to them that they are not entirely correct. Your genes are not your destiny. We can change our environment (inside of our bodies and outside of our bodies) and harness the power of our beautifully intricate bodies to create positive changes in our health!
As an integrative physician, I am often asked about what things can be done that can help improve gut health. With so much confusion about which medications are safe to use and what supplements are best to take, many are left wondering if what they are doing is the best or if they are just wasting their time and money. While there are many things you can do to improve your gut and overall health, I wanted to focus on something we often forget to talk about: social interconnectedness.
Social interconnectedness means your social connections, relationships, and friendships. Yes, you can do things to be healthier that don’t cost you anything. Here are my top 3 tips.
- Kindness. Kindness and compassion are two of the most powerful medicines. Helping others has a much more powerful impact on our bodies than if we just did something to help ourselves. When we are kind to others we are being kind to ourselves. Our heart rate and blood pressure is improved and stress levels are reduced. On the flip side, if we get angry or even have negative thoughts towards someone, we are just creating negative energy against ourselves. We now know that there is a connection between the gut (i.e., our digestive tracts) and the brain and that this is a two-way superhighway. How we think, feel, and act can influence the trillions of bacteria that live inside our gut. Additionally, those bacteria can influence how we think, feel, and act as well. A study performed at UCLA showing that taking probiotics can influence brain activity (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839572/) helps show us how closely connected our brain and gut really are.
- Breathe. One of the best ways to heal your gut is by taking a few minuteS to slow down and take a few deep breaths. Meditating or yoga doesn’t have to be as complicated as we might think it is. There are so many ways to relax during the day so find what works best for you. Meditation has been associated with lower levels of the stress hormone cortisol, lower levels of inflammation, lower blood pressure and heart rate, lower triglycerides, and the leakiness of the gut (https://www.ncbi.nlm.nih.gov/pubmed/27576169). There is no medicine that exists that can do all of these things and more!
- Talk. Talk to your friends. Talk to a stranger. We know that social connections play a huge role in our health. In neighborhoods with lower levels of trust and social interactions between people we have seen that there is an increased risk of heart disease and depression and lower life expectancy. What’s fascinating is that under these circumstances we also see a decrease in the diversity and amounts of good bacteria in our gut (https://www.ncbi.nlm.nih.gov/pubmed/26859894). Even if there is one person in your life that you can trust and count on, that is all you need.
Human beings are social creatures. We are all so unique yet built in the same way. If you are kind, compassionate, mindful, and just make some time to have fun or connect with someone, you are giving your body a dose of very powerful medicine, one that you cannot buy in a pharmacy! Your gut will definitely thank you!
There is a lot of press and chatter in the medical community about stool these days. Some of you may be wondering why and what the big deal is?
Well, this is actually a very important topic. There are over 100 trillion microorganisms that live inside of our intestinal tract. They make up 10 times the amount of human cells on our bodies and have 100 times the amount of DNA compared to human DNA. It's no understatement that these tiny bugs that live inside of our gastrointestinal tracts are important. We are learning more and more about this ecosystem of microorganisms in our guts (referred to as the gut microbiome) and discovering new things on a daily basis it seems. We have found associations in gut imbalance with diseases such as Alzheimer's and Parkinsons to diabetes, heart disease, mental illness, and various cancers. We are seeing literature surface on stool transplants to help those with inflammatory bowel disease (Crohn's disease and Ulcerative colitis) and we have known for a while now that stool transplants for the severe bacterial infection in the colon called C.diff (Clostridium difficile) can be extremely helpful. What these stool transplants do is rapidly change the environment inside the colon to help reset balance very quickly so that you can regain health. This supports the notion that the composition of the gut microbiome is central to health. Just recently there was a study suggesting that infection with a particular virus (reovirus) could be contributory to an immune response whereby people can develop celiac disease and be symptomatic when eating gluten.
These little bugs may be invisible to the naked eye but understanding their importance is paramount to preventing and managing various conditions and diseases. Manipulating the microbiome and shifting its abilities to produce various different substances is going to become a focus of medical care for patients in the coming times (in fact, it already is).
So, in a nutshell....yes, your stool is important. It is very important. It is a reflection of your health. It is a reflection of your microbiome. It is a reflection of the inner you!
Cheers to your (gut) health!
There is a lot of talk about lifestyle medicine these days and people often ask me what this really means and why it is important. I thought I would take a few minutes to address this.
Lifestyle medicine simply means that you are living your life in a way to optimize overall whole health. It's not so much a "medicine" as it is a way of treating yourself to reduce inflammation and prevent chronic disease. Here are some of the main principles of lifestyle medicine:
1) Avoiding toxins (environmental toxins, excess alcohol, excess tobacco, plastics, pesticides, flame retardants, etc)
2) Eating healthy: avoiding processed foods, trans fats, fast foods, sugary beverages, artificial sweeteners and focusing on whole foods that are organic and non-GMO and include plenty of colorful vegetables and fruits, whole grains, and healthy fats (aka the anti-inflammatory diet or Mediterranean style diet)
3) Movement: exercise, be active (especially out in nature), shooting for at least 150 minutes per week
4) Sleep: often neglected but paramount to maintaining a healthy lifestyle; shoot for 7-9 hours of sleep per night
5) Stress reduction: including a meditative practice in your daily routine, deep breathing, yoga, tai chi, among others is extremely important so that we can soothe the gut-brain pathways and cultivate a healthy mind-body relationship
6) Love: Cultivating meaningful relationships, enjoying life, laughing, singing, dancing!
These are all components of a healthy lifestyle. There is a growing body of scientific evidence that is continuously being added to that demonstrates the importance of these elements in order to obtain whole health and longevity. The best part is that these are things that you don't need a prescription card or a doctor's appointment to do!
Cheers to your health!
Everyone wants to know what the secret to life is. What is it that will make us live long? What is it that will keep us well?
This is a loaded question with many different perspectives. Dan Buettner worked very hard to study the areas in the world where people live the longest and are the healthiest. In his book, "The Blue Zones Solution" he outlines the the secrets of living long:
1) Move naturally: exercise and live in enviroments that push you to move
2) Purpose: essentially having purpose or a goal in life
3) Downshift: relax, take it easy, find a way to reduce stress
4) Hara Hachi bu: eating until you are 80% full
5) Plant Slant: favoring a plant based diet and one rich in beans and lentils with small amounts of meat (mostly pork, interestingly) a few times per month
6) Wine at 5: 1-2 glasses of wine daily with friends/food (assuming no alcohol problem)
7) Right tribe: having a healthy social circle
8) Community: faith based community (denomination is irrelevant)
9) Loved ones first: family first
These are wonderful principles of life and we should all strive towards living like this. All it says is that you should eat well, focusing on real whole foods while finding time to relax in the day, socialize with friends, having a sense of community, and staying active. Doesn't sound like anything too fancy does it? Really, it's not. But it is hard for most of us, in our busy lives to figure out a way to do these things or to appreciate their power and beauty. Stop for a moment and think about these 9 points. In the blue zones of the world, these are the main things that people have in common....they all do this...and they live long healthy active lives. There is no magic fountain of youth or magic pill you can take. It boils down to being present and remaining grounded, doing what you love to do, have social connectedness, and treating your body the way it should be treated.
This book, The Blue Zones Solution, isn't the only text that outlines these principles. There are studies that show how important social interactions and connectedness are and there are studies that show how little things like meditating can lengthen your telomeres, the caps at the end of DNA that keep us young.
So when you think and reflect upon your life and wonder what you can do to be healthier and what you can do to live a long happy life, just remember these above 9 principles. Start working on them one at a time and strive to do your best in these categories. I promise you will be healthier and happier, and in turn this will make your desire to optimize the other categories stronger.
Cheers to your health!
1) The Blue Zones Solution by Dr. Dan Buettner
Many people have seasonal allergies and/or allergies to various types of foods (namely nuts). Most probably wouldn't flinch before taking an antihistamine to help reduce the nuisance of the watery eyes, runny nose, or sneezing that one might experience when it's that time of the year for allergies. What really causes allergies? Well, recent research suggests that the answer may be uncovered in your poo...yes, you got it...your poo!
Within our intestinal tract lives over 100 trillion microorganisms. This is refered to as the gut microbiome. It is essentially a powerful "organ system" that is being researched by many across the globe; we are uncovering many of the secrets to human life that were not really clear before. Now, there is still a lot of work to be done and a lot of things are not entirely clear but there is some exciting research coming down the pipelines.
I recently reviewed one study by scientists at the National Cancer Institute. They reviewed data from the American Gut Project (http://americangut.org/). What they discovered was that in those with allergies, especially seasonal allergies and nut allergies, there was "lower richness and altered composition of their gut microbiota." We know that one of the keys to gut health is having a microbiome that is diverse, which means a nice wide spread of different kinds of bugs. What this statement means is that they found that in those with allergies, there was less diversity in the bugs found in the participants' stool samples. This concept is called dysbiosis, which basically refers to an imbalance in the bugs in your gut. People with seasonal and nut allergies were also found to have higher amounts of Bacteroidales and less Clostridialis.
So, what does all this mean? Well, it means that if you have allergies you may have an imbalance in your gut microbiome. It could mean that when you pop that allergy pill all you are doing is just covering up the problem instead of addressing the root cause of the issue, which is that your poo may not be well balanced. Certainly we need more research and studies into this particular issue. This was not a clinical trial and we need to investigate this concept further. We also need to understand how this dysbiosis is established? Does it have to do with being born vaginally or by cesearan section? Does it have to do with being breast fed or bottle fed? Does it have to do with what environmental exposures you may have had? An even more interesting question is, can allergies be prevented or symptoms reduced/eradicated with specific targeted treatment for this dysbiosis? We don't have all these answers yet. But this is definitely exciting new research.
My take on it is that we are discovering more and more that there are a lot of conditions associated with alterations in the microbiome. What we can do to help ourselves is eat a healthy, diverse diet rich in colorful fruits and vegetables while including probiotic and prebiotic foods (See The Microbiome), avoiding chemicals and products that can have harmful effects on our gut bugs, and living a healthy balanced and centered life. The gut bugs are the keepers of our immune system. We need them to be happy!
Cheers to your health!
Shi J, et al. Allergy associations with the adult fecal microbiota: Analysis of the American Gut Project. EBioMedicine 3 (2016): 172-179.
Hello everyone! Welcome to my Blog!
I thought I would start off by talking a little bit about food. As a gastroenterologist, I’m often asked what types of foods are good to eat. The old saying “an apple a day will keep the doctor away” certainly does have meaning and value. However, with our increasing awareness of digestion and how the 100 trillion bacteria, viruses, and fungi in our guts affect how we feel and what medical problems we can develop, we should consider other foods that can help us protect those microscopic organisms that are good, while fighting off those that are not.
Everyone wants to know which probiotics are good for you and which ones they should take. The important thing to remember is that overall diversity and balance are very important and key to helping maintain a healthy and happy environment in the gut. Fermented foods, like pickles, sauerkraut, kimchi, kombucha tea, and kefir are examples of some probiotics that help you do this the best. They have some of the best health effects, and they don’t come in a cardboard package you buy in the grocery store or pharmacy. A probiotic supplement may certainly be beneficial. However, if you have concern over costs and don’t like taking pills, think about introducing some of these probiotic foods into your diet.
How can a food be a probiotic? Well, all it means for a food to be a probiotic is that it contains active bacteria. Fermented foods are some of the best sources for this. These types of foods help keep the good bacteria in and help to keep the bad bacteria out. This is in the same manner as the probiotic supplements you might take.
There are proven health benefits of including fermented foods in your diet. They can help you lose weight and regulate your metabolism. We know that these foods help reduce inflammation, improve digestion, and even have the potential to reduce your risk of heart disease, diabetes, and other chronic conditions like Alzheimer’s disease.
Not only can you buy these fermented foods in the grocery store, you can make them in your own home. This gives you the power to control your health and be proactive with staying healthy.
So, yes, a pickle a day could keep the doctor away. Just make sure it’s truly fermented!
Cheers to your health!
For more information, check out the following books, which were used as references. Both are both excellent:
The Gut Balance Revolution by Dr. Gerard Mullin
Super Genes by Dr. Deepak Chopra and Dr. Rudolph Tanzi
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