chapter 1
YOUR FORGOTTEN ORGAN
Understanding the Gut and Why It Matters to Your Health
“Everything has been said before, but since nobody listens we have to keep going back and beginning all over again.”
André Gide
“All disease begins in the gut.”
Hippocrates
From the time I started working as a nutritionist, my clients came to me with a wide range of complaints: everything from sluggish metabolism and excessive weight, to fatigue, headaches, and mood swings, to digestive discomfort and skin issues, to chronic conditions like type 2 diabetes, arthritis, and high blood pressure. I’d counsel them through their individual maladies, but I never saw a connection among all these cases until the day I took “the test.”
In 2007, I attended a digestive health seminar sponsored by one of the largest laboratory testing facilities in the world. At its conclusion, everyone was handed a test, known as a GI panel kit, which helps identify issues in the gut. Up until that point, my only understanding of the gut was pretty much input/output. After all, this test had traditionally been used pretty narrowly to diagnose digestive disorders like Crohn’s disease or diverticulitis. When I returned to my office, I tucked the kit into the back of a file cabinet. After all, I felt fine . . . not amazing, but I didn’t have any symptoms of being “sick.” I chalked up feeling run-down and depleted to being busy, running a successful practice, and maybe not getting as much sleep as I needed.
Months later, I stumbled across the test. It was close to its expiration date, so I thought, Why not take it before it’s too late?
The results left me thunderstruck. The report showed a disproportionate level of bacteria and the presence of microbial pathogens in my gut, which meant I was inadequately absorbing micronutrients such as iron and basic cell-building essentials like protein and fats.
I recalled a swim meet in Santa Barbara, where I’d finished a 200-meter heat, gotten out of the pool, and nearly passed out on the ground next to the starting blocks. My mother panicked, but my coach dismissed it as meet-related stress. A blood test and GI panel told the real story: I had abnormally low levels of ferritin—the protein that stores and controls the amount of iron in the body. Apparently I wasn’t absorbing it properly, thanks to small intestinal bacterial overgrowth. I finally had the answer to my “unexplained” severe anemia. I wanted to call my old swim coach and say, “Here’s the reason I couldn’t push myself any harder!”
These findings prompted me to dig deeper and learn more about why something seemingly isolated in my gut could have such far-reaching health repercussions. I eventually learned that all of this had started years earlier, beginning with the coach, doctor, and nutritionist-prescribed “athlete’s diet.” Add to that intense physical training, and I’d created the perfect storm for a condition that was depriving my system of nutrients and throwing my internal systems into complete disarray. Despite following all the “golden rules” of nutrition, this imbalance went untreated for years and became more severe over time. Even though I was an adult—and a nutritionist at that—I called my mother in tears. The mystery illness I’d suffered as a teen had never gone away.
But then my athlete’s never-give-in mentality kicked in, and I was motivated to find a solution. And not just for me—for my clients, too. I read everything about digestive health I could find. I attended dozens of professional conferences on cutting-edge subjects such as nutrigenomics, the study of the effects of food and nutrition on gene expression. (That’s right—you are more than your hereditary destiny!) The more I learned, the more I saw a common thread through most, if not all, of my clients’ cases: poor digestive health. It struck me that the foundation of health lay in the gut, the forgotten organ that has long been written off as the collection spot for food eaten and poop-to-be. As Hippocrates intuited some two thousand years before me, I recognized that the gut was the key to developing a new program for my clients.
Of course nutritionists, researchers, scientists, and health experts are all looking at the gut now, but up to 2000 they were just starting to focus on the microbiome; by 2015 there were nearly twelve thousand studies published on the subject. Among them were experiments dedicated to exploring the link between microbial imbalance and the immune system; and all of the research confirmed the relationship between poor diet and a range of health disorders, including infertility, coronary disease, diabetes, and even cancer. And you know you’re really on to something when Silicon Valley gets involved. A genomic research company called uBiome wants to do for the microbiome what earlier researchers did for DNA. Working in collaboration with the CDC, uBiome plans to analyze a large number of stool samples to help “sequence” the modern microbiome. Part of uBiome’s long-term plan is to develop a Microbiome Disruption Index to track how factors like antibiotics, foods, lifestyle, and stress can alter the gut and hamper key functions, particularly the immune system. They also plan to explore how our microbiomes can be shifted and reshaped to potentially benefit generations to come.
These advancements in microbiome sequencing technology helped me understand how you not only can feed beneficial gut bacteria, but can also quantitatively verify how this daily healthful practice affects overall health. This rich pool of data has helped me develop and hone a program that would allow my clients to heal their guts and restore optimal health not only to their digestive systems, but to their entire body.
It all starts with what we eat and how we live, and it turns out that the best practices for optimal digestive health aren’t cutting-edge, or even new for that matter. They’re the very same foods and traditions that my ancestors have observed in the Mediterranean for generations. These “wild” ingredients and lifestyle observances help the microbiome thrive and, in turn, support overall health because of how they nurture the colonies of beneficial bacteria in our gut.
Your Internal Ecosystem
We commonly refer to the gut in positive ways. He’s got guts. I have a gut feeling. Yet, we rarely consider how the state of our digestive tract can impact our overall lives—and we rarely discuss the state of our own gut in polite company. But the human gut is a true wonder. It harbors a dynamic, complex microbial environment known as the microbiome. An average human gut is host to more than two pounds of bacteria, just a bit less than the weight of a human brain. You most likely know that your gut digests food; but here’s something I’ll bet you didn’t know: More than 70 percent of the body’s immune system tissues reside in this metabolic organ. This portion of the immune system is referred to as gut-associated lymphoid tissue (GALT). These lymphatic cells are some of your body’s most vigorous defenders, developing antibodies to combat invading microorganisms. These little guys work tirelessly without fanfare to protect you every moment of the day. But when your gut and all its beneficial bacteria fall out of balance—most likely from an overgrowth of harmful bacteria or pathogens—that work is disrupted. The good bacteria become overwhelmed trying to chase after what they perceive to be a constant stream of offenders. As a result, your immune system’s first line of defense gets run-down, leaving you vulnerable to disease.
Also living in our guts are toll-like receptors (TLRs). These respond to the presence of unknown antigens—or suspected bad guys—by unleashing an inflammatory response to what they perceive as infection in the gut. Believe it or not, this inflammation isn’t a bad thing. In fact, a little bit of inflammation, when it comes to fighting off infection, is good. It stimulates damaged tissues to heal. However, it is possible to have too much of a good thing. Some foods—like processed products, sugar, and dairy—possess antigens that trigger the immune system to produce antibodies against them. While all foods contain potentially antigenic molecules—and any of these can trigger an immunogenic reaction—some foods, such as the ones listed above, are more common offenders than others. Eating these foods regularly can put your body in a constant state of inflammation. Even more alarmingly, some processed foods can fool the TLRs into thinking they’re good guys. So if your system doesn’t send out a hostile greeting team—either because it doesn’t know any better or it’s too taxed from dealing with all the other antigen action—then these potentially dangerous molecules get a free ride in your system. That’s why when the gut’s ecosystem is disrupted, the result is often inflammatory diseases such as rheumatoid arthritis, gastroesophageal reflux disease (GERD), lupus, fibromyalgia, multiple sclerosis, Hashimoto’s thyroiditis, psoriasis, inflammatory bowel disease (IBD), and pelvic inflammatory disease (PID).
Dysbiosis and You
In nature—and in health—symbiosis, different organisms existing together in harmony, is crucial. This balanced state is what’s considered eubiotic, “eu” from the Greek word for “good” or “healthy,” and “bios” meaning “life.” As we’ve learned from nature, when a delicate ecosystem is thrown out of this balance, chaos ensues. If a natural predator is eliminated, populations of their natural prey explode. A similar concept is at work in your gut. If whole colonies of damaging microbes are left unchecked, they will eventually overwhelm the beneficial ones. In turn, organisms that are not usually predominant in our intestines, such as overpopulated strains of unfriendly bacteria, yeast, and protozoa, can take charge. Thus starts a vicious cycle that can make the imbalance even greater. The result is called dysbiosis, and its impact on the body is far-reaching, though it doesn’t affect everyone the same way. Problems stemming from dysbiosis can range from mild to extremely debilitating, depending on the extent of the gut’s bacterial imbalance. It can alter how your brain functions—causing anything from “cloudy” thinking to emotional fluctuation—and has even been connected to psychiatric disorders, including depression. Scientists have found that dysbiosis negatively affects iron absorption, which in turn can lead to fatigue, mental “fog,” depression, hair loss, restless leg syndrome, and even chronic heart disease. Research has even shown a direct correlation between the development of colon cancer and specific strains of harmful gut bacteria. In fact, a 2014 study published in the journal Nature has shown “unequivocal evidence” linking dysbiosis to the progression of a variety of cancers. A disturbing recent study shows that patients with cardiovascular disease, obesity, and type 2 diabetes often have dysbiosis, which promotes and accelerates their symptoms. Dysbiosis is also manifested in skin conditions such as eczema and dermatitis. And it can also cause bloating, constipation, or loose stools. It routinely rears its head as indigestion, heartburn, and GERD. You might assume that indigestion stems from excess stomach acid, but in truth, it’s probably due to low stomach acid. Without enough digestive acids, your food isn’t properly digested, causing it to be treated as a potentially dangerous invader and triggering an inflammatory response. What causes low stomach acid? Dysbiosis.
Dysbiosis occurs for a variety of reasons. The most common culprit is what we eat. Processed foods, an overdose of sugar, animal fats, hormone-laced dairy, fried foods, and artificially flavored or colored anything all have a negative impact on our guts, as do diets with too little plant-based fiber. Stress and being sedentary play a major role, too. Unnecessary use of antibiotics—and the CDC says about 30 percent of all antibiotic prescriptions fall into that category—can also throw the gut into disorder.
How Do I Know If My Gut Is Out of Whack?
The connection between how you feel and what might be happening in your gut isn’t always apparent, which is why I order GI panels for all of my clients. In nine out of ten cases, my clients’ results confirm a bacterial imbalance and buildup of pathogens. And sometimes we find the needle in the haystack that explains symptoms that have been baffling a client for a long time. I strongly recommend that you take one too. To learn more about the test I recommend, go to these websites for comprehensive stool tests/analyses:
www.doctorsdata.com
www.gdx.net
www.greatplainslaboratory.com
You can share this information with your healthcare provider if he or she isn’t familiar with the test. You can also order a gut microbiome sequencing test from uBiome (ubiome.com).
Where Do We Go from Here?
By now it should be clear that the state of our digestive tracts has a powerful impact on our overall health.
And the foods we eat—plus the way we live (i.e., how much we move, how content we feel, how well we sleep)—can make the difference between a thriving digestive system and one that’s sick. So our goal is to create a harmonious, healing state that balances the gut and restores wellness to the entire body.
Luckily, we can undo previous damage, whether it’s been inflicted over a series of months or years. We can restore harmony to the gut and health to the body using concepts at the forefront of modern health advancement, which are—naturally—rooted in the sage wisdom of people who have been doing this for centuries. It’s a process called “re-wilding,” or reintroducing beneficial bacteria and microbes into the gut that have been either wiped out owing to things like overuse of antibiotics, or have been unable to flourish because of an overabundance of harmful pathogens. Think about it this way: Most of us live in a sterile world. We use antibacterial wipes to clean up, wash our hands with antibacterial soap, and eat irradiated or otherwise processed foods that lack from-the-soil nutrients and probiotic qualities that encourage beneficial bacterial growth. We also don’t eat a broad enough variety of foods that are good for our gut. Our modern diet—which has become increasingly limited as fresh, plant-based foods and sustainably raised animal foods are less accessible than processed “convenience” foods—doesn’t stoke the digestive system with the rich array of bacteria it’s accustomed to (and needs in order to prevent disease). We consume only 10 percent as much fiber as our ancestors did on a daily basis. As a result, our guts aren’t the wild places they need to be in order to thrive. Think about a fallow plot of land by the highway: The soil is packed and dry, most likely a little pale—not rich and black—and above all, has nothing growing in it but a few stray weeds. If you scooped up a handful, there’d be no bugs. Nothing can flourish in this environment, and you know why? Because it lacks the nutrients that support vital bacteria and microbes, which in turn encourage the growth of critters and plants. Your gut is no different. If we’re going to get beautiful things growing again—to boost your energy; improve your sleep; maintain a healthy weight; clear up your skin; and alleviate chronic aches, pains, and illnesses—then we have work to do. We need to remove detrimental bacteria and pathogens from the gut, flush your system with healing nutrients, and re-seed the gut with all the beneficial critters it needs. Plus, we need to get your body moving in a way that naturally boosts circulation and supports long-term homeostasis. Because your gut—and consequently your digestive system, immune system, neurological system, and just about every other element of your body—thrives on wild. It’s what’s called the 4 R’s of creating harmony in your gut: Repair, Restore, Re-inoculate, and Rejuvenate.
And it all starts with a detox, or at least my version of it.
I developed this Wild Detox program to eliminate the foods that are disrupting the gut, while adding food-derived nutrients that will restore balance—specifically from Wild Mediterranean foods and supplements that will help reintroduce beneficial flora to your microbiome. The first phase is the “pre-tox,” during which we’ll flood your body with plant fibers, the edible equivalent of a car detailing. This is followed by the “land-tox” or “sea-tox,” customized detoxes that you’ll read more about in the next chapter. I’ve come to believe that some people need the digestive boost that comes from the land’s bounty (such as chicken, beef, root vegetables, and olive oil), foods that tend to be rich in conjugated linoleic acid (CLA) and omega-3s, which are powerful gut protectors and anti-inflammatories. Others require a jolt of minerals and proteins that come from the sea (such as those found in fish and sea vegetables). These foods are loaded with zinc, vitamin D, and magnesium, which aid mucosal healing, normalize glucose levels via the gut, and improve mood and reduce anxiety, respectively. Fish and sea vegetables also aid the absorption of iodine in the small intestine, making them excellent for thyroid health. As opposed to nutrition’s traditionally one-size-fits-all approach, this method allows you to choose what suits your unique physiological disposition best—something I’ll help you determine with a quiz here. This detox process is a crucial first step toward recreating harmony in your gut and balancing your system, and also acquainting you with what it means to have a “wild kitchen,” one that harnesses the power of eating a diversity of Mediterranean foods. These are foods that have proven for hundreds of years to support our bodies in ways “experts” only just now realize can help alleviate many of our health problems, both because they pack a hefty nutritional punch and also because they offer the opportunity to eat a diverse diet—a crucial element for stocking your gut with a wide range of beneficial, health-boosting bacteria.
I’ve dedicated this program to helping you make that happen. Unlike fad diets and fancy meal plans, the lifestyle based on living wild and the foods of the Mediterranean is time-tested. It has enabled people to thrive for hundreds of years. I’ve just updated it by combining ancient wisdom with modern science.
Fat vs. Lean Microbes
You may have been drawn to this book in part because you’re interested in losing weight. Everyone knows that obesity is a major problem not just in the United States, but in many countries throughout the world. Unfortunately, people of every age, gender, class, and ethnicity struggle with their weight.
But I’m going to suggest switching your goal from losing weight to making digestive health your number-one priority. That’s why I don’t provide a caloric menu for my program. Too often, people associate foods primarily with the calories they contain, not with their other nutritional values. (Artificial sweeteners are a great example. They’re low-calorie, but researchers have discovered that they—specifically aspartame and saccharin—can alter gut bacteria in a way that causes our blood sugar levels to spike, leading to type 2 diabetes and heart disease.) It’s also worth mentioning that certain additives—such as processed sugar, saturated fats, and MSG—trigger us to crave those very items. When we get a hit of sweet/artificially savory/greasy, we are wired to want more. It’s our brain’s dirty little trick for getting us to eat foods that pack the biggest caloric punch. But we don’t need to scavenge for our food anymore. (And we certainly don’t need to eat foods that have been chemically engineered to taste good, either.) Instead, I want you to think of the food you take in as the way you nourish yourself and strengthen your health via your microbiome. Once you experience the amazing power of gut balance through food and lifestyle choices and your body begins to absorb the crucial micronutrients needed for full-throttle metabolism, you’ll find that you will feel a lot less discomfort and lose weight in the bargain.
In fact, scientists are now discovering that gut bacteria are powerful players in whether or not you hold on to fat. A 2014 study conducted by researchers from Cornell University and King’s College, London, compared intestinal bacteria in obese and lean individuals. The study concluded that the gut ecosystems in thin people flourish with a wide variety of bacteria, specifically the kind that can break down starches and fibers into shorter molecules, which the body then uses as energy. On the other hand, the study showed that the gut environment in heavier people is imbalanced and much less diverse. (I suspect this is partly due to a lower intake of plant fibers on the part of the overweight individuals—something we’ll get to later.) An imbalance in gut flora can negatively affect your metabolism. If your levels of a beneficial bacteria fall too low, it can lead to decreased levels of TSH, a crucial hormone that impacts your thyroid and slows your metabolism, making it difficult to lose weight.
This leads me to a couple of mice I’d like to introduce you to. That big guy? He’s Big Jim. That lean little fella? He’s Mini Fred. In a study led by a Harvard researcher, obese mice like Big Jim were injected with a fecal implant from a lean mouse like Mini Fred. The idea was that such an implant would change the profile of the bacteria in the intestines of the obese mice. The result? The fat mice experienced rapid weight loss. While we don’t know for certain if such methods would work in humans, the bottom line is clear: A healthy, balanced gut is good for the waistline.
My Promise to You
You might think your health issues are unavoidable, whether it’s struggling with digestive discomfort, extra weight, low energy, headaches, skin problems, or other health maladies. Maybe some of these issues run in your family. But your genes are not your entire destiny. We now know that our microbiota can actually influence epigenetic factors, or gene expressions that are passed down from generation to generation and woven into our DNA. Factors like body weight, physical activity, dietary factors, and environmental toxins can all affect—and be affected by—the gut microbiome. So it stands to reason—and has been proven in studies—that if you change your weight, physical activity, dietary factors, and exposure to environmental toxins, you no longer need to fall prey to conditions once thought to be a life sentence. Change your gut, and you can change your life. So let’s get you started on reconnecting to your gut, your wild side, and your true health.