In centuries past, the leading causes of death were the result of poor sanitation and infectious diseases. Countless people died from smallpox, yellow fever, malaria, and dysentery, among many other causes. Since the accidental discovery of penicillin, and the manufacturing of vaccines and other forms of biotechnology, these infectious diseases are not the prevailing reason for our current suffering (though they still exist). Today, a poor state of health, for many, is self-inflicted. I know that’s tough to hear, but it’s true.
You may have been told that the cause of or reason for your chronic disease or condition is unknown, or that it runs in your family. In this chapter, I provide an explanation of how certain diseases develop, but it’s important to understand first that the main reason behind your cancer, heart disease, diabetes, obesity, or other chronic condition is probably not your inherited genes.
Before you scan the list of chronic diseases looking for your health issue, let’s define chronic. A chronic illness is a long-lasting condition that does not self-remedy and for which there is no vaccine. It usually requires ongoing medical attention and often treatment with pharmaceuticals. It may remain stable, or it may worsen over time. Sometimes the symptoms of a chronic disease go dormant for a time and then reappear with a vengeance.
Chronic disease develops due to alterations in some aspect of your physiology. Networks within the body short-circuit and cause a breakdown of cells, tissues, or even an entire organ. When the disease progresses, you often develop symptoms. The onset of symptoms leads to a diagnostic evaluation, which then leads to naming the pathology (deviation from normal cells and tissues) or giving it a diagnosis. The symptoms dictate what treatment is recommended, whether drugs, surgery, or some other form of therapy.
Here is a list of the major conditions classified as chronic diseases. Some are potentially life-threatening, while others can impair your daily activities or just make you miserable.
Z NOTE: Obesity is now considered a chronic disease. Rather than an actual “disease,” it is a chronic metabolic and inflammatory condition that can create more serious diseases, such as most of those in the list above. Obesity is typically classified based on a measurement called body mass index (BMI), a value derived from your height and weight that can be an indicator of an unhealthy body composition. BMI is a screening method to categorize your weight, but it does not reveal the amount of fat you have on your body. In the pages that follow, you will find simple calculations that will tell you how overfat you are.
According to the Centers for Disease Control (CDC) and World Health Organization (WHO), chronic disease is the leading cause of death and disability in the United States, accounting for 87 percent of all U.S. deaths, or roughly 1.7 million people, annually. An estimated 50 percent of all Americans have a chronic health condition, and one in four have multiple chronic conditions. The journal Public Health Reports projects chronic conditions to rise in the next thirty years. Not surprisingly, health care costs are expected to rise in tandem. The Milken Institute projects that by the year 2023, there will be a 42 percent increase in cases of chronic disease, costing this country $4.2 trillion in treatment fees and lost economic output.
Disease: Inherited or Self-Inflicted?
Dr. Jeffrey Bland, known as the “father of functional medicine” and author of The Disease Delusion, has said, “Inherited doesn’t mean inevitable.” Let me explain.
Genes are sets of instructions programmed for specific functions that control health and patterns of disease. Genes are distinct portions of a cell’s DNA that make everything the body needs, especially protein. The proteins produced by genes are the building blocks for everything that allows the body to work properly. As a computer responds to a programmer, genes respond to signals. These signals come from your internal environment, which is determined mainly by the foods you eat, the amount of exercise you get or how much you move, the stressors you experience, your sleep, your exposure to toxins, and your thoughts. If your genes are getting signals from habits that encourage normal function (such as a diet of healthful foods, moderate exercise, and enough sleep), you remain healthy. But if your genes are getting their signals from toxic, processed, inflammatory foods; lack of exercise; chronic unresolved stress; and a lack of sleep, those signals tell the genes to switch on the production of disease.
No single gene causes the development of chronic illness. When the dance between your environment and your gene network goes awry, your physiology begins to deteriorate to the point of dysfunction, what we call disease. Disease can be acute, rapid onset, and short-lived; but chronic disease lasts for a long time. Basically, your unhealthy internal terrain has influenced your genes over a long period of time, and that influence gradually causes the making of a disease.
DISEASES ARE RELATED
An unhealthy internal terrain sets the stage for any number of conditions that lead to disease—sometimes more than one. For example, heart disease is not an isolated pathology that develops within a small artery of the heart. It is created from the combined influence of abnormal blood sugar, the immune system, and distress in the liver. Cancer is not one disease but an accumulation of smaller diseases that interact in a network to create a tumor. The network is made up of high insulin levels, weakened immune cells, poor liver detoxification, abnormal hormone levels, low levels of vitamin D, and DNA damaged by free radicals and nutrient deficiency. Autoimmune diseases develop from a reaction in the gut when certain proteins interact with gut bacteria, an unbalanced immune system, stress hormones from the adrenal glands, and an unhealthy body composition (too much fat and not enough muscle).
A free radical is a simple molecule with a missing electron. To become whole again, free radicals interact with, and steal, electrons from other cells or tissues in the body. Doing so leaves those cells or tissues damaged. This process, called oxidation, has been linked to many chronic diseases.
Z NOTE: Oxidation takes place when free radicals attack and damage the low-density lipoprotein (LDL) particle; think of hail denting the hood of a car. A common theme, threaded throughout the research, states that free radicals from a processed and nutrient-deprived diet, high blood sugar, and smoking are the initiators and main drivers for coronary artery disease, a preventable, lifestyle-based, and often fatal disease.
As you can see, the chronic condition from which you want to rebuild stems from many different systems of the body. Therefore, if you are rebuilding from heart disease, read the diabetes section as well. If you are rebuilding from cancer, read the information on diabetes and obesity. Our current health care system is based on treating the ill with a pill, rather than looking at the broader causes of why diseases develop. We also have specialists who treat just one organ system, rather than treating the whole person to uncover why disease has developed. That’s where functional medicine differs from conventional medicine. Functional medicine looks at the whole person as an interconnected system—not a series of independent variables.
Symptoms of a chronic disease can be insidious, or they can come on abruptly, as in a sudden heart attack. Sometimes you get a warning signal that something is wrong. For example, those with developing heart disease may get chest pain (angina) and shortness of breath. In extreme circumstances, the first sign of a major disease—like advanced coronary artery disease—is sudden death due to abrupt heart failure. If you have symptoms in one part of the body, it could mean there’s a problem in another part; this is sometimes called referred pain. As you rebuild yourself, it’s important to listen to your body and keep track of your symptoms. If you have any, make sure you describe them in detail to your doctor(s).
LEADING CAUSES OF DEATH VS. ACTUAL CAUSES OF DEATH
In the United States, heart disease is the number one killer of men and women, and cancer is the runner-up. Approximately 610,000 people die each year from heart disease, and roughly 589,000 die from cancer. Right behind them are medical errors, stroke, respiratory issues, and diabetes. Yet while these conditions are what we die from, they are only the end results of issues long stewing within us.
A landmark study in the Journal of the American Medical Association (JAMA) revealed the most prominent causes of mortality in the United States were tobacco use, poor diet (soon defined, keep reading), and physical inactivity, accounting for 80 percent of the factors that create disease. We have complete control over these factors. If you don’t smoke, then you need to focus only on poor diet and physical inactivity. Simple, right?
Mortality data reported to the CDC were published in a more recent study found in JAMA. Smoking, poor diet, and physical inactivity are still the top killers. However, current trends say a poor diet and inactivity will soon overtake smoking to become the leading causes of early mortality.
The good news is that modifying your personal choices will profoundly affect your health. This is also borne out by research: a large population-based study published in the Archives of Internal Medicine showed that people who ate healthful foods, routinely exercised, avoided smoking, and controlled their body composition had an 80 percent lower probability of developing and dying from chronic illnesses. An 80 percent lower probability sounds like a get-out-of-jail-free card to me. Just as heartening is the fact that changes in your lifestyle will help you rebuild from disease and prevent any recurrences. This is why I wrote this book.
I WON’T LIE: rebuilding your health takes discipline and determination; sometimes it’s hard work. That’s because rebuilding your health is a process, not an event. However, the support protocols (what I call “supportocols”) in Rebuild are not difficult to implement, and restoring your health is not as complicated as you may think. If you follow the steps in this book, they will help you rebuild your body’s internal environment. It worked for me, and it has worked for countless patients who have found themselves dealing with a health crisis.
The following sections explain how the top chronic diseases develop, so you can better understand your condition when you begin your personal rebuild. It’s important to also understand that all diseases have common roots in an unhealthy internal terrain. For example, having too much body fat not only is linked to all chronic diseases but is one of the primary drivers of the development of disease. Another common link to all chronic disease is inflammation. As such, I’d advise that you read about each condition even if you don’t think it pertains to you, as the root cause is likely relevant to your overall health.
Z NOTE: What is inflammation? Under normal circumstances, the inflammatory response, created by the immune system, is needed to fight foreign invaders and heal injuries. We can feel and see inflammation when there is pain, redness, and heat—a sore throat, a cut, a sprained ankle, even a sunburn. Inflammation is a sign that the immune system is actively fighting infection and/or mending cells and tissues. This type of immune response should be short-lived. However, the body runs into trouble when the immune system runs out of control, creating chronic inflammation. Unmanaged, this type of inflammation can result in cancer, atherosclerosis and coronary artery disease, autoimmune disease, and obesity. The extent of chronic inflammation is influenced by diet, physical inactivity, exposure to toxins, too much stress, and genetics.
Z NOTE: A new study estimates that more than 400,000 Americans are dying each year due to hospital errors. Yes, you read that correctly: 400,000 deaths from mishaps and improper care provided in hospitals. Data published in in the Journal of Patient Safety put medical errors as the third leading cause of death in the United States. Errors that cost thousands of lives included improper diagnosis and inappropriate treatment; a procedure done incorrectly; poor communication among doctors; and improper advice and treatment recommendations. John James, PhD, the author of the article, proposed a great strategy to help reduce the incidence of serious harm and death: a national bill of rights for hospitalized patients that would allow them to be more integrated into their personal care so they could take the lead in reducing their risk of serious harm or death. Politics, bureaucracy, and red tape would undoubtedly make this challenging, but it is a suggestion worthy of pursuit. In the wise words of Sophocles, “All men make mistakes, but a good man yields when he knows his course is wrong, and repairs the evil. The only crime is pride.”
Cardiovascular Disease
Heart disease remains the leading cause of morbidity (state of poor health) and mortality (death) in the United States with more than 90 million Americans living with some form of cardiovascular disease. Roughly 800,000 people die of heart disease each year; 2,200 people die each day, an average of 1 death every 40 seconds. Almost 800,000 people in the U.S. have heart attacks each year, with coronary artery disease claiming more than 380,000 lives. An estimated 50 percent of males and 30 percent of females over the age of forty will develop coronary artery disease. Although cardiovascular disease is an umbrella term encompassing different disorders of the heart and the peripheral blood vessels, coronary artery disease is the most common condition.
Modern medicine has created multiple ways of treating coronary artery disease, including coronary stents, bypass surgery, and drugs to lower cholesterol (statins). Cholesterol has become synonymous with heart disease; for decades we have been told that cholesterol is the single reason for its development. Promotional campaigns by pharmaceutical companies are designed to convince us that the only way to reduce the chance of developing heart disease is to lower cholesterol with the use of statins. Let’s take an in-depth look at what cholesterol really is and why it is essential to health.
THE STICK-AND-CLOG THEORY
Cholesterol—a natural fat found in the body—has long been blamed for hardening arteries and the development of coronary artery disease. The pharmaceutical establishment and mainstream media—through pictures and pamphlets—show depictions of cholesterol sticking to and clogging arteries, like melted butter solidifying and sticking to the pipes of your kitchen sink.
Unfortunately, the theory of cholesterol sticking to the arteries has been proven false. According to Circulation, the journal of the American Heart Association (AHA), and the New England Journal of Medicine, atherosclerosis (clogging of the arteries) is an ongoing inflammatory condition, not the accumulation of fat on the artery wall. If cholesterol does not stick to your arteries, then what does it do?
Cholesterol is one of a family of compounds called lipids (fats). It is an essential component of the myelin sheath, the fatty covering that insulates nerve fibers (axons). It is essential for the synthesis of vitamin D and steroid hormones (testosterone, progesterone, pregnenolone, androsterone, estrone, estradiol, corticosterone, and aldosterone), as well as the production of bile for digestion; in fact, every cell in the body needs it to function normally. Cholesterol is produced from fragments of fats, proteins, and carbohydrates by several organs—the liver, gut, adrenal cortex (the glands above your kidneys), ovaries, and testes. Cholesterol from food can also be absorbed by the body, but only to a small extent. Cholesterol prevents pro-inflammatory fats from causing damage to cells. In addition, it acts as an antioxidant that neutralizes free radicals—key ingredients in the formation of atherosclerosis.
We know fat and water don’t mix. Blood is a watery system; therefore, cholesterol needs a way to travel through the blood via some transport vehicle. Lipoproteins shuttle cholesterol through the blood. You are probably familiar with the terms LDL and HDL. LDL (low-density lipoprotein) is a protein that brings cholesterol into tissues and arteries. HDL (high-density lipoprotein) shuttles cholesterol away from the heart and arteries to be recycled by the liver. Both HDL and LDL have beneficial jobs in the body. Is there such a thing as “good” or “bad” cholesterol? No. Cholesterol is just cholesterol. LDL and HDL are just the lipoproteins that transport it.
FACT: Fifty percent of those who suffer a heart attack or stroke have normal cholesterol levels. That’s right: according to the New England Journal of Medicine, 50 percent of those who suffer a heart attack or stroke have LDL cholesterol levels below the current recommendations for treatment. Despite all the brainwashing to consume cholesterol-lowering drugs, the real question is this: Why would something naturally found in the body turn against us? We need to stop targeting cholesterol and focus on inflammation.
MECHANISM OF CORONARY ARTERY DISEASE
Coronary artery disease was once thought of as a “stick-and-clog disease.” The AHA now recognizes that coronary artery disease is an inflammatory response created by a hostile environment in the wall of the artery. This process is called atherosclerosis. It is characterized by a thickening and hardening of the vessel wall in large and medium-size arteries.
Coronary artery disease develops in stages:
(In chapter 8, Testing the Disease Terrain, you will read about a revolutionary panel of biomarkers found in blood work that provides information regarding the inflammation in your arteries. This critical test panel goes far beyond the old standard tests of liver function: cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. This is not to say you shouldn’t have your cholesterol checked as a general screening, but the test does not determine the health of your heart.)
Z NOTE: Cholesterol-lowering drugs (statins) go beyond lowering your cholesterol levels. Statins block inflammation. They function by modifying the orchestrator of inflammation—a genetic switch known as NF-kB. This switch turns on the process of inflammation and its production of pro-inflammatory compounds called cytokines, chemical messengers that communicate with and control the function of other cells. NF-kB and cytokines are involved in all chronic diseases.
What can you do to avoid coronary artery disease? The endothelium (lining of the artery) can be damaged by nutrient-depleted processed foods, smoking, high blood pressure, too much belly fat, thyroid weakness, stress hormones, chronic inflammation, infection, and high blood sugar (hyperglycemia). It’s important to make a connection between heart disease and high blood sugar and diabetes. Atherosclerosis is a complex dysfunction with multiple causes, including high blood sugar and too much insulin. Unmanaged blood sugar can cause tissue damage by several mechanisms; one is the addition of a sugar to a protein in a process called glycation. These sugarized proteins are called advanced glycation end products (AGEs). Research published in Diabetes Care has demonstrated the detrimental effects of these AGEs on blood vessels. AGEs impair the endothelium, and the glycated proteins cause the passage of white blood cells into the wall of the artery. Both are crucial steps in the development of coronary artery disease.
Z NOTE: As previously stated, atherosclerosis is an inflammatory disease caused by multiple factors, including bacterial toxicity. In the section titled The Leaky Gut Connection, you will learn of a destructive and dangerous compound that is released when specific bacteria in the gut die. Lipopolysaccharides (LPS) are toxins released from the broken-down cell wall of dead bacteria; they interact with the lining of the intestine to create increased gut permeability (leaky gut) and systemic inflammation. According to Cellular Microbiology and Human Physiology, LPS plays critical roles in the development of atherosclerosis. For one, LPS may initially cause the induction of atherosclerosis by damaging the endothelium. LPS—through inflammatory cytokines—was shown to increase the accumulation of fats in the artery and increase the migration of white blood cells into the arterial wall, thus furthering the progression of inflammation and disease.
DAVE’S STORY
Roughly three years before my “heart event,” I had embarked on a new health plan, eliminating all harmful foods—including fried calamari, my favorite junk food—and began an exercise regimen of exercising six days a week, doing weight training, biking, and functional training using the TRX straps. I felt good. However, during one of my workouts, I felt an odd pressure in my chest, which got my attention. I called my general practitioner, who told me to go to the ER. I listened, but then ran some errands and headed home. I was thinking, “I’m healthy, nothing to worry about.” Sound familiar? But on the way home the feeling came back, stronger. I took my doctor’s advice and headed to the ER. Without delay, diagnostic testing was done to assess what was happening.
It took me by surprise to hear that I needed stents. There was no time for a second opinion; I was told “time is muscle”; stents were my only option. After the procedure, my doctors told me my healthful diet and exercise had allowed me to sail through without pain or complications.
Ironically, at my most recent physical six months earlier, my blood work had shown great numbers, and I received a glowing report from my doctor. That was good to hear, but it’s why my need for three stents came as such a surprise. Although I was on the right path, three years of “good” had not been able to overcome sixty-three years of “less-than-good”—eating too much junk food (that fried calamari) and not working out regularly.
Following the procedure, I went to cardio recovery, but the pace was so slow that I felt I was losing conditioning. I wanted to get back to my regular workouts as soon as I could. Many patients there were repeat offenders of the same procedure, and it was not a very stimulating environment.
The focus of my medical treatment was to stay on a number of meds for months and on statin drugs for the rest of my life. I had to fight the doctors to reduce my dosages and to take me off each drug as soon as it was safe (in their minds). I also told them I had no intention of staying on strong statins for the rest of my life. I was sure my diet/exercise/healthy-emotional-life plan would eventually eliminate the need for the statin.
I believe that proper diet and exercise, including a positive attitude, were the keys to accelerating my recovery. I continue to eat well and exercise, despite my doctors’ thinking that people don’t stick to plans like that; they think I should just stay on the medications they prescribed. I also realized that the tests done during standard physicals are indirect measures of health at best. Despite my glowing reports, the tests did not reveal the state of my cardiovascular system. Therefore, my answer was to stay in charge of my own recovery and health. Years after my stent procedures, I continue to stay on my diet/exercise/emotional-life plan. I’m not taking any meds, and I feel great. At seventy-three years old, I’m enjoying new adventures; I just achieved a personal best with a deadlift of 330 pounds. My advice to you is to find new challenges and strive for your personal best. Check back with me in thirty years.
DR. Z SAYS . . . Dave made an abrupt lifestyle change to overcome sixty-three years of not taking care of himself. Fortunately, he got in the game and saved himself from further internal damage. As with all inflammatory conditions, once they start, they can gain momentum, requiring you to slam on the brakes—with nutrient-dense foods, short bursts of exercise, and, often, targeted supplements—in order to stop the disease process and rewind back to a healthy state.
Right before he heard “time is muscle”—meaning that the longer the heart goes without adequate blood flow (ischemia), the more damage (necrosis) to the heart muscle is created—Dave had gotten a “glowing report” from his doctor. What was done to determine that Dave was in excellent health—the standard fifteen-minute physical exam, unspecific blood work, blood pressure taken in one arm, jumping on a scale, and having someone listen to his heart? Unfortunately, for the majority of people, health evaluations are both antiquated and inadequate. For more on this, see chapter 8, Testing the Disease Terrain, where I outline specific tests you should have done to give you a more detailed picture of the health of your internal terrain.
STROKE
A stroke is essentially a heart attack in the brain. Similar to the mechanism of coronary artery disease, a stroke is caused by a sudden arterial blockage and subsequent reduction of blood flow to some part of the brain. When that flow is interrupted, brain cells no longer receive nutrients and oxygen, and they die. When you are rebuilding from a stroke, you will likely need various forms of physical therapy. However, proper nutrition is still the key to recovery. Throughout this book, I will circle back to nutrition and the importance of whole foods, because—as I said earlier, but it bears repeating—research shows that a poor diet is the number one cause of all chronic disease.
According to the Journal of Nutrition and Metabolism, malnutrition and nutrient deficiency are not only serious risk factors for having a stroke; poor nutrition appears to exacerbate brain damage after a stroke and lessen likelihood of successful recovery. Longer hospital stays were also attributed to malnutrition—we know how toxic hospital food is— and malnutrition also worsened impairments due to the actual stroke itself, including an inability to use a limb, depression, or difficulty swallowing. The research found a deficiency of protein and nutrients— including folate; vitamins B6, B12, and D; zinc; and antioxidant vitamins A, C, and E—were all associated with increased risk of recurrence and poor recovery after a stroke. If you are rebuilding, physical rehab is very important to help prevent atrophy (shrinkage) of your affected limbs. Adopting the supportocols I’ve outlined in Rebuild will give you the best chance for recovery, as well as help prevent permanent impairment.
Z NOTE: Autoimmune diseases are linked to heart disease. For example, rheumatoid arthritis greatly increases your risk for developing atherosclerosis and coronary artery disease. Autoimmune diseases are a group of inflammatory disorders characterized by aggressive immune reactions to different tissues and organs of the body. Systemic autoimmune disorders include rheumatoid arthritis (RA), multiple sclerosis (MS), systemic lupus erythematosus (SLE), and primary Sjögren’s syndrome (pSS). The link between atherosclerosis and autoimmune disease is inflammation, driven by specific white blood cells. These same cells drive the process of inflammation in the walls of the arteries.
To summarize, in heart disease, inflammation is the culprit, not cholesterol. The factors that trigger and then drive inflammation include a diet of nutrient-absent and processed foods, smoking, hypertension, high blood sugar, abdominal obesity, psychosocial factors, a lack of consumption of fruits and vegetables, excessive alcohol, physical inactivity, and bacterial toxicity. These are all modifiable factors that are under your control. Later in this book I will explain how.
Cancer
Cancer is a disease of uncontrolled cellular growth, a result of alterations not only to the genetic information within the cells but also to the signals those cells receive from the body. Normally, all cells have stages of development, internal cell mechanisms for regulating cell growth, and eventually a programmed death. This is the natural life cycle for a cell. With natural growth and proliferation, a cell needs checkpoints to make sure its operations work properly. When those checkpoints lose their ability to regulate normal growth, cancer develops.
The checkpoints are specific genes called oncogenes—genes that can transform a cell into a cancer cell—and tumor-suppressor genes—genes that control cell growth and division. They are like the yin and yang of gene regulation. When genes are damaged or mutate, they lose control over cell division, creating uncontrolled cell growth. Unfortunately, due to their compromised checkpoints, mutated cells have no limit on cell division. Unmanaged cell growth eventually leads to the development of a tumor. However, there are genes that can repair the damage causing uncontrolled cell growth. One example is a gene called p53.
The p53 gene is a guardian of your genes. It has two unique functions: it can help repair corrupted DNA, and it can act as a tumor suppressor to slow or stop tumor growth. When DNA gets impaired, p53 puts the brakes on cell function long enough for the cell to repair itself. If the defect can’t be repaired, p53 causes the cell to commit suicide—a process known as apoptosis. This natural termination of defective cells is a protective program to prevent the cells from passing on faulty DNA. However, p53 itself can become broken and cease to function normally. This can lead to abnormal cell growth, thus causing the formation of cancer.
Once genes are damaged and can no longer stop cell growth and/or cause the faulty cell to commit suicide, cells with DNA mutations rapidly proliferate until they become a tumor. Once a tumor reaches the size of one millimeter, it needs its own blood supply to provide nutrients for its survival. This tiny tumor spits compounds into the blood that cause neighboring blood vessels to sprout new blood vessels in a process called angiogenesis; these eventually reach the tumor and supply it with nutrients. With this nourishment, the cancer cells continue to rapidly divide, increasing the size of the tumor until it becomes detectable.
With continued growth, cells from the tumor can become invasive and leave their initial growth site to migrate to other parts of the body. This is called metastasis, the process by which cancer cells from a primary site spread to a new location, where they develop into a secondary tumor. Metastasis is a poorly understood process, and for many patients, metastases remain undetected until long after the initial cancer diagnosis. In my research on the process of metastasis, I learned that we have more control over it than we think. According to a study published in Nature Reviews, metastasis is an inefficient process. After cancer cells are shed off the primary tumor, they have to survive an attack from the immune system and also circumvent mechanical factors, such as the size of the blood vessels they must travel through. If cancer cells make it to a distant organ, they also have to survive the internal environment of that organ.
To put this into perspective, a study in the New England Journal of Medicine states that only a tiny minority (0.01 percent or fewer) of cancer cells entering circulation actually develop into metastases. Simply stated, if ten thousand cancer cells are shed from the primary tumor, only one will survive. A rogue cancer cell, or a group of clones that break off a tumor, rarely survives in the body unless something favors its survival. What is it about the internal environment of the body that would favor the survival of this cell, thus allowing it to grow into a secondary, health-threatening tumor? Similarly, what is it about the internal terrain of the body that prevents the vast majority of cancer cells to set up a home in some other organ?
The immune system presents another obstacle. The immune system is a complex and intricate arrangement of white blood cells that all have some role in defending against a possible threat. As the body’s watchdog, it has evolved to scout, search, and destroy bacteria and viruses, as well as unwanted cells, including cancer cells.
T lymphocytes—a type of white blood cell—play a pivotal role in killing cancer. One specific type of T lymphocyte is called a natural killer (NK) cell. Its job is to find and kill cancer cells and cells infected by viruses. When the immune system is fully charged, NK cells find and attach to cancer cells, then kill them in two ways. In the first, they inject chemicals into the cancer cell, which causes an influx of free radicals, called an “oxidative burst,” that damages the machinery in the cell and causes its death. The second way NK cells destroy cancer involves the death receptor pathway. (Sounds cool, doesn’t it?) Here, the NK cell comes into contact with a cancer cell and activates a ligand (an ion or molecule that acts as a flag) on the surface of the cell, which then sends a signal into the cancer cell instructing it to activate its self-destruct program. As a result, the cancer cell dies.
But we run into a problem when our immune system ceases to target and kill cancer cells. When we compromise the immune system via stress, eating processed foods, overexercising, and overloading our bodies with toxins, cancer gains a survival advantage and puts us in danger.
To summarize, cancer develops as a result of a series of cellular changes caused by errors or dysfunction in the genes that control specific cellular processes. Researchers recognize that the biology of a tumor is made up of not one cell type, but a collection of different mutated cells. This is why there will never be a single magic bullet to cure cancer. It will require different therapies based on the individual and the makeup of his or her genetically unique cancer.
CAUSES OF CANCER
According to work published in Pharmaceutical Research, only 5 to 10 percent of all cancer cases can be traced to genetic defects, while the overwhelming majority are born of unhealthful lifestyles. You may have heard that certain lifestyle habits can contribute to the development of cancer, but not really know what that means. Listed within each one of the following habits or behaviors are more detailed reasons for its connection to the development of cancer.
Nutrient-Deficient Processed Foods
Nutrient deficiency causes DNA damage and poor cellular repair, poor detoxification of hormones and environmental toxins, high blood sugar and insulin, and chronic inflammation.
Physical Inactivity
Lack of exercise can increase estrogen levels and inflammatory hormone-producing fat, weaken the immune system, and cause high blood sugar and insulin levels.
Unhealthy Body Composition (Being Overfat)
Fat produces cancer-promoting compounds called adipocytokines. Fat can also increase estrogen levels and cause inflammation that can trigger cancer and drive the cancer process.
Chronic Stress
Reactions to stress cause surges of hormones, including cortisol, adrenaline, and norepinephrine. These hormones suppress the immune system, cause inflammation, and ignite and fuel all stages of tumor development.
Smoking, Toxins, and Other Environmental Pollutants
Chemicals from smoking, processed foods, and the environment can act like hormones, damage DNA, and cause vitamin deficiencies.
Poor Sleep
Lack of sleep disrupts many cellular, metabolic, and physiological functions, ultimately increasing inflammation; preventing DNA repair; increasing hormone abnormalities, including cortisol; and causing immune suppression.
Most cancers (90 to 95 percent) are due to both eating processed foods and not eating enough nutrients—in other words, a poor diet. However, current media hype says cancer is just bad luck. According to that theory, for some unknown reason, all your specialized cancer-fighting processes simply break down. If this is the case, why are so many businesses raising money to stave off “bad luck”? People are led to believe that they have no control over their health. That, in turn, allows them to continue their unhealthful lifestyles.
You do have control over your health. If you disrespect your genes, they will turn on you and cause disease. Respect them, and your health will be amazing. Rebuilding from cancer and preventing a future crisis requires that you eat nutrient-dense foods; exercise with short moments of intensity; put your stressors in check; eliminate environmental and food-based toxins; and get enough sleep.
Z NOTE: Nutrient deficiency causes cancer. The damage a nutrient-deprived diet inflicts on a cell’s DNA mimics the effects of radiation. Dr. Bruce Ames, professor emeritus of biochemistry and molecular biology at the University of California, Berkeley, found that deficiencies of the micronutrients folate, vitamin B6, vitamin B12, niacin, vitamin C, vitamin E, iron, and zinc cause DNA damage that will contribute to the formation of cancer. Deficiencies of folate, vitamin B6, and vitamin B12 in particular were found to cause breaks in certain parts of chromosomes in the same manner as radiation would.
Countless studies have shown that vitamins, minerals, antioxidants, and other bioactive compounds from fruits and vegetables reduce the incidence of all cancers, and those who don’t eat enough nutrient-dense fruits and vegetables have a much higher cancer rate. In chapter 3, you will learn about the importance of food and the nutrients within certain food groups that will further enhance your ability to rebuild yourself.
Eating right has an additional crucial benefit: it dissolves the link between cancer and body fat, blood sugar, and inflammation. There are two types of body fat, also known as adipose tissue: subcutaneous fat, which forms the layer just beneath the skin; and visceral fat, the dangerous fat deep inside the body that surrounds the organs. Visceral fat and the hormones it produces are like a petri dish for the development and progression of cancer. Visceral fat is involved in numerous mechanisms that promote tumor development. Both fat and tumors are low in oxygen, a state called hypoxia. When both fat cells and cancer cells lack oxygen, they release a protein called hypoxia-inducible factor 1 (HIF1). HIF1 from fat cells is known to cause dysfunction in the immune system, and contributes to all stages of cancer development, including cell growth, proliferation, and metastasis. When released by a tumor, HIF1 causes surrounding blood vessels to sprout new blood vessels to provide nutrients to the developing tumor. Visceral fat will also release a protein called fibroblast growth factor 2 in the body, which can cause a non-cancerous cell to turn into a cancerous one.
There is a connection between cancer and high blood sugar as well. A high-sugar, low-nutrient diet causes high blood sugar levels, which eventually trigger the release of high amounts of insulin to deal with the excess sugar. Insulin acts on a cell much like a key in a lock, causing a gate in the cell to open and allow blood sugar in. In a normal state, when your blood sugar elevates, insulin helps get the sugar into your liver and muscles, where it is stored as an energy source called glycogen; the excess is stored as fat.
However, when your diet contains too much sugar for your body to handle, your cells eventually reject insulin, a condition known as insulin resistance. This causes excess sugar to remain in the blood, leading to an increase in both subcutaneous and visceral fat. The visceral fat eventually becomes a hormone-producing organ that causes more insulin resistance, inflammation, and the production of the hormone estrogen. Here is where the danger lies. Research published in the journals Integrative Cancer Therapies and Diabetology & Metabolic Syndrome shows the role of the hormones insulin and insulin-like growth factor 1 (IGF1) in enhancing cancer growth and tumor development. Insulin and IGF1 were shown to increase cancer proliferation and prevent cancer cells from activating their programmed cell death.
Fat is also a metabolically active organ, producing many proteins and inflammatory compounds called adipocytokines. These include interleukin 6 (IL-6), tumor necrosis factor (TNF), and leptin—all chemical messengers created by fat cells. IL-6 is an inflammatory agent that has many effects, including regulating different malignant cancers (prostate, lung, and breast). IL-6 is known to increase cancer cell proliferation, survival, and invasion into other tissues. IL-6 was also shown to suppress the components of the immune system needed to fight cancer and tumor activity. Thus, being overfat causes a metabolic mishap that leads to insulin resistance, inflammation, and the development of cancer.
REBUILD DURING CANCER CARE
Can you rebuild yourself while you are undergoing chemotherapy? Yes. To do so, you need to know exactly which chemotherapy drugs you are getting, what side effects to expect, why those side effects occur, and what you can do to combat them.
The term chemotherapy means to fight disease with chemicals. Pharmaceutical agents destroy the cancer both by direct damage and by interrupting the cancer cells’ ability to replicate. Chemo also destroys healthy cells, especially cells that reproduce quickly, including those found in the gut, hair follicles, sperm, eggs, and the lining of the mouth. Chemo drugs cause injury to all cells, tissues, and organs, resulting in a variety of unpleasant side effects that can range from mild to devastating. As you go through conventional cancer care, knowing what to expect in terms of side effects will allow you more control when combating those side effects. If you are rebuilding yourself during your cancer care, here is a list of potential side effects, which may be temporary or permanent:
This list creates fear and concern, for sure. Who wants to hear about the possibility of developing permanent nerve pain, heart damage, or a secondary cancer? Fortunately, the supportocols in Rebuild will mitigate the side effects of the chemo and lessen your suffering. The tools in this book will also keep you strong so you can continue your day-to-day activities. Chemotherapy causes malnutrition and nutrient deficiencies, particularly of vitamin C, folate, and vitamin B6. Eliminating unhealthful processed foods, bread, dairy, and sugar and eating plenty of nutrient-dense foods will help you avoid these deficiencies and boost the effectiveness of chemotherapy. Radiation (radiotherapy) as a cancer treatment also has its list of complications, including malnutrition, nutrient malabsorption, and deficiencies. Patients receiving radiation therapy to the head, neck, and abdomen frequently experience symptoms ranging from painful mouth sores and swallowing, to nausea, vomiting, abdominal pain, and diarrhea, all of which can lead to an inability to ingest and digest food.
However, the uninformed oncology community has warned patients going through cancer care to refrain from taking nutraceuticals (supplements), as they might interfere with the toxic effects of chemotherapy drugs. Research conducted by Dr. Charles Simone and published in the journal Alternative Therapies found this not to be the case. Dr. Simone and his researchers collected data from 280 peer-reviewed studies that included 5,081 patients who took supplements while undergoing chemotherapy. Their findings revealed that nonprescription antioxidants and other supplemental nutrients did not interfere with the cytotoxic effects of chemo. They actually found the opposite to be true: vitamins A, C, D, E, and K; beta-carotene; selenium; cysteine; and B vitamins enhanced the cancer-killing effects of chemo while protecting normal tissue. Patients taking these nutrients had fewer side effects and, most important, increased survival rates compared with those who took no nutrient supplements.
I can attest to the truth of this research based on my own personal experience with chemo, as well as the experiences my patients have had while rebuilding during their cancer care. With proper nutrition and targeted supplements, you can significantly mitigate the debilitating impact of chemotherapy and prepare your body to rebuild after treatment. Once your cancer care is completed, you will also experience a speedier recovery, as well as improved health and fitness.
REBUILD FROM BREAST CANCER
The global impact of breast cancer is enormous, and growing. Since human genes have remained constant for eons, the only plausible reason for this epidemic is dysfunction of the internal terrain. According to the CDC and the American Cancer Society, breast cancer is the second leading cause of cancer deaths among women, after lung cancer. In 2017, an estimated 252,710 new cases of invasive breast cancer were diagnosed among women, and 2,470 cases were diagnosed in men. In addition, 63,410 cases of in-situ breast cancer were diagnosed in women. Most serious, approximately 40,610 women and 460 men were expected to die from the disease.
Contrary to the common assumption that breast cancer is genetic, a study published in the Journal of Epidemiology Community Health states, “Genetic inheritance is an infrequent, but not the main, cause of breast cancer.” The consensus is that breast cancer susceptibility, or genetic cancer predisposition, is associated with only 4 to 8 percent of breast cancer cases. These estimates are uniform across the spectrum of medical studies. Research published in the New England Journal of Medicine found that only 7 percent of women from families with a history of breast cancer had BRCA1 mutations. BRCA1 and BRCA2 are the well-known genes associated with the development of breast cancer. They are tumor-suppressor genes that produce proteins to help repair damaged DNA. If these genes mutate or become damaged, they fail to produce the right proteins, and the damaged DNA may not be repaired. This can lead to more mutations and, eventually, the development of breast cancer. According to research published in the journal Carcinogenesis, mutations of the BRCA1 and BRCA2 genes account for only 5 percent of breast cancer cases in the United States annually.
Here is a key question: If genes cause breast cancer, why is it so rare for adolescent girls to develop breast cancer? Why does it show up in women in their thirties, forties, and fifties? Basically, genes like BRCA1/BRCA2 or the p53 gene don’t just fail. The body’s internal environment causes those genes to stop functioning as they were intended. Remember, our cells have checks and balances to regulate cell growth, create differentiation, and even trigger the death of malfunctioning cells. Breast cancer, along with other tissue cancers, stems from a malfunction in these control mechanisms that leads to uncontrolled cellular growth and tumor formation.
The regulation of estrogen, insulin, and insulin-like growth factors—hormones that can play a role in the development of breast cancer—are all controlled by diet, exercise, and stress levels. Eating nutrient-deficient, high-calorie foods and dairy; carrying too much body fat; smoking; drinking excessive alcohol; vitamin D deficiency; and environmental exposure to pollutants like bisphenol A (BPA) from plastics increase the risk for breast cancer, as does a high intake of unhealthful fats during hormone replacement therapy (HRT). HRT has been clinically proven to induce cell proliferation. According to research published in Perspectives in Cancer Research, “Chronic administration of estrogen [a primary component of HRT] results in tumor formation.” Yet despite the research, HRT is still prescribed.
You may have heard that breast cancer is driven by estrogen. How does that happen? Estrogen is a hormone essential for normal sexual development, and it helps control a woman’s menstrual cycle—a process that prepares the body for reproduction. Estrogen is also important for a woman’s heart and bones, as well as the development of the breasts and reproductive organs. Many of the cells in the body, both healthy and potentially cancerous, have estrogen receptors on them. These receptors stimulate cell growth when they come in contact with estrogen. Raising your lifetime levels of estrogen, as well as the length of time your cells are exposed to estrogen, increases your risk of developing breast cancer.
Your body composition plays a role here: too much body fat can raise your estrogen levels. Fat tissue creates an enzyme called aromatase, which can transform other hormones into estrogen. Believe it or not, cancer cells can also produce aromatase, thereby increasing estrogen levels. It would seem that cancer may have been initiated and then driven by the high levels of estrogen from both the fat and the cancer itself. In chapter 3, you will read about foods that can shut down the production of aromatase, reducing your estrogen levels and thus your chance of developing breast cancer.
High blood sugar levels have a connection with breast cancer, too. Insulin and the hormone IGF1 are the other major hormones implicated in breast cancer. Similar to estrogen, insulin and IGF1 have strong anabolic (growth) effects, resulting in increased cell growth and proliferation. A study published in the Journal of Clinical Oncology sheds light on the link among type 2 diabetes, insulin, and breast cancer. The authors of the study discovered that breast cancer cells have an abundance of insulin and IGF1 receptors, which, once turned on by insulin and IGF1, cause the rapid growth of breast cancer. Type 2 diabetes and high insulin levels are the direct result of an unhealthful diet.
One more important factor in breast cancer is vitamin D. This is produced in the body when UV radiation from the sun comes in contact with the skin. The sun’s energy turns a form of cholesterol in the skin into a pre–vitamin D, which is then processed in the liver and sent to the kidneys, where it becomes the active hormone 1,25-dihydroxyvitamin D3 (calcitriol). (See section on vitamin D in chapter 3 for more information.) Every single tissue in the body has receptors for vitamin D, as vitamin D is required for more than just healthy bones. It regulates genes that control cell growth and development in various tissues of the body, including breast tissue.
Calcitriol (the active form of vitamin D) was found to turn off cell proliferation and tumor growth. Studies published in the Indian Journal of Pharmacology found that vitamin D and the vitamin D receptor shut down tumor growth in the breast and interfered with the anabolic effects of insulin and IGF1 on breast cancer cells. Sound too good to be true? Another study, published in Annals of Epidemiology, found that raising blood levels of vitamin D from 30 ng/ml to a therapeutic level of 40 to 60 ng/ml would prevent 58,000 new cases of breast cancer (and 49,000 new cases of colorectal cancer) each year.
Diabetes
Diabetes mellitus is a condition of high blood sugar resulting from either inadequate insulin production (type 1 diabetes) or lack of cellular response to insulin (type 2 diabetes). Some of the symptoms of diabetes include increased thirst and hunger, frequent urination, impotence in men, and numbness or tingling in the hands and feet (peripheral neuropathy).
Type 1 diabetes (also known as juvenile diabetes and insulin-dependent diabetes) is caused by an autoimmune reaction; the immune system destroys the beta cells of the pancreas, resulting in extremely low insulin levels. Type 1 diabetes has always been regarded as having an unknown cause. Its development has been blamed on viruses, German measles, mumps, and, of course, genes. While viruses and bacteria can spark the immune process, the foods we are introduced to early in life may also cause autoimmune diseases. The journals Diabetes and PLOS ONE found that the protein casein in cow’s milk and the protein gliadin—a component of gluten in grains—caused an immune response that destroyed the cells of the pancreas, causing them to fail to produce insulin and triggering type 1 diabetes.
Type 2 diabetes (also known as adult-onset diabetes) is characterized by high blood sugar as a result of cells failing to respond to the hormone insulin. Normally, when your blood sugar goes up, the pancreas produces insulin, which triggers cells to take in the sugar. When cells don’t respond to insulin, blood sugar elevates, causing the pancreas to release more insulin and contributing to the development of hyperinsulinemia (high levels of insulin in the blood). Type 2 diabetes is now a global epidemic. Statistics from the International Diabetes Federation (IDF) show that 387 million people have diabetes; those numbers are projected to rise to 592 million by 2035. Currently, diabetes costs this country $310 billion in annual health care expenditures. According to the IDF, cardiovascular disease is the major cause of death in diabetics, accounting for 50 percent of all diabetes-related fatalities.
Both types of diabetes have an inflammatory component in their cause. Type 1 is the direct result of an immune reaction destroying the insulin-producing cells of the pancreas. Type 2 is caused by cells rejecting the function of insulin due to an unhealthful diet and too much body fat. As stated previously, body fat releases inflammatory compounds called adipocytokines, which are known to contribute to insulin resistance. Uncontrolled high blood sugar can also cause inflammation from the creation of sugar-derived compounds called advanced glycation end products (AGEs). These crystallized proteins increase free radicals and turn on NF-kB—the orchestrator of inflammation. This causes the production of numerous inflammatory cytokines, which rapidly accelerate the disease process occurring in atherosclerosis, cancer, and diabetes.
This brings us back to the point that chronic diseases are not separate entities, but are connected through a dysfunctional internal terrain. The link between diabetes or high insulin and cancer was shown in a study published in Integrative Cancer Therapies. The study found that insulin enhances cancer cell growth by allowing a steady flow of nutrients, including glucose and amino acids, to cancer cells. Insulin was also found to increase unwanted hormones and to activate receptors on the surface of cells responsible for accelerated cell growth and proliferation.
Type 2 diabetics with increased belly fat and other markers of insulin resistance have a higher incidence of colon cancer. Likewise, insulin has in recent years been implicated in the onset of colon cancer. A low-fiber diet and consumption of red meat have historically been blamed for the development of colon cancer, but mounting evidence suggests that insulin and IGF1 are the primary drivers. Research published in the Journal of Nutrition and the American Journal of Clinical Nutrition consistently showed high levels of insulin and IGF1 in people with colon cancer. Other studies indicate that a diet high in sugar and simple starches stimulates insulin production and the growth of colon cancer cells.
On the list of physical ailments and diseases that stem from diabetes is sleep apnea, a serious disorder in which you periodically stop breathing while you sleep. Chronic sleep apnea is associated with higher rates of heart disease, high blood pressure, brain fog, and serious fatigue. Poor sleep increases your risk for heart disease, cancer, and immune suppression (more on sleep in chapter 6). Sleep apnea is typically associated with being overfat, which sets you up for low-grade inflammation and insulin resistance. Studies published in the Journal of Applied Physiology and the American Journal of Respiratory and Critical Care Medicine suggest that sleep apnea is independently associated with poor control of blood glucose and insulin levels. If you want to get rid of that bothersome CPAP machine, you need to rebuild your body: get rid of the excess fat, and get your blood sugar and insulin under control.
Z NOTE: If you feel tired after you eat, you may have a problem regulating your blood sugar. This may be due to insulin resistance and/or high or low cortisol levels. See chapter 8, Testing the Disease Terrain, for more information on specific tests to have done when you are rebuilding from insulin resistance and the complications of diabetes.
Supportocols to lowering your blood sugar naturally:
DIABETES AND ALZHEIMER’S DISEASE
It’s important to bring up another chronic disease associated with diabetes—Alzheimer’s disease. This is a deteriorating neurological condition characterized by the formation of beta amyloid plaques, abnormal clusters of protein that build up between nerve cells in the brain. These clusters clump together, causing failed electrical signals, nerve atrophy, and, eventually, nerve death. This reaction turns on the immune system, which triggers the inflammatory response, causing further destruction to the nerve cells and brain. The symptoms of Alzheimer’s include dementia, forgetfulness, confusion, and eventual brain failure and death.
Alzheimer’s is also an inflammatory condition, similar to diabetes, that I call “inflammatory diabetes of the brain.” In fact, Alzheimer’s is now being considered type 3 diabetes. Research published in the Journal of Alzheimer’s Disease links abnormal blood sugar, insulin, and IGF1 as major causes of beta amyloid proteins and plaque production. The amyloid plaques that develop in the brain, as well as chronic insulin resistance, both increase the harmful cytokines IL-6 and TNF, which cause nerve-signaling dysfunction and nerve damage. Data from Frontiers in Aging Neuroscience show that low-grade inflammation is linked to the cognitive dysfunction seen in Alzheimer’s disease.
Growing evidence shows that the development of Alzheimer’s disease is also linked to an unhealthful diet of processed foods. Chronic exposure to nitrosamines (carcinogenic compounds) contributes to the development of insulin resistance, a fatty liver, and Alzheimer’s disease. Nitrosamines are found in processed cured meats and bacon, cheese, and milk products, as well as tobacco smoke, chewing tobacco, and the vapor from e-cigarettes. Data from Mutation Research show that nitrosamines found in processed meat also increase the risk of developing cancer of the stomach, esophagus, and nasopharynx.
Z NOTE: Food for thought—literally. Although diabetes does not cause Alzheimer’s disease, they have the same root: an unhealthful diet full of refined white sugars and processed foods that cause a yo-yo effect with your blood sugar and insulin. The link between a poor diet and Alzheimer’s again voids the notion that chronic disease is all in your genes.
Overfat and Obesity
According to the CDC, 69 percent of the adult population is overfat and 35 percent is obese. Why is this significant? Excessive body fat, especially visceral fat (the fat surrounding your organs), can release hormones, modify your appetite, increase inflammation, and increase your risk of developing diabetes, high blood pressure, heart disease, cancer, sleep apnea, arthritis, reproductive issues, and gallbladder problems, to name a few. Obesity is not only taking a toll on health; it is affecting the economy: the annual cost to deal with obesity-related conditions is roughly $147 billion. Simply stated, being overfat and/or obese is dangerous and expensive.
Being overfat and/or obese is a catch-22. There are specific metabolic steps that create obesity, as well as metabolic changes in the body that create disease caused by the excessive body fat. Being overfat or obese results from a chronic imbalance between energy intake and energy expenditure. Too much energy in and not enough energy out creates fat.
As discussed earlier, there are two types of fat: subcutaneous (under the skin) and visceral (inside the body surrounding the organs). Subcutaneous fat may be a nuisance and make buying nice jeans difficult, but visceral fat increases your risk of developing the most serious diseases. Visceral fat serves as a reserve of energy for the body, but it can also produce hormones and cause chronic inflammation.
JC’S STORY
Here’s a quick backstory on JC: the general manager of a high-end car business, he is a workaholic with erratic eating habits—late-night eater, fast eater, and, under stress, binge eater. (Sound familiar?) Consequently, JC had become obese and suffered from low energy, sleep apnea, knee pain, and difficulty urinating. As he pushed through the day, his energy puttered out from chronic stress and poor nutrition. Let’s not forget his interrupted sleep from the apnea, which required him to hook up to a CPAP machine every night before going to bed.
When JC came to see me, he was fed up and frustrated with the state of his health. He had also watched his father slowly deteriorate and pass away from Parkinson’s disease. Fearing he might follow in his father’s footsteps, JC was highly motivated to rebuild himself back to health. Following a comprehensive workup, including blood work, hormone profiling, and a body composition evaluation, we diagnosed the following: low testosterone, low vitamin D, high blood sugar, high hemoglobin A1c (a long-term blood sugar marker), low cortisol levels throughout the day, and 37 percent body fat.
There were multiple mechanisms at play: Eating nutrient-deficient, high-calorie foods elevated his blood sugar and insulin. With little physical activity and poor eating habits, his body composition shifted to one of excessive fat. His elevated body fat and blood sugar caused decreased signaling from the hypothalamic-pituitary region of the brain to the testes, resulting in low testosterone levels. High blood sugar and insulin levels can cause sleep apnea and enlargement of the prostate, which contributed to his difficulty urinating. Finally, his low cortisol levels (a condition known as adrenal fatigue) were a consequence of his high-stress work environment and also certainly due in part to not eating enough nutrient-dense foods.
Based on his test results, I worked with him to create a personalized food plan of five to six small meals of nutrient-dense foods to be eaten throughout the day, not just late at night or when it was convenient. I stressed that eating during the day allowed his body to use the nutrients and calories from the foods—rather than eating a lot of food late, which would shift his body into storing the unused calories (energy) as fat.
I emphasized also that the more nutrient-dense foods he ate, the more fat he would lose. At first, he couldn’t grasp the concept. More food = less body fat? The principle was counterintuitive to what he’d been told all his life. However, eating more calories creates more body fat. Eating nutrients, not calories, causes the body to get rid of fat.
The food plan was supplemented with specific nutraceuticals to improve adrenal function, in turn increasing energy, regulating blood sugar, and increasing testosterone levels. I had custom orthotics made to support his feet, thus reducing the mechanical issues in his knee that were causing him pain.
Following his plan, JC has lost 120 pounds of body fat to date. His cortisol and testosterone levels are back to normal. Functionally speaking, he has little knee pain, more energy, and no difficulty urinating, and with more time, I expect he will no longer depend on his CPAP machine.
FAT AND CANCER
Studies have shown that excessive body fat and obesity are associated with hormone-dependent cancers (such as breast and prostate cancers), along with cancers of the esophagus, pancreas, colon and rectum, and kidney. A cancer prognosis is also adversely affected by a patient’s excessive body fat. We have already covered the link between body fat and cancer (see here), but let’s dig deeper into the scientific causes: estrogen and inflammation.
It’s disturbing to think that estrogen, a natural hormone found in both women and men, is a cancer-causing agent. As mentioned earlier, fat tissue produces the enzyme aromatase, which converts other hormones into estrogen. Under normal circumstances, estrogen undergoes a process called oxidative metabolism, in which liver enzymes modify and change estrogen into three different forms: 2-hydroxyestrone, 4-hydroxyestrone, and 16-alpha-hydroxyestrone. The form 2-hydroxyestrone has a protective effect against estrogen-induced cancers in specific organs, including the breast and prostate. On the dark side, the form 16-alpha-hydroxyestrone, and to a lesser extent 4-hydroxyestrone, promotes breast and other cancers. Breast tissue also produces higher levels of 16-alpha-hydroxyestrone and lower 2-hydroxyestrone, a combination that increases the risk of developing cancer. (Additionally, when these estrogen forms get damaged by free radicals, they can in turn damage DNA, leading to cell mutations and the formation of cancer.)
So what can you do to reduce the 16 and raise the 2? Cruciferous vegetables, such as kale, broccoli, cauliflower, and Brussels sprouts, contain a compound called indole-3-carbinol (I3C) that steers estrogen into creating 2-hydroxyestrone and simultaneously shuts down the production of 16-alpha-hydroxyestrone. (You will read more about the benefits of cruciferous vegetables and I3C in chapter 3.)
Individuals with excessive body fat have higher estrogen levels, and the tissues of obese/overweight and overfat women are exposed to more estrogen stimulation than the tissues of women who are lean. In men, there is evidence that increased body fat and estrogen act as fuel for prostate cancer. That’s because on the surface of prostate cells, there are receptors called estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta). ERalpha promotes cell proliferation, and ER-beta shuts it down, either directly or by blocking the effects of ERalpha. Although other growth factors are involved, like insulin and IGF1, research is pointing to estrogen as a trigger for prostate cancer.
Studies have also shown that being overfat is associated with cancers of the kidney, gallbladder, esophagus, and colon. Going further than that, a study published in the New England Journal of Medicine reported that increased body fat is associated with increased death rates for all cancers. Studies in the Journal of Clinical Investigation, Frontiers in Bioscience, and Trends in Molecular Medicine reveal the influence interleukin 6 (IL-6) and tumor necrosis factor (TNF), two of the inflammatory adipocytokines produced by body fat, have on the cancer microenvironment. TNF was found to initiate tumor growth and proliferation, and to increase angiogenesis (blood vessel development; see here), tumor invasion into tissues, and tumor metastasis. It was also shown to make cancer cells resistant to chemotherapy and radiation.
If a cancer doesn’t respond to the different chemotherapies thrown at it, chances are good that inflammation is blocking the effects of the treatments. At the same time, chemo is killing healthy cells and tissues, setting the patient up for the miserable side effects associated with toxic cancer drugs (see here). Things get worse: IL-6 helps keep cancer cells alive by deactivating their built-in suicide program, and was also shown to increase cancer cell growth and proliferation, and contribute to insulin resistance, another trigger for the growth of tumors.
Being overfat can also increase your risk of developing cancer by suppressing a component of the immune system needed to kill cancer: natural killer (NK) cells (see here). A study published in Autoimmunity Reviews discovered that the soup of inflammation created in fat tissue lowered the number of NK cells.
FAT AND DIABETES
Adipose tissue is a highly complex and active organ, producing inflammatory chemical messengers and hormones that have many effects in the body; one of those is insulin resistance. Many studies have documented that visceral fat is closely associated with type 2 diabetes. When you eat too many sugars and carbs, the excess energy from these food sources gets stored as fat. Over time, the fat cells swell like oversized water balloons, then release IL-6, TNF, and free fatty acids (fat released from adipose tissue and transported in the bloodstream). Fatty acids are similar to glucose (blood sugar) in that both are used as fuel for the body. When the body contains too much fat, there are too many circulating free fatty acids. These block the actions of insulin, leading to the onset of type 2 diabetes. It’s a vicious metabolic cycle that perpetuates itself.
FAT AND HEART DISEASE
IL-6 from fat travels into the liver, causing the production of another harmful protein called C-reactive protein (CRP). Numerous studies have shown that baseline levels of CRP are highly predictive of future heart attack, stroke, and sudden cardiac death. CRP can also be used as a marker to predict future coronary events in those who have already had a heart attack.
Adding salt to the wound, TNF plays an important role in damaging the lining of the arteries, which is the first step in the development of atherosclerosis and coronary artery disease.
FAT AND AUTOIMMUNE DISEASE
Toxic fat is also associated with autoimmune conditions including Crohn’s disease, rheumatoid arthritis, systemic lupus erythematosus, Hashimoto’s thyroiditis, multiple sclerosis, type 1 diabetes, and psoriatic arthritis. The question is, how? In recent decades, a dramatic increase in cases of autoimmune disease has paralleled the major growth of obesity. Fat can suppress the function of natural killer cells, increasing susceptibility to infection and cancer. Fat tissue will also inhibit the function of a specialized white blood cell called a regulatory T cell, which acts like a mediator in the immune system to prevent excessive immune responses. When regulatory T cells fail to function, the unruly division of the immune system goes after the body’s own cells and tissues, a condition known as autoimmunity.
Among the inflammatory adipocytokines produced by body fat is the hormone leptin. It plays a major role in regulating appetite and energy expenditure. When fat cells get bigger and more toxic, they spit out more leptin, which has the adverse effect of promoting inflammation, while at the same time suppressing regulatory T cells. Research in Autoimmunity Reviews found a link between the foods that cause obesity—the Western diet, including synthetic salts, processed sugars, and unhealthful fats—and abnormalities in gut bacteria, resulting in reduced function of the regulatory T cells.
Now that you see how detrimental excessive body fat is on the body and its link to serious disease, here is a more detailed list of the conditions linked to being overfat:
Do you see why improving your body composition is so important?
Autoimmune Disease
The American Autoimmune Related Diseases Association estimates that up to 50 million Americans suffer from autoimmune disease, and those numbers are rising. Researchers have identified roughly eighty to one hundred different autoimmune diseases, which cause decreased quality of life, high health care costs (estimated at $100 billion annually in the United States), and loss of productivity. Rebuilding from an autoimmune disease requires an understanding of how and why these diseases develop.
The main function of the immune system is to defend against foreign invaders, things like viruses and bacteria. Our defenses are made up of specialized white blood cells and organs that directly assault invaders and produce antibodies to fight off infection. But sometimes the immune system becomes overactive and targets the body’s healthy cells, tissues, and organs rather than infections and viruses—basically, it fails to sense the difference between self and non-self. When this reaction occurs, it is known as autoimmunity. Autoimmune diseases are complex dysfunctions of the immune system involving an imbalance of the Th1, Th2, and Th17 immune cells. Let me explain further.
The immune system is composed of five types of white blood cells; lymphocytes are one type. Lymphocytes can be divided into three groups: B cells, T cells, and natural killer (NK) cells. B cells produce antibodies that neutralize viruses and bacteria. T cells produce chemical messengers called cytokines that help direct the immune response. Within the group of T cells are white blood cells called T helper (Th) cells, which can be further divided into Th1 and Th2 cells. Th1 cells are involved with immunity against viruses and parasites, while Th2 cells direct the immune system to get rid of unwanted bacteria and environmental irritants or allergens. Less than a decade ago, a new set of T helper cells was identified: Th17 cells. Th17 cells play an important role in defending against bacterial and fungal infections at mucosal areas of the body, such as on the skin and in the intestinal tract. NK cells are the white blood cells that kill cancer, as well as cells infected by viruses.
JUNE’S STORY
June was suffering from symptoms associated with the autoimmune disease scleroderma, including significant pain in both knees, Raynaud’s disease in her fingers, major sensitivity to cold temperatures, and joint pain that made it difficult to walk for extended periods of time. She also had chronic heartburn and acid reflux, insomnia, fatigue, and gastrointestinal distress with loose stools and diarrhea that occurred just about every day. Her thyroid had been removed due to cancer, and she had also had a complete hysterectomy. June also complained of slowly progressing weight loss that she and her doctors couldn’t figure out. She was taking numerous medications, including Synthroid (synthetic thyroid hormone), Dexilant (a proton pump inhibitor), Benadryl, and Zantac, and she ate Tums like candy to help soothe her irritated gut.
While the autoimmune disease caused annoying chronic symptoms, the most distressing health issue for her was the irritable bowel and midday diarrhea that had haunted her for years. She was told by a scleroderma specialist that her GI distress was due to her autoimmune disease; she was told to “just live with it.”
After our lengthy consult, June had three major goals to improve her health: she wanted to gain weight, reduce her pain, and figure out why she had daily diarrhea. After reviewing her history, including past blood tests, I suggested more detailed blood work and hormone profiling. Not satisfied that her gut issues were caused by scleroderma, I recommended stool testing to rule out any pathogens that could have been responsible for her midday digestive distress. As we waited for the results of the new tests, June was scheduled for a weekend trip to Chicago with her niece; she was reluctant to go due to her chronic knee pain, and feared her symptoms would put a damper on their trip. Days before the trip, I urged June to eliminate bread, dairy, and processed sugar from her diet. Knowing that grains with gluten are the single greatest cause of autoimmune disease, I encouraged her to fight the urge to eat any crumb of bread or grain or other food containing gluten. She agreed, and to her surprise, she had much less discomfort while she enjoyed the day with her niece.
June’s test results came in with expected findings: low estrogen and progesterone levels, adrenal fatigue, and high inflammatory markers. But after twenty years of suffering, June learned the culprit of her gastrointestinal issues: the parasite Blastocystis hominis, found via stool testing. June immediately began taking a product containing the probiotic Saccharomyces boulardii. Within six weeks, her suffering ended: her gut issue was resolved. With a food plan and supplements, June has put on healthy weight and now has minimal joint pain. She says she feels fantastic.
HOW AUTOIMMUNE DISEASES DEVELOP
Autoimmune diseases develop from an abnormal immune response to cells and tissues of the body, which occurs when there is an imbalance of Th1 and Th2 cells and the cytokines (chemical messengers) they release. Generally speaking, Th1 cytokine production is inflammatory and responsible for the autoimmune reaction in the body, while Th2 cytokine production is more involved in allergic responses and generally considered anti-inflammatory. If Th1 cells are overactive, they can suppress Th2 cells. When Th2 cells are overactive, they can suppress Th1. In people with autoimmune dysfunction, there is usually a dominance of Th1 or Th2 cytokine production.
Th1-dominant conditions include:
Th2-dominant conditions include:
The onset of autoimmune disease can be triggered by foods you have eaten, including foods containing the protein gluten and/or the dairy protein casein; leaky gut syndrome; viral and bacterial infections; major stressful events; pregnancy; changes in hormones; heavy metal toxicity; vitamin D deficiency; insulin resistance; and obesity.
THE LEAKY GUT CONNECTION
Before we look deeper into the specific causes of autoimmune disease, here is a little anatomy and physiology of the gastrointestinal (GI) tract. The GI tract is a thirty-foot-long tube, running from the mouth to the anus, that separates the outside world from the body’s internal environment. It is designed to digest food and absorb nutrients, electrolytes, and water. It is also a barrier that prevents harmful substances, unwanted bacteria, parasites, and toxins from getting into the bloodstream.
In addition to its extreme importance to health and survival, the GI tract even has a mind of its own, as well as a specialized defense system. The gut’s brain—the enteric nervous system—is located in the tissues lining the esophagus, stomach, small intestine, and large intestine (colon). It is a massive network of neurons capable of carrying out complex activities without any influence from the brain and spinal cord. It records and responds to chemical stimuli and mechanical conditions involved in digestion and peristalsis—the wavelike muscle movement that pushes food through the GI tract. The enteric nervous system also produces and regulates neurotransmitters identical to those within the central nervous system, including serotonin, dopamine, nitric oxide, and acetylcholine. The gut’s “brain” can act independently of the brain; it is also responsible for producing your “gut feelings.”
In addition to digestion and absorption of nutrients, another crucial function of the GI tract is to safely traffic unwanted bacteria, toxins, and food particles that may injure the body in some way. The GI tract possesses the largest immune tissue in the body, the gut-associated lymphoid tissue (GALT). The GALT stores B and T lymphocytes (see here), which defend against invaders, including bacteria, viruses, fungi, parasites, and other microorganisms.
To maximize the absorption of nutrients, the surface of the intestines is covered with tiny fingerlike projections called villi, which are lined with epithelial cells, a single layer of specialized cells that separates the GALT from the outside environment. The tissue of the epithelium is composed of sheets of cells joined together at tight junctions; it performs the vital function of blocking unwanted proteins and microorganisms from entering the bloodstream.
The gut microbiota is a complex community of up to one thousand different species of “good” bacteria. Among the many critical roles it plays is working synergistically with the immune system. It also makes vitamins, including vitamins B and K; enhances the muscular activity that moves waste through the intestines; and assists in the digestion of food and absorption of nutrients. These beneficial gut bugs also help eliminate toxins and break down plant-based foods to produce butyrate, an energy source for the GI tract. Butyrate is a short-chain fatty acid that acts as an anti-inflammatory and reinforces the gut’s defense barrier by increasing its antimicrobial proteins. Research published in the Journal of Medical Microbiology shows that butyrate decreases intestinal permeability by increasing the strength of the tight junctions between the epithelial cells, thus preventing unwanted leakage through the wall of the gut into the bloodstream.
Where is all this going? Numerous illnesses can occur when the protective functions of the gut are diminished, either by the overgrowth of gut bacteria or compromised function of the epithelium and its tight cellular junctions.
In reading the scientific literature on the causes of autoimmune disease, I was consistently directed back to a condition called leaky gut syndrome. Leaky gut is a condition in which the tight cellular junctions of the epithelium are weakened and fail to prevent the passage of unwanted substances through the walls of the intestine and into the bloodstream. While I’m sure there are others, there appear to be three major reasons for leaky gut: the consumption of foods containing gluten; an overgrowth of harmful gut bacteria, known as dysbiosis or small intestinal bacterial overgrowth (SIBO); and surges of the stress hormone cortisol. Regardless of the cause, leaky gut has been linked to countless diseases, including celiac disease, a host of neurological diseases, and many autoimmune diseases.
Eye-opening research published in Physiological Reviews found that the protein gluten compromises the epithelium and its tight cellular junctions. Gluten, found in many grains, is a nasty protein that interacts with bacteria in the gut to produce a compound called zonulin. Zonulin is the biological key that opens these tight junctions. Once open, they allow unwanted foreign proteins, bacteria, and toxins to exit the intestines into the body, causing an immune response and systemic inflammation.
Leaky gut has been linked to celiac disease, a well-known autoimmune condition characterized by an aggressive immune response in the gut, which ultimately destroys the villi lining the walls of the intestines. Since the villi are responsible for nutrient absorption in the intestines, the body is unable to properly process nutrients, which can result in malnutrition. Left unresolved, celiac disease can lead to additional complications, including anemia, osteoporosis, infertility, miscarriages, epilepsy, and stunted growth. The treatment for celiac disease is the complete elimination of grains and other foods containing gluten.
But celiac disease isn’t the only condition related to gut dysfunction. Here is a list of diseases proven or suspected to be associated with leaky gut syndrome:
Autoimmune diseases
Cancer
Neurological disease
Z NOTE: Hashimoto’s thyroiditis is a condition of decreased thyroid function due to an autoimmune attack on the thyroid. The inflammation occurring from the immune reaction often leads to an underactive thyroid gland, a condition known as hypothyroidism. Among the many symptoms associated with hypothyroidism are chronic low-grade depression, unintentional weight gain, poor stamina, low energy levels, and fatigue.
According to the American Thyroid Association, an estimated 20 million Americans have some form of thyroid dysfunction, and roughly 60 percent of those are unaware they have it. Having a weak thyroid and low levels of thyroid hormones can cause some of the metabolic issues that contribute to the development of heart disease, cancer, diabetes, and obesity. The links between Hashimoto’s thyroiditis and the other chronic diseases are autoimmune response and inflammation. If you’ve been diagnosed with hypothyroidism, dig deeper to find out if there is an autoimmune dysfunction behind it.
Several other autoimmune diseases are intimately connected to leaky gut and the toxic proteins that often lead to colon cancer. Crohn’s disease and ulcerative colitis, the two most common inflammatory bowel diseases, are chronic conditions characterized by severe inflammation of the GI tract. A study published in the American Journal of Gastroenterology has shed light on how leaky gut causes these diseases. The inflammatory adipocytokine tumor necrosis factor (TNF) is a possible reason. Leaky gut causes inflammation; in turn, inflammation perpetuates leaky gut.
Gluten, zonulin, and overgrowth of toxic bacteria can disrupt the function of the tight junctions, thus causing leaky gut. The microbial population living in the intestines is made up of roughly one thousand different species, including both friendly bugs and potentially harmful or toxic bacteria, coexisting in unity. For multiple reasons—including the use of antibiotics, synthetic hormones, antacids, H2 blockers, and/or proton pump inhibitors; the consumption of alcohol; stress; and a high-calorie, low-nutrient diet—friendly bacteria are reduced and harmful bacteria become the majority. This overgrowth of “bad” bacteria is called bacterial dysbiosis.
When dysbiosis occurs, the elevation in harmful bacteria poses a serious threat to a person’s health. For example, when potentially harmful bacteria such as E. coli die, the bacterial cell wall disintegrates, releasing large toxic compounds called lipopolysaccharides (also known as endotoxins). These toxins are known to disrupt tight junctions in the gut, thus increasing gut permeability. In fact, researchers have found that even the smallest dose of endotoxin compromised the integrity of the GI mucosal barrier, leading to leaky gut. Lipopolysaccharides are extremely toxic and have been implicated in the onset of serious diseases, including Parkinson’s, Alzheimer’s, irritable bowel syndrome, and cardiovascular disease. Lipopolysaccharides are also linked to the formation of mood disorders such as depression and the neurobehavioral dysfunction autism.
How are stress and cortisol linked to leaky gut? Stress is a threat to the internal equilibrium. It involves a stressor—a threat or demand— and the ensuing stress response, a neurological and hormonal event that prepares the body to deal with the stressor. During the stress response, the hormone cortisol is released to increase blood sugar for the brain and the availability of energy-rich substances to repair tissues. The adrenal glands release the hormone adrenaline, which increases your heart rate and blood pressure, and gives you a surge of energy meant to help you run from the threat. In times of stress, these hormones activate mast cells (a type of white blood cell) in the intestinal tract, causing them to release the inflammatory compounds TNF (tumor necrosis factor) and IFN (interferon gamma). These inflammatory immune chemicals have been shown to open the tight junctions, increasing intestinal permeability.
Z NOTE: The Western diet, characterized by the consumption of processed foods, factory-farmed meat, dairy, refined grains, and high-sugar foods and drinks, is a major cause of endotoxemia (high levels of lipopolysaccharides in the blood) and dysbiosis. Research published in the journal Gastroenterology states that eating a typical Western diet for one month caused a 71 percent increase in blood levels of lipopolysaccharides—71 percent. Both the lipopolysaccharides and the unhealthful food sources caused increased gut permeability and systemic inflammation. It was also found that the consumption of omega-3 polyunsaturated fatty acids (good dietary fats) reduced lipopolysaccharide production, gut permeability, and systemic inflammation.
KRISTINA’S STORY
Kristina’s health had begun to decline two years prior to her first visit with me. It started with chronic respiratory issues, where breathing became a physical chore requiring the use of a nebulizer several times a day. Over time, she developed hives, first on her hands and feet, then spreading to the rest of her body. The hives—an immune reaction—would flare up in times of stress, as well as after Kristina had eaten certain foods, including grain and dairy.
In addition to her hives, Kristina was dealing with headaches, joint pain, and chronic low energy. Her lack of stamina arose from her immune dysfunction, the nutrient-poor diet, and avoidance of food out of fear of triggering a severe reaction.
The hives became unbearable; she woke every night incessantly scratching her skin to the point of bleeding. Multiple doctors and many vials of blood later, Kristina was diagnosed as suffering from an extreme elevation of immunoglobulin E (IgE) antibodies. IgE antibodies are produced by the immune system in response to some type of foreign protein. They activate specific white blood cells called basophils and mast cells, which, in turn, produce inflammatory agents— including histamine, leukotrienes, and cytokines—responsible for her allergic reactions. The only treatment she was offered at that time was antihistamines, which provided no relief.
Experiencing medical apathy, Kristina continued to search for the cause of her condition. She heard about functional medicine and eventually got to my clinic. During our first consultation, it was clear that Kristina had some issue in her gut that was either the cause of her extremely elevated IgE or an agitator for her immune dysfunction. Having seen an extreme case of elevated IgE before, I had her tested for Hyper IgE Syndrome (HIES) and the genetic dysfunctions that cause it—mutations to the STAT3 and DOCK8 genes. Fortunately, Kristina did not have mutations of either gene. We continued to dig.
With the suspicion that her extremely elevated IgE antibodies were due to faulty gut function, stool testing was performed to check for dysbiosis (small intestinal bacterial overgrowth, or SIBO). Kristina’s stool testing revealed significant overgrowth of harmful bacteria, including Odoribacter, Prevotella, Pseudoflavonifractor, and E. coli.
Kristina immediately eliminated all refined flours, breads, and grains containing gluten; dairy; and refined sugar. She loaded her diet with healthful protein and fat, and plenty of plant-based foods. I put her on two different probiotics to balance her bacterial flora, a medical food to help heal the gut, and nutrients to rebuild the lining of the gut to prevent further permeability issues and immune reactions. Within a few weeks, Kristina’s hives dramatically diminished and she could sleep through the night without scratching her skin away. She was ecstatic.
Despite the fact that there are as many as one hundred autoimmune disorders, by some estimates, they all appear to have similar causes. Leaky gut and intestinal permeability caused by the reaction between gluten and an overgrowth of gut bacteria top the list. Additional causes of autoimmune dysfunction include:
As you can see, autoimmune diseases develop for different reasons, but for the most part these causes are under our control—under your control. Taking action to eliminate the causes of leaky gut—including omitting all refined grains and grains containing gluten from your diet, regulating bacterial overgrowth, and controlling your stress levels— should begin immediately.
How do you know if you have increased gut permeability and leaky gut? Self-diagnosis is difficult, and your family doctor may not know the mechanisms and health consequences of a leaky gut. However, it may be worth having a functional medicine specialist help you evaluate your gut condition. My motto is “Test, not guess.”
TESTS FOR LEAKY GUT
In addition to the diseases linked to gluten, zonulin, and lipopolysaccharide toxicity, other signs and symptoms may point to leaky gut and warrant undergoing these specialized tests. These symptoms include reactions to certain foods, stomach pain, indigestion, gas, heartburn, unexplained fatigue, fibromyalgia, skin issues (hives, eczema, acne, rosacea, psoriasis, rashes), brain fog, asthma, irritable bowel syndrome, mood swings, depression, allergy symptoms, and weight gain.
REBUILDING FROM LEAKY GUT
At this point, if you have identified with any of the chronic health issues listed in this chapter or you are rebuilding from a chronic disease and/or leaky gut, follow all the supportocols described between the covers of this book, beginning with the following:
Z NOTE: It’s estimated that 60 to 70 million people suffer from some form of gastrointestinal disease or disorder, including abdominal pain, esophagitis, ulcers, gastroesophageal reflux disease (GERD), nausea, vomiting, constipation, diarrhea, Clostridium difficile infection, pancreatitis, and colorectal cancer. For many, the first-line therapy for peptic ulcers, esophagitis, and GERD is the use of proton pump inhibitors (PPIs).
PPIs work by shutting down the proton/potassium pumps found in the parietal cells of the stomach, thus reducing the production of stomach acid. The theory is that acid reflux or heartburn is caused by excess stomach acid, so shutting down the pumps that produce the acid will reduce overall acidity, prevent the formation of ulcers, and reduce the burning pain associated with heartburn. However, research from the Journal of Gastroenterology and Proceedings of the Nutrition Society has confirmed that low stomach acid (a condition called hypochlorhydria)—not an overproduction of acid—is to blame for GERD. Hypochlorhydria can be caused by an H. pylori infection; a hiatal hernia (where the muscular upper valve of the stomach pushes through the diaphragm); overgrowth of harmful bacteria in the gut; and poor carbohydrate digestion. PPIs don’t treat any of these causes and should not be used by those with gastric reflux.
PPIs also come with a host of detrimental side effects. For one, they will change the pH of the gut, causing dysbiosis and an overgrowth of harmful bacteria. They impair the body’s ability to absorb vitamins and minerals, including vitamin B12, vitamin C, magnesium, calcium, and iron. And that’s hardly all—PPIs damage the lining of the arteries, reducing the production of nitric oxide, which then restricts the dilation of arteries and subsequently blood flow. PPIs have also been shown to negatively affect kidney and cognitive functions.
Before someone convinces you to take these damaging drugs, instead consider removing all refined grains and bread, dairy, and refined sugars from your diet, getting tested for bacterial overgrowth, and taking digestive enzymes containing betaine HCl (hydrochloric acid).
Summary
If you want to rebuild from and prevent recurrence of a chronic disease, you should know that it is caused not by a single gene, but rather by the interaction between your genes and the internal environment they inhabit. Since human genes have remained constant for eons, the major changes driving chronic diseases are our personal choices, habits, and food sources. An unhealthy body composition is the trigger for the development and progression of heart disease, cancer, diabetes, and autoimmune diseases, among others. Within this diseased internal terrain, the inflammatory process fuels chronic disease as gas fuels a fire. Excessive body fat is a burning inferno of inflammatory compounds, including IL-6, TNF, and leptin, which all play a role in worsening the disease.
The research clearly shows that chronic diseases develop from a diet of nutrient-deprived processed foods, unresolved stressors, environmental toxins, lack of exercise, and poor sleep. When any or all of these factors are out of alignment with your genes, disease is the result. The tried-and-true supportocols outlined in this book will help you rebuild from your health crisis and avoid future complications.
But first, you need to assess your baseline health and habits so you know where your weaknesses lie and where to focus your time and energy. How do you do that? Easy: Read on.