CHAPTER 22
I once had a patient whom I will name Cathy. She was diagnosed with ulcerative colitis more than ten years before coming to my clinic. This chronic inflammatory condition, including significant losses of blood, frequent diarrhea, and extreme fatigue, not only was a serious health problem but it was also wrecking her entire life. The medications that were keeping her alive had many side effects, and each year, on one or two occasions, she would get so ill that hospitalization was the only option. She resisted surgery, and as a last resort, she was willing to try a more natural approach one more time.
After extensive evaluations, I recommended that she strictly adhere to a healthy lifestyle to quickly pull her out of the vicious cycle she was in for most of her adult life. She made significant dietary changes beginning with the Two-Week Test. It was evident that Cathy had to eliminate all grains and starchy carbohydrates, eat smaller more frequent meals, and eliminate all processed and packaged foods. She started taking a number of supplements, including fish oil, L-glutamine, betaine hydrochloride, a natural form of folic acid, and probiotics. She listened to the music she loved whenever possible during the day and made a great effort to avoid the people and activities in her life that caused her stress.
Within a couple of weeks, her health was noticeably improved, and after a month, her intestinal function was significantly better. After another month, she quickly weaned off all medication. By six months, she claimed there were no symptoms of colitis—no discomfort, no bleeding, and normal bowel movements. A visit to her gastroenterologist showed significant healing of her colon, and blood tests were dramatically improved. She continued to see me about twice a year without return of any problems, except on occasion when she would eat improperly during travel or holidays—but eventually she was able to resolve these problems too.
Indigestion, upset stomach, heartburn, ulcer, gas, bloating, constipation, and irritable bowel syndrome are common complaints in today’s modern, fast-paced society. Each year, about one hundred million people in the United States experience some kind of digestive disorder. While most of these ailments are temporary and not life-threatening, ten million people are hospitalized annually for evaluation and treatment of gastrointestinal, or GI, complaints. Health care costs exceed $40 billion annually for these patients, with new cases continuing to rise with an aging and increasingly overfat population. While digestive symptoms rise with old age, they can occur at any time, even in children. The increase in GI problems as the decades march by in one’s own lifetime is often due to a general decline in health, and by a reliance on over-the-counter and prescription medications. These drugs, taken regularly or in larger doses, especially to alleviate pain symptoms, further increases the risk of intestinal disturbances due to their side effects.
The GI tract—also called the gut—is a reflection of one’s overall health. So let’s take a closer look at what the gut does. It physically and chemically digests food into smaller pieces so these nutrients can be absorbed by the small intestine, with the unused matter eliminated from the body. We think of the gut as synonymous with the stomach and intestines, but that’s not entirely the case. The gut actually begins in the mouth and continues through the digestive system into the esophagus, stomach, small intestine, large intestine (colon), and the rectum. Other organs that play a role in the function of the GI tract include the liver, gallbladder, and pancreas. The intestine is also home to a significant amount of an adult’s immune system, and it is in constant and direct communication with the brain (consider where you first feel emotion—right there in your gut).
Gut problems are not just uncomfortable but an indication that the body may not be functioning properly. If this is the case, one may be unable to obtain all the nutrients from even a healthy diet. A faulty gut can also have a negative impact on immune, muscle, and brain function.
Even those without gut symptoms can have intestinal problems. An example is the individual who develops damage to the intestinal lining, such as from stress or too much alcohol. He or she might not even be aware of it, but small yet significant amounts of GI bleeding can occur without any symptoms being present, with blood in the stool not even noticeable.
A better understanding about the gut, and how different foods and stress affect it, is a first step in helping you correct many intestinal problems, leading to better absorption of nutrients.
The main function of the gut is the digestion of food and the absorption of nutrients. Most people are well aware of these activities, but the gut also assists the liver by eliminating toxins from the whole body. The gut produces vitamins and hormones and has its own extensive nervous system. So even if you eat the right foods, if they’re not properly digested and the nutrients unabsorbed, nutritional imbalances can occur due to malabsorption. This could create a problem identical to those associated with not eating the right foods. Or a poor-functioning gut can reduce immune function, leading to more colds, flu, and allergies.
Signs and symptoms of gut dysfunction are common in people of all ages. Among the biggest sellers of drugs, both over-the-counter and prescriptions, are those that cover the symptoms of an improperly functioning GI tract. Most don’t treat or correct the causes of the problems. But by being healthy and fit, most people with intestinal distress can significantly improve, and usually eliminate, their gut-related conditions.
Causes for many gut symptoms include poor diet, excess stress, hormone imbalance, and dehydration. Side effects of medication are frequent stresses for the intestines. Of particular concern are patients with arthritic conditions as more than fourteen million of them consume NSAIDs regularly. Up to 60 percent will have gastrointestinal side effects related to these drugs, and more than 10 percent will cease recommended medications because these symptoms are severe—they include intestinal upset and discomfort and GI bleeding.
Highly processed carbohydrates—including grains and other starches and sugars such as sucrose, maltose-based sugars, and corn sugars—can cause intestinal bloating and nausea. These problems can occur especially if food is not thoroughly chewed and mixed with saliva to assist in digestion.
Upper-gut symptoms include those that come from the stomach, such as nausea, cramping, vomiting, and discomfort sometimes felt upward into the chest and throat. Those specifically associated with lower intestinal stress are also common and include lower abdominal cramping and diarrhea, bloating and gas, and constipation.
The good news is that the majority of gut problems—from vague indigestion and acid reflux to ulcers and more serious conditions such as Crohn’s disease and ulcerative colitis—can be significantly improved or eliminated by making the appropriate changes to improve your food intake, exercise habits, and other factors such as reducing physiological stresses. Let’s consider each major area of the gut, its primary purpose, and how one can help it function better.
You use it for talking, singing, screaming, kissing, and even making odd noises. The mouth, however, serves another important function that many people neglect—helping to get more nutrients from your food and keeping the gut working well. Many intestinal problems begin in the mouth.
Gut symptoms often come from not properly chewing food or rushing through a meal. Problems with teeth, gums, or the jaw joint can affect chewing, due to discomfort or the bite being out of alignment. The chemistry of the mouth can also be a problem, such as low salivary pH, discussed below, which can contribute to poor use of digestive enzymes and related dental problems.
In the 1890s, Russian physiologist Ivan Pavlov was fascinated by how dogs tended to salivate before food reached their mouths. His groundbreaking research into the timing and importance of saliva, chewing, and also human digestion later won him a Nobel Prize in 1904. After more than a century, physiologists continue building on that understanding.
Chewing helps the taste receptors on the tongue detect extremely small concentrations of substances within a fraction of a second of tasting it—one of the main reason humans love the taste of food. This stimulation elicits a variety of immediate responses throughout the body, including stimulating heat production and fat burning and improving digestion, absorption, and even the use of nutrients from foods. Chewing your food, called the “cephalic phase” of digestion because the brain immediately senses and responds to what’s being consumed, can also help control blood sugar and insulin and control fluid and mineral balance. Most of us have experienced being ravenously hungry and even feeling weak, only to perk up the moment we started chewing on some food.
All food should be chewed for better digestion. But those that require the most chewing include concentrated carbohydrates—bread and other starchy grain products, including pasta, rice and beans, all cereals, starchy vegetables such as potatoes and corn, and most sugars. Of course, these processed foods should be avoided anyway.
A key enzyme in saliva is amylase. It starts the digestion of most carbohydrate foods, and without it, normal digestion of this food group may not properly occur, with the risk of producing gas, indigestion, and bloating. Most carbohydrates should be chewed sufficiently and mixed with saliva for better digestion. Fruit and honey contain simple carbohydrates that don’t require chemical digestion to obtain the important sugars they contain. However, fruit needs to be chewed into smaller pieces to help the intestine obtain the nutrients within, and chewing both brings out their wonderful tastes.
It is important to chew your food well. Keep matters simple: Rather than counting each mouthful, just chew and enjoy the tastes and textures of your food. Once it has turned into small pieces and is well moistened, swallow it and enjoy another bite. Rushing meals, eating while working at your desk or driving, and other poor dietary habits make it almost impossible to chew and digest well. Listening to enjoyable music during meals can help all phases of digestion.
The environment of the mouth is a critical part of its overall health, especially the acid-alkaline balance—the pH—of the saliva. And it can influence the rest of the gut. In addition, the pH in the mouth may reflect the body’s overall fat-burning ability—those with lower pH levels typically have reduced fat burning frequently associated with low energy and increased body fat. As you improve your diet, build your aerobic system, and increase fat burning, your oral pH, among other things, should improve.
The acid-alkaline balance in saliva can be measured with a pH paper, available at a pharmacy, health store, or online. The pH of the mouth should be slightly alkaline, in the range of about 7.4 to 7.6 (slightly higher in children). You may hear or read that the mouth should be an acid pH, but this is confused with the fact that many people have a mouth with a pH in the acid range—6.0, 6.5, 6.8, and so forth. (A pH of 7.0 is neutral; above is alkaline and below is acid.)
Here’s the procedure to test your pH:
• Wait about fifteen minutes after eating or drinking, or completely rinse your mouth with water and wait about five minutes.
• Use a small strip of pH paper, and thoroughly moisten it in your mouth for about five seconds.
• Immediately compare the color on your test strip with the color on the pH paper container to determine the approximate pH.
Initially, perform this test two or three times in one day, then again a few days later to establish your average pH level—although it should not vary by much if you follow the above procedure properly. If your pH is consistently too high (above 7.6), it may indicate a need to increase natural carbohydrates in the form of fruits. But if your pH is too low, it may indicate two things: You’re eating too many carbohydrates, most likely the refined types, and you need to add more protein and fat to your diet. After making the appropriate dietary changes, check the pH twice a week to follow progress; improvements in pH could take up to a month or more.
In children and adults, low pH—less than 7.0—promotes tooth decay. While in practice I noticed those individuals with proper pH did not get cavities, but those who had tooth decay almost always had low pH.
Proper salivary pH is important to protect the environment of the mouth, especially the tooth’s enamel and the regulation of healthy bacteria that normally reside there. Eating sugar-laden foods increases the risk of cavities. This occurs for two reasons. First, sugar and most carbohydrate foods trigger changes in the mouth that shift the environment, enabling unhealthy bacteria to reside there. Normally, healthy strains of bacteria reside in the mouth, but with poor diet, the unhealthy bacteria take over and convert some of the sugar to lactic acid, reducing the pH and promoting tooth decay. Second, consuming sugar and other high-glycemic foods affects the body’s metabolism, reduces fat burning, and also lowers oral pH even when there is no sugar residue in the mouth—and even right after brushing. This lower pH environment is perfect for unhealthy bacteria to thrive and damage the teeth and gums.
The unhealthy bacteria in the oral cavity promote demineralization of the teeth—the loss of calcium. This can result in decay and loss of teeth and dislodging of old fillings.
In a healthy mouth, the normal bacteria include Streptococcus sanguinis, made up of a number of species. These bacteria are found in saliva and are also absorbed by dental plaque, where they modify the environment to make it less hospitable for the various strains of unhealthy Streptococcus that cause cavities.
Unfortunately, with the regular intake of refined carbohydrates, unhealthy bacteria are common. Once inside the plaque, the bacteria continue to maintain an acid environment, promoting tooth decay and demineralization.
The influence of fresh fruit on oral pH and bacterial is minimal because, with normal saliva production, the mouth is quickly cleared of these natural sugars. But with sucrose (white table sugar), which is the most common sugar consumed, and cooked starch (such as bread, pasta, and other grains), the mouth is unable to rapidly remove the residue due to the stickiness of these foods. This increases the risk for lower salivary pH.
A sufficient amount of chewing stimulates the increased production of saliva to help with the rinsing effect of the mouth and maintains a healthy pH. At the end of a meal, eating foods that raise oral pH can also help maintain the proper environment. A number of studies show that even a small serving of natural cheese works well.
After entering the mouth, food is swallowed down a long muscular tube, the esophagus, into the stomach. The two most important aspects of digestion here are the physical mixing of food and the chemical action of hydrochloric acid, which is produced in certain cells inside the stomach lining. Food is mixed with the help of three layers of smooth muscle that make up the stomach. This is the reason you may feel and hear normal noises from your gut—there’s a lot of churning going on there, especially after a meal. It’s much like your washing machine doing a load of clothes.
PRACTICE GOOD ORAL HYGIENE
Going to see your dentist should be habit-forming. But we often leave the dentist chair armed with conflicting recommendations. A recent study published in the International Journal of Paediatric Dentistry found that “oral hygiene messages delivered by professional organizations showed inconsistencies and lacked scientific support.” Much of this confusion is due to dental-based companies giving away free products such as that complimentary toothbrush or tube of toothpaste you receive after your visit.
The answer to dental problems is not simply brushing, using mouthwash, and flossing. Most people already do that and still have unhealthy teeth and gums.
The mouth is really no different from the rest of the body, with teeth, gums, and other living tissues relying on a healthy diet, optimal circulation, avoidance of chronic inflammation, and well-functioning immune system. So this is the place to start when it comes to the building and maintaining the best teeth and gums.
By avoiding poor health and chronic illness, you’re more likely to have healthier teeth and gums. For example, more severe periodontal disease is higher in patients with heart disease.
Optimal pH is also one of the more important ways to better dental health.
Companies making unhealthy products have clearly infiltrated the dental profession, and it’s often difficult to distinguish between safe recommendations and marketing hype. You should avoid toothpastes that are made with unhealthy ingredients such as fluoride, artificial sweeteners (including aspartame, saccharine, acesulfame-K, sucralose), sodium lauryl sulfate, and other artificial ingredients.
Also stay clear of mouthwashes with these and other unhealthy ingredients, including alcohol, which can dry out the mouth.
Brushing and a water pick are very effective at removing food particles and plaque, two important aspects of oral health.
Don’t procrastinate either. Take care of dental problems if they develop—the sooner they are successfully treated, the better. However, finding the right dentist is equally important. When in doubt, don’t hesitate to get a second opinion, especially if your dentist recommends seemingly more extreme or costly procedures.
Like other aspects of a healthy body, diet plays a key role in oral health. The single most important factor here is that by avoiding refined carbohydrates, your mouth will be significantly healthier. In fact, it’s unlikely you’ll have a healthy mouth long term no matter how often you brush, floss, and get cleanings and regular checkups if you continue eating refined carbohydrates.
When food enters the stomach, hydrochloric acid is normally secreted and is vital to proper digestion, helping to make nutrients from foods available for absorption. This natural acid stimulates other enzymes, such as pepsin for the digestive of protein.
Hydrochloric acid helps make vitamins, minerals, and other nutrients more absorbable. It also kills bacteria, viruses, parasites, and other potentially harmful invaders that commonly enter through almost all foods. Reducing your hydrochloric acid with antacids can be detrimental for many reasons. First, protein digestion may be impaired and you may not absorb the much-needed amino acids. Undigested protein can get absorbed and trigger immune reactions, one common cause of allergies. Hydrochloric acid triggers the production of digestive enzymes in the small intestines and pancreas, which complete the digestion of protein and carbohydrate and prepare nutrients for absorption.
Taking antacids is not the only way to reduce levels of hydrochloric acid. As we age, there is often a lowering level of normal stomach acid. Excess stress can have the same effect since it typically reduces the stomach’s acid, despite the common notion that stress overproduces acid—much of this myth comes from the marketing of popular antacids. Fewer people than one might think overproduce hydrochloric acid under stress. This usually happens between meals, where most have learned that eating a small amount of food reduces or eliminates the discomfort caused by too much acid.
Drinking liquids with meals may also dilute stomach acid and enzymes, resulting in less-efficient digestion. Drink all your water between meals, avoiding it about twenty minutes before and an hour or more after eating. Soda, milk, sports drinks, fruit juice, and other liquids are not part of a healthy diet and as such should be avoided. An exception to drinking liquids with meals is red or white wine, which can help digestion—not only can it relax you, it can also increase digestive enzymes. But drink in moderation.
For those with inadequate hydrochloric acid production, dietary supplements of betaine hydrochloride (a solid which turns to hydrochloric acid when swallowed) can be helpful. Common symptoms in people with low levels of normal stomach acid include belching and bloating after meals, bad breath, loss of appetite, and large amounts of foul-smelling gas. Those with reduced acid can develop abnormal fermentation in the stomach that produces other acids that are irritating, especially if they go upward into the esophagus, causing a burning feeling.
THE WONDERS OF SALIVA
Saliva more than moistens foods before swallowing. It plays an important role in the oral cavity against infections and in maintaining the overall health of the tongue, throat, and the other soft tissues in the mouth. That’s because saliva has antibacterial, antifungal, and antiviral capacities—one reason why animals “lick” their wounds to help them heal faster (humans with proper oral pH can do this too). Saliva also assists in the actions of the many muscles in the mouth, including the tongue, which helps in chewing, swallowing, and speaking. (The mouth contains many muscles—there are eight within or that attach to the tongue, along with others, including the powerful jaw muscles.)
About 80 percent of the saliva stimulated throughout the day is accomplished by chewing, producing up to a quart or more, with a small amount produced during sleep. Most saliva is made in the three pairs of salivary glands—particularly in the large parotid in front of the ear and the sublingual under the tongue and the submandibular below the jaw bone. These glands also produce bicarbonate, which is how, in a healthy person, saliva maintains a relatively high pH.
Poor health can disturb the normal functioning of the nervous system, which specifically regulates salivation, often reducing its production. Those who have too little saliva are more vulnerable to oral health issues from cavities, demineralization of teeth, gingivitis, and infections from bacteria, viruses, and candida.
Xerostomia is a condition of reduced salivation—by about 50 percent—resulting in abnormal dryness of the mouth. In addition to an unhealthy body, it can be triggered by various medications, including antihistamines, antidepressants, diuretics, antihypertensives, and many others—ask your health care professional if this problem is affecting you. In addition, poor diet, dehydration, hormone imbalance, excess stress, and smoking can significantly reduce saliva production.
Low salivary production can contribute to inflammation and infection in the mouth and throat, chronic hoarseness, dry cough, and difficulty with speech. It can also reduce your sense of taste and smell, and in some cases, it is associated with reflux esophagitis, heartburn, and even constipation.
With higher levels of health, proper saliva production plays a primary role in oral health. Not only does it help rinse the mouth of food particles, control pH, and possess antiplaque and antimicrobial factors, but saliva contains important nutrients. These originate from the diet and are carried through the bloodstream to the salivary glands and are important for tooth mineralization. They include calcium, phosphates, sodium, fluoride, and protein.
A common condition called GERD—gastroesophageal reflux—has become a frequently diagnosed ailment. It is also a bonanza for drug companies. In true cases of GERD, stomach contents back up into the esophagus, causing irritation, with symptoms such as heartburn, indigestion, and discomfort occurring mostly after meals or when lying down or bending down. In severe cases, ulceration can occur in the esophagus. Most people with GERD have bloating due to gas. This often comes from eating starchy or processed carbohydrates, especially at the same time as eating dense proteins. Reducing or eliminating refined carbohydrates often eliminates the symptoms of GERD. In some individuals, eliminating lactose from dairy can do the same (lactose is a sugar that requires digestion). In other cases, poor stomach digestion, often from not enough stomach acid, causes GERD.
After leaving the stomach, food passes into the small intestines for the completion of digestion and the absorption of nutrients. The small intestine, with its fingerlike projections called villi, is capable of pulling nutrients from the now-well-digested foods. Certain portions of the small intestine absorb specific nutrients as they pass. Once nutrients are made available through the action of digestion, they can now be absorbed into the bloodstream for transport to the liver and throughout the body.
While the villi are the structures that absorb nutrients, the overlapping factors of stress, poor digestion, or not eating (dieting, fasting, hospitalization) can significantly impair their function. In addition, the villi use an important amino acid, L-glutamine, as their energy source for the absorptive mechanism to function. Without adequate glutamine, absorption of nutrients can be impaired. Glutamine is a common amino acid found in meats and other proteins, but it is easily destroyed by heat (a reason to cook meat rare or medium rare, even medium-cooked meat can lose a significant amount of glutamine).
Once absorbed into the blood, nutrients are carried to the liver for processing. The liver acts like a manufacturing plant and distribution center. Some nutrients rely on others for their utilization. For example, calcium requires certain fats to be carried into bones and muscles. Other nutrients such as thiamin can go directly into cells to help generate energy.
The digestion of macronutrients—carbohydrates, fats, and proteins—into their basic respective components of glucose, small fat particles, and amino acids provides the raw materials for the body’s energy needs. Once absorbed, glucose is acted upon by insulin and either used immediately for energy, stored as fat, or stored as glycogen. Fats are sent to storage until called for by the aerobic muscles for use as energy, and even amino acids are used to produce small amounts of energy.
INTESTINAL GAS
When too much gas accumulates in the intestine, it can cause more than discomfort. Pockets of gas anywhere in the gut can trigger a sympathetic nervous system response—a stress reaction. You could feel this anywhere in the gut. While small amounts are normal, larger volumes of gas are not, and usually indicate something is wrong with your diet or even the way you’re eating. Here are the four most common causes of intestinal gas:
• A common cause is from eating starchy carbohydrates—bread, cereal, the many products made from wheat flour—and sugar. This includes milk sugar (lactose) from dairy products.
• Another common cause of intestinal gas is swallowing air. This occurs during eating and drinking liquids, especially water, as people tend to drink several ounces or more at one time. Drink liquids slowly to avoid swallowing air, and most importantly, keep your head more level—not tilted backward—to avoid swallowing air. In addition, chewing food and not rushing meals will help you avoid swallowing large amounts of air. Once air is swallowed, if it doesn’t come back up soon as a burp, most of it must travel through the gut and come out the other end.
• Stomach dysfunction can cause of gas. This is typically due to low levels of hydrochloric acid.
• Large intestine dysfunction—often due to the wrong bacteria residing in the gut—can cause excess gas. This can also cause bad breath as some of this gas is absorbed into the blood and released through the lungs. (Some bad breath is due to local infections in the mouth.)
Other foods that promote gas include chewing gum, especially the sugar-free products containing sorbitol and other alcohol sugars. In addition, some individuals are sensitive to the natural sugar fructose found in fruits, and it is especially high in fruit juice.
Despite all their marketing hype, drugs to reduce gas simply don’t work. The American College of Gastroenterology has reported, “Despite the many commercials and advertisements for medications which reduce gas pains and bloating, very few have any proven scientific value.” If you have excess gas, addressing the causes as discussed here can usually significantly reduce the problem.
After digestion and absorption of nutrients in the small intestines, the remainder of the food material passes into the large intestine or colon. Here, it’s acted upon by healthy bacteria—microorganisms that humans have hosted for millions of years. An assortment of bacterial strains is normally present and varies with an individual’s diet and lifestyle. These bacteria produce important nutrients, including vitamin K, some B vitamins, and biotin. Important end products produced by the bacteria are fatty acids, which help regulate the acid-alkaline balance in the large intestine and which in turn control the type of bacteria that thrives there. Some fatty acids also serve as an important energy source for the cells in the lower intestine. These micro-organisms ferment some of the fiber from the diet, also improving the health of the intestine. Optimal large intestine function also impacts immune function.
Antibiotics, the lack of adequate dietary fiber, and excess carbohydrates are some reasons why bacteria in the large intestine change to a less friendly and often harmful type. These unhealthy bacteria and other microorganisms can produce metabolites that are absorbed into the bloodstream and can adversely affect brain and body function.
For those who have taken antibiotics, which quickly kill the natural gut bacteria, a dietary supplement containing live, freeze-dried friendly bacteria may be useful. Care must be taken when purchasing these products since many no longer contain live cultures. The best products are those that are refrigerated; contain six, eight, or more different strains of bacteria; and have bacterial counts in the billions, not millions. In addition, cultured foods, such as yogurt and kefir, may help accomplish the same task. However, avoid products containing added sugar and starch.
The bulk of the waste leaving the body is greatly influenced by gut bacteria. In some cases, up to 40 percent of waste volume can be attributed to bacteria. Reduced stool volume may be an indication of a poor micro-organism population. Foul odor is another common sign. Likewise, reduction of odor and increased stool bulk would indicate an improved gut environment.
I mentioned the importance of proper pH, such as in the mouth. In fact, various areas of the gut maintain different pH values from an alkaline mouth, a high-acidic content of the stomach, a mildly alkaline small intestine, and a slightly acidic colon.
A healthy diet does more than provide you with many important nutrients. Through digestion of food, an important bodywide biochemical acid-alkaline balance occurs, which significantly helps maintain your overall health. In addition to the digestion of food affecting body pH, the kidneys play a vital role in this pH balance and require sufficient water for their action.
CONSTIPATION AND DIARRHEA
Constipation and diarrhea are two of the most common gut complaints. Most people can avoid or resolve these problems by being healthy and fit. Constipation technically refers to excess straining with bowel movements and the passage of small hard stools. It can occur when the waste (stool) moves too slowly through the lower gut. The most common causes include dehydration, changes in diet (this may occur initially, even when improving your diet), physical inactivity, and a variety of drugs. Treatment and prevention measures include sufficient water between meals, ten servings of vegetables and fruits (prunes are effective for stubborn cases, one to three per day with a large glass of water), psyllium (taken with a large glass of water), and easy physical activity (such as regular walking). In almost all cases, these habits will result in normal gut function (having at least one to three bowel movements a day). However, if more remedies are needed to treat constipation, it’s best to see your doctor. The use of laxatives is usually not needed by those who follow a good diet and are healthy. The regular use of laxative can impair function of the whole gut and reduce your ability to have natural bowel movements (thereby being “addicted” to laxatives).
Diarrhea is an abnormal looseness of the stools, usually with increased frequency. Acute watery diarrhea is usually associated with some illness, accompanied by gas, cramping, and intestinal pain. When severe, it can lead to dehydration and dangerous losses of electrolytes (including sodium, potassium, calcium, and magnesium). Acute diarrhea is often caused by a viral infection and sometimes by drugs (especially antibiotics). Bacterial infections are sometimes the cause, especially when blood is present. Artificial sweeteners can also cause acute diarrhea (especially the alcohol sugars sorbitol, xylitol, and others that end in “ol”). Some people develop diarrhea under the stress of public speaking, travel, or staying away from home. These situations are usually associated with adrenal dysfunction. In addition, international travel can result in consumption of food and water containing bacteria your body is not familiar with, producing gut-related infections.
If you have serious acute diarrhea lasting more than ten days to two weeks, consider seeing your doctor as you could become depleted in electrolytes and water and there could be a more serious underlying health problem. When acute diarrhea becomes chronic, it may also be associated with more serious problems.
NSAIDs, antibiotics, and antacids can also cause chronic diarrhea, as can dairy foods and gluten-containing grains—especially wheat. Finding and eliminating the cause of the problem is the best remedy. In the meantime, keeping well hydrated is important; and pectin, best consumed from fresh apples or applesauce, can be effective as well.
An imbalance in the acid-alkaline state can seriously disrupt your health, not unlike too low a pH in the mouth causing tooth and gum problems or too high a pH in the stomach adversely affecting digestion.
The simple act of eating a healthy, balanced diet—as discussed throughout the first section of this book—accomplishes this pH control. The market is full of so-called miracle products that claim to fix your pH by making you alkaline, at ten times the cost of real food. But you can do it with a healthy diet without added costs.
For almost all of human existence, our diet has been slightly alkaline, which is considered to be optimal for the body’s brain, muscles, and metabolism. With the agricultural revolution of the past ten thousand years came a dramatic rise in processed grain consumption, which significantly added more acid-producing foods to the diet, disturbing the delicate pH balance. Grain foods also replaced many vegetables and fruits in the diet, which were primarily those needed to maintain one’s healthy alkaline state. Today, most “Westernized” diets are full of highly processed grains, especially wheat, which contribute to an over-acid state. Excessive animal protein intake can also make the body more acidic.
Most food in the diet produces either an acid or alkaline residue. This affects the whole body via the bloodstream. Maintaining proper pH is vital because of the many systems affected by it.
The most potent foods that improve pH balance—keeping the body more alkaline—are vegetables and fruits and, to a lesser degree, nuts and seeds. The most dangerous foods are grains.
Below is a list of the key foods associated with pH balance.
Acid-producing foods, which lower pH, include the following:
• All grains, whether whole or refined
• Milk products, cheese, and all dairy
• Meats from all animals, including fish
• Eggs
• Salt
Alkaline foods, which raise pH, include the following:
• Vegetables
• Fruits
• Nuts and seeds
These foods are not meant to be a list of “good” and “bad” but rather a way to relate to your diet. For example, if your meals are typically high in bread, pasta, cereal, rolls, and other grains, it can obviously be a problem for acid-alkaline balance. By eliminating refined carbohydrates and replacing them with vegetables and fruits, you’ll quickly be on the way to better pH balance.
Eating too many acid-producing foods can result in a general bodywide imbalance—a state of chronic acidosis. This can cause bone and muscle problems such as fractures, osteoporosis, muscle weakness, and even muscle wasting. With aging, this increases the risk of falls, fractures, and disability and also leads to the loss of independence, all of which contribute to increased mortality rate and reduced quality of life. Many other problems can develop too, such as a kidney disease, high blood pressure, poor mineral balance (with significant loss of magnesium), asthma, cardiovascular disease, and other conditions. That is why maintaining proper pH will ensure better health and fitness in your later years.
The answer to the problem of acid-alkaline imbalance is not to create an opposite imbalance by overconsuming a high-alkaline product or eliminating all acid foods. Such is the case when high-quality animal protein is eliminated from the diet (which can actually worsen bone and muscle problems). Rather, establishing balance in the diet is a key to an optimal acid-alkaline state. It means eating sufficiently from both the healthy acid and the alkaline food groups. For many people, this means eating more fresh vegetables and fruits—ten servings a day for adults. It also means eliminating refined grain products. And this gives your kidneys an easier time at doing their job.
In addition to helping filter the blood and removing unwanted substances from the body through the urine, the kidneys also help maintain the correct body pH or biochemical acid-alkaline balance for your metabolism to function better.
The kidneys are bean-shaped organs, about the size of your fist, located just below the rib cage in the middle back, one on each side of the spine. Like the liver, the kidneys also filter the blood—about 200 quarts a day. From this, the kidneys filter out about two quarts or more of waste products, including extra water, which becomes urine. With rising rates of obesity and carbohydrate intolerance, there has been a dramatic increase in kidney disease.
The kidneys also produce hormones, some important ones include the following:
• EPO (erythropoietin) stimulates the bone marrow to make red blood cells.
• Rennin works with adrenal hormones to help regulate blood pressure by controlling sodium and water.
• Calcitriol continues the process of vitamin D production, which began in the skin with exposure to sunlight.
YOUR LIVELY LIVER
A healthy, fully functioning liver can make your life go much more smoothly. The largest of your internal organs, the glandlike liver is located under the front ribs on your right side. It weighs about three pounds, more in larger and less in smaller people. It performs thousands of important jobs for the body’s metabolism. It maintains blood sugar during the night (by converting its stored glycogen to glucose), makes bile that’s stored in the gallbladder for digestion of fats, produces most of the cholesterol in our blood (for use in cells throughout the body), and even manufactures the hormone somatomedin for building muscle and cartilage. One of the liver’s most important tasks is removing toxins and waste products created naturally in your body during the course of normal metabolism and those unnatural ones taken in through food and air.
Like the kidneys, the liver also filters the blood, and by doing so, it breaks down and eliminates an untold number of chemical compounds. Some of these are normally produced within the body during metabolism while others are consumed in a healthy diet, with many more toxins in bad foods. In doing its job, the liver regulates hormones, cholesterol, fats, proteins, caffeine, sulfur (from cruciferous vegetables like broccoli and cabbage), various phytonutrients, iron, and many other compounds. Even healthy substances such as hormones and nutrients, when completing their tasks in the body, are disposed of by the liver. But if this does not happen, the continuous actions of hormones, for example, causes an imbalance—just as if there was too much production of that hormone. The brain also plays an important role in this regulation process by helping the liver decide how to regulate the breakdown of various substances.
Just as important, toxins that enter the body through food and our environment are filtered out and eliminated in the liver. These include pesticides and other toxic chemicals that find their way into our food and water, chemicals from air pollution (auto exhaust, cleaning products, perfumes, and toiletries), medications, and others. The liver accomplishes this through a complex process called detoxification. Once filtered, the liver disposes of all these substances, via the gallbladder, into the gut for removal from the body. Thus, optimal gut function also plays an important role in this process.
To be successful with detoxification, the liver requires a variety of nutrients. Unfortunately, among the advocates of liver detox, many scams lure the public into buying their products by promising miracle cures. Most won’t be as effective as eating real food because they contain synthetic vitamins and other chemicals—all of which must be broken down and eliminated by the liver. The very best way to promote healthy liver function comes from eating real food and avoiding environmental toxins as much as possible.
To obtain the many nutrients required for liver detox, focus on a regular diet full of a variety of organic, unprocessed foods—fresh vegetables and fruits, whole raw nuts and seeds, and high-quality protein (including whole eggs). Organic foods have more of these important nutrients and fewer toxins such as pesticides.
The signs and symptoms of poor liver detox may be subtle. So how do you know if your liver function needs more support? Ask yourself the following questions:
• Are you sensitive to caffeine (can consume only small amounts or none at all)?
• Are you sensitive to perfumes, paints, and other chemical smells?
• Are you sensitive to certain drugs: benzodiazepines (Valium, Ativan, Xanax), antihistimines (Benadryl, Claritin), certain antibiotics (Bactrim, erythromycin), and antifungals (Lotrimin)?
• Are you sensitive to certain foods: grapefruit, turmeric, curry, chili (capsaicin), or cloves?
• Do you eat less than two servings a day of animal protein (meat, fish, whole eggs)?
• Are you taking nonsteroidal anti-inflammatory drugs (Advil, Aleve)?
• Are you taking more than one dose of Tylenol or aspirin per week?
• Are you sensitive (even to the smell) to high-sulfur-containing foods such as egg yolks, onions, garlic, broccoli, or cabbage?
• Do you consume more than two alcoholic drinks per day?
• Do you eat less than about eight servings of vegetables and fruits per day?
If you answer yes to even one or two of these questions, it could indicate that your liver detoxification pathways are not as efficient as they should be. Liver function also slows down with age if we don’t keep it going with adequate healthy food.
For ease of study, researchers and clinicians discuss liver detox as two different chemical pathways called phase I and phase II. Each is associated with specific toxins and nutrients. Through a careful evaluation of a patient, I could often determine which pathway needed more support, something difficult to do here. For simplicity, I have combined phases I and II together as one general category of liver detox. It is important to understand that too much of one nutrient may help one phase while hurting the other. This is another reason why many detox supplements can be harmful—they’re too general and may not be specific for your needs. But a healthy diet will provide a natural balance of nutrients for the liver to use.
The most important compound for liver detox is a substance called glutathione. Fortunately, the body makes glutathione when we eat a variety of foods rich in specific nutrients. It’s important to consume these foods regularly. Some of the key nutrients the body needs, and some foods containing them, to make glutathione include the following:
• Lipoic acid found in spinach, broccoli, peas, brussels sprouts, and many other bitter-tasting vegetables
• Sulforaphan from broccoli and kale (highest in broccoli sprouts)
• Gamma tocopherol and alpha-tocotrienol from fresh vegetables and raw nuts and seeds
• The amino acid cysteine, highest in certain animal proteins, especially whey
In addition, the process of detoxification normally produces large amounts of unstable chemicals called oxygen free radicals. A diet rich in antioxidants helps sweep up this radical “fallout” from liver detox. Potent antioxidants found in brightly colored vegetables and fruits—tomatoes, yellow summer and winter squash, cilantro, kale, carrots, melons, blueberries—include the carotenoids (lycopene, beta-carotene, zeaxanthin, lutein) and the full vitamin E complex, especially beta-, delta-, and gamma-tocopherol. Food doses of vitamin C (found in the white spongy material in red peppers and citrus and other vegetables and fruits) also work with other antioxidants.
To liven up your healthy meals, include foods rich in phytonutrients that also assist liver detox. These include citrus peel (make a citrus peel zest or a marmalade with honey), caraway seeds (grind them just before use), turmeric, ginger, garlic, and dill, just to name a few.
The liver detox pathways also require B vitamins, especially thiamin (B1), niacin (B3), and the folates. But avoid the synthetic forms because these have to be detoxed and eliminated through the liver too. Alcohol, in small amounts, such as red wine, may actually help liver detox. In moderation, alcohol is broken down in the liver (although the process starts in the stomach) but by a different mechanism that also requires B vitamins. But excessive alcohol taps into phase II detoxification, where it can cause significant stress.
If you have a history of liver problems, you should avoid certain foods and drugs. These include iron from dietary supplements, alcohol, and products containing acetaminophen (including Tylenol, Excedrin, and other aspirin-free products). Any drug, especially those taken by mouth (after absorption in the gut, they go directly to the liver) can be a problem. These substances can add significant chemical stress to the liver. In addition, avoid the foods that you know you’re sensitive to and be especially aware of your caffeine tolerance. The liver is a powerfully amazing part of the human body—if a piece is surgically removed, it can even grow back. And many people won’t get signs or symptoms that the liver isn’t functioning well until a third or even half of its function is gone.
The liver makes bile to help carry toxins through the gallbladder and into the intestines for elimination. Dietary fats in the diet keep bile flowing properly, helping the liver do its job. These include olive oil, avocado, nuts and seeds, and other healthy fats and oils, including coconut. Extremely low-fat diets can reduce bile production and can be dangerous. Likewise, high-fat diets can overwork the gallbladder. (A variety of natural foods will also contain sufficient fiber to help remove the toxins from the gut.)
Improving liver function is a key to helping the entire intestine function in a normal, healthy way, especially the large intestine. The ability to detoxify many chemicals made in your body and taken in via the air, water, and food is one of the liver’s important functions. This contributes significantly to improved fitness and health.
Anyone eager to jump-start his or her way back to health and fitness might think, “Aha! Time for that two-week detoxification!” Would a juice or fasting diet be the best way to rid one’s body of harmful toxins—the yucky sludge that resides deep inside the gut? Hollywood celebrities, for example, looking to lose weight before a movie often go on detox diets such as the Master Cleanse, which is a concoction of lemon juice, cayenne pepper, maple syrup, and water.
Some of these do-it-at-home detox regimens don’t come cheap. The Fat Flush kit costs $112 and is made with herbs and nutrients like dandelion root, milk thistle, and Oregon grape root.
So what does the medical community think of these detox brews? Not much, actually. “It is the opinion of mainstream and state-of-the-art medicine and physiology that these [detox] claims are not only ludicrous but tantamount to fraud,” Dr. Peter Pressman, an internist with the Naval Hospital in Jacksonville, Florida, told The New York Times in 2009. “The contents of what ends up being consumed during a ‘detox’ are essentially stimulants, laxatives, and diuretics. There is absolutely no scientific basis for the assertion that the regimens popularly defined as ‘detox’ will augment the body’s own capacity for identifying and eliminating your own metabolic wastes or doing the same for environmental toxins.” The fluids in your body constantly pass through the liver and kidneys; these organs serve as the primary heavy lifters when it comes to removing toxins and wastes.
Understandably, the public is always eager for a quick detox fix or the next super-food like the acai berry, whose health-curing properties have not been fully investigated. Fifty-four new food and beverage products debuted in 2008 with the word “detox” in their descriptions. Many of these fasting kits and juice regimens promote short-term weight loss because there are fewer calories being consumed, but the pounds usually return afterward. Some detoxers even believe that bowels should be irrigated several times a day and suggest colonics, enemas, and herbal laxatives to hurry things along. This practice, however, can cause long-term harm to one’s gastrointestinal system.
Dr. Ronald Strum, medical director and founder of the Center for Integrative Health and Healing in Delmar, told The New York Times that “eating whole foods always trumps fasting or juice diets—and that education overrules everything.” These whole foods include plenty of leafy green vegetables, especially spinach and kale, apples, onions, and carrots; and don’t forget to drink a lot of water throughout the day, because the body needs fluid to transport toxins to the kidneys and liver for elimination.
Your body knows how to take care of itself; millions of years of evolution have seen to that. It’s another reason why you need to stay away from the latest “gut-cleansing” fads or gimmicks. Just practice good nutrition instead.
Food Intolerance
I’ve discussed carbohydrate intolerance in great detail, but various other foods can also cause problems generally labeled as food intolerance. Symptoms come from various reactions in the body, although the gut is usually the main area of involvement; intestinal gas, nausea, diarrhea, and abdominal discomfort are the most common indications. More serious food intolerances can cause skin reactions such as a rash or welts; breathing difficulties such as wheezing and asthma symptoms; head and sinus problems including inflammation, runny eyes and nose, and headache; and whole body reactions such as edema (fluid retention) or even shock.
In addition to carbohydrates, including lactose (milk sugar), fructose, and the so-called sugar-free sugars sorbitol, mannitol, and xylitol, other foods can sometimes cause bad reactions. These include the following:
• Monosodium glutamate (MSG), commonly used in packed foods and in restaurants.
• Sulfites, which naturally occur in red wine, but are sometimes sprayed on vegetables and fruits (another reason to eat organic).
• Histamine-containing foods including cheese, eggplant, spinach, some fish (tuna and mackerel) and yeast
• A variety of additives and other agents used to make dietary supplements, medications, and cosmetics can also trigger reactions.
Your gut is truly a gateway to good health. By allowing it to function well—through better food choices and relaxed eating of regular meals—not only will the entire gastrointestinal track be happy, but also you’ll reap untold benefits throughout your body.