Optimise your Gut Health Workshop 4 Introduction

Content of Workshop Recap of Workshop 3 and Self Care Journey homework The gut as central to health The importance of your gut microflora The gut/brain connection The positive and negative influences on your gut microflora How to optimise your gut health Self Care Journey home study Action Against Alzheimer’s Programme © Cytoplan

Gut Health – Workshop 4 Explain the quote ‘all disease starts in the gut’ Describe the structure and functions of the gut Explain the functions and importance of gut microflora Understand the connection between the gut and the brain List the factors that disturb gut microflora and the symptoms caused by an imbalance Describe how gluten can have a negative effect on gut flora and gut health Explain how to optimise gut health by removing the main culprits Identify the nutrients, foods, supplements and techniques that can help heal the gut Action Against Alzheimer’s Programme © Cytoplan

Recap of Workshop 3 How our ancestors ate Increasing nutrient density The trouble with gluten Basic & Advanced Dietary Programmes Smoothies Self Care Journey home study Action Against Alzheimer’s Programme © Cytoplan

In a nutshell Choose NUTRIENT DENSE foods, foods rich with vitamins, minerals, enzymes, healthy fats and fibre Choose organic where possible Choose either the Basic or Advanced dietary approach and try it Get creative with smoothies and include them in your diet Action Against Alzheimer’s Programme © Cytoplan

Self Care Journey Home Study How did you get on? What did you think about the Self Care Planning Guidelines? Were you motivated to find out more about mindfulness? Action Against Alzheimer’s Programme © Cytoplan

“All disease begins in the gut” “A bad digestion is the root of all evil” “Death sits in the bowel” Hippocrates, circa 400 BC Action Against Alzheimer’s Programme © Cytoplan

The Digestive System The digestive system is made up of: Liver Gallbladder Pancreas Gastrointestinal tract (GIT) Action Against Alzheimer’s Programme © Cytoplan

Gastrointestinal Tract The Gastrointestinal Tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. It consists of: Mouth Oesophagus Stomach Small intestine Large intestine (includes rectum) Anus Action Against Alzheimer’s Programme © Cytoplan

Functions of the gut Barrier Immunity Digestion Absorption Detoxification Elimination Action Against Alzheimer’s Programme © Cytoplan

Gut Microflora Approximately 100 trillion microbes in gut Referred to as gut flora, gut microflora, gut microbes, gut microbiome There are 10-100x times more microbes in the gut than human cells in the human body In total, the microflora can weigh up to 2kg Gut flora can be categorised into groups: Beneficial/commensal flora Potentially pathogenic flora Pathogenic flora Benign flora   Action Against Alzheimer’s Programme © Cytoplan

Functions of gut microflora Breakdown carbohydrates Vitamin production Immune system – barrier effect Action Against Alzheimer’s Programme © Cytoplan

Functions of the gut microflora: gut-brain communication Communication between gut and the brain Can influence behaviour Research into live bacteria (probiotics) shows probiotics beneficial effects for disorders such as memory loss, depression and anxiety Gut bacteria produce brain chemicals – GABA and BDNF Action Against Alzheimer’s Programme © Cytoplan

Imbalanced gut flora Sometimes called ‘dysbiosis’ Can lead to many symptoms Diarrhoea Constipation Pain Bloating Can lead to leaky gut and chronic illnesses and symptoms beyond the gut Action Against Alzheimer’s Programme © Cytoplan

Factors that can disturb gut microflora Ageing Caesarean/ Formula Fed Food choices Stress Pollution Chronic illness Antibiotics PPIs Not enough Fibre Food sensitivities eg gluten Action Against Alzheimer’s Programme © Cytoplan

Antibiotics Kill friendly bacteria species Disturbs metabolism and absorption of vitamins Can lead to an overgrowth of yeast Antibiotic associated diarrhoea Long term effects (Jernberg et al. 2010) Action Against Alzheimer’s Programme © Cytoplan

Proton Pump Inhibitors (PPIs) PPIs are widely prescribed for gastric ulcers, gastro-esophageal reflux disease, treatment of Helicobacter pylori eg Omeprazole They reduce stomach acidity Interfere with absorption of minerals eg calcium, magnesium, zinc and iron. Also may reduce absorption of vitamin B12 May lead to Small Intestinal Bacterial Overgrowth - SIBO - especially in elderly Action Against Alzheimer’s Programme © Cytoplan

What we eat influences the population of our gut microflora Food Choices What we eat influences the population of our gut microflora Action Against Alzheimer’s Programme © Cytoplan

Fibre Dietary fibre is the indigestible portion of food derived from plants Different types of fibre: Soluble fibre (dissolves in water) – food for bacteria Insoluble fibre (does not dissolve in water) – provides bulk On average people eat about 12-18g a day Government recommendation: 30g a day Our fibre intake low compared to some more traditional populations Average daily fecal production 80-120g in Western Society Compared to up to 470 g in Sub-Saharan tribes Action Against Alzheimer’s Programme © Cytoplan

Importance of fibre Promotes beneficial bacteria in intestines – they ferment, in particular, soluble fibre into short-chain fatty acids which have anti- inflammatory effects and may delay the development of neurodegenerative diseases Soluble fibre has a beneficial effect on cholesterol Fibre balances hormones e.g. oestrogen, testosterone Helps with weight management, balances blood sugar Action Against Alzheimer’s Programme © Cytoplan

Bristol Stool chart Stool Type Description Type 1 Separate hard lumps Lumpy and sausage like Type 3 A sausage shape with cracks in the surface Type 4 Like a smooth, soft sausage or snake Type 5 Soft blobs with clear-cut edges Type 6 Mushy consistency with ragged edges Type 7 Liquid consistency with no solid pieces © Cytoplan

How to relieve constipation Avoid laxatives Squatting – natural position to pass stool Increase fibre-rich foods – linseeds, vegetables, fruits, nuts Psyllium Live bacteria, Aloe Vera and magnesium supplements Increase intake of water Move regularly - walking is a great way of getting things moving. Action Against Alzheimer’s Programme © Cytoplan

Gluten Gluten is comprised of two different proteins, gliadin and glutenin. An intolerance can give rise to coeliac disease Non-Coeliac Gluten Sensitivity (NCGS) is more common and may cause gut dysbiosis (ie imbalance) – an alteration in the gut microbiome. This dysbiosis can be associated with gut AND/OR non gut symptoms Gluten can trigger ‘leaky gut’ Action Against Alzheimer’s Programme © Cytoplan

Focus on gluten NCGS with/without Digestive Imbalance Poor food choices and lifestyle Dysfunctional Gut-Brain Axis Action Against Alzheimer’s Programme © Cytoplan

Focus on gluten A dysfunctional gut-brain axis allows pathogenic bacteria to upregulate gut and systemic inflammation which may further exacerbate: Obesity Insulin resistance Neuroinflammation Brain dysfunction Hence even without coeliac disease, gluten sensitivity is of critical importance Action Against Alzheimer’s Programme © Cytoplan

Gluten Grains An easy way to remember the gluten grains is through the acronym BROW: Barley Rye Oats (through cross contamination rather than the oats themselves) Wheat – includes cous cous, tabbouleh, farro, kamut, spelt Many commercially available foods contain gluten – but it is easy to avoid with practice! Action Against Alzheimer’s Programme © Cytoplan

Factors that can disturb gut microflora Ageing Caesarean/ Formula Fed Food choices Stress Pollution Chronic illness Antibiotics PPIs Not enough Fibre Food sensitivities eg gluten Action Against Alzheimer’s Programme © Cytoplan

Non gut conditions Action Against Alzheimer’s Programme © Cytoplan POOR GUT HEALTH Bloating IBS IBD Leaky gut Constipation Non gut conditions Reflux Action Against Alzheimer’s Programme © Cytoplan

Intestinal Mucosal Cells Healthy Gut Leaky Gut Intestinal Mucosal Cells Normal Tight Junction Compromised Junction Action Against Alzheimer’s Programme © Cytoplan

Leaky Gut = Leaky Brain Source: https://upload.wikimedia.org/wikipedia/commons/a/a6/NIA_human_brain_drawing.jpg Action Against Alzheimer’s Programme © Cytoplan

Optimise Gut Health Action Against Alzheimer’s Programme © Cytoplan

Remove ‘insults’ Gluten, other food sensitivities Toxins Sugar, alcohol Undesirable bacteria (natural anti-microbials may be useful eg garlic, caprylic acid, oregano) Stress Certain medications (if prescription then MUST discuss and agree with GP) Action Against Alzheimer’s Programme © Cytoplan

Chewing Action Against Alzheimer’s Programme © Cytoplan

Oral Hygiene – Oil Pulling . Action Against Alzheimer’s Programme © Cytoplan

Benefits of oil pulling Tooth decay Kills bad breath Reduces inflammation Whitens teeth Prevents cavities Heals cracked lips Immune System Gums and jaw Action Against Alzheimer’s Programme © Cytoplan

Digestive Enzymes and Hydrochloric Acid Stomach acid (hydrochloric acid) and digestive enzymes are needed for digestion With age, the gut produces fewer digestive enzymes, making it harder to breakdown the proteins, fats and carbohydrates in food Lack of digestive enzymes / stomach acid can lead to bloating, malabsorption, nutrient deficiencies Action Against Alzheimer’s Programme © Cytoplan

Apple Cider Vinegar Digestive Enzymes One teaspoon of apple cider vinegar in a little water before meals can improve digestion Digestive Enzymes Some people may find a digestive enzymes supplement useful for a short period Action Against Alzheimer’s Programme © Cytoplan

Other Ways to Improve Digestion Eat real foods Eat fermented and cultured foods Manage your stress Be good to your liver Get hydrated Action Against Alzheimer’s Programme © Cytoplan

Foods that Heal the Gut Fermented foods Vegetables (Dairy) / non-dairy eg coconut milk Beverages eg water kefir, Kombucha Prebiotic foods green leafy vegetables, chicory, Jerusalem artichoke, apples, berries, olives, onions,mushrooms, almonds, asparagus, garlic Bone broth – must use organic bones Action Against Alzheimer’s Programme © Cytoplan

Nutrients & Supplements to Heal the Gut Live bacteria supplement Vitamins A & D Curcumin Digestive Enzymes/ACV Essential Fatty Acids Action Against Alzheimer’s Programme © Cytoplan

Fasting Fasting allows the gut to perform a self cleaning action between meals Insulin (a hormone released when we eat) inhibits melatonin (the sleep hormone) Cell breakdown and repair processes occur when we fast e.g. beta- amyloid is broken down Insulin sensitivity is increased by fasting Brain derived neurotrophic growth factor (BDNF) is increased which promotes production of new neurons in the brain. This is important for anyone suffering from neurological diseases Action Against Alzheimer’s Programme © Cytoplan

Time Restricted Fasting Recommended: A long stretch of at least 12 hours with no food (between dinner and breakfast) Fast at least 3 hours between evening meal and bedtime Action Against Alzheimer’s Programme © Cytoplan

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Engage your Mind Home Study Module Week 4 Changing limiting beliefs into supportive beliefs Continue with self care planning and mindfulness Engage your Mind Action Against Alzheimer’s Programme © Cytoplan

Limiting beliefs Many people have beliefs that prevent them achieving their goals Common limiting beliefs around health include I always fail I can’t lose weight I can’t stick to a diet I am always getting ill I have no time Action Against Alzheimer’s Programme © Cytoplan

Activity 4 - Limiting Beliefs Write down one of the limiting beliefs you identified as part of the Well Formed Outcome exercises Above it write in red in large letters I USED TO BELIEVE …… Screw up the piece of paper and throw it over your shoulder or towards your past Re-write “I used to believe ……..” – and screw up and throw 2 more times On a new piece of paper create a new belief to replace the old belief – Now I believe …….. See yourself with this new belief Action Against Alzheimer’s Programme © Cytoplan

Summary of today All disease begins in the gut The gut bacteria are vital for gut and brain health Gluten, dairy, sugar, alcohol, antibiotics, PPIs, other medications, stress, infections, toxins and other foods can have a negative effect on gut health Vegetables, fruit, nuts, seeds, olive oil, apple cider vinegar, fermented foods have a positive effect on gut health Specific nutrients and supplements that help heal the gut if needed Action Against Alzheimer’s Programme © Cytoplan

Feedback questionnaires Feedback is welcome – please complete now and hand-in on your way out. Thank you ! Action Against Alzheimer’s Programme © Cytoplan