1. Lunch and Learn May 7, 2015 Deb Kirchhof-Glazier

2.  The U.S. is #1 in the world for health care expenditure but… ◦ We are 53 out of all 228 nations/territories on the globe for life expectancy ◦ 50% of American adults have one or more chronic health problems ◦ 33% of Americans have a digestive disorder and 74% live with some form of digestive symptoms  The gut microbiome plays a major role in health and disease

3.  Benefits of a healthy gut ◦ Optimal digestion and absorption ◦ Optimal nutrition- production of vitamins B1, B2, B12, and K ◦ Optimal immune function ◦ Physical and psychological well-being

4.  What is the gut?  What is the gut microbiome?

5.  The digestive tract goes from the mouth to the anus  The gut consists of the small and large intestines

7.  The gut lining is one cell thick  Substances are absorbed through the lining into our blood in two ways  Through the cells  Between the cells through dynamic tight junctions  If these tight junctions are damaged leaky gut occurs

9.  Digestion and absorption of nutrients  Waste disposal  Production of immune cells- 70%  Body balance- through the gut-brain axis- nerves (enteric nervous system), hormones, and bacteria in the gut work with nervous and hormonal systems  Satiety and food intake  Carbohydrate and fat metabolism  Insulin secretion and sensitivity  Bone metabolism  Lifespan

10.  Gut microbes outnumber our cells by 3:1 ◦ 2 to 6 pounds in most people ◦ 8 million genes compared to our 20,000  1200-1500 species; with 150-400 in a given individual  Most are in the large intestine  Work with our body cells in a mutual ecosystem

12.  Extracts energy and nutrients from food  Protects against pathogens  Affects mood, cognition, and sleep  Affects disease susceptibility-including cardiovascular disease, cancer, and diabetes ◦ Disrupted microbial ecology leads to systemic effects  Directly  Indirectly through leaky gut

13.  Leaky gut allows large proteins from food or bacteria to directly enter bloodstream  Can trigger ◦ autoimmune disease ◦ food allergies ◦ neurological problems ◦ various systemic problems -ex. eczema, chronic fatigue, headache, joint pain

14.  Causes of leaky gut ◦ Processed food ◦ Lack of sleep ◦ Chronic stress ◦ Toxins- includes alcohol, many medications ◦ Inflammatory foods- ex. sugar and wheat  All these things impact the microbiome

15.  Weight loss  Children’s health  Mental health  Practical tips for creating a healthy microbiome

16.  Factors contributing to weight gain ◦ Antibiotics in food and meds- activate genes in the microbes that increase fat production in the body ◦ Leaky gut- metabolites increase visceral fat ◦ Microbial ecology- High Firmicutes to Bacteroidetes bacteria ratio is associated with more calorie extraction, sugar cravings, and overall hunger

17.  Rx for weight loss ◦ Plant-centered diet- high nutrient and moderate energy content + fiber gives satiety ◦ Low sugar- especially high fructose corn syrup ◦ Probiotics and fermented foods ◦ Exercise Note: Severe calorie restriction does not help, especially if just means consuming less of the standard American diet

18.  Pregnancy and birth set the stage for the development of the child’s microbiome  During pregnancy ◦ Mother’s microbiome changes in gut and vagina + placenta acquires its own microbiome ◦ Bacteria begin to colonize the fetus ◦ Recommendations  Consume fermented foods and/or probiotics (latter under doctor’s supervision)  Lower stress- affects gut and vaginal microbiome

19.  Birth ◦ Baby acquires important bacteria by passing through the birth canal ◦ If C-section  Swab baby’s nose and mouth with vaginal secretions  Take probiotics to address post-op antibiotics  Breastfeed

20.  Infants ◦ Breastfeed- mother’s milk has beneficial bacteria and natural prebiotics, which feeds the bacteria  Children ◦ Accustom them to fermented foods ◦ Use antibiotics only when necessary, followed by probiotics ◦ Allow them to experience “healthy dirt” Note: Emerging evidence of disrupted microbiome in autism, ADHD, OCD, and eating disorders

21.  Enteric nervous system produces more than 30 neurotransmitters and 95% of our serotonin  Emerging evidence that microbiome affects anxiety, depression, and cognition, including Alzheimer’s disease  Importance of low-stress, mindful eating for overall process and the microbiome ◦ 5-10 slow rhythmic breaths stimulates the vagus nerve, which goes to the gut

22.  Nutrition ◦ Whole foods diet with an emphasis on plants, optimally fresh or alive  Note: To avoid kidney stones, do not overdo green smoothies that contain high oxalate plants like spinach, Swiss chard, beet greens, parsley, and kale ◦ Minimize processed food and sugar ◦ Minimize alcohol

23. ◦ Boost your good bacteria with  cultured dairy products- yogurt (plain), kefir  unpasteurized fermented foods – sauerkraut, kimchi  Probiotics, optimally with prebiotic foods like raw asparagus, banana, raw garlic, raw onions and leeks, wheat flour

24.  Eat at the optimal time ◦ Gut is most active in the morning and mid-day ◦ Allow 4-5 hours between meals- allows small intestine to sweep bacteria into the large intestine  Exercise  Drink adequate water- preferably not in plastic!  Tame your stress and get sufficient sleep

25.  5 Rs for healing the gut ◦ Remove- problem foods; elimination diet ◦ Replace- with healing foods; ex bone broth ◦ Repair- specific natural supplements ◦ Rebalance- probiotic rich foods for the microbiome ◦ Relax - helps overall

26.  Emerging extreme treatment- fecal transplants from a healthy donor for ◦ Clostridium difficile infections ◦ Irritable bowel syndrome ◦ Crohn’s disease ◦ Ulcerative colitis ◦ Diabetes ◦ Autism ◦ Multiple sclerosis

27.  Professional help ◦ Naturopathic physicians- http://www.naturopathic.org/AF_MemberDirectory.asp?v ersion=2 http://www.naturopathic.org/AF_MemberDirectory.asp?v ersion=2 ◦ Functional medicine physicians- https://www.functionalmedicine.org/practitioner_search.aspx?id=117 https://www.functionalmedicine.org/practitioner_search.aspx?id=117 ◦ Nutritional consultants- ex Monica Montag at BeWell Associates http://www.bewellassociates.com/http://www.bewellassociates.com/

28.  From the science ◦ The role of the microbiome in health is indisputable ◦ The details are complex and more research is needed for targeted clinical application  From applying the science ◦ Self care is preferable to health care ◦ When in doubt about the cause of a chronic disease, treat the gut ◦ It is never too late to make a positive impact on your gut and overall health