How do we take care of our gut health: Pharmaceuticals, Probiotics, and Diet:
Pharmaceutical manufacturing has become one of the biggest businesses in the world. The number of drugs that you can choose from is staggering. They are not, however, without problems of their own. Your medications for acne, insomnia, asthma, malaria, birth control, smoking cessation, and blood pressure may come with a side effect of depression. Ironically, even some anxiety meds can cause depression. Your first act on your psychobiotic journey is to rebuild your gut, taking steps to heal any lesions or permeability —so-called leaky gut. There are a number of possible causes for such distress, including: infections, inflammation, chronic stress, overuse of painkillers, continuing or repeated rounds of antibiotics, excessive alcohol consumption, autoimmune disorders like lupus, IBD and IBS, gluten sensitivity or food allergies, radiation or chemotherapy, overeating, and lack of exercise. When choosing a probiotic to help give your gut the good stuff you’ll want to take note of the main features: product name, manufacturer’s name and contact info, claims, dosage, format, suggested use, warnings, supplement facts, %DV, other ingredients, expiration date, lot number, and quality seals. The bacteria should be compatible with one another in a combined psychobiotic formula. It’s useful to note that most are Bifido and Lacto species. Bifidobacterium longum (R0175 & 1714) or Bifidobacterium infantis (35624): B. longum inhibits pathogens in the large intestine, reducing inflammation and helping to prevent diarrhea. It also helps mitigate lactose intolerance and food allergies. Some research has shown that it can lower cholesterol and can act as an antioxidant. B. longum reduces anxiety and cortisol levels. B. longum boosts the amount of available tryptophan, a precursor to serotonin, which can have an antidepressant effect. Bifidobacterium breve (1205): It seems to have a greater influence on anxiety than depression. It prevents the growth of E. coli, as well as Candida albicans, the fungus behind yeast infections. Its strong antipathogen effect may explain why it helps in the fight against diarrhea, IBS, and allergies. In addition, B. breve has long been known to alleviate problems associated with antibiotics. B. animalis, another member of the Bifido genera that includes the subspecies B. animalis lactis, has proven a benefit to people with ulcerative colitis. It has been shown to improve both constipation and diarrhea associated with irritable bowel syndrome. If you were born vaginally, B. bifidum will be one of your oldest bacterial friends. B. bifidum in combination with L. acidophilus and L. casei (in capsule form) for eight weeks has been shown to help people with major depressive disorder. L. acidophilus is the most popular bacteria in probiotic and psychobiotic formulations. found in fermented foods such as yogurt, sauerkraut, and kefir. It helps to prevent diarrhea and is useful in treating small intestinal bacterial overgrowth (SIBO). L. acidophilus is a potent fighter against Campylobacter jejuni, a pathogen that causes gastroenteritis and anxiety. L. bulgaricus is found in yogurt and kefir and is often found with other Lacto and Bifido species in these products. It has been shown to improve mood when used in a mix with other milk fermenters. Because it ferments lactose, it can help with lactose intolerance. L. helveticus is a popular addition to cheese cultures, as it inhibits bitter flavors. It has been shown to reduce blood pressure as well as depression and anxiety. Its main mode of action is to lower inflammation and enhance serotonin signaling. L. rhamnosus has been found to be useful for treating peanut allergies, diarrhea, dermatitis, and obesity. It lowers levels of corticosteroids, which reduces levels of stress, and it produces short-chain fatty acids, including butyrate, that both feed and heal the gut. Butyrate can also penetrate the BBB, where it acts as an antidepressant. L. rhamnosus is found in yogurt, Parmigiano-Reggiano cheese, kefir, fermented sausage, and fermented soy cheese. Note: Use caution with this psychobiotic if you have an impaired immune system, such as what accompanies HIV or lupus, as it could trigger sepsis. L. reuteri produces antibiotics against pathogenic bacteria, yeasts, and protozoans, making it a potent probiotic and an anti-inflammatory. It improves skin tone, along with reproductive fitness, lowers inflammation, and increases oxytocin levels in both mice and humans.29 It increases levels of leptin (the satiety hormone) and decreases levels of ghrelin (the hunger hormone), potentially decreasing your caloric intake. L. plantarum is found in many fermented foods, including pickles, kimchi, brined olives, and sauerkraut—all great ways to consume this psychobiotic. It has been shown in humans to attenuate soy allergies and reduce inflammation. Patients with chronic fatigue syndrome had less anxiety and better gut health after eating L. casei. L. paracasei is commonly found in fermented milk products and is common in probiotic mixes. It has been shown to lower levels of pain and intestinal distress caused by antibiotics and is a good adjunct when taking those drugs. Not all probiotics are reliable. One sobering study showed that out of 13 commonly available probiotics, only four contained what was claimed on the label. The few that have been found reliable include: Probio’Stick, VSL#3, Mutaflor, Align, Culturelle, Florastor, Yakult, and Activia. Please note eating the right kinds of foods has always been and still is the best way to achieve and maintain a healthy gut and will always be better than taking a pill form of a probiotic. Remember supplements are meant to supplement the diet not replace the diet. You should be eating more vegetables and fruit and less not so great meat. Among other good things, fruits and veggies contain substances called polyphenols that are important to your health. Polyphenols act as antioxidants, protecting you against pathogens as well as diabetes, heart disease, and neurological problems. They are, however, largely useless unless your microbiota is healthy and can properly break them down. Some of your friendly gut bacteria really like fiber. Bifido, for example, consumes the fiber moving through your intestines and produces butyric acid as a by-product. Butyric acid turns out to be a superfuel for the cells lining your gut, helping to rebuild your lining on a continuous basis. Butyric acid can also affect your brain, encouraging the production of feel-good neurotransmitters. The problem with refined food is that it takes no account of your gut bacteria. What we gave up was manna for our microbes. Today, we recognize the fiber processed out of refined foods as prebiotic—food for gut bacteria. Manufacturers cannot force us to eat healthy food. They are in the business of selling what people will buy. The more we demand our missing fiber, the sooner new products will show up on our store shelves. Fiber comes in soluble and insoluble forms. Insoluble fiber doesn’t dissolve in water and mostly passes through your gut quickly and with little ceremony. Soluble fiber, on the other hand, is the real gold. Prebiotic rich foods are key. These molecular chains are called oligosaccharides, Greek for “a few sugars.” The oligosaccharide chains that feed your microbiota have at least three sugar molecules and rarely more than ten. Typically a chain is made by adding identical links of a single sugar, which determines the first part of that complex sugar’s name. Fructo-oligosaccharide (FOS) is a chain of fructose, whereas galacto-oligosaccharide (GOS) is a chain of galactose, and both are proving to have psychobiotic possibilities. The advantage of eating prebiotic-rich foods over taking prebiotic supplements is that you are less likely to overdo it. Inulin is a kind of FOS found in many plants and a major natural source of fiber. Other great prebiotic foods include: sunchokes (Jerusalem artichokes), artichokes, chicory, endive, lentils, asparagus, beans, especially limas, onions, garlic, leeks, bananas, beets, broccoli, and fennel root. Many studies of gut-healthy diets recommend a Mediterranean diet, but other studies have found more species of gut bacteria, lowered anxiety, and improved cognition on a diet that includes lean beef. This is likely because the greater the diversity in your diet, the greater the diversity in your microbiota. Eat Fermented Foods, look for the Live & Active Cultures seal to ensure that the product has living probiotics in it. If you are trying yogurt for the first time as a psychobiotic, give yourself four weeks of a daily serving to see if it works for you. If you get bloating or diarrhea, back off the serving size. One caveat: Many yogurts are packed with sugar, which pretty much negates their probiotic benefit. Read the label and choose yogurt with no added sugar. So go for full fat if you can find it, or reduced fat—but stay away from fat-free yogurt products. The biggest psychobiotic contributor to your diet should be leafy greens and vegetables. Fruits, nuts, and berries are important, as are fish and fermented foods. You should consider probiotic supplements an important but relatively small player in the mix of what you eat for gut health and good mood. As far as a healthy diverse microbiota is concerned, diet turns out to trump environment and geography both. Studies have shown that a high-fat, low-fiber diet increases inflammation and endotoxins—illness-inducing chemicals released by certain injured or killed bacteria—by some 70 percent. High-fat and high-sugar diets increase inflammation, the source of much disease and discomfort, and can actually degrade your blood-brain barrier allowing dangerous toxins to access your brain. Minimize Sugar: Sugar, of course, can actually make you happier, but the effect is temporary. Long-term sugar use can make you sick, inflamed, and depressed. Fructose, a common sugar, can increase circulatory bacterial toxins and lead to liver damage as that poor organ tries valiantly to eliminate those toxins. Fortunately, we have some sugar substitutes that may actually be good for you. Real maple syrup, Honey has also been shown to decrease edema and lower inflammation. Get Plenty of Omega-3s: Saturated fats—think those that are solid at room temperature, like butter or meat fat—are the ones that can cause inflammation and gut distress. Omega-3 oils are the opposite. They are polyunsaturated as are olive or nut oils and the oils naturally occurring in fish. A diet deficient in omega-3s leads to microbial overgrowth in the small intestine—related to IBS—and inflammation,88 whereas a diet rich in omega-3s dampens inflammation and improves the diversity of your microbiota—These oils are also essential for creating new nerves and synapses, which can improve cognition and memory. Drink Less Alcohol. Get Antioxidants From Food: Antioxidants are your body’s way of fighting off the damage brought about by ordinary metabolic processes. Certain antioxidant foods—such as coffee, cocoa, green tea, turmeric, strawberries, and blueberries—have been shown to lower the risks of depression and cognitive decline. Just adding berries to your diet can delay mental decline by two and a half years or more. Avoid Emulsifiers: Two commercially important emulsifiers, carboxymethylcellulose (CMC) and polysorbate 80 (P80), have been shown to negatively affect both the thickness of your gut mucus and the diversity of your microbiota.Lecithin, originally isolated from egg yolk and now also derived from soybeans, is a good substitute, because it doesn’t induce the same dysbiotic effect as CMC and P80. Minimize Your Use of Proton Pump Inhibitors (PPIs) and H2 Blockers. Exercise. It’s actually difficult to overstate the benefit of low to medium levels of exercise (aerobics), which improves every system in your body. Although there are many ways to help your gut there are also many ways in which your gut can be hurt. People under chronic stress often change their eating habits, and many of them overeat. Psychological stress elevates circulating ghrelin, which stimulates a preference for calorie-rich “comfort” foods. These foods activate reward circuits, increasing dopamine and reducing stress-induced anxiety and depression.In our laboratory, we found that a high-fat diet protects against the deleterious effects of chronic stress. Fasting changes your microbiota, increasing levels of Akkermansia, a microbe known to encourage your gut to produce more mucus, providing greater protection from pathogens. Akkermansia is associated with a healthy gut and improved insulin sensitivity. Intermittent fasting and calorie restriction also increase levels of Lacto species with psychobiotic properties. When starting your gut healing journey try to monitor three or more things in your life that contribute to your health and mood the best: feelings of sadness or despair, feelings of nervousness or fear, sleep patterns, daily cycles of alertness, clarity of thought, ability to concentrate, changes in bowel movements, and changes in appetite or cravings. When talking about gut health we also have to talk about the many diseases of the gut. Up to 90 percent of people with IBS also experience depression or anxiety, making it clear that IBS is a disorder of the gut-brain axis. There might be a reason to try foods with a low insulin response to treat IBS. The microbiota is the number one culprit in these inflammatory diseases. Both UC and CD have been characterized by a reduction in Bifido and Lacto species, and treatment with probiotics has had encouraging results—but only in the quiescent stage, before the symptoms become virulent. When the disease becomes active, that situation reverses and there is an overgrowth of these species, so adding more only exacerbates the problem. Also unhelpful: In the last century, the government decided to recommend high levels of carbohydrates in the diet. A food pyramid was published and widely circulated that placed bread and pasta at the foundation of your diet. That was a bad decision based on bad science, but it has taken far too long to redress the error. Carbs are delicious, but they become deadly when the fiber is refined out. The microbiota of people with obesity is perversely efficient, squeezing the last bit of energy out of each morsel. That’s why your skinny friends don’t gain weight: Their bacteria are inefficient. People with obesity appear to have excess quantities of Bilophila, a family of bacteria that loves bile. Bile is necessary to digest meat and fats, two common mainstays of a weight-enhancing diet. But Bilophila also appears to secrete toxins that may, in turn, lead to chronic inflammation that can affect your mood. But exhortations to diet don’t lead to long-term success, likely because the complex system of hunger and satiety has been somehow compromised. Your gut microbes play a role in the health of your heart. A chemical called trimethylamine N-oxide (TMAO) is known to contribute to atherosclerosis. When the gut microbiota processes meat, it may produce excess TMAO and thus increase your odds of getting heart disease. Those who suffer from CFS often have dysbiotic guts, including IBS. Their levels of Bifido are lower than normal. Modern processed foods were developed, for the most part, in the United States. We have a tradition going back only hundreds of years and resulting in a mixed, poorly vetted, inconsistent cuisine. The quintessential American food is the hot dog, a finely ground sausage of varying animal parts. We eat corn products like they are going out of style (they are not). As we spread our cheap treats around the world, Western diseases and obesity follow close behind. The diets we should strive for all have fiber and probiotics, the items most desirable for a well-balanced microbiota. Western food has lost both. Probiotic foods like sauerkraut have often been abandoned now that refrigeration is ubiquitous. Most store-bought fermented products such as sauerkraut are likely pasteurized, meaning that most of the microbes have been killed. Remember real food is king to a healthy gut and I hope the takeaways from this book have helped you and that you have learned something about your gut health.
