How all disease begins in the gut

Hippocrates’ famous words are still eagerly cited over 2000 years later. Even though he knew that the digestive tract was a special place, at the time he may not have known why exactly. So what does it really mean that ‘all disease begins in the gut’? Many chronically ill people have never experienced any digestive symptoms so how can they relate?

The gateway to good health

The answer is in the INDIVIDUAL MICROBIAL ECOSYSTEM, also called the microbiota, microflora or microbiome. Although every part of the body has a unique microbial environment, most organisms colonise the gut and include bacteria, fungi, archaea, parasites and viruses. Even parasites play a key role for our health by helping us detoxify or modulate the immune system. Whether you like it or not, we all have them.

We now know that the human body has a lot more microbes than cells, and it has been estimated that our gut carries around 2 kilograms of various organisms. While we all have a similar DNA, only around 5% of microbial genetic code is shared among people. Some say we are only 1% human. Depending on the type and strain, the microbes produce all sorts of messengers, nutrients and toxins, making us who we are (yes, personality too!), energising us, keeping our metabolism in check or causing disease. While microbial imbalances can disrupt digestion, they often don’t, which depends on the specific organisms and their action within the human body. In other words, the fact your digestion is smooth doesn’t mean you don’t have a microbial imbalance.

Factors that positively influence gut microbiota:

• Maternal health and diet before and during pregnancy

• Being born through the vaginal canal

• Being breastfed

• Diet and lifestyle throughout life

• Contact with animals and nature

• Getting your hands dirty (e.g. gardening)

Major disruptors of microbial balance:

• Antibiotic treatments and other medication (e.g. antacids, anti-fungals or the pill)

• Inappropriate diet

• Stress

• Living in a sterile environment

One man’s meat is another man’s poison

The main factor that influences health and diversity of our microflora is food. After all, we may not be what we eat but rather what our unique microbes can eat and process into beneficial or toxic substances. Before food is available to us, it is first processed by microbes. This brings nutrition onto a truly personalised level and is the main reason why I become a nutritional therapist. I think that out of all therapies, food has the most direct effect on the microflora, therefore influencing our biology and addressing the root cause of illness. While the reasoning and research behind Hippocrates’ words are relatively new, I hope that it will be the future of medicine.

While eating a whole food diet is great for anyone, there are no universally healthy foods. The various microbes feed on different substances, and what makes one person healthy can be inflammatory for another. For example, while some people do great on raw fruit and vegetables, others may get bloated after eating raw apples or carrots. Many are unable to tolerate fermented foods which are routinely recommended as a blanket remedy for gut health. Spinach, blueberries and broccoli may cause adverse reactions too, from joint pain to hives. My rule of thumb is:

“If something gives you a digestive discomfort, it’s most certainly a source of toxicity and therefore illness. ”

The same goes to fad diets. While one person may be doing great on a high fat diet, another will need a lot more carbohydrates. Research is now emerging about how the same food can affect two people differently, even in terms of weight management. Did you know that the microbiota are responsible for extracting calories from food?

Functions of microbiota

• Coating the gut, preventing it from toxins and allergens (i.e. preventing from the ‘leaky gut’)

• Digestion and absorption of nutrients

• Production of antimicrobial substances

• Production of various enzymes

• Production of antioxidant and anti-inflammatory substances

• Production of nutrients

• Appetite modulation

• Detoxification of hormones

• Modulation of cholesterol levels

• Immunity

• Metabolism (including extraction of calories from food)

• Energy production

• Ageing

• Binding and excretion of heavy metals

Health problems that originate in the gut

We are just starting to understand the microbiome but below are some health conditions that have been well researched in terms of their relationship to unhealthy microflora:

• Allergies, intolerances

• Autoimmune diseases

• Respiratory infections like asthma or chronic sinusitis

• Mental health disorders (depression, anxiety, schizofrenia, behavioural issues)

• Neurodegeneration (Alzheimer’s, Parkinson’s)

• Skin conditions

• Weight gain / obesity / metabolic syndrome

• Digestive issues

• Cancer

• Physical degeneration, e.g. arthritis

How does unhealthy microfora cause disease? By producing inflammatory toxins (called endotoxins or lipopolysaccharides) that escape through the ‘leaky gut’ and attach themselves to various tissues and receptors.

How to support the microbiome

‘Test, don’t guess’ is the first step to evaluate individual gut environment. After that, it’s about feeding specific beneficial microbes with the foods they thrive on, and eliminating any pathogenic overgrowths. Optimising digestion and stress response are key elements of the process because pathogens feed on undigested foods and tend to outgrow when chronic stress is present.

What about probiotics for gut health?

While there are many wonderful products on the market, probiotics should be left to professional advice. Each strain corresponds to specific health properties and without the expertise, it’s easy to waste a lot of time and money. Probiotics on their own won’t shift health if concurrent dietary and lifestyle changes are introduced anyways. Home made fermented foods is a safe start for anyone who can tolerate them.

How I can support you

In order to address any health complaint, I first analyse the function of the gut which covers digestive capacity, microbial balance, infections, gut integrity, inflammation and oral tolerance to foods. I can also offer advanced functional testing for all health concerns, with testing kits delivered to your preferred location. Based on the information I have gathered, I formulate a recommendations plan which includes a personalised list of foods that are optimal for you, meal ideas, lifestyle tips and supplementation, if needed.

Article published in The Islander, December’18 edition

The smelly side of yachting

Behind the glamurous scenes of yachting, probably all stewardesses and engineers know that toilets can be no fun. The substantial amount of toilet paper that lands in the drains poses a question: why so much? Ideally, there should be no or little need for tissue but bowel habits can be far from perfect.

Digestion is the primary area of dysfunction in the body that impacts all areas of health, even when no apparent digestive symptoms are present. In my experience, other ongoing issues often resolve themselves once the gastro-intestinal tract has been appropriately addressed. After all, we’re not so much what we eat but rather what we can break down and absorb. This is why people who ‘eat well’ can still look and feel unhealthy.

Why does it matter in the yachting industry? Because the level to which food is digested and absorbed dictates energy levels, overall health status and mental wellbeing.

What is digestion?

It is the process of mechanical, chemical and microbial breakdown of food, extraction, production and absorption of nutrients, and removal of waste. We do not absorb food as such but the extracted vitamins, minerals, amino acids, glucose and fatty acids. We then utilise them to regenerate, produce new cells, hormones,neurotransmitters, etc.

Digestion works in a cascade order, meaning one disrupted process will result in the impairment of all consecutive steps. The brain plays the important role of a command centre, and it can take as little as looking at the phone while eating to maldigest.

Most common reasons for impaired digestion:

• processed diet

• stress of any sort

• burning the candle at both ends

• mindless eating

• stimulants

• not chewing food properly, eating fast

• microbial imbalance

• lack of animal protein

• low fat diet

• coeliac disease, gluten intolerance

• nutrient deficiencies

• too much grains (baked goods, cereal, pasta, rice, etc)

• drinking while eating, especially cold beverages

Immediate signs:

• feeling of fullness after a small amount of food

• bloating, passing smelly wind or too much wind in general

• belching

• indigestion

• heartburn / acid reflux

• light coloured / floating stools

• pain / cramping in the abdomen

• constipation / diarrhoea

• sticky stool, the need to wipe with multiple pieces of paper

Long-term signs:

• nutrient deficiencies (zinc, calcium, iron, B12, folate, vit A, D, K2)

• inability to build muscle

• high cholesterol

• poor energy

• slow metabolism

• allergies and intolerances

• anaemia

• osteoporosis

• loss of smell / taste

• no desire for meat

• recurring infections

• dry / itchy skin / rosacea / acne

• mental issues, hormonal imbalances, cancer, autoimmunity and all other chronic health conditions

Due to the nature of work, stress levels and insufficient expertise in nutrition, diet and digestion on yachts leave a lot to be desired. Indeed, it can be tricky for chefs to cater for individual needs but it’s no coincidence that bathrooms can be smelly. Pasta, pizza, cereal, bread and sweets may be convenient fillers but ongoing indulgence can result in a post-season burnout. A number of chefs and stewardesses saw me after the season to help them bounce back. All of them had digestive symptoms.

What to do

• Look at your poop and have a think about the smell - much as it may seem gross, it’s an important ‘test’ that will tell you a lot about your health, for free. My next post will help you interpret your waste

• Squatty-Potty or just an Ikea foot stool is a great aid that can be kept in the toilet and used by everyone. It forces gentle squatting, imitating the way humans used to evacuate and making bowel movements easier

• Have a shot of water with lemon juice or raw apple cider vinegar (e.g. this brand) before each meal

• If salad is available, have it before rather than with the main meal, and dress it with olive oil and vinegar

• Eat slowly and mindfully - the stomach doesn’t have teeth. Chew well and put cutlery down each time you take a bite. Leave all phones in a designated place before sitting at the table. Tune into YOUR body and how YOU react to the various foods

• Add quality salt to your food (e.g. sea, Himalayan or Celtic) as it enhances digestion of protein

• Try not to combine animal protein with starches, e.g. steak and fries or spaghetti Bolognaise. Have the meat or ragu with vegetables instead and increase the portion if possible. Do not add fresh fruit to cereal, granola or porridge except for ripe banana

• Drink plain hot water during breaks. If available, add a bit of fresh ginger

• Manage stress, e.g. Headspace app, brief workout (especially stretching combined with diaphragmatic breathing), few deep breaths, book, even just a page a day. It is important to have a think about your possible stressors as these go beyond the emotional aspects, e.g. food intolerances or spinal misalignment

• Sleep whenever you can

How I can support you further

During consultations, I analyse the function of the entire digestive tract which includes the state of the gut in terms of dysbiosis, infections, leakiness, inflammation and oral tolerance to foods. All aspects of restoring digestive balance depend on individual factors and medical examination is often invaluable. I can also offer advanced functional testing, with testing kits delivered to your preferred location.

Outside the clinic, I support chefs in developing health oriented menus not only for crews but also guests who may have specific health ailments, with the main focus on digestion. I also help my clients organise their kitchen, pantry, and we go food shopping together.

Article published in The Islander, November’18 edition