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Gastrointestinal Balance: Do you have the guts for health?. Mark Pettus MD March 8, 2018. The Epigenome How are “ Book of Life ” is interpreted and ultimately written. Disease (how things appear)
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Gastrointestinal Balance: Do you have the guts for health? Mark Pettus MD March 8, 2018
The Epigenome How are “Book of Life” is interpreted and ultimately written.
Disease (how things appear) Pre-diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Cognitive decline-Alzheimer’s, Cancer Core Metabolic Imbalances (what drives them) Inflammation Intestinal permeability-microbiome Root Causes (what are their origins) Gene-Environment-Compatability Nutrition Movement Stress Response Environmental toxins Sleep Social Connection Trauma Conflict Management Light Quality Stress Management Meaning in Work, Love, Play
H E A L T H S P A N Decline in our food quality Loss of Diversity of our gut microbiome
Problems with gut health can promote/worsen… • Allergy • Weight Gain • Asthma • Autoimmunity • Arthritis • Metabolic Bone disease • Skin problems • Mood disorders • Dementia • Cancer • Inflammation
Increased Intestinal Permeability And molecular trafficking
Common causes of increased intestinal permeability • SAD: Carbohydrate dense, high-sugar, low-fiber, processed diet; • Overuse of medications such as NSAIDs, antibiotics, acid blockers, steroids e.g. prednisone, chemotherapy • Food sensitivities – allergies e.g. gluten and casein • Low-grade bug imbalances (dysbiosis) involving yeast, bacterial overgrowth (SIBO) • Toxins e.g. BPA, pthalates, pesticide residues, glyphosate (GMO) • Stress or the brain-gut connection • Alcohol
GI Disruptors • Antibiotics (prescription and agri-production) • NSAIDs • Proton-Pump Inhibitors • Insufficient fermentable fiber • GMO foods; glyphosate • Toxins e.g. petrochemicals, plastics, packaging, cosmetics, teflon, herbicides, preservatives e.g. BHT, BHA • Blue light
Lectins • Highly evolved plant defense proteins • Whole grains, nightshades, beans, legumes, seeded veggies, unripened fruits/veggies • Enhance gut permeability • Elicit inflammatory response • Disrupt cell signaling, receptor function, endocrine disruption • Examples include WGA, gluten, A1-beta casein • WGA mimics insulin • Additive impact with altered microbiome, stress, sleep, medications, etc. • Strong effect on inflammatory and auto-immune conditions
Carbohydrate-dense foods Major contributor of obesity, insulin resistance, changes in blood lipids, inflammation, and alterations of the organisms in the human microbiome A huge area of opportunity in individuals with increased belly fat, pre-diabetes or diabetes…these are health features of carbohydrate intolerance. For most, sugar and refined, grain-based foods are problematic: eliminate and observe.
High-Quality Plant-Based Carbs Sugar, Fructose and Carbohydrate-Dense Grains Oral and Gut Microbiome Inflammation Neurotransmitters Insulin Resistance Weight and Metabolism Mitochondria-Oxidative stress HPA axis –Stress Response Protection from: Inflammation Diabetes Cancer Obesity
Noteworthy contributions to alterations of the human microbiome • Dietary changes e.g. refined, processed simple starches and sugars “carbohydrate-dense” foods • C-sections • Formula feeding • Marked decreases in fermentable fiber • Antibiotic use in prescriptions and in industrialized foods • Glyphosate as an anti-microbial • Hygiene hypothesis • Prior GI infections; H. pylori; systemic infections SIBO-small intestinal bacterial overgrowth • Medications e.g. PPIs, steroids, chemotherapy
Remove • Foods that one may be intolerant to (elimination diet: • start with gluten and dairy). • Medications that may negatively influence an optimal • GI environment (such as PPIs, H2 blockers, NSAIDs, • antibiotics, steroids). • For IBS or persistent dyspepsia, consider SIBO and • treat with xifaxin 200 mg, two tabs twice daily for • 10-14 days with neomycin • Consider a 2-4 week trial with Diflucan for yeast • Stress: how we interpret and respond
Replace For persistent dyspepsia, indigestion, or long-term use of stomach acid suppression consider digestive enzymes to promote better macronutirent breakdown. These are usually plant-based (papaya, pineapple) compounds e.g. bromelain taken with each meal.
Re-populate • Administer probiotics from the following three families that have been found to be beneficial for GI function: Bifidobacteria, Lactobacilli, and Saccharomyces. • Administer prebiotics (food that promotes beneficial bacterial growth) such as, plant-based fermentable fiber e.g. Jerusalem artichoke, onions, asparagus and garlic, cruciferous, resistant starch, leeks, berries. • Target at least 20-30 billion cfus/day