The relationship between gut health and our overall well-being is a topic of immense importance. It has a far-reaching impact beyond the gut, it is the portal to better heart health, brain function, longevity, and day-to-day vitality. I would like to emphasize the three core principles of good gut health:
- Food as Medicine
- Gut-Brain Axis and its interplay with your microbiome
- Personalized Screening for Inherited Cancers
The ongoing quest for the perfect diet that promises the best health, cures all discomforts, optimizes metabolic health, aids in weight loss, and prevents cancers remains a never-ending debate. In the midst of differing dietary ideologies like low-carb, Paleo, Plant-Based, Gluten-Free, Intermittent Fasting, and more, it’s essential to recognize that a one-size-fits-all approach doesn’t suit everyone. While some broad principles, rooted in ancient Eastern wisdom and now supported by modern science, such as intermittent fasting and a plant-based diet, can benefit a majority of people, a deeper understanding of individual factors is crucial.
Factors like genetic makeup, ancestral dietary patterns, acquired food intolerances, and specific health conditions all play a significant role. Take gluten, for example—it has historically served as a nutritious staple, helping large populations combat malnutrition during times of hardship. However, for some individuals with genetic predispositions, gluten can lead to conditions like celiac disease (an intolerance to the carbohydrate portion of wheat) or trigger IBS (Irritable Bowel Syndrome) due to immune reactions to wheat proteins.
For most people, a sensible approach involves limiting carbohydrate-rich grain-based foods without the complete depravity of the occasional pleasure of breaking freshly baked bread while surrounded by loved ones. In fact, a balanced diet that includes sprouted whole grains and live ferments, without artificial preservatives, can offer both nourishment and healing for the body.
Let’s delve into the topic of fiber! Just by adherence to a consistent consumption of 20-30 grams of fiber every day, I might see an 80% reduction in my outpatient appointments, with fewer cases of polyps at colonoscopy. However, it’s important to note that not everyone can benefit from high-fiber diets. Certain conditions, such as slow gut motility leading to problems like constipation, small bowel bacterial overgrowth, and delayed stomach emptying, can make patients feel excessively bloated when consuming fiber. In such cases, alternative approaches may be necessary, including a combination of laxatives, a low-fat, low-fiber diet, and medication.
Fiber comes in two primary forms:
Soluble Fiber: It dissolves into a gel-like substance when mixed with water. It’s found in starchy vegetables, fruits, beans, grains, and over-the-counter fiber supplements. Soluble fiber can slow gut peristalsis and help with diarrhea.
Insoluble Fiber: It is present in whole grains, leafy vegetables, and bran, and can speed up digestion, alleviating constipation.
Finding the right balance of soluble and insoluble fiber can create the optimal environment called prebiotics, for the growth of beneficial gut bacteria, known as probiotics.
Outside the brain, is a large network of over 200 million nerve cells that innervate the gut called the enteric nervous system, to the extent the gut is called the second brain. It is the hub of intelligence and a two-way communication highway also known as the gut-brain axis that links the enteric and central nervous systems, that interfaces with the endocrine, humoral, metabolic, and immune systems as well. This way the brain influences intestinal activities, and the extensive gut bases immune cells, and in turn the gut influences mood, cognition, and mental health.
A very important player in this interface is your friendly neighborhood gut bacteria we call the microbiome. If you consider yourself an individual with your own unique unwavering personality think again, each human is a host to trillions of microorganisms that make you a universe, of your own accord. The symbiosis and synergy between you and your plethora of microbes indeed set the tone of the communication on this gut-brain super highway and consequentially your gut motility, immune balance, metabolism, and even mental clarity and emotional health. Serotonin, an important mood-regulating hormone, 95 % is produced in the gut from enterochromaffin cells in the presence of symbiotic bacteria and the right nutrition. Nutrients rich in tryptophan an essential precursor of serotonin, such as Egg yolk, Tofu, whole grains, insoluble fiber, and fermented foods that enhance good bacteria, Omega-3-rich seafood, and nuts enhance the production of this “ happy hormone” in the gut. Constipation, destruction of the good bacteria by antibiotics, refined starch, foods with added preservatives, and emulsifiers can all contribute to low serotonin production. When tryptophan is not used properly in the body due to the absence of good bacteria, its potentially harmful metabolites can be the trigger for several neurodegenerative disorders and cancers.
Food and bacterial toxins can injure the gut lining by production of proinflammatory cytokines. Leaky gut refers to the microscopic damage to the gut lining which then sets the stage for various gut nuisance disorders such as IBS and various autoimmune disorders and degenerative diseases from immune dysregulation originating in the gut.
The current gold standard screening recommendation for colon cancer is a colonoscopy starting at age 45 and repeated every 10 years if no polyps are found, I believe that a more advanced approach, which I call Medicine version 2.0, should involve an in-depth and personalized assessment of each persons risk and provide a tailored protocol for cancer screening. With the advancement of blood-based DNA analysis, we can identify over 80 inherited mutations. Combining this genetic information with a thorough understanding of a person’s family history of cancer, and awareness of their environmental and lifestyle-related risks, we can develop an individualized surveillance plan to check for various types of cancers, both gastrointestinal (GI) and non-GI, to ensure early detection and a more personalized approach to cancer prevention and management.
My key message here is to embrace these 3 pillars of good gut health into our daily lives to achieve holistic, yet state of art health. Fuel your body with foods that promote harmony between your microbiome, neurohormones, and your metabolism. Additionally, timely and strategic interventions to outwit any genetic health risks that may be ticking away inside you will enable you to maximize your health and life span. Ultimately your health is intricately linked to your gut, nurturing this relationship can lead to a happier and healthier life.
