Mind-Body Balance: The Science of Allostasis

Lecture by Mark Pettus transcribed by Carolann Patterson

“Direct your eye inward and you’ll find a thousand regions in your mind yet undiscovered.  Travel them and be expert in home-cosmography.” - Henry David Thoreau

Learning objectives for this lecture are to:

• Review the concepts of allostasis and allostatic load.
• Connect the burden of allostatic load with a biologic basis for chronic complex medical disease.
• Review strategies for reducing allostatic load, reducing disease risk, and promoting health.

al·lo·sta·sisˌ aləˈstāsis/: noun. 1. the process by which the body responds to stressors in order to regain homeostasis.

Allostatic Load and Health

Our brain weighs 3 pounds and contains trillions of neurons and wired connections. Our brain is the interpreter of all environmental inputs in our lives. The brain is not geared toward accuracy. It is geared toward SURVIVAL…and sometimes, it doesn’t interpret signals in the right way….

1 out of 2 Americans currently has a chronic complex disease. 1 out of 4 has a meaningful disruption in their lives. This is the result of The Contemporary Convergence, where the Gene-Epigenome + Environment + Microbiome = Outcome, an outcome that is equal to how the outside gets inside us. The outcome sends clear signals that Health is not just a matter of DNA...

The science of epigenetics reveals how the choices we make can change our genes – and those of our kids [John Cloud, Time magazine January, 2010].

Allostasis is the ability to achieve stability through CHANGE... Your DNA is therefore not your destiny.

Health is a byproduct of gene-environmental compatibility and so it follows: 

Change Your Life:Change your Genes.

An Ancient Design in Modern Times: 

The social and cultural context in which we live has moved forward at lightning speed into the 21st century.  Our genetic endowment and the survival edge it brings with it are still Primitive.  Our design has maintained many of the Stone Age imperatives, but life in the fast lane has not. We are not well adapted for this and we will eventually break down. 

Here's how things have shifted from Ancient to Modern: 

• THEN: Targeted fight-flight [quick turn off and on]
• NOW: Anxiety, fear, PTSD, depression, all chronic, complex diseases [always on]
• THEN: Energy Conservation [quick turn off and on]
• NOW: Obesity and Metabolic Syndrome [does not turn off, we are always saving for a rainy day that will never come]
• THEN: Immunity [quick turn off and on]
• NOW: Autoimmunity and allergy [constant hyper-vigilant state]
• THEN: Promotion of clotting
• NOW: Heart attack and stroke [hyper-vigilant clotting]

Three great Nobel-prize-worthy researchers in the field of Mind-Body Science:       

Richard Davidson PhD, Director, Waisman Lab Neurosciences, University of Wisconsin Medical School; Bruce S. McEwen, PhD, Alfred E. Mirsky Professor, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University; and Robert Sapolsky PhD, John A. and Cynthia Fry Gunn Professor of Neuroscience and Primatology, Stanford University

Primal Neurobiological Systems are deeply rooted, well adapted systems that are aligned throughout our body:

• Fight-Flight - [or the “stress response” as identified by Bruce McEwen]. We might not even know when it is engaged or we might sense gut discomfort or shortness of breath, but there are always high levels of reasoning behind being hi-jacked.
• Reward Response – Dopamine is our body’s reward transmitter. We receive health promoting rewards through Love, Exercise, and Mental Engagement. Equally, non-health promoting reward responses are promoted through Drug Use, Alcohol, and Sugar. It is possible to recreate a healthy reward system, by changing an unhealthy one.
• Attachment or Bonding – we are born to bond. Babies take longer to develop and the greater the bonding, the greater the chance for survival. More attachment leads to more dopamine. There is a specie tendency to be drawn in by others, but social connectivity can disrupt as much as it can heal.

An increased allostatic load yields poor health outcomes - a sudden overload of stress can create a life-threatening health crisis. Too much stress over time can also create life-threatening situations. Cardiovascular disease and depression are the top two causes of disability in the industrialized world. As many as 5 percent of Americans are experiencing symptoms of depression at any point in time. High levels of cortisol are known to decrease serotonin receptors in our pre-frontal cortex. Decreased serotonin activity in the brain is central to the feelings of despair and depression.

The Stress Response: CRH [Corticotropin Releasing Hormone] stimulates release of the adrenal corticotropic hormone [ACTH] from the pituitary gland. ACTH travels in the blood to the adrenal glands which then produce the hormone cortisol. Powerful boosts of cortisol and adrenaline inhibit higher levels of conscious thinking and increase hyper-focus on a very specific target of concern.

Thoughts [being "lost at sea"]; Behaviors [away from healthy choices]; Emotions and Feelings [fear, sadness, anxiety] are all manifestations of fight:flight that increase blood pressure, insulin, sugar, and a fatty mid-section, while decreasing memory and resilience.  

We are also driven by another neurobiological system - the reward-motivation response. It is hard getting through life without the experiences that inspire, motivate and reward us with meaning and feelings of optimism, hope and joy.  Resilient individuals have cultivated a reward system that is resistant to setbacks, sometimes catastrophic or chronic. Life's difficulties do not diminish their capacity to experience positive emotions. Individuals whose reward response is dampened are less likely to experience pleasure in their lives and are more prone to states of anxiety and depression. They are less resilient.

Neurotransmitters associated with the reward response include dopamine, glutamate, GABA [Gamma Amino Butyric Acid which facilitates a calming effect]. At this point, it's important to note that a behavior that elicits a reward response is not always health-promoting. Dopamine, for example, rewards carbohydrate binging as much as it does exercise.

The reward response, just like the fight:flight response can drive behaviors that bypass or diminish input from the pre-frontal cortex, which is responsible for reasoning, judgement, and emotional control.

Stressful environments are hard to over-ride, but if we change our patterns of behavior, the brain has plasticity and can learn new tricks to conform with new behavior...

Now that we know the good news - that a brain CAN learn new tricks because it has plasticity and is able to morph. The Science of Mind further demonstrates that the brain is designed for adaptation at any time in life.  

Up your Game: Change your Brain - Brain Derived Neurotrophic Factor [BDNF] aka a healthy "Miracle Grow" is decreased in Depression, Alzheimer's, Epilepsy, Schizophrenia and OCD. A healthy increase in BDNF comes with Exercise, Caloric restriction combined with plant-based nutrition, Coffee [and other phytonutrients], DHA-omega 3, Curcumin-turmeric, EGCG [green tea], Meditation, Reduction in gut permeability. 

Fight-Flight and the Sympathetic Tone? Get “Para” as much as you can...

Many age-related diseases come as a consequence of over-stimulation of our sympathetic nervous system, e.g. fight-flight. We have within us a built-in system to counter this response: the parasympathetic system. Turned on by meditation and relaxation techniques, this system has a calming and protective effect of decreasing heart rate, reducing brain distraction and anxiety-provoking neurotransmitters while improving metabolism. Cultivating behaviors that enhance parasympathetic tone – meditation, positive relationships, mindfulness, or listening to a beautiful piece of classical music – will serve as potent antidotes to sympathetic overdrive.

Medical evidence linking meditation with many positive health outcomes is unequivocal.

The Buddhist practice to displace a negative mindset and cultivate a positive mindset is an excellent health promoting strategy.  

Evidence links positive emotional states/traits with better health outcomes.

Mind Body Stress Relief [MBSR] leads to a Reduction in Inflammatory Biomarkers. Emotional wellness increases. Inflammatory gene expression patterns down regulates; NF-kappa B * - the master switch of inflammation - gets turned off; and C-reactive protein is reduced. 

* NF-κB - keep it turned off... 

NF-κB is a nuclear transcription factor that is triggered by diet, stress, environmental toxins, visceral fat, infections, intestinal barrier integrity disruption, oxidized LDL, free radicals, vitamin D deficiency, altered microbiome, LPS, inflammation from other sources. It up-regulates expression of 400+ genes involved with cytokine production, cell proliferation, apoptosis, angiogenesis. Exercise, meditation, Vitamin D, Spices [e.g. turmeric] and many plant flavonoids have shown to inhibit NF-κB in vitro and in vivo. Nrf2 is the antidote to NF-κB. 

Nrf2 - keep it turned on. Activation of Nrf2 is a critical intracellular defense:  Exercise, Meditation, EGCG, Resveratrol, Coffee, Sulfurophane, Curcumin all boost Nrf2. 

Mindfulness does a body good - Contrary to popular misconception...Mindfulness does not need to be carried out in a silent sanctuary with incense burning and soft background recordings of babbling brooks.

Mindfulness practices - meditation, prayer, yoga, relaxation response, guided imagery, biofeedback, and gratitude journals - are not deliberate attempts to detach from the busy world around us. They are the opposite, intentionally heightening awareness of each and every passing moment. 

The health benefits of mindfulness include: decreased cortisol, fight:flight response and blood pressure; increased parasympathetic tone [the antidote to stress]; improved mood, concentration, pain tolerance, and resilience; decreased cardiovascular risk; and enhancedneuro-plasticity .

Motion is the Lotion - Activity and Movement neutralizes the fight:flight response. Muscle acts as a metabolic engine to decrease insulin resistance, drop cortisol levels and increase endorphins and dopamine. Movement enhances strength, resilience, balance, concentration and mood. It also decreases inflammation, cardiovascular, diabetes and cancer risk and profoundly enhances longevity and quality of life. 

Meaning-Maker - Create meaning in your work, love and play. Meaning cannot be willed. It comes from Experience, Discovery, and Awareness. Meaning comes from a healthy reward response, bonding and social attachment, and the parasympathetic tone that diminishes fear and fight:flight mode.

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For more "news to use" from Dr. Pettus and the science to go with it, visit The Health Edge: Translating the Science of Self-Care. Not all research slides are shown in this article. To download complete lecture, follow this link to BHS Creating Health Wellness Series.

ENVIRONMENTAL TOXINS: What CAN we do about them?

Lecture by Mark Pettus transcribed by Carolann Patterson

ENVIRONMENTAL TOXINS: How do they get inside of us; what do they do to us; and how can we undo the damage they cause?

Learning objectives for this lecture will be to

i. Review some common sources of environmental toxins that pervade daily living.

ii. Examine how the growing burden of environmental toxic exposure affects health and quality of life.

iii. Examine lifestyle, behavioral, and supplement strategies that can reduce our toxic burden and optimize our capacity for detoxification.

The Precautionary Principle

“We as physicians must act on facts…and on the most accurate interpretation of them, using the best scientific information.  That does not mean that we must sit back until we have 100% evidence about everything. When the state of the health of the people is at stake…we should be prepared to take action to diminish those risks even when the scientific knowledge is not conclusive” Horton. Lancet. 1998;352(9124):251

America does not apply The Precautionary Principle as do other parts of the world - especially in Europe and Canada. In America, THOUSANDS of chemicals are permitted to be used in food and countless other products until proven 100% unsafe and dangerous. Other countries approach it from the opposite angle: when a chemical is proven 100% safe it is then permitted to be used. If it happens that it is already in the system and considered to be unsafe it is more readily removed than would be the case in the US.  

Exposure to environmental toxins

Since WWII, more than 85,000 new synthetic chemicals have been released into the environment. As a species we are exposed to 6 million lbs mercury and 2.5 billion lbs of other toxic chemicals each year. Most have not been tested for potential toxicity in adults [few in children]. Over 4 billion lbs of pesticides are used annually in the US. Current law allows 350 pesticides to be used on the foods we eat. The average home contains 3-10 gallons of hazardous materials. Traces > 280 synthetic chemicals can be found in the average newborn.

Our Toxic Load is being passed on

The Environmental Working Group commissioned five laboratories in the U.S., Canada, and Europe to analyze umbilical cord blood collected from 10 minority infants born in 2007 and 2008. Collectively, the laboratories identified up to 232 industrial compounds and pollutants in these babies, finding complex mixtures of compounds in each infant. This research was the first ever to detect BPA in US cord blood as found in 9 out of 10 cord blood samples. Environmental  Working Group [EWG.org] -Neonatal Toxicity Study.

The research demonstrates that industrial chemicals cross the placenta in large numbers to contaminate a baby before the moment of birth. Of 10 babies born in US hospitals, 287 chemical compounds are identified in their cord blood, with an average of 200 chemicals per infant. In total, the nine EWG subjects with chemical traces in the cord blood carried:

• 76 chemicals linked to cancer in humans or animals [average 53]
• 94 chemicals that are toxic to the brain and nervous system [average 62] – nb: a more sensitive part of the body, Parkinson’s, Alzheimer’s
• 86 chemicals that interfere with the hormone system [average 58] – nb: endocrine disruptors, puberty is now 2 years earlier, PCOS poly-cystic-ovarian-syndrome is an epidemic in, infertility is close to epidemic, sperm counts are down and 1:8 women develop breast cancer]
• 79 chemicals associated with birth defects or abnormal development [average 55] – nb: associated with Autism
• 77 chemicals toxic to the reproductive system [average 55]
• 77 chemicals toxic to the immune system [average 53] nb: autoimmunity epidemic linked to toxic exposure 40-50 million adults with thyroid disease, rheumatoid arthritis, psoriasis, MS. 

Pesticide Levels in Children

Some foods have more “residue” from pesticides. Switching your Dirty Dozen to 100% organic will yield 90% reduction in pesticide residue levels in urine.

What are the Main targets of chemical toxins? Chemical compounds clearly affect the:

• immune system [allergies/asthma, chronic infections, auti-immunity]
• Nervous system
• Endocrine-hormonal system
• Generational [coding and programming that is passed on to children who are born with their systems on alert and “switched on“].

The Effects of Toxins

• Fatigue
• Muscle aches / joint pain
• Brain fog
• Headaches
• Sinus congestion and allergies
• Digestive problems
• Skin problems
• PMS and hormone imbalances
• Weight gain

 Plausible evidence links toxic exposure with risk of:

• Immune: Autoimmune diseases, allergies, asthma, chronic dermatitis, and multiple chemical sensitivities [MCS]
• Mitochondrial and Metabolic: Chronic fatigue, fibromyalgia, PD, autism spectrum, obesity, insulin resistance
• Endocrine and reproductive disorders: weight gain, PMS, PCOS, Infertility, Endometriosis, Fibroids
• Digestive disorders: IBS, nausea and vomiting
• Neurological disorders e.g. Parkinson’s, ALS, Alzheimer’s disease, autism spectrum, and multiple sclerosis
• Behavioral health disorders e.g. depression, anxiety, attention deficit and hyperactivity
• Diabetes and cardiovascular diseases

Mitochondria are our “powerhouses.” There are 53 trillion contained in every cell. They have their own DNA - their own “book of life” - and can run themselves.  We get our mitochondrial DNA from our mothers. Mitochondria from the father are loaded in the tail of the sperm and exclusively designed for one thing: to be the first to get to the egg. Once there, the tail falls off and all mitochondria then come from the mother. 

Sick mitochondria are driving many complex diseases:

• Parkinson’s, Autism, ALS, MS, Dementia
• Fibromyalgia
• Chronic fatigue
• Complex pain syndromes
• Congestive heart failure
• Pre-diabetes/diabetes

There are many things that can be done to restore mitochondria health by following the same protocol as Anti-Inflammatory diet and lifestyle. To learn more, link here to The Health Edge podcast on mitochondria.

Chemicals Cause Damage:

• Mitochondrial toxicity – reduced function of the mitochondria and reduced function in cells/organs that contain mitochondria
• Oxidative damage [ATP ‘our energy.” Fats are more efficient than carbs for energy production. They improve metabolism and decrease oxidative damage]
• Neurotoxicity – solvents diminish neural functioning and Pesticides are neurotoxins by design

Some people retain more toxins than others for the following reasons:

• Genetic differences in Phase One and Phase Two enzymes [polymorphism] nb- this is less about a “bad” gene and more about “typos” in the genes that we are given at birth
• Nutrient deficiencies [in Mg – Magnesium; Se - Selenium, and Vitamin B6] prevent detoxification. Many of us are also deficient in Vitamins A, E, and K all of which are powerful antioxidants that aid detoxification.
• High sugar/Low protein diets
• Stress, emotional stuffing, trauma – allostatic overload impairs one’s ability to detoxify
• Heavy metal presence [esp Hg – Mercury]
• Increased exposure to toxins

We enter the world with genetic pre-dispositions towards certain conditions, but that does not mean you will get it

We enter the world with genetic pre-dispositions towards certain conditions, but that does not mean you will get it.

Inheriting “typos” can lead to poor detoxification.

Glutathione S-Transferase pi-1 is responsible for Phase II detoxification of xenobiotics*, carcinogens, steroids, heavy metals, and products of oxidative stress. GSTP1 is located primarily in the brain and lungs.

GSTP1 polymorphisms are associated with either higher or lower enzyme activity, depending on specific environmental exposures. There is an increased risk of toxic burden, oxidative stress and various cancers especially if “GSTM1 Absent” or exposed to cigarette smoke. *Xenobiotic: a foreign chemical substance found within an organism that is not naturally produced by or expected to be present within that organism; substances which are present in much higher concentrations than are usual.

Treatment options to Boost GST activity:

• Eat cruciferous vegetables [broccoli, bok choy] and alliums [garlic] to increase GST activity and reduce cancer risk
• Eat a diet rich in antioxidants [colorful foods] and consider supplementation
• Ensure availability of GSH cofactors [methionine-rich foods, NAC, L-glutamine, glycine, Mg, B6
• Limit Glutathione depletion with alpha lipoic acid, milk thistle and taurine
• Minimize exposure to xenobiotics, including polycyclic aromatic hydrocarbons and toxic metals

Pharmaceuticals are in our Drinking Water

At least one pharmaceutical was detected in tests of finished drinking water supplies for 24 metropolitan areas, according to an Associated Press survey of 62 major water providers. Only 28 tested finished drinking water. Tests results vary widely. Some water systems said tests had been negative, but the AP found independent research showing otherwise.

Phthalates are in the Products we use...and in our Urine...

Phthalates are used in many common products easily released into the environment. Exposure is airborne, from food and from direct contact. They disrupt endocrine function [EWG's list of endocrine disrupters] and are associated with cancer e.g., breast

Environmental Toxins are prevalent in many products:

• Persistent Organic Pollutants “POPS” : e.g. PCBs, dioxin, DDT, organochlorine pesticides, petrochemical fertilizers, herbicides
• Perfluorooctanoic acid “PFOA”: water repellant in Scotch Guard, Gortex, carpeting, upholstery and PTFE in Teflon
• Polybrominated compounds PBDEs : flame retardants in TVs, computers, etc. “21st century PCBs”
• PCBs : in meat, fish, dairy
• Bisphenol A “BPA”: polycarbinated plastics, canned foods, cash register receipts
• Atrazine agricultural pesticide and herbicide seeps into drinking water

Toxic Chemicals are in Beauty Products:

The average woman uses 12 products daily, containing 168 unique ingredients. The average man uses 6 products daily, containing 85 unique ingredients. Get to know what you are putting ON your body, not just IN your body:

• Phthalates and Parabens: found in hair and skin care products
• Fragrance: found in shampoos, deodorants, skin and body care
• DiethanolamineI: DEA
• Triethanolamine: TEA - found in many cosmetics
• Diazolidinyl Urea, Imidazolidinyl Urea, and Quarternium-15: found in skin and hair products…all release formaldehyde and are linked to sensitivities
• Sodium Lauryl Sulfate: [SLS]
• Sodium Laureth Sulfate: [SLES] found in makeup, shampoos, conditioners and toothpaste. When combined with DEA and TEA they form nitrosamines which are carcinogenic
• Triclosan: a synthetic antibacterial in skin cleaners and household products is a hormone disrupter. The EWG Dirty Dozen Endocrine Disrupters are listed here

A useful site for to help you get to know the cosmetics you use: 

• Cosmetic Safety Database     www.cosmeticdatabase.com

Explore switching to natural cosmetic products:

• www.avalonorganics.com
• www.evanhealy.com
• www.sumbody.com

MERCURY is found in Fish

Mercury is environmentally ubiquitous with levels 30x higher last 2 generations. It enters the air and rain from coal and oil-fired power plants, incinerators, waste and manufacturing plants that use mercury to produce chlorine-containing plastics, PVC piping, pesticides, etc. It enters water and soil from natural deposits, volcanic activity, mining ore, and disposal of wastes e.g. batteries. Methyl mercury is formed in soil and water by algae and bacteria that is then ingested by fish. It is also found in fungicides. Elemental mercury and amalgams used in dental fillings, batteries, electrodes, barometers, fluorescent light bulbs, red tattoo dye, skin-lightening creams and thermostats. Federal Toxic Release Inventory states that over 6 million lbs of toxic waste in the form of mercury compounds in toxic waste are generated by industry, most of which is released directly into the environment.

High levels found in: Bluefish, Grouper, Marlin, Tuna [yellowfin, blue, albacore], Tilefish, Sea bass, Mahi, Swordfish

Low levels found in: Arctic cod, Anchovies, Catfish, Crab, Flounder, Haddock, Herring, Mackerel, Non-farmed salmon, Trout, Tilapia, Oysters, Tuna [skipjack and chunk light]

MERCURY causes Negative Health Effects

• Damages enzymes and other proteins by binding sulfhydryl groups, e.g., metallothionein, hemoglobin, glutathione
• Promotes oxidative stress by formation of lipid peroxides, H2O2, and hydroxyl radical
• Depletes glutathione and selenium
• Penetrates nerves and binds to cysteines on Ach receptors
• Damage to brain and kidneys
• Cognitive dysfunction, depression, irritability, tremors, changes in vision and hearing
• Probable carcinogenic

Chemical Additives are in Food. Read labels and steer clear of the ones pictured below:

MSG and Glutamate

• Glutamic acid is a non-essential amino acid found in plant and animal protein. 
• Glutamate is the most abundant neurotransmitter in the brain.
• Glutamate activates or excites cells to “communicate” important messages important for growth, development, learning and memory…essentially a brain stimulant.
• MSG or monosodium glutamate is a synthetic chemical added to processed foods to make them more palatable.
• The scientific literature regarding the health effects of MSG indicates controversy over the potential of MSG to cause various adverse reactions—from headaches and migraines, altered mood and cognition to endocrine disruption.
• Possible Genetic susceptibility and “leaky” blood brain barrier
• MSG goes by many names, read labels carefully. See image below for other names to watch out for.

HERE’S WHAT YOU CAN DO TO MINIMIZE YOUR EXPOSURE AND REDUCE-REPAIR IMPACT

Switch out THE DIRTY DOZEN to Organic and Stick to THE CLEAN FIFTEEN when not buying Organic

Follow the Principles of Healthy Detoxification:

• Minimize your exposure to toxins by eating organic foods, moderating processed foods with refined grain flour, sugar, avoiding large game fish
• Drink filtered water
• Keep your bowels moving at least once a day through use of flax seeds and magnesium citrate [400mg/day]
• Eat only organic animal products
• Eat 6-8 servings of colorful vegetables and fruits including cruciferous veggies [broccoli, cauliflower, Brussel sprouts, kale] and allium family [garlic, onions, leeks, watercress, green tea, cilantro, berries, etc]
• Eliminate nicotine and moderate alcohol intake [no more than 1 drink/day]
• Exercise: Interval cardio 20-30” twice week; yoga; tai chi; Resistance 20” twice/week; Walk a lot and use stairs
• Eliminate white flour and sugar and HFCS
• Minimize char-broiled meats [heterocyclic amines]
• Don’t be afraid to sweat e.g. sauna, steam
• Mercury and dental amalgams
• Home testing for mold
• Reduce toxic thought-behavioral patterns e.g. Mindfulness practice, CBT
• Apply chelation protocols for heavy metals

Reduce your toxic burden:

• Buy and eat organic whenever possible
• Consider glass or ceramic containers instead of plastic
• Decline stain protection treatments for upholstery or floor coverings
• Ask about VOCs (volatile organic compounds) in paints, new carpeting, furniture
• Avoid polycarbonate plastics with “7” and “3” stamped on bottom.  Consider aluminum instead
• Switch to stainless steel or hard-anodized aluminum pots and pans when Teflon cookware wears out
• Vacuum/dust at least once per week: Air purification ionizers
• Carbon Filter water

Practice Mind-Body Detoxification

• Mindfulness about the dietary and lifestyle choices you make
• Meditation

Enhance Blood and Lymph Circulation through:

• Aerobic exercise
• Yoga
• Massage and body work
• Sauna and heat therapy
• Skin exfoliation and brushing

Talk to your doctor or nutritionist to find out what SUPPLEMENTS are right for you to help you detoxify:

• Multivitamin with mineral supplementation
• Milk Thistle
• Curcumin/turmeric and rosemary
• Probiotics
• Magnesium citrate [400-800 mg/day]
• N-Acetyl Cysteine [NAC, 1200-2400mg]
• SAMe, pronounced Sam-MEE [400-800]
• Vitamin D [2,000-5,000 units/day to level 30+]
• Co-Q-10 [200-400mg]
• Alpha lipoic Acid [400-1000 mg]

 Explore Helpful websites such as these:

• www.foodnews.org
• www.centerforfoodsafety.org
• www.orgfood.com
• www.diamondorganics.com
• www.ewg.org
• www.greenhome.com
• www.allergybuyersclub.com
• www.seventhgeneration.com
• www.ewg.org/skindeep

Use Helpful APPS such as these:

CREATING HEALTH #4: Gastrointestinal Balance

Lecture by Mark Pettus transcribed by Carolann Patterson

Gastrointestinal Balance: Do you have THE GUTS for Health?

LIFE is comprised of tightly integrated relationships between our Environment [what do we eat, how do we move, what toxins are in our life, how much sleep do we get, how do we resolve conflict and manage stress?]; Gene Epigenome [our unique "Book of Life" which sets our body's on and off switches]; and our Microbiome [90% of our body is microbial]. We are not locked in to our genes and patterns - everything is modifiable.

Healthy choices in our Environment lead to healthy changes to our gene Epigenome and greater balance in our Microbiome. Everything is connected and overlapping. This approach is central to a Functional approach to your good health. 

How does a Functional-Systems Biology Model differ from the way we are currently looking at our health? Instead of looking at "the leaves" of disease to determine treatment, Functional Biology turns the model on its head and shifts analysis to begin at the roots, to find the root causes. Once we discover the root causes we can change our biology by changing our behavior. Our DNA is more malleable than we think. We are NOT locked in to our genetic legacy. 

Disease [how things appear] - Pre-Diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Alzheimer’s, Cancer, Autism, ADD, Hypertension.

Core Metabolic Imbalances [what drives them] - Inflammation-Immunomodulation, Fight-Flight (HPA axis), Microbiome (Gut-Immune), Detoxification, Hormonal, Insulin resistance 

Root Causes [what are their origins] - Gene-Epigenome Environment, Nutrition, Movement Stress Response, Environmental-toxins, Conflict Management Sleep, Social Connection, Traumatic events, Mindfulness, Meaning in Work, Love & Play

We don't get sick overnight. Disease is the accumulation of unhealthy choices, life patterns and events, and exposure to toxins over time. When we determine the root causes of Long Latency Disease [found in the roots], we can prevent disease from happening or make it disappear. 

Our intestines are so much more than just a tube for digestion and absorption.  The gut contents are an inner world that is “outside” the cellular body. Its surface is a frontier of 100 square meters and is only one cell layer thick. Your gut flora are an organ [the microbiome] that contains 10 times more microbial cells than the body has mammalian cells. Our microbiome has 100x the DNA than all of human DNA combined. From a cellular perspective, we are 10% human and 90% microbial. 

Our gut is one cell layer thick. Most of our immune system is attached to the gut on the outside. It is poised and ready to attack threats.

The most sophisticated immunologic component in our body resides in the gut. A profound neuroendocrine connection exists within the Gut which is considered to be "the second brain" where 90% of serotonin in your body is produced. Our gut is one cell layer thick. Most of our immune system is attached to the gut on the outside, poised and ready to attack threats.

Digestive Disease impacts MILLIONS of Americans:

• 60-70% Americans suffer from Digestive Disease
• GERD effects 45-60 million
• 7-10% Americans experience heartburn at least daily
• 20% [60 million] experience at least once-monthly
• Irritable bowel disease [IBS] effects 30-45 million
• Gallstone disease, 20-25 million
• Diverticular disease, 20-40 million
• Celiac is estimated at 3 million, approximately 1:100 [up from 1:133 from 2003 Alessio Fasano study] 
• Gluten sensitivity is seen in as much as 5-8% of Americans
• Crohn's Disease, 750,000-1 million
• Colerectal Cancer is approximately 260,000  

Is your gut trying to tell you something? Yes.

100 million people experience various GI problems e.g. IBS, bloating, gas, reflux, constipation, diarrhea, and crampy pain. Americans spend $3 billion/year on OTC antacids, laxatives, acid blockers and fiber supplements [and some of the most popular prescription drugs used to alleviate digestive symptoms only exacerbate the cause, more on that below]. It is a common reason to seek medical care and a frequent reason for diagnostic testing...so yes, your gut is definitely trying to tell you something. The question is: WHAT is it telling you?

Problems with your gut health can promote and worsen the following conditions:

• Allergy
• Asthma
• Autoimmunity
• Arthritis
• Metabolic Bone disease
• Skin problems
• Mood disorders
• Dementia
• Cancer
• Inflammation

The Microbiome…it's an evolving story

The microbiome has evolved with humans. These "bugs" have allowed us to survive. The microbiome provides important functions in digestion, immunity, metabolism and detoxification. From a cellular perspective, our body is 10% human and 90% microbial. The gut microbiome in each person contains 100-150 times as many genes as the human gene pool and over 99% of the genetic diversity in our bodies is due to microbial colonization. 70% of the immune system is located in the gut epithelium [outer layer].

Gut microbes can drive appetite. Low Microbial Diversity in the gut drives obesity. Studies show that colonizing germ-free mice with the intestinal microbiome from obese mice led to an increased total body fat despite lack of change to diet.

Dirt is Good for Diversity. Increased diversity within the microbiome is seen with decreased hygiene. Early and diverse exposure to germs is key to a “healthy microbiome.” Reduced microbiome diversity is seen in obesity, IBD, and autism spectrum. 

Diet is a powerful factor that can shift the gut microbiome. There is an increased carbohydrate digesting microbiome in populations with higher carbohydrate [CHO] intake. 

SIBO - Small Intestinal Bacterial Overgrowth

SIBO is the root cause of many GI and systemic problems and is typically associated with carbohydrate intolerance and bloating after eating. It is also associated with:

• Nausea, diarrhea, constipation

• Contributes to food allergies
• Intestinal permeability-systemic inflammation
• Present in 75% of people with IBS, fibromyalgia, CFS [Chronic Fatigue Syndrome]
• Eradicating SIBO often resolves symptoms of IBS
• Breath test is available 

IBS - Irritable Bowel Syndrome

IBS is the most common GI functional disorder diagnosed by gastroenterologists and affects about 5-10% of the population with female predominance of 2-3:1. Its symptoms include abdominal pain, altered bowel function, bloating, mucosal inflammation, exaggerated stress response, increases in plasma pro-inflammatory cytokines. Stress [including early life stress] plays a major role in the onset and exacerbation of symptoms in IBS. It is closely linked to Dysbiosis [alterations, loss of diversity in microbiome], food sensitivities and SIBO [as many as 75%]. It is associated with:

• GERD
• Interstitial cystitis [inflammation of the bladder]
• Fibromyalgia
• Chronic Fatigue Syndrome
• Disrupted sleep
• Rosacea
• Migraine headaches
• Restless leg syndrome [RLS]

GERD [Reflux] - do we have it all wrong?

GERD has been thought to stem from too much acid and our approach has been to block acid production [a case of treating the "leaves" not the "root cause"], but with Reflux, there already is LOW stomach acid. Many who have GERD also have SIBO. The diagram below outlines how it works: Low stomach acid leads to bacterial overgrowth + maldigested carbs [from poor quality simple sugars] which create increased gas and pressure, pushing up towards the esophagus while also increasing IAP [Intra-Abdominal Pressure]. As SIBO breaks down the simple sugars [FODMAPS] it produces the gas that increases IAP that allows stomach acid to reflux into the esophagus. 

Reflux is not a result of excess stomach acid. It is driven by LOW stomach acid. Prolonged use of PPI's - Proton Pump Inhibitors, such as Prilosec and Nexium - to alleviate symptoms of Reflux increases low levels of acid needed to properly digest food.

LPS - Lipopolysaccharide

Bacteria produce an endotoxin called lipopolysaccharide [LPS] from shedding their cell walls and induce inflammation. Researchers have found that gut-derived bacterial LPS enters the bloodstream and triggers insulin resistance that typically accompanies type II diabetes. Chronic high-fat [from bad fat] raises LPS levels and sets the stage for metabolic disease. LPS induces Leptin Resistance [the hormone that tells us we’re full].

Intestinal Permeability - Uncontrolled Trafficking of Molecules. How does the barrier break down?

• Dietary choices [reference Ian Spreadbury]
• SIBO
• Food allergies, lectins
• Dysbiosis [alteration in the gut, ANTIBIOTICS are the biggest contributor]
• ACID SUPPRESSION [PPI's not wise for long-term. We need acid to protect us and break down food]
• STRESS response [causes alterations in the gut]
• Environmental toxins
• Medications

...Antibiotics on top of antibiotics - STAT food is neither ethical, nor healthy:

DIET - no lecture is complete without reference to Ian Spreadbury's research:

Ian Spreadbury points to the single greatest difference between ancestral and modern life: acellular carbohydrates. Wheat just ain't what it used to be. 

WHEAT can be viewed as a Triple Threat from:

• Amylopectin - A high glycemic carb, a simple sugar that propagates an overgrowth of bacteria and yeast
• Gluten [for some]/gluteomorphins are an opiate-like substance 
• Fructans - FODMAPs - simple sugars

Ingesting acellular carbohydrates [not from vegetables or legumes] increases inflammation and leads to:

• Insulin-fueling lipogenesis
• Insulin resistance in muscle and liver
• Inhibited capacity to burn fat
• NF-κB goes up [bad]
• Increased LPS - Lipopolysaccharides elicit a variety of inflammatory responses and may be a part of the pathology of Gram-negative bacterial infections [bad]
• Cytokine up-regulation [bad]
• Leptin resistance [hungry and less energy to move]
• Poor health and many symptoms [including Periodontal disease]

STRESS and the GUT 

The Vagus Nerve is the largest nerve. It's a super-highway, central to all our systems and travelling in both directions between the brain and the gut.

HEALTHY GUT and HEALTHY BRAIN = BALANCE

Mindfulness and balance are associated with healthy gut microbiome.

Depression, auto-immune, fibromyalgia [etc] are associated with STRESS, an UNhealthy gut and intestinal dysbiosis. 

Host genes shape the gut microbiota. 90% of our bodies is not human: it's microbial. Microbes are essential to our health and most of them live in the gut sending out messages to support digestion, immunity, metabolism. When the microbiome is disrupted and out of balance [dysbiosis] messaging to the brain and throughout our body gets mixed up. Big time.

LEAKY GUT and GLUTEN

Gluten attacks the intestinal tract. Boston Mass General's Alessio Fasano is a gastroenterologist and pioneering researcher whose team discovered Zonulin, the molecule which regulates intestinal permeability, a.k.a. Leaky Gut.

Gluten triggers Zonulin. Over-production of Zonulin has been linked to a series of autoimmune diseases, including Type 1 Diabetes, Celiac Disease and Multiple Sclerosis.

Fasano's research in 2003 demonstrated the prevalence of Celiac Disease in the U.S. to be far higher than previously thought, at a rate of 1 in 133 persons. Currently, 1:100 Americans have Celiac Disease.

Gluten causes Celiac Disease and from this we know that Environment can impact our immune system. It may not just be gluten but other molecules, too, that play a role in digestive disease. WHEAT can be viewed as a Triple Threat from its contents - Amylopectin [a high glycemic carb, simple sugar that propagates an overgrowth of bacteria and yeast]; Gluten [gluteomorphins are an opiate-like substance]; and Fructans [FODMAPs - simple sugars].

GLUTEN aggrovates the gut and causes Inflammation

When the mucous layer in the intestines is reduced, opportunists can move close to the gut lining, inciting inflammation. Fermentation of plant-based fiber seems to keep the mucous layer intact. So does the presence of peace-keeping microbes such F. prausnitzii.

F.prausnitzii colonizes the mucous layer and produces by-products such as Butyrate [saturated fat is good-health promoting and down-regulates immune response]. Theses short-chain fatty acids seem to have an anti-inflammatory effect by reducing regulatory T cells which in turn control aggressive aspects of the immune system. The absence of F.prausnitzii and other microbes that perform similar functions often correlates with diseases such as IBS and obesity. Some of its relatives - clostridial clusters - have similar properties. [see image below]

Celiac and Gluten Sensitivity are associated with the following inflammatory problems:

• Thyroid disease
• Neurologic diseases
• Osteoporosis
• Decreased fertility
• Recurrent UTIs
• Autoimmune disease
• Skin disorders e.g. eczema, rosacea
• RLS – restless leg syndrome

The following changes in our modern food supply are linked to chronic complex disease:

• Sugar and refined grain flours, processed - high glycemic foods with high “carbohydrate density”
• Fructose from sugar and HFCS [a dose response]
• Increased processed-seed oils [Omega-6] relative to Omega-3 EFA intake
• Food sensitivities such as gluten, grains or dairy
• Insufficient vegetables [phytonutrients-epigenetics]
• Insufficient fiber [microbiome]
• Foods contaminated with environmental toxins such as game fish (mercury), non-organic fruits and vegetables with pesticide residues, BPA in plastics, Genetically Engineered foods

The Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. African and European results were exactly opposite. Firmicutes are common in depression and obesity and are dominant in the European diet and far less present in the African diet.

The New Frontier will be found in the elegant inter-connections between the gut and all parts of the body. There are a growing number of examples connecting health problems to the microbiome, such as the emerging role of the gut in chronic heart failure. "Lack of mucosal integrity with consecutive local and systemic inflammation and dysfunction in transport proteins may worsen the clinical symptoms of chronic heart failure". [Curr Opin Clin Nutri Metab Care, 2008; 11:632-639]

REVERSE. It is possible to reverse and un-do the damage caused by disease in the gut by changing our behavior and following the Recommendations of The 5R Model to:

• Remove
• Replace
• Repair
• Reinoculate
• Rebalance

REMOVE. 

• Elimination of disease causing microorganisms [dysbiosis] e.g. SIBO, yeast, parasites. Rx with appropriate agent e.g. Diflucan, Nystatin, Xifaxin. See FODMAPs example below
• 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]
• Stress: how we interpret and respond

 Common FODMAPs include:

• Fructose: A simple sugar found in many fruits, vegetables and added sugars
• Lactose: A carbohydrate found in dairy products like milk
• Fructans: Found in many foods, including gluten grains like wheat, spelt, rye and barley
• Galactans: Found in large amounts in legumes
• Polyols: Sugar ALCOHOLS like xylitol, sorbitol, maltitol and mannitol. They are found in some fruits and vegetables, and often used as sweeteners.

REPLACE. 

• Stomach acid using apple cider vinegar, Swedish bitters, Betaine HCL tablets 30-60 minutes before meals
• Digestive enzymes [plant-based], Pancreatic enzymes e.g. pancreas, Similase, GB digestion
• Choleretics [increase the secretion of bile from the liver], Ox Bile, dandelion root

REPAIR.

• Nutrient support with whole-foods, minimally processed, e.g. elimination diet or FODMAPS
• Zinc carnosine [protective]
• DGL-Deglycerinated Licorice, Slippery Elm
• Turmeric-Curcumin [will turn off your NfkB and that's a good thing]
• Glutamine [amino acid] 1,000 mg three times/daily
• Gelatin rich bone broths that are amino acid nutrient dense e.g. chicken, beef. Recommended reading: Nourishing Broth by Sally Fallon and Kayla Daniels PhD.

RE-INOCULATE.

• Administer probiotics from the following three families that have been found to be beneficial for GI function: Bifidobacteria, Lactobacilli, and Saccharomyces.  Ther-biotic by Klaire
• Administer prebiotics (food that promotes beneficial bacterial growth) such as bananas,    plantains, onions, asparagus and garlic, most vegetable-based fiber
• Fermented foods like sauerkraut, cabbage, kimchi, beets, yogurt, kefir

RE-BALANCE. 

• Rest and relaxation-response
• Adequate sleep
• Meditation
• Yoga
• Tai chi
• Cognitive behavioral therapy
• Health coaching

For more "news to use" and the science to go with it, visit The Health Edge: Translating the Science of Self-Care. Not all research slides are shown in this article. To download complete lecture, follow this link to BHS Creating Health Wellness Series.

Balance.