The Essential Role of the Gut in Immunity

Is the Gut the Driving Force of Systematic Inflammation?

Dr Robin Martingale (2019)

Film Review

In the following video, ICU general and trauma surgeon Dr Robin Martingale explains the role of gut bacteria in protecting human beings from infection and inflammation. The key take home from his presentation is that it always seems to take the medical establishment at least 20 years to catch up with basic science research. Peer reviewed research about the role of the gut microbiome first appeared in medical journals about 20 years ago. When the mainstream media began reporting on the research around 2010, many  “alternative” health practitioners (naturopaths, homepaths, etc) began incorporating the knowledge into patient care. It’s only thanks to efforts of pioneers like Martingale, that some mainstream medical practitioners are finally incorporating it into mainstream medical practice.

The research Martingale presents shows a direct statistical link between modern humans declining diversity in gut bacteria* and the the epidemic of chronic illnesses we presently experience (eg diabetes, cardiovascular disease, autism, obesity, cancer, asthma, chronic fatigue, fibromyalgia and even mental illnesses, such as schizophrenia, depression and bipolar disorder). The mechanism here is a loss of “good bacteria” (symbiants and commensual) that protect us against endotoxin-producing pathogens (“bad bacteria”) that lead to chronic inflammation.

Martingale blames the loss of microbiome diversity to our increasing exposure to pesticides (especially Roundup), vaccines, chlorine, artificial sweeteners, emulsifiers (in processed food) and overuse of antibiotics.

He also presents numerous animal and human studies showing that obesity correlates far more closely with gut dysbiosis and systemic inflammation than lifestyle.

I found the ICU-related research he reported on the most interesting. For example, he cites one study that shows an 30% increase in ICU mortality in patients who have taken antibiotics in the past six months. And another showing a significant correlation between “leaky gut” syndrome and sepsis and multiple organ failure in ICU patients.

In the ICU at Oregan Health Sciences, where Martingale works, he has significantly increased survival rates by prescribing probiotics for all ICU patients and even fecal transplants** for patients with sepsis and multiple organ failure.

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*Human immunity is based on friendly gut bacteria that prevent pathogenic bacteria from producing endotoxin. When absorbed into the blood stream, the latter can can cause systemic inflammation.

**A fecal transplant involves the transfer of stool of a healthy patient to one with dysbiosis, an imbalance in normal gut bacteria.

Plant-Based Diets: Pluses and Minuses

Eating You Alive: One Bite at a Time

Directed by Paul David Kennamer Jr (2018)

Film Review

In essence, this documentary is a series of glowing testimonials from patients who reversed life threatening illnesses by switching to an organic whole food plant-based (ie vegan) diet. Although the film is disappointingly short on research evidence, the list of illnesses overcome with this diet is extremely impressive: end stage pancreatic cancer, lupus, stage 4 metastatic ovarian cancer, stage 4 renal cancer, severe heart disease, dementia, rheumatoid arthritis, breast cancer, cervical cancer, uterine cancer, malignant hypertension, type II diabetes, and morbid obesity.

Although I have no reason to doubt the sincerity of any of the patients (who include Penn the magician and the actor Samuel L Jackson), I had reservations about some of the film’s basic premises. Given its heavy emphasis on obesity and type II diabetes, I was surprised it made no mention of insulin resistance or dysfunctional gut bacteria as triggers for obesity. In my experience, patients with insulin resistance are far more likely to lose weight on a high fat ketogenic diet. The latter is also extremely helpful for treatment-resistant seizures.

Unfortunately some of the doctors advocating for plant-based diets also make statements that aren’t strictly accurate. For example, decades of research has totally debunked the myth that consuming large amounts of cholesterol causes high blood cholesterol levels. It is now established that cholesterol is part of the body’s normal defense against inflammation, that the main cause of high cholesterol in otherwise “healthy” people is inflammation caused by excess dietary sugar. See How Sugar Really Affects Your Cholesterol

I was also concerned about the way featured doctors trashed olive and coconut oil as major culprits in cardiovascular disease and cancer. Numerous studies suggest otherwise.

The statement one of the doctors makes about no prior human culture relying on meat-based diets (as most of the industrialized world does at present) is simply untrue. Both the Massai people of Africa and the Inuit people of the Arctic traditionally ate 100% meat-based diets. Likewise all hunter gatherer societies relied on occasional meat in addition to a routine diet of fruits and vegetables.

I was also concerned that the doctors featured saw no need to caution viewers about limitations of a 100% plant-based diet in terms of specific key nutrients: Vitamin B12, zinc, iron (in menstruating and pregnant women), Vitamin D and omega 3. Most of the doctors I know recommend their vegan patients take supplements providing these nutrients. Pregnant women following a vegan diet also need to be monitored closely to ensure their protein intake is adequate.

The full film can be viewed free at https://tubitv.com/movies/475193/eating-you-alive

 

 

Combating Illness Through Diet Change

The Magic Pill: Combating Illness Through Diet Change

Directed by Robert Tate (2017)

Film Review

Although this documentary was made two years before the COVID19 pandemic, it offers a highly plausible reason why COVID19 mortality rates are much higher in patients with obesity, heart disease, diabetes, and hypertension. Given that most patients with these conditions are still eating a low fat diet high in sugar, refined carbohydrates, and processed foods.

Citing both archeological and research evidence, the filmmakers maintain that modern day humans have evolved (over 100,000 generations)* to flourish on a hunter gatherer diet high in animal fats and fresh fruits and vegetables.

They believe the hunter gatherer diet for is probably most similar to the modern ketogenic (high fat, low carbohydrate diet). Many pediatricians are successfully treating with refractory epilepsy with a ketogenic diet. Likewise a number of oncologists are using it as an an adjunct to cancer chemotherapy.

Unfortunately this high fat, low carbohydrate diet is the exact opposite of the low fat, high carbohydrate diet (aka the Food Pyramid) most Western doctors and public health officials continue to recommend for their patients. According to growing research evidence, this diet is largely responsible for an epidemic of obesity, type II diabetes, hypertension, heart attacks, strokes, cancer, and Alzheimer’s (which many diet researchers refer to as type III diabetes).

The film follows a dozen patients with a myriad of health problems (including obesity, diabetes, asthma, autism, arthritis, autism, seizures, recurrent respiratory infections, and early dementia) who switch to a ketogenic diet. Amazingly all their medical problems either resolve or improve dramatically after only 10 weeks. Even the two autistic children are markedly calmer and exhibit a big increase in verbal interaction.

The filmmakers also follow 11 Yoingu (a northern Aboriginal tribe) women experiencing similar chronic medical conditions. After only two weeks they, too, experience significant improvement when they abandon their high carbohydrate Western diet for more traditional foods. Prior to adopting the Western diet in the 1940s, the Yoingu were extremely healthy and rarely suffered from chronic illnesses.

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*Evidence of tool making suggests there were ancient human living in China 2.1 million years ago https://www.theatlantic.com/science/archive/2018/07/early-humans-left-africa-250000-years-earlier-than-thought/564896/

Anyone with a public library card can view the film free at Kanopy. Type Kanopy and the name of your library into your search engine.

 

Corruption, Federal Farm Subsidies and the False Economy of Cheap Processed Food

Food Fight: How Corporations Ruined Food

Real Stories (2017)

Film Review

This is a documentary about the rise of the organic/local food movement in the late sixties and early seventies and the ongoing battle to end a corrupt federal food subsidy program. The latter plays a major role in the US epidemic of obesity and diabetes.

The film depicts the organic food movement as arising out of a 1960s hippy counterculture that viewed America’s growing system of industrial agriculture as intimately linked to the military industrial complex waging the war in Vietnam.*

Ironically the organic food movement began to take off just has the Nixon administration was repealing New Deal agricultural subsidies that supported small family farms and redirecting USDA subsidies to corporations producing the cheap commodities used in processed foods, such as corn, wheat and soy.

The activists interviewed decry the federal emphasis on cheap food as a false economy – we will never save enough to cover skyrocketing medical costs related to processed food diets.

Despite the rapid growth of small organic farms across the US, food activists face an uphill battle without major changes to the USDA farm subsidy program which makes cheap processed food the only affordable option for many low income families.

The high level of corporate-financed corruption becomes clear as the film follows Representative Ron Kind’s efforts to get his Fairness in Farm and Food Policy Amendment added to 2016 Farm Bill.

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*Monsanto and Dow, the corporations producing Agent Orange and Napalm also produce the toxic pesticides and herbicides used in industrial agriculture.

 

How the Sugar Industry Blocks Health Research: A Thirty Year Scandal

The Case Against Sugar

Gary Taubes (2017)

Taubes is an investigative journalist whose main focus is the deplorable state of public health research in the US.

During the 1990s, Taubes cut his teeth debunking the shoddy studies leading to public health recommendations that salt in the diet leads to high blood pressure and heart disease (which turn out to be totally groundless). He followed this with a series of exposes on the biased studies erroneously linking saturated (animal) fat to obesity, heart disease and cancer. These studies, and the infamous “low fat diet” western doctors have been pushing for nearly fifty years have been a major culprit in our current global epidemic of obesity, diabetes, cancer and tooth decay (see The Role of Western Medicine in the Epidemic of Obesity, Diabetes, Heart Disease and Tooth Decay).

His most recent book, The Case Against Sugar, focuses on a successful 30-year effort by the sugar industry to shut down independent research into sugar as a major causative agent in these chronic illnesses.

He maintains a big part of the problem was the demise of German and Austrian research into obesity after World War II. This European research, informed by the developing fields of genetics, metabolism and endocrinology, supported a hormonal regulatory defect as the primary cause of obesity. Lacking this background in genetics, metabolism and endocrinology, US researchers were blinded by their puritanical bias that lack of willpower causes obesity. With the discovery of metabolic syndrome and insulin resistance (both aggravated by high sugar and carbohydrate diets), it turns out the European researchers had it right all along

For me, the most interesting part of this talk is Taubes’ discussion of sugar’s role as an addictive drug. I had no idea the tobacco industry began adding sugar to their cigarettes in 1954 to make them more addictive. I also like the point he makes about sugar, along with rum, chocolate and tobacco, being important New World discoveries to cheaply dull the pain of oppressed workers under industrial capitalism.

Saving Your Child from an Over-Sanitized World

Let Them Eat Dirt: Saving Your Child from an Over-Sanitized World

By B. Brett Finlayy and Marie-Claire Arrieta

Algonquin Books of Chapel Hill (2016)

Book Review

Let Them Eat Dirt is a down-to-earth parental guide to the latest research about the role of intestinal bacteria in preventing obesity, diabetes, autism, schozophrenia, depression, anxiety, asthma, eczema, allergies, autoimmune illness, inflammatory bowel disease and irritable bowel syndrome. The book also provides a lot of practical suggestions for parents seeking to promote healthy gut bacteria in their kids.

Most research points to the avoidance of antibiotics during pregnancy and the first few months of life as being most important in preventing the gut-relaed illnesses described above. In addition to recommending that expectant mothers take probiotics and give them to their infants, the authors also emphasize the importance of vaginal birth and breast feeding in transferring maternal gut bacteria to the infant. Where C-section can’t be avoided, they recommend inoculating a newborn with a swab from the mother’s vagina.

Let Them East Dirt also provides numerous tips on increasing the diversity of gut bacteria to maximize immunity. In infants and children, this is done by exposing them to a wide variety of foods and indulging their natural urge to get dirty and put things in their mouths. Finlay and Arrieta believe children are biologically programmed to engage in these behaviors to increase gut bacteria diversity.

In discussing the science behind their recommendations, they point out that only 100 species of bacteria cause human illness, out of a total of 5,000,000,000,000,000,000,000,000,000,000 bacterial species on the planet. They also discuss the essential role “friendly” bacteria play in training the human immune system, as well as the devastating health consequences of disrupting this process through antibiotic overuse.

The part of the book I found most helpful gives useful suggestions for ways parents can work with pediatricians to safely minimize antibiotic use in their kids.

The Care and Feeding of Gut Bacteria

The Diet Myth: The Real Science Behind What We Eat

by Tim Spector

Weidenfeld and Nicholson (2015)

Book Review

The Diet Myth is all about looking after our intestinal bacteria – which are ultimately responsible for the proper functioning of our digestive, immune, endocrine and nervous system. As Professor Tim Spector explains, all mammals co-evolved over millions of years with the bacteria that inhabit their intestines. Because these bacteria produce a number of vital biochemicals that our bodies are genetically incapable of producing, without them the species homo sapiens would not exist. This relatively recent discovery has led many scientists to classify the microbiome (the collective name given to gut bacteria) as a vital organ like the brain, liver or kidneys.

Civilization hasn’t been kind to our intestinal bacteria. For various reasons (overuse of antibiotics, processed foods and pesticides like Roundup), urban life has caused us to lose half of the septillions of gut bacteria we started out with. Nearly all the chronic illnesses that plague modern society (obesity, heart disease, stroke, diabetes, cancer, autoimmune disease, depression, autism, schizophrenia and possibly drug addiction and alcoholism) can be traced to loss or malfunction of intestinal bacteria.

For this book, Spector has chosen to focus on dietary research into foods that improve the health and diversity of our remaining gut bacteria. He blames the myriad of contradictory diet fads on the reality that each human being has their own distinct collection of bacteria. This means the foods that keep them healthy depend on the preferences of their particular bacteria.

Fortunately he’s able to make a few general recommendations that seem to apply to most people.

According to Spector, people with the most diverse profile of gut bacteria are the healthiest. The best way to promote this diversity is through a diverse fiber-rich diet that includes:

• At least 20 different food types per week
• A daily serving of 5 vegetables and 2 fruits
• Daily servings of probiotic foods (fermented foods, such as yogurt, sauerkraut and miso, raw milk and unpasteurized cheeses) that contain beneficial bacteria.*
• Daily servings of prebiotic foods rich in polyphenols that gut bacteria love**
• A strict limitation on red meat,*** sugar, refined carbohydrates, transfats (hydrogenated fats found in vegetable oils, margarine and Crisco) and processed foods

Research also indicates that lifestyle factors such as exercise (athletes have the most diverse microbiomes) also promote bacterial diversity (and good health). As does episodic fasting.****

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*These mainly provide different strains of lactobacillus and bifidobacteria that crowd out harmful inflammatory gut bacteria.

**Foods rich in polyphenols include dark chocolate, coffee, green tea, turmeric, red wine, onions, garlic, (uncooked) extra-virgin olive oil, roasted nuts, Jerusalem artichokes, chicory root, leeks, asparagus, broccoli, bananas, wheat bran and fermented fruits and vegetables.

***Citing numerous studies, Spector totally debunks the claim that red meat is harmful due to its fat content. He maintains the risk associated with red meat is the conversion (by gut microbes) of L-carnitine to trimethylamine oxide, which causes plaque build-up in arteries (in Europeans – this effect appears to be absent in other ethnic groups). He recommends that Europeans limit their intake of red meat to ½ serving or less per day. Those who eat more than this have a 10% increase in mortality. Those who eat one daily serving or more of processed meat (sausages, ham, salami, etc) have a 40% increase in mortality.

****When people fast, a gut organism caused Akkermansia cleans up gut inflammation by feeding off the intestinal lining. Research reveals specific benefit from the 5/2 diet in which people fast two days a week and eat normally the other five.

Big Sugar, Inc

Big Sugar: Sweet, White and Deadly

Brian McKenna (2005)

Film Review

Big Sugar is about the sugar lobby and how they use their wealth and power to prevent the World Health Organization (WHO) and other regulatory agencies from dispensing accurate information about the link between high sugar intake and obesity, type 2 diabetes and heart disease.

This Canadian documentary is divided into two parts. Part I deals with the links between sugar and slavery and the modern sugar barons have replaced the slaveholders who effectively controlled British foreign and domestic policy for 200 years. Part II is about the global obesity epidemic and efforts by WHO in 2005 to issue guidelines limiting daily sugar intake to 10% of total calories. The powerful sugar lobby defeated this initiative by employing many of the same techniques as the tobacco industry (and the climate denial industry). After attacking the science linking high sugar intake and obesity, they attacked the scientists themselves as biased fanatics. They then got them fired, demoted, and/or transferred. Under pressure from Big Sugar, both Bush administrations threatened to withhold the funding they owed WHO, and the pesky nutritionists who sought to warn people about the dangers of sugar magically vanished.

The documentary focuses on two of the most prominent slave holding families, as well a Canadian woman of African descent whose ancestors were owned by the Church of England and worked on a plantation in Barbados. The filmmakers liken these historical paragons to a modern day Cuban exile family in Florida called the Fanjuls. The latter donate generously to both major parties to make sure the US government continues to subsidize sugar production. The Fanjuls and other Florida sugar barons reap $1.5 billion in subsidies for $3.1 million in campaign contributions.

In addition to exposing the ecological devastation sugar cultivation has caused in the Florida Everglades, the filmmakers also visit the Fanjuls’ sugar plantations in the Dominican Republic. Despite the official abolition of slavery, working conditions on Dominican sugar plantations remain virtually unchanged. The Fanjuls lure Haitian immigrants across the border with a promise of paying work. Once their passports are confiscated, they become virtual slaves. Workers, who are paid $2 for a twelve hour day, experience chronic hunger and malnutrition. Forbidden to grow their own vegetables, they’re forced to rely on a company store that charges them three times the normal price for food. They have no access to medical care, and child labor is rife.

Food Inc

Food Inc

Directed by Robert Kenner (2008)

Film Review

Food Inc is a 2008 classic only recently available for free on-line screening. Featuring investigative journalist Eric Schlosser and food activist Michael Pollan, it’s the first and (in my view) the best expose of factory farming.

This film mainly focuses on the deplorable disease-inducing conditions of battery chicken houses and industrial feedlots and slaughterhouses. However it also draws attention to the current epidemic of food borne illness, diabetes and heart disease; the corporate capture of regulatory agencies meant to protect us; the federal subsidies that make junk food cheaper than fresh fruits and vegetables; Monsanto’s vicious treatment of farmers who choose not to grow GMO crops and the food disparagement and anti-labeling laws meant to keep consumer sin the dark about where their food comes from.

Most importantly this documentary questions whether the “cheap” food produced by industrial farming is really so cheap when you add in the health costs (especially of chronic diseases like diabetes and cardiovascular disease)

The cinematography captures horrific scenes of factory chicken houses where chickens live on top of each other in total darkness and feed lots in which cows spend their whole life knee-deep in manure. The latter cakes their hides and inevitably contaminates carcasses at the slaughterhouse.

The films draws interesting parallels between the abysmal treatment of animals and workers in the industrial food chain. Food executives argue that animal suffering is inconsequential because they’ll all be dead soon. They also regard immigrant workers as expendable because there are so many of them.

The filmmakers catch meat processors deliberately recruiting illegal laborers in Mexican villages devastated by the North American Free Trade Act (NAFTA). Employers are never prosecuted for these activities. Only immigrant workers are targeted.

https://vimeo.com/29575879

The Role of Western Medicine in the Epidemic of Obesity, Diabetes and Heart Disease

Carb Loaded: A Culture Dying to Eat

Directed by Lathe Poland (2014)

Film Review

Carb Loaded follows the personal journey of a 40 something male (one of the filmmakers) who suddenly develops type II diabetes, despite being physically fit and follow a “heart healthy” diet. What he discovers is that the low fat, high carbohydrate promoted for fifty years by Food Inc, the USDA, and the American Dietetic Association is responsible for a global epidemic of diabetes, obesity, heart disease and most likely Alzheimer’s Disease.

The Food Pyramid was an Experiment and Americans the Guinea Pigs

The documentary begins by tracing the history of the “food pyramid,” which the FDA and corporate cronies foisted on the unsuspecting American public in 1977 – without a single clinical trial supporting its safety and effectiveness. With the adoption of the “food pyramid,” doctors and dietitians induced hundreds of millions of patients to drastically reduce their intake of protein and fat and to increase foods previously associated with weight gain (bread, pasta, potatoes, high carb snacks, etc). in other words it was a vast experiment and Americans – and citizens of other industrialized nations – were the guinea pigs.

Statistically the prevalence of diabetes, obesity heart disease and Alzheimer’s began to take off in the late seventies, the widespread adoption of the low fat, high carbohydrate diet. Over the last decade the researchers have identified the mechanisms by which a high carbohydrate diet causes these conditions.

A high carb diet causes diabetes by triggering excessive insulin production, which over time leads to insulin resistance, a physiological condition in which cells fail to respond to insulin, leading to higher blood sugar levels.

It causes obesity by reducing brain sensitivity to leptin, a hormone produced by fat cells that notifies the brain when we’re full.

It causes heart disease mainly by triggering an inflammatory response in our blood vessels that increases cholesterol production. Contrary to popular belief (driven by relentless corporate marketing), most cholesterol is produced by the body in response to inflammation and is totally unrelated to diet.

Alzheimer’s: Type III Diabetes

Most ominous of all, high carbohydrate diets can cause the accumulation of “glycated”* proteins in the brain. These are linked to the development of Alzheimer’s Disease, which doctors and researchers have begun referring to as Type III diabetes.

The film goes on to explore numerous lifestyle changes which have led many residents of the industrialized world to cook less and rely more on cheap, carbohydrate-rich fast foods. It also explodes the myth that fast food is cheap, with a recent study that the average American spends $3,000 a year on fast food and $8,000 on doctors visits for medical problems caused by fast foods.

Potential Solutions

The filmmakers finish by reviewing a range of possible solutions at the government, community and individual level. High on the list of policy changes are an end to the US corn subsidy (responsible for the ubiquitous presence of damaging high fructose corn syrup in most processed foods) and a tax on sugary beverages similar to those enacted by Mexico, Denmark, Hungary and France.

On a community level, they talk about what activists can do to eradicate food deserts and increase the availability of fresh, unprocessed food.

On a personal level, they explore the importance of understanding the addictive effect of sugar and specific behavioral changes people can make to gradually wean themselves and, most importantly, their children off sugar and other refined carbohydrates.