The Care and Feeding of Intestinal Bacteria

My personal knowledge and understanding of intestinal bacteria stems from being diagnosed with a Clostridium difficile in 2012. C. difficile is an opportunistic intestinal infection that typically develops when excessive antibiotic exposure kills off normal gut bacteria. According to Dr Thomas Borody, the Sydney gastroenterologist I consulted, I most likely became infected with C difficile in 1993 owing to excessive use of broad spectrum antibiotics for a chronic sinus infection. For 19 years other doctors dismissed my extremely debilitating symptoms (constant watery diarrhea, pain and insomnia) as “irritable bowel syndrome” and told me I had to live with them.

Borody, founder and director of Sydney’s Center for Digestive Diseases, is world renowned for pioneering the use of fecal transplantation to treat C. difficile, ulcerative colitis and other bowel disorders triggered by an imbalance of intestinal bacteria. A growing number of doctors and holistic practitioners have come to regard intestinal bacteria, collectively known as the “microbiota” as a vital organ like the brain, liver and kidneys.

Regretfully fecal transplants didn’t work for me. My symptoms persisted until December 2013, when a chance encounter with a local chemist turned me onto the GAPS diet.

Gut and Psychology Syndrome

Dr Natasha McBride, a British neurologist with a postgraduate degree in nutrition, first developed the Gut and Psychology Syndrome (GAPS) diet for her autistic son. Like most autistic children, her son had major bowel problems in addition to the autism. Researchers have since uncovered links between endotoxin-producing intestinal bacteria, “leaky gut” syndrome and other neuropsychological conditions, such as schizophrenia, depression and ADHD.

The basic premise of the diet, which draws from the Weston A Price diet (see The Taboo Against Animal Fats) and the Specific Carbohydrate Diet (SCD), is to suppress the growth of pathogenic bacteria by eliminating the sugar and starches they feeds on, while simultaneously promoting the growth of healthy bacteria by taking probiotics and eating fermented foods.

McBride recommends that all patients begin with a strict elimination diet aimed at controlling the diarrhea. For the first six weeks, all I was allowed to eat was bone broth made from boiling stewing meat or fish heads, along with probiotics, juice from fermented vegetables, water kefir and kombucha. Once the diarrhea stopped, I was allowed to add new foods at six week intervals, starting with egg yolks (raw), then whole eggs (scrambled), then avocado, then nuts soaked in salt water overnight, cooked apple, and finally lentils, navy and lima beans soaked overnight in lemon juice or vinegar solution. Like most patients with C difficile, I have great difficulty digesting fibrous vegetables and fruits. Thus I have also been very gradually adding small amounts of cooked vegetables.

At the end of 18-20 months, I am allowed to cautiously allow starchy foods, starting with new potatoes and eventually sprouted buckwheat. After 24 months, I can cautiously add very small amounts of other grains, such as rice, oatmeal (soaked) and quinoa.

Even after the C difficile resolves, I can never return to a typical Western diet, with its heavy emphasis on carbohydrates, sugar and processed food, owing to demonstrated links with many chronic illnesses, such as cancer, diabetes, arthritis and heart disease (I discuss this in The Taboo Against Animal Fats).

My Total Life Makeover

Given the high stress fast paced lifestyle most of us lead, westerners find it extremely difficult to totally eliminate processed foods, sugar and starch from their diet. For the past six months, I have spent most of my waking hours shopping, cooking and learning to make fermented vegetables, water kefir and almond milk yoghurt (both dairy and soy products are forbidden). The first six weeks were the hardest, due to the copious amounts of fat I had to consume in my bone broth to compensate for the calories I previously derived from sugar, rice and potatoes. McBride is very explicit: patients must eat all the fat off the stewing bones they use to prepare the bone broth.*

After six months on the diet, I feel the sacrifice is definitely worth it. After 20 years of nearly constant diarrhea, pain and insomnia, it’s like a miracle to feel normal again.

Now the only major issue in my life is a social disease called monopoly capitalism.

*I admit to cheating a bit on this requirement by substituting coconut oil (which is allowed on the GAPS diet) for half of the animal fat. I am extremely concerned about the high concentration of industrial toxins found in animal fats and dairy products. Classified as endocrine disruptors, many of these toxins mimic estrogen, which is promotes the development and growth of breast cancer.

photo credit: jamesjoel via photopin cc

The Taboo Against Animal Fat

(The first of two posts about the damaging effect of the western diet on intestinal bacteria and human health.)

As a traditionally trained physician, I watch with horror and dismay as for-profit corporations intrude ever deeper into so-called evidence based medicine. I have written at length about the role of Big Pharma in corrupting good medical practice to promote the sale of prescription pharmaceuticals – and their bottom line (see Menopause: Made in the USA and Drug Companies: Killing Kids for Profit). The role of Food Inc in the dietary recommendations doctors (and government) make to patients and the public at large are even more insidious and damaging.

The current taboo against saturated animal fats is a case in point. For the past thirty years, doctors and government agencies have been lecturing us that diets high in saturated animal fats (found in red meat, whole milk, eggs, butter and lard) cause high cholesterol levels, heart disease and stroke. They have persisted in this three decade campaign against animal fat – despite the total absence of scientific research supporting a link between fat intake and high cholesterol levels – or heart disease and and stroke. In fact, growing evidence suggests just the opposite: diets low in saturated fats and high in sugar and refined carbohydrate promote obesity, type 2 diabetes, high cholesterol levels, high blood pressure, heart disease and stroke.

In other words, government and the medical fraternity have it backwards. Worse still, it appears that their purely theoretical (based on no evidence) phobia against animal fat may be the single most important factor in the current epidemic of obesity and type 2 diabetes.

An Unproven Hypothesis

The current taboo against animal fats is based on a hypothesis first promoted forty years ago when I was in medical school. The theory works like this:  consumption of foods high in cholesterol and saturated fats promotes high levels of blood cholesterol, which lead to calcified plaque formation in arteries, which restrict blood flow to the heart and brain, as well as increasing blood pressure by making blood vessels less elastic.

There’s a credible body of research linking high cholesterol levels to plaque formation and the latter to high blood pressure, heart attack and stroke. However there’s no research whatsoever linking diets high in animal fats and cholesterol to high blood cholesterol levels.

In March, Annals of Internal Medicine published a metanalysis of 72 scientific studies on the effect of different fats on heart disease. The authors conclude there is insufficient research evidence to support guidelines discouraging consumption of saturated animal fats.

The Work of Weston A Price

A growing body of evidence suggests that diets low in saturated fats are, in fact, harmful to human health. Many of these studies were inspired by the work of dentist Weston A. Price in the 1930s. Puzzled that Maori, Australian aboriginals and other indigenous groups experienced no tooth decay prior to adopting a western diet, Price studied their dietary habits. To his surprise, he discovered it wasn’t the direct effect of sugar on tooth enamel that caused cavities. His patients developed tooth decay because diets high in sugar and refined carbohydrates were deficient in basic nutrients essential for human health. When he helped them alter their diets, his patients not only avoided further tooth decay but healed existing cavities.

One of Price’s discoveries was that animal fats* provide essential fat-soluble vitamins (A, D, E and K) that play a vital role in the absorption of other nutrients essential for hormonal and neurological function and protection against chronic diseases, such as cancer and heart disease.

The Role of Intestinal Bacteria

More recent studies have elucidated the mechanism by which diets high in sugar and refined carbohydrate predispose to both high cholesterol levels and obesity. Some of this research is summarized in an April 2013 article in Mother Jones Are Happy But Bacteria Key to Weight Loss?

The article explains how high sugar and refined carbohydrate diets, coupled with massive antibiotic overuse in medicine and factory farming**, promote the growth of gram negative, endotoxin-producing intestinal bacteria. When endotoxin is absorbed into the bloodstream, it sets up a wide ranging inflammatory response that can manifest a variety of effects, including arthritis, eczema, psoriasis and neuropsychological syndromes such as autism, Asperger’s disorder, schizophrenia and ADHD. A number of studies suggest that high cholesterol levels are also an inflammatory response to this endotoxin. Others link endotoxin to inflammatory damage in the brain’s appetite center. An impaired appetite center will cause people and animals to eat indefinitely without ever feeling full.

The Mother Jones article also describes several studies in which obese patients lost weight by simply suppressing endotoxin-producing bacteria – by taking probiotics and eating fermented foods containing beneficial bacteria.

*The contamination of animal fats and dairy products, even when produced organically, with fat-soluble pesticides and other industrial toxins makes choosing “safe” saturated fats somewhat problematic. Classified as endocrine disruptors, many of these toxins mimic estrogen, which promotes the development and growth of breast cancer. For this reason, I prefer coconut oil as my saturated fat of choice.

**Factory farmed animals are routinely fed antibiotics to hasten and maximize growth.

To be continued.

photo credit: {Guerrilla Futures | Jason Tester} via photopin cc