Probiotics? No. Metabiotics? Yes and more is better

Probiotics, Prebiotics, Synbiotics and Metabiotics

  1. Probiotics: beneficial gut microbiota
  2. Prebiotics: substrate that feeds and promotes growth of beneficial microbiota
  3. Synbiotics: combinations of probiotics and prebiotics
  4. Metabiotics: products of microbiota degeneration or metabolism that provide nutrients and signaling functions that benefit the host

 

Why we should be learning how to boost the gut production of “metabiotics”, the least known and most recently named …biotic

Making sense of the 4 biotics

Following on from successive hysterical food fads comes the stampede to find and sell the next probiotic. And naturally those with more money than sense are throwing it at probiotics but what does scientific plausibility add to the picture?

So far, very few probiotic bacteria or combination of bacteria other than total fecal transplant has been able to modify the microbiome, and why on earth would anyone expect a few bacterial colonies to impact an ecosystem containing up to 10,000 species of micro-organisms and trillions of individual cells.  On the other hand, different diets invariably produce profoundly contrasting microbial patterns. We already know how important substrate is for microbial growth, they bloom with appropriate substrate and vanish just as quickly and become dormant without it.  A probiotic without an ecological niche and substrate to sustain it is unlikely to survive so synbiotics make a lot more sense but still the probiotc component of any synbiotic mixture has yet to be seen to impact the overall complex microbiota ecosystem.

What we do know is: 1. diet and particularly fibre profoundly changes the microbiota and 2. increased species diversity is better than decreased diversity and 3. diverse diets with mixtures of different fibres increase microbiota diversity much more than a single fibre source.

But by what means do the microbiota improve health, certainly not directly because the integrity of the gut permeability barrier, (tight junctions between gut lining cells and thickness of the mucus layer) separates an incredibly hostile concoction of antigens and microbes from gut lining cells and the blood stream.  The microbiota must be kept out to prevent all manner of immune malfunction and inflammation while compounds produced by them, their metabiotics harvested.

Ecology of gut microbiota

The importance of metabiotics should not be surprising as most plant eating animals rely almost exclusively for their nutrition on biproducts of microbial breakdown of otherwise indigestible plant materials. The most important of these metabiotics that we know of are short chain fatty acids (SCFA) but there must be many more as grazing animals build all their body mass eating virtually no digestible protein, carbohydrate or fat and these animals demonstrate a direct relationship between the amount of fibre consumed and microbiota derived nutrients available for growth and energy. This dose response relationship must hold for humans as well, levels of SCFA increase proportionately with fibre intake, mainly acetate, propionate and butyrate, but little is known of how much SCFA is best for man. Whereas the EFSA has so far denied all health claims for “Prebiotics” they have approved several claims for fiber, however the health benefits of fiber go way beyond the simple concept of bowel regularity. Fibre is a powerful antidote to diabetes and its benefits are being linked to many other diseases  (Kim, 2014).  SCFAs are essential nutrients for intestinal cells particularly butyrate which provides colonic epithelial cells their main energy source as well as cell signaling effects that produce profound changes in the structure and function of the whole hind gut  (Riviere).  Further beneficial effects of SCFA are mediated through 2 types of free fatty acid receptors present in cells widely distributed in the body such as CNS, immune cells, fat cells, and insulin producing pancreatic islet cells  (Priyadarshini, 2016). Colonic entero-endocrine cells increase in number and increase production of incretin hormones GLP1 and PYY on stimulation by SCFA  (Konishi, 1984).  GLP1 and PYY suppress appetite and voluntary food intake  (Spreckley, 2015).  GLP1 has multiple beneficial actions across the body but particularly regulating glucose metabolism, pancreatic beta cell function and appetite suppression  (Zietek, 2016). GLP1 agonist drugs are widely used for the treatment of diabetes and obesity but endogenously produced GLP1 is largely responsible for the remarkable cure rate of type2 diabetes with gastric bypass surgery  (Madsbad, 2014). Both GLP and SCFA are involved with preserving intestinal permeability barrier function  (Cani, 2009) and butyrate and propionate are powerfully anti-inflammatory and may reduce autoimmune diseases, allergies and promote oral tolerance of potential food allergens  (Richards, 2016).  The so called ‘Leaky Gut Concept’ may be a triggering event in inflammatory conditions and autoimmune diseases such as colitis, arthritis, asthma, celiac disease and type 1 diabetes  (Marino, 2017) as well as a factor in age-related diseases that are thought to be increased by systemic inflammation such as heart attacks, strokes, cancer, and dementia  (Bourassa, 2016). Recent research links Parkinson’s Disease with “leaky gut” inflammation and recommends fibre pre-biotic nutritional therapies to boost SCFA production  (Perez-Pardo, 2017). Systemic inflammation is a prominent factor in type 2 diabetes and the anti-inflammatory effects of butyrate and propionate may be involved in the observed protection from diabetes with high fibre diets (Meijer).

What is the ideal level of fibre consumption and can you have too much of it?

Risk reduction from heart disease with increasing consumption of fiber

Risk reduction from heart disease with increasing consumption of fiber

This figure from Threapleton’s meta-analysis shows increasing protection against heart attack (CHD) with increasing consumption of fibre. The study suggests larger amounts (60-70 g/day) than current nutritional guidelines (25-35 g/day) would be at least as protective as the 30-40% relative risk reduction claimed in statin trials.  The average carbohydrate consumption in the US is around 500 g/day but that could be replaced with 60-80 plus g/day of fibre and because of the self limiting satiating effect of fiber it’s difficult to eat too much. The effects are transformational, reducing energy intake, eliminating glucose and insulin variability while increasing substrate to promote microbial diversity and SCFA production  (Threapleton, 2013).  For the paleo afficionados, one thing we know is that pre-historic man relied on much more dietary fibre for sustenance possibly 100-200 g/day and from the available studies so far- more is better.

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DIABETES EPIDEMIC RESULT OF INSULIN TSUNAMI

Summary

  1. Diets dominated by rapidly absorbed carbohydrates produce chronically high levels of insulin.

  2. Excess Insulin signalling alone can explain obesity, inflammation and insulin resistance progressing to diabetes.

High insulin levels (from diet) cause:

Diabetes

Obesity

Inflammation

 It is important to reduce high insulin levels simply by avoiding rapidly absorbed carbohydrates that spike blood glucose 

 

The Insulin Tsunami

  • Across modern societies most people are experiencing chronically high levels of insulin from diets dominated by rapidly absorbed carbohydrates
  • Insulin is the hormone that directs food into fat stores and high levels of insulin and glucose will constantly syphon calories into fat stores and stimulate increased food consumption for energy needs.
  • Recently Insulin itself has been found to directly increase inflammation throughout the body and diet driven insulin excess may be the precipitating cause of Type 2 Diabetes.
  • Inflammation is the most important risk factor for heart disease, stroke, cancer, etc.
  • No decrease in the epidemic of obesity and diabetes can occur without specifically addressing the route cause—chronically high levels of insulin from diets dominated by rapidly absorbed carbohydrates

Insulin is a vital hormone regulating many more processes than just blood glucose levels such as growth and development but once we are fully grown insulin continues to drive ever increasing waistlines, metabolic disturbances and age related diseases.  Even small amounts, such as 50 grams of rapidly digested carbohydrates spike glucose levels and produce large increases in insulin secretion that not only produce insidious weight gain but a cell signaling pattern that increases our risk of age related diseases. Unfortunately rapidly digestible carbohydrates have become the staple foods of modern societies and it requires a great deal of effort and commitment to avoid them. 50-60% of all calories consumed in the Western Diet are high glycemic starches and sweeteners such as flour, potatoes, rice, corn syrup, corn flour and sugar.

CHEATING THE SYSTEM: GET BENEFITS OF FASTING WITHOUT FASTING

Self-Eating (Autophagy) an ancient process involved in repair & aging, switches on while fasting and is exquisitely sensitive to dietary glucose abundance.

The tools of the “blind watchmaker” (Richard Dawkins on evolution) are serendipity and improvisation.  The first lesson in order to uncover the secrets of biology is to recognize the untidiness of it all, where mechanisms for doing one thing are borrowed to do another and the process repeated ad infinitum; if it works after a fashion, at least to get to the point of sexual maturity then all the better but after that he could care less, however after maturity the human condition involves 70 years or so of decline and unraveling the idiosyncrasies of the blind watchmaker may turn up some benefits to our fragile existence.

This is how I view the evolution of autophagy over a billion years:  A process that worked to preserve the life of single celled organisms when dormant and starved of nutrients has evolved to become a complex and lethally indispensable process for the existence of any form of multicellular animals. Funny that autophagy is unknown to most doctors, its discovery is so new, but its untidiness and improvisation is evident from the numerous overlapping functions it fulfills.  While fasting it provides glucose and fatty acids for energy and amino-acids for assembly of vital new proteins but simultaneously fasting likely improves autophagy’s other improvised roles; it detoxifies cells and stops them gumming up, regulates recycling, healing, repair, cell turnover, immunity and inflammation.  The exciting thing for us is that this vital process is eminently amenable to regulation through lifestyle choices such as exercise and nutrition.  Differentiating between fasting and feasting is critical to survival and a barometer of this switch is the level of glucose in blood and extra-cellular fluid, just 10 grams: a tiny amount compared to energy demands which, if supplied by glucose alone could vary between 0.5 grams per minute at rest to 5 grams per minute while running (clearly 5g per minute form a pool of 10g would be rapidly unsustainable). This delicate sensitivity of blood glucose to feeding argues that glucose is a barometer of energy status and not our primary energy source, this role is  reserved for fatty acids of which we carry hundreds of thousands of Calories in our 10-20% plus body fat. The molecular signaling pathway of this pivotal role of blood glucose is becoming clearer; simply restricting blood glucose reverses the ratio of insulin to glucagon that controls the activation of mTOR that in turn regulates autophagy and numerous other things that influence aging and age related diseases that are now the commonest causes of death and disability,

NO GAS NO GAIN

Headlines across UK media on November 27th 2014

2 MILLION ELIGIBLE TO HAVE GASTRIC BYPASS SURGERY ON THE NHS

No Gas No Gain:  virtually all gastric bypass patients have increased intestinal gas production”

No Joke Bottom line: Increased dietary fiber better diabetes solution than gastric bypass surgery

Alternative headline:
NHS TO TREAT NATIONWIDE DIETARY FIBRE DEFICIENCY WITH GASTRIC BYPASS SURGERY

2 million for GBS no Aldi ad

“NICE” guidelines recommend all diabetics with a body mass index over 35 should be evaluated for gastric bypass surgery. A bariatric surgeons’ spokesperson interviewed on BBC Radio 4 said the procedure produces remission of diabetes within days after surgery independent of any weight loss but the reasons for this improvement are unknown. 10% of the NHS budget goes to treating diabetes and its complications, for example she stated 100 amputations take place every week in NHS hospitals and argued that gastric bypass surgery is a more economical way for the NHS to treat diabetes—now enter the laws of unintended consequences:  COST & COMPLICATIONS.

In my past life as an anesthesiologist I know full well the seriousness of obese patients undergoing any type of surgery and gastric bypass surgery comes with a long list of serious and life threatening complications but among the less serious, virtually everyone has increased gas/flatus production and this is likely the key to its remarkable cure of diabetes.

Contrary to the statement by the bariatric surgeons’ spokesperson, much more is known about the mechanisms whereby gastric bypass but not gastric banding improves diabetes (1) and is likely related to dramatically increased production of certain hormones from intestinal cells in response to undigested food and/or products of fermentation such as short chain fatty acids(SCFA). One of the reasons for assuming fermentation and SCFA’s are important is that virtually all gastric bypass patients have increased intestinal gas production i.e. flatulence, bloating, rumbling feelings and noises, etc. (2). Food consumed by those who have had gastric bypass enters the small intestine downstream avoiding our own digestive enzymes secreted by the pancreas and is therefore available for fermentation by the bacteria which inhabit the gut. These bacteria produce hydrogen, organic gases and carbon dioxide along with SCFA’s which are important intestinal nutrients and signalling compounds that interact with SCFA receptors present at the surface of numerous cell types and organs of the body including immune cells regulating inflammation (3) (4) (5) (6) (7) (8) (9). SCFA’s stimulate receptors in intestinal cells to produce hormones (GLP1) that regulate glucose metabolism and appetite (10) (11) (12) (13) (14).

Conclusions:
Urgent reappraisal of farting as a social stigma is required as one way or another if you want avoid diabetes you take your choice— gastric bypass surgery or up your fibre but either way  avoiding the indiscretion of letting one rip at an embarrassing moment is not an option.

Works Cited
1. Madsbad S, Dirksen C, Holst JJ. Mechanisms of changes in glucose metabolism and bodyweight after bariatric surgery.  Lancet Diabetes Endocrinol 2014;2:152–164.
2. Potoczna N1, Harfmann S, Steffen R, Briggs R, Bieri N, Horber FF. Bowel habits after bariatric surgery. Obes Surg. 2008 Oct;18(10):1287-96. doi: 10.1007/s11695-008-9456-4. Epub 2008 Mar 8.
3. Andrew J. Brown, Susan M. Goldsworthy, Ashley A. Barnes, et al. The Orphan G Protein-coupled Receptors GPR41 and GPR43 Are Activated by Propionate and Other Short Chain Carboxylic Acids.  THE JOURNAL OF BIOLOGICAL CHEMISTRY Vol. 278, No. 13, Issue of March 28, pp. 11312–11319, 2003.
4. Canani RB, Costanzo MD, Leone L, Pedata M, Meli R, Calignano A. Potential beneficial effects of butyrate in intestinal and extraintestinal diseases.  World J Gastroenterol. 2011 Mar 28;17(12):1519-28. doi: 10.3748/wjg.v17.i12. 1519..
5. D. Zapolska-Downar, M. Naruszewicz. Propionate Reduces The Cytokine-Induced Vcam-1 And Icam-1 Expression By Inhibiting Nuclear Factor-K B (Nf-Kb) Activation.  Journal Of Physiology And Pharmacology 2009, 60, 2, 123-131. http://www.jpp.krakow.pl.
6. Patrick M. Smith, Michael R. Howitt, Nicolai Panikov, Monia Michaud, Carey Ann Gallini, Mohammad Bohlooly-Y, Jonathan N. Glickman, Wendy S. Garrett. The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic Treg Cell Homeostasis. Science 341, 569 (2013). DOI: 10.1126/science.1241165.
7. Vinolo, Rodrigues, Nachbar, Curi. Regulation of inflammation by short chain fatty acids. Nutrients 2011, 3, 858-876. doi: 10.3390/nu3100858.
8. Xiao, et al. A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome. FEMS Microbiology Ecology, Volume 87, Issue 2, pages 357–367, February 2014.
9. Sebely Pal, Alireza Khossousi, Colin Binns, Satvinder Dhaliwal and Vanessa Ellis. The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals.  British Journal of Nutrition (2011), 105, 90–100.
10. Gwen Tolhurst, Helen Heffron, Yu Shan Lam, Helen E. Parker, Abdella M. Habib, Eleftheria Diakogiannaki, Jennifer Cameron, Johannes Grosse,2 Frank Reimann, Fiona M. Gribble. Short-Chain Fatty Acids Stimulate Glucagon-Like Peptide-1 Secretion via the G-Protein–Coupled Receptor FFAR2. Diabetes 61:364–371, 2012.
11. Holst, JJ. Incretin hormones and the satiation signal. s.l. : International Journal of Obesity (2013) 37, 1161–1168.
12. Ji Hee Yu, Min-Seon Kim. Molecular Mechanisms of Appetite Regulation. Diabetes Metab J 2012;36:391-398.
13. L. Geurts, A.M. Neyrinck, N.M. Delzenne, C. Knauf, P.D. Cani. Gut microbiota controls adipose tissue expansion, gut barrier and glucose metabolism: novel insights into molecular targets and interventions using prebiotics. Beneficial Microbes, December 2013; 4(4): 1-15. ISSN 1876-2833 print, ISSN 1876-2891 online, DOI 10.3920/BM2012.0065 1 .
14. Slavin, Joanne. Fiber and Prebiotics: Mechanisms and Health Benefits.  Nutrients 2013, 5, 1417-1435; doi:10.3390/nu5041417 .

Fallacy 2:  “Detox”

Never underestimate the difficulty of changing false beliefs by facts.  Henry Rosovsky

Fallacies are not just crazy ideas and usually have at least some element of plausibility, “detoxification” sounds like a good thing right, so an industry of snake oil salesmen thrive on nothing more than word association to convince impressionable and naïve people to spend valuable vacation time in detox centers and consume concoctions supposed to clean the liver and digestive tract in a similar fashion to a colonoscopy preparation regime: make no mistake about it those who use the term “detox” in serious conversation are either naïve or unscrupulous and often both.  On the other hand detoxification is a complex and vital process to the health of individual cells and the body as a whole but it’s not something that we can go away one weekend a month for or indulge in the occasional chemically induced episode of diarrhea.  Before we throw the baby out with the bathwater, there are ways to enhance the body’s natural detoxification processes but first we have to better define the biological processes involving detoxifying functions.

Autophagy (self-eating):  At the cellular level substantial amounts of potentially toxic proteins are constantly produced and need to be broken down and recycled in order to prevent cell stress and dysfunction which can ultimately lead to premature cell death and degenerative conditions like dementia.  Sophisticated systems have evolved (autophagy and ubiquitin/proteasome machinery) to recycle not only proteins, but mobilize fats and carbohydrates for energy use during times of fasting.  For instance this is accomplished during sleep where brain cells switch energy resources to the task of clearing a backlog of protein fragments generated during periods of consciousness and we now know that sleep deprivation can cause increased neuronal cell death.  The link between fasting and cell detoxification may explain the beneficial effects of calorie restriction on longevity but also suggests that the sensing mechanisms of fasting, such as lower glucose levels, enhance cellular detoxifying via autophagy as well.  Abundant glucose dramatically increases insulin secretion and the insulin signaling system suppresses autophagy as does high amino acid levels from high protein consumption.

Liver Function:  At the whole body level the liver is the main organ of detoxification of enormous amounts of endogenously produced waste products as well as potentially harmful substances absorbed from what we eat.  Fat soluble waste is excreted into the gut as bile and water soluble waste via the kidneys as urine. The role of water in urine excretion is self-evident but the role of the bile and digestive tract is detoxification is not so widely appreciated.  One of the many remarkable functions of fiber is the enhancement of removal of fat soluble excretory products in bile.

Take Home Message!  Eat low glycemic high fiber foods:  Foods that produce low levels of glucose and only moderate amounts of protein are good for cellular detoxification and high fiber foods are good for liver and gut function.

What to eat and avoid?

Harmful Foods-Minimize these 

Over 70% of calories consumed by children and adults alike are quickly digested carbohydrates resulting in large increases in blood glucose that prompts insulin secretion resulting in fat deposition, stops energy production from fat and increases food consumption and hunger.  Long term effects of frequent spikes of high blood sugar are cell damage and inflammation, hypertension, metabolic syndrome that can lead to serious problems later in life such as heart attacks, strokes, cancer and dementia.

  • Sugar, High Fructose Corn syrup, all caloric sweeteners including honey and agave syrup, sweets & candies. Use low calorie sugar substitutes if necessary
  • All Juices, even orange juice, eat the fruit instead, sodas, energy drinks, gatorade, powerade, grape juice, cranberry juice, etc. Also avoid cocktail drink mixes like margarita and sweet and sour mix.
  • White flour, bread, pasta, cakes, cookies, biscuits, etc.
  • Potatoes, white rice, corn flour products, chips, etc.

 

Beneficial Foods-Instead Choose to Eat High Fiber, Low Glycemic Foods

Carbohydrates can be roughly categorized by the speed of their digestion into simple sugars; the faster the worse for health and slower the better, with fiber on the most beneficial end of the spectrum, which also minimize the amount of simple sugars obtained from your diet. Low glycemic food choices, vast, varied and enjoyable include many foods that were previously stigmatized like eggs, dairy and meat.  Calorie counting is unnecessary if high fiber plant foods are the bulk of your diet as they are satiating and suppress hunger due to slow digestion and low insulin response, in addition they contain thousands of phytonutrients which protect against stress, inflammation and cell damage. 

 

  • Unlimited consumption of salads, leafy green vegetables, whole fruits, and nuts.
  • Moderation but not overindulgence in all sorts of interesting foods, including meat, fish, cheese, butter, eggs, olive oil, rape seed/canola oil, herbs and spices. These are what make foods enjoyable and they are mostly nonfattening and nutritionally beneficial
  • Peas, lentils, legumes and beans are high in protein and fiber good in moderation as they still contain digestible carbohydrates.
  • Whole grains, while much better than refined flour are still high glycemic carbohydrates and counteract ketogenesis if you are trying to lose weight or reverse hypertension and metabolic syndrome. Oat bran and oat germ are an inexpensive alternative, as are wheat bran and wheat germ.
  • Drink: water or tea (green tea), coffee, diet drinks if necessary. Again avoid drinks with any sugar, HFCS, or any other calorie containing syrup.
  • Alcohol: Fine in moderation: red wine may have particular benefits.
  • Supplements most are unnecessary and could even be harmful other than a source of omega3 and vitamin D such as in fish liver oils.

 

 

 

 

HEALTHY FOOD FALLACIES

Never underestimate the difficulty of changing false beliefs by facts.  Henry Rosovsky

Fallacies are not just crazy ideas and usually have at least some element of plausibility, most of the dogma parroted on topics of healthy food by the media, self-serving advertising and common gossip are fallacies.  But if the consequences are a global epidemic of obesity, diabetes and human suffering that threatens to overwhelm our health services and our ability to pay for them; it’s about time to clear up some of the deep rooted fallacies of the “healthy eating conundrum”.

Here follows the first of my fallacy rants  (not necessarily in order of importance)

Vitamins and probiotics for children, or anyone else?  The question itself implies a belief that there may be antidotes for harmful food habits that we don’t want to change and instead a vitamin or probiotic can fix the problem.  The simple answer is that there is no antidote to harmful foods and vitamins are just as likely to be damaging as helpful to children’s’ health and “probiotics” are a seriously flawed concept anyway:  to cut to the chase, save your money and don’t bother with vitamins and probiotics.  However, no-one is likely to change unless they believe strongly enough that it is necessary to do so.  But there is no magic or medicine that can undo damage better than prevention in the first place, therefore, it is vitally important to avoid harmful foods-This is almost impossible if you fall in line doing what everyone else does but we are killing our kids with “kindness”, sweet treats, ice cream, sodas, juices, etc. and doing what everyone else does will get you the result that the majority already have; overweight, inactivity and worse, the risk of diabetes, heart attacks, strokes, cancer, the list goes on.

All things necessary to life are toxic, the key is the dose

All biologically active substances are toxic outside of their homeostatic range: that includes water, oxygen, salt, glucose, protein, everything inside our cells and circulation is just as toxic above as below its normal range, “the Goldilocks Phenomenon” applies to all of these things.  Vitamins have been known for 80 years or so, numerous studies have been carried out on possible health benefits of vitamin supplements none have been helpful but more important several studies on vitamins and antioxidants have shown deterioration instead and it is scientifically plausible that this should be so.  Foods contain thousands, maybe hundreds of thousands of necessary nutrients including vitamins and minerals and it is the interaction of multiple ingredients in highly variable food patterns such as the “Mediterranean Diet” that have been found most beneficial.  However, the food we eat is also food for the trillions of micro-organisms that exist in our digestive system (the microbiome) and the importance of this relationship is only just beginning to be discovered.

Prebiotics more useful than Probiotics?

What are probiotics and how do they help us?   The Probiotic concept is that some bacteria have a beneficial effect on gut function and overall health.  To accomplish this they may thrive and replace harmful bacteria and produce beneficial “fermentation products”.  There is no doubt that our health benefits from a symbiotic relationship with gut microbes, however, the gut has trillions of micro-organisms, at least 1,500 and some estimate over 30,000 different species with a combined mass of 1-2 kg and like an algal bloom in the Gulf of Mexico, gut microbes can proliferate in favorable nutrient conditions but the seeds for growth are already present and ubiquitous. The reasons claims for health benefits for probiotics have been repeatedly denied by US and EU authorities are that eating a food containing 1 or 2 species of bacteria has never been shown to have an effect on the hugely complex pattern of organisms further down the digestive system and at any rate sufficient substrate is required for significant numbers of bacteria and fermentation products to have an effect.  On the other hand different diets have been shown to have profound effects on the microbiome and the quantity of beneficial fermentation products that they produce this is the basis of the prebiotic concept where resistant starches and fibers provide substrate for proliferation of bacteria that produce beneficial fermentation products such as short chain fatty acids.

 What to eat and avoid?

 Harmful Foods-Minimize these  

Unfortunately over 70% of calories consumed by children and adults alike are quickly digested carbohydrates resulting in large increases in blood glucose that prompts insulin secretion resulting in fat deposition, stops energy production from fat and increases food consumption and hunger.  Long term effects of frequent spikes of high blood sugar are cell damage and inflammation, hypertension, metabolic syndrome, all things that can lead to serious problems later in life such as heart attacks, strokes, cancer and dementia.

  • Sugar, High Fructose Corn syrup, all caloric sweeteners including honey and agave syrup, sweets & candies. Use low calorie sugar substitutes if necessary
  • All Juices, even orange juice, eat the fruit instead, sodas, energy drinks, gatorade, powerade, grape juice, cranberry juice, etc. Also avoid cocktail drink mixes like margarita and sweet and sour mix.
  • White flour, bread, pasta, cakes, cookies, biscuits, etc.
  • Potatoes, white rice, corn flour products, chips, etc.

 

Beneficial Foods-Instead Choose to Eat High Fiber, Low Glycemic Foods

Carbohydrates can be roughly categorized by the speed of their digestion into simple sugars; the faster the worse for health and slower the better, with fiber on the most beneficial end of the spectrum, which also minimize the amount of simple sugars obtained from your diet. Low glycemic food choices, vast, varied and enjoyable include many foods that were previously stigmatized like eggs, dairy and meat.  Calorie counting is unnecessary if high fiber plant foods are the bulk of your diet as they are satiating and suppress hunger due to slow digestion and low insulin response, in addition they contain thousands of phytonutrients which protect against stress, inflammation and cell damage. 

  •  Unlimited consumption of salads, leafy green vegetables, whole fruits, and nuts.
  • Moderation but not overindulgence in all sorts of interesting foods, including meat, fish, cheese, butter, eggs, olive oil, rape seed/canola oil, herbs and spices. These are what make foods enjoyable and they are mostly nonfattening and nutritionally beneficial
  • Peas, lentils, legumes and beans are high in protein and fiber good in moderation as they still contain digestible carbohydrates.
  • Whole grains, while much better than refined flour are still high glycemic carbohydrates and counteract ketogenesis if you are trying to lose weight or reverse hypertension and metabolic syndrome. Oat bran and oat germ are an inexpensive alternative, as are wheat bran and wheat germ.
  • Drink: water or tea (green tea), coffee, diet drinks if necessary. Again avoid drinks with any sugar, HFCS, or any other calorie containing syrup.
  • Alcohol: Fine in moderation: red wine may have particular benefits.
  • Supplements most are unnecessary and could even be harmful other than a source of omega3 and vitamin D such as in fish liver oils.

 

 

 

 

Inactivity: The Chicken or the Egg?

Influence of Diet on Voluntary Physical Activity?

Explanations of how high glycemic foods as well as fiber deficiency can directly influence physical activity and exercise habits and lead to a vicious cycle of increased obesity and inactivity. 

 Physical activity is very important to health and longevity and to a certain extent exercise can help lose weight from fat stores but few of us have the time, dedication or body strength needed to lose weight by exercise alone: consider that an hour of fast running consumes around 1000 Calories and 10 kg of fat contains 90,000 Calories.  Nevertheless, many regard lack of exercise the main reason for rising obesity rates in children and adults alike but evidence suggests the type of foods we eat can suppress spontaneous activity and the natural desire for playful exercise.  These same foods fail to satisfy hunger and therefore lead to a vicious circle of overeating and inactivity.

In other pages of this blog we describe how high glycemic carbohydrates (sugar, flour, potatoes, rice, etc.) make up 60% or more of our staple foods and after every meal, day after day year after year, elevate blood glucose 2-3 fold and insulin levels more than 10 fold. There are numerous detrimental biological consequences of such changes and amongst them is an avoidance of physical activity.  This notion is supported by a recent study whereby laboratory animals were fed either a high glycemic or low glycemic diet.  Voluntary physical activity was 45% higher for the Low Glycemic fed mice after 38 weeks of feeding. The authors concluded that dietary composition can affect physical activity level (1) in addition body composition was changed by the type of food not energy intake and the high-GI diet caused a pre-diabetic condition which other studies suggest affect up to 30% of adolescents in the USA (2).

Basic science research has revealed some of  the biological mechanisms whereby physical activity can be suppressed by the type of food we eat:    Most people will be familiar with the overwhelming lack of energy and need for rest that occurs with illness for example a bout of “flu”.  Inflammatory cytokines, produced by activated immune cells, induce “sickness behaviour” (1) (3) which is essentially avoidance of physical activity.  Inflammation is associated with depressive symptoms, anxiety and invokes fatigue and reduced movement (3), anti-inflammatory compounds can block/reverse many of these changes (3).  A much milder form of sickness behavior may be brought about by low grade inflammation associated with high levels of blood glucose (and fructose) after meals containing large amounts of high glycemic starches and sugars documented by increased levels of markers of inflammation in these situations (5).  A more recent study has shown increased intestinal wall permeability in obese individuals associated with inflammation and its reversal with a low glycemic high fiber diet  (6).  Several other possible interactions exist such as the suppression of mitochondrial biosynthesis with high levels of insulin brought about by high glucose may directly decrease exercise tolerance.  High glucose also increases stress by increasing production of reactive oxygen molecules and widespread glycation of proteins results in serious impairment of cell function (7).

Although the science may seem complicated the take home message is simple: avoid high glycemic foods and eat much more fiber.  The sad reality is that trying to follow such a lifestyle choice is very difficult as just the opposite, high glycemic low fiber foods dominate our food culture and supermarkets.

1. Inflammatory modulation of exercise salience: using hormesis to return to a healthy lifestyle. Alistair V Nunn, Geoffrey W Guy, James S Brodie, Jimmy D Bell. s.l. : Nutrition & Metabolism , Vols. 2010, 7:87.

2. The Prevalence of the Metabolic Syndrome Among a Racially/Ethnically Diverse Group of U.S. Eighth-Grade Adolescents and Associations With Fasting Insulin and Homeostasis Model Assessment of Insulin Resistance Levels. R. Jago, T. Baranowski, J. Buse, S. Edelstein, P. Galassetti, J. Harrell, F. Kaufman, B. Linder, and T. Pham. s.l. : Diabetes Care, Vols. 31:2020–2025, 2008.

3. Inactivation of the cerebral NFkappaB pathway inhibits interleukin-1beta-induced sickness behavior and c-Fos expression in various brain nuclei. Nadjar A, Bluthe RM, May MJ, Dantzer R, Parnet P. s.l. : Neuropsychopharmacology , Vols. 2005, 30:1492-1499.

4. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Miller AH, Maletic V, Raison CL:. s.l. : Biol Psychiatry, Vols. 2009, 65:732-741.

5. High–glycemic index carbohydrate increases nuclear factor- B activation in mononuclear cells of young, lean healthy subjects. Scott Dickinson, Dale P Hancock, Peter Petocz, Antonio Ceriello and Jennie Brand-Miller. s.l. : Am J Clin Nutr, Vols. 2008;87:1188 –93. http://www.ajcn.org/cgi/content/full/87/5/1188.

6. Xiao, et al. A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome. s.l. : FEMS Microbiology Ecology, Volume 87, Issue 2, pages 357–367, February 2014.

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