When the ancient Greek father of medicine, Hippocrates, said “All disease begins in the gut,” he was probably right. Poor gut health has been linked to a broad range of diseases and health conditions, from depression to diabetes, cancer to obesity, and autism to autoimmune disease. Search the medical literature and you’ll probably find links between the gut and any illness you can imagine.
So—all the world’s health issues solved, right? Not exactly.
Gut health is one of those topics that gets more complicated the deeper you go. The more you read about gut bacteria, the less you realize you know and the less you realize anyone knows, even the researchers. It’s infinite onions, all the way down. The layers never stop, and exposing them eventually makes you want to cry. (Speaking of which, onions are actually a very good food for gut health).
All that said, the scientific community is honing in on the signs and symptoms of an unhealthy gut. We know how to heal an unhealthy gut, or at least improve gut health. An incredible amount of research has determined the best foods for gut health, and we know the worst foods for gut health. We understand that gut health comes down to supporting healthy gut bacteria and avoiding leaky gut. Top-down micromanagement might not work yet, but big-picture, bottom-up intervention does.
Gut Inflammation: Signs of an Unhealthy Gut
Some of the signs are obvious. Others are more pernicious. Not all of these will apply to someone with unhealthy gut bacteria or leaky gut, but some will.
Chronic Constipation, Bloating, and/or Diarrhea
Everyone gets a little constipated now and then. We’ve all had the runs, and we’ve all felt bloated after a particularly large meal. As long as these conditions are acute—as long as they’re brief and transient—they don’t indicate any serious gut inflammation. It’s when constipation or diarrhea or bloating endure and become chronic conditions that you should pay close attention. Chronic constipation, bloating, and diarrhea are signs of an unhealthy gut biome.
Obesity or Overweight
Although the connection hasn’t been established as causal, there is a consistent and significant association between obesity/overweight and poor gut health. If you are obese, you very likely have room to improve the health and function of your gut.
Food Intolerances and Allergies
If the integrity of your gut is compromised due to excessive gut inflammation or missing gut bacteria, undigested components of the foods we eat can slip past the intestinal barrier and into our bodies where they trigger an allergic reaction. This appears to be a necessary step in the development of a food allergy, and a 2011 review concluded that an overly leaky gut facilitates this transportation and leads to the inducement of allergy.
Depression and Anxiety
Researchers have long puzzled over observations that mental health conditions like depression and anxiety often present with common gastrointestinal complaints like constipation and diarrhea. It’s not just circumstantial: gut bacteria produce large amounts of neurotransmitters like serotonin, interact with neural pathways involved in anxiety and depression, and help form the gut-brain axis.
Animal studies show that replacing the gut bacteria of anxious mice with gut bacteria from fearless mice makes the anxious mice more brave, while giving bold mice bacteria from anxious mice makes them more anxious. In human subjects, a probiotic supplement (containing L. helveticus R0052 and Bifidobacterium longum R0175) reduces measures of anxiety and depression, and by some accounts, 35% of depressed patients have leaky gut.
Skin Problems (Eczema, Psoriasis)
In the last section, I told you about the gut-brain axis. There’s also a gut-skin axis: a constant interplay between the health of your gut and the health of your skin. People who have eczema are also likely to have leaky gut, while psoriasis patients show clear signs of unbalanced gut bacteria.
One of the world’s premier autoimmune disease researchers, Dr. Alessio Fasano, considers poor gut health a necessary pre-condition for all autoimmune diseases. It’s a similar situation to the allergy/intolerance issue: a leaky, inflamed gut allows outside proteins and other food components into the body, the immune system mounts an immune response to deal with the invaders, and this response gets out of hand and redirected toward the body’s own tissues.
Okay, so how does it all happen? Apart from food, which I’ll get to later on…
What Causes an Unhealthy Gut?
There are many potential causes of poor gut health.
Stress can directly induce leaky gut (PDF) and stress can take many forms, as we all know. Bad finances, marital strife, unemployment, too much exercise, lack of sleep, extended combat training, and chronic under-eating all qualify as significant stressors with the potential to cause leaky gut, especially chronically and in concert with one another.
Sleep is restorative, and restorative sleep means you’re lowering stress and improving gut health. If your circadian rhythm starts to shift, starts getting a little dysfunctional, your gut health soon follows.
Inadequate Dirt Exposure
Too sterile an environment causes too sterile a gut. We are made to spend time in nature, feet and hands getting dirty, exposed directly to the natural soil teeming with trillions of bacteria. We’re meant to eat produce directly from the ground, and nature didn’t intend for us to always wash it. (That said, if you didn’t grow it yourself, it’s best to wash your produce.) Exposure to healthy soil may even bestow upon us anti-anxiety gut bacteria—gut microbes that actually make us less anxious.
Not Enough Exercise (or Too Much)
Exercise has been shown to directly improve gut function, increasing the production of beneficial short cain fatty acids by gut bacteria. When you stop training, the gut benefits cease.
Just don’t do too much. An acute bout of intense training causes a transient rise in leaky gut that subsides and even improves several hours after the session. This is fine. This is normal. This is adaptive. But if you start stringing together intense training sessions without adequate rest, the exercise becomes a chronic stressor and the transient rise in leaky gut starts looking more permanent.
Too Many Antibiotics
Antibiotics are great at killing pathogenic bacteria attacking you, but they also tend to be indiscriminate. They do not distinguish between friendly bactieria and harmful bacteria in your gut biome. The broad spectrum antibiotics we commonly take also wipe out the bacteria living in our guts, leading to gut bacteria imbalances and poor gut function.
After addressing the major causes of poor gut health, is there anything you should avoid eating? Are there foods you should focus on eating to improve your gut health?
What Are the Worst Foods for Gut Health?
The worst foods for gut health are no surprise to regular readers of this site, but that doesn’t make them any less important to avoid.
When we eat refined carbs like grains or sugar, glucose is immediately released into the digestive tract, increasing the concentration of carbohydrate available to your gut biome. This concentrated influx of dense carbohydrate into the gut produces an inflammatory microbial population that increases production of bacterial endotoxin and increases leaky gut. Meanwhile, the lack of prebiotic fiber means your beneficial gut bacteria have no food to consume.
Gluten, a protein found in wheat, barley, and rye, causes your body to release zonulin—a chemical messenger that tells your intestinal junctions to open up. Many people can handle this increase in zonulin, but if you’re already suffering from poor gut health or are sensitive to gluten, the zonulin response may be strong enough to trigger leaky gut.
What Are the Best Foods for Gut Health?
- Fermentable fiber
- Red wine
- Skin, bones, and broth
- Fermented foods
- Resistant starch
- Onions, garlic, and leeks
Without food, your gut bacteria suffers. And the best food for your gut bacteria is fermentable fiber, found in many different plants. Asparagus, carrots, Jerusalem artichokes, and alliums like garlic and onions are your best bet.
Besides being delicious, high-cacao dark chocolate is an excellent source of prebiotic fiber (fiber your gut bacteria can consume) and prebiotic polyphenols (plant compounds that also feed your gut bacteria).
Name a berry and it’s been shown to improve gut health. Strawberries feed the gut biome and improve the gut function of diabetic mice. Blackberries restore gut health and trigger neuroprotective effects. Eating blueberries leads to compositional changes to the gut bacteria linked to improved metabolic health. And black raspberries have been shown to cause “anti-inflammatory” bacterial profiles in the gut.
Skin, bones, and broth
Skin, bones, and broth offer gut health benefits in a number of ways. First, they provide “animal fiber,” collagenous and gristly substrate that our gut bacteria can digest and prosper on. Next, they offer ample amounts of gelatin, which can help repair damaged gut lining. In a pinch, collagen can fill the gap.
This is an obvious one, but it’s incredibly important and more complex than you probably think. First of all, fermented foods like yogurt, sauerkraut, pickles, kefir, and dozens of other varieties seed our guts directly with beneficial probiotic bacteria. That has real benefits—though they don’t “form colonies” and you do have to continually eat fermented foods for the full benefit. Some fermented foods also have the ability to “train” your resident bacteria to digest new compounds. One example is fermented milk: in one study it didn’t colonize the gut but led to increased microbial expression of carbohydrate metabolizing enzymes in the existing bacteria.
Resistant starch isn’t like other starches. Our stomach acid and digestive enzymes cannot break it down, but our gut bacteria can digest it. Multiple studies indicate that resistant starch consumption generally leads to an increase in “beneficial” colonic bacteria and a reduction in “pathogenic” colonic bacteria, including a boost to bifidobacteria and a decrease in firmicutes and a huge boost to butyrate production. The best sources of resistant starch are green (unripe) bananas and raw potato starch.
Meat usually doesn’t pop up on these lists, but that’s a huge mistake. Red meat especially provides ample B-vitamins required for energy generation and general physiological maintenance, including gut function. It’s a nutrient-dense “safe” food for even damaged guts who need to be careful about the plant foods they eat. And if you’re eating a significant amount of meat, you’ll have less room to eat the refined carbs and refined sugar that really cause gut issues.
Pistachios are the most potent nut for improving gut health. Other nuts like almonds are good too, but pistachios produce a biome richer in butyrate-secreting bacteria which is extremely beneficial to several body systems.
Onions, garlic, and leeks
Onions, garlic, leeks, and other members of the allium family offer concentrated doses of fructo-oligosaccharides, some of the best-studied and most beneficial fermentable prebiotic fibers in the plant kingdom. Plus, they’re delicious, and humans have been eating them for thousands of years (if not longer).
Some people will react poorly to some of the foods listed in the “Best” section. If your gut health is compromised and your gut bacteria dysfunctional, you may very well have trouble consuming fermentable fiber, resistant starch, berries, and other fibrous foods without bloating, gas, stomach pain, constipation, and diarrhea. Please read my article on FODMAPs to understand how to work around this issue and maintain your gut health.
Thanks for reading, everyone. If you have any questions about gut health or the info contained in this post, let me know down below!
Bell DS. Changes seen in gut bacteria content and distribution with obesity: causation or association?. Postgrad Med. 2015;127(8):863-8.
Tordesillas L, Gómez-casado C, Garrido-arandia M, et al. Transport of Pru p 3 across gastrointestinal epithelium – an essential step towards the induction of food allergy?. Clin Exp Allergy. 2013;43(12):1374-83.
Perrier C, Corthésy B. Gut permeability and food allergies. Clin Exp Allergy. 2011;41(1):20-8.
Foster JA, Mcvey neufeld KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013;36(5):305-12.
Hidalgo-cantabrana C, Gómez J, Delgado S, et al. Gut microbiota dysbiosis in a cohort of patients with psoriasis. Br J Dermatol. 2019;181(6):1287-1295.
Allen JM, Mailing LJ, Niemiro GM, et al. Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans. Med Sci Sports Exerc. 2018;50(4):747-757.
Petersen C, Wankhade UD, Bharat D, et al. Dietary supplementation with strawberry induces marked changes in the composition and functional potential of the gut microbiome in diabetic mice. J Nutr Biochem. 2019;66:63-69.
Marques C, Fernandes I, Meireles M, et al. Gut microbiota modulation accounts for the neuroprotective properties of anthocyanins. Sci Rep. 2018;8(1):11341.
Lee S, Keirsey KI, Kirkland R, Grunewald ZI, Fischer JG, De la serre CB. Blueberry Supplementation Influences the Gut Microbiota, Inflammation, and Insulin Resistance in High-Fat-Diet-Fed Rats. J Nutr. 2018;148(2):209-219.
Pan P, Lam V, Salzman N, et al. Black Raspberries and Their Anthocyanin and Fiber Fractions Alter the Composition and Diversity of Gut Microbiota in F-344 Rats. Nutr Cancer. 2017;69(6):943-951.
Mcnulty NP, Yatsunenko T, Hsiao A, et al. The impact of a consortium of fermented milk strains on the gut microbiome of gnotobiotic mice and monozygotic twins. Sci Transl Med. 2011;3(106):106ra106.
Haenen D, Zhang J, Souza da silva C, et al. A diet high in resistant starch modulates microbiota composition, SCFA concentrations, and gene expression in pig intestine. J Nutr. 2013;143(3):274-83.
Martínez I, Kim J, Duffy PR, Schlegel VL, Walter J. Resistant starches types 2 and 4 have differential effects on the composition of the fecal microbiota in human subjects. PLoS ONE. 2010;5(11):e15046.
Liu Z, Lin X, Huang G, Zhang W, Rao P, Ni L. Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans. Anaerobe. 2014;26:1-6.
Ukhanova M, Wang X, Baer DJ, Novotny JA, Fredborg M, Mai V. Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study. Br J Nutr. 2014;111(12):2146-52.
Gibson GR. Dietary modulation of the human gut microflora using prebiotics. Br J Nutr. 1998;80(4):S209-12.
The post 6 Signs of an Unhealthy Gut, 7 Likely Causes & the Best Foods for Gut Health appeared first on Mark’s Daily Apple.
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While some keto or low-carb proponents claim fiber is useless at best and actively harmful at worst, I come down on the side that says fiber is probably helpful for most people. Some folks have persistently better responses to low- or no-fiber keto diets, and I won’t argue with that—I’ve seen it happen and I’ve read the studies where de-emphasizing fiber can actually improve constipation, for example.
I’ll just say that I have an opposite reaction, and, most importantly, I love eating a variety of plant foods that also happen to contain a ton of great nutrients in addition to fiber.
Do I buy into the idea that fiber is important because it is every human being’s responsibility to produce as much colonic bulk as humanly possible? No.
Do I think we should be consistently pushing the limits of our digestive tracts, performing feats of bathroom heroism so momentous they border on Herculean, and making sure the toilet bowl buckles beneath us? No.
The real value of fiber lies not in its coarseness, its tendency to form colonic bulk, to keep us topped off. The true value lies in its fermentability. A fermentable fiber is a prebiotic fiber—fiber that feeds our gut bacteria.
I will, however, explain why we need to be feeding our gut bacteria. Our gut bacteria form a physical barrier against incursions and colonization by pathogenic bacteria; they take up room along the gut lining so pathogens can’t. If we don’t feed our gut bacteria with prebiotics, it won’t be around to protect us. After antibiotic treatment where both good and bad gut flora are indiscriminately targeted and wiped out, pathogenic obesity-promoting bacteria take advantage of the open space. That’s a worst-case scenario, but it shows what can happen when the harmony of the gut is disturbed by antibiotics or, to a less extent, a lack of fermentable prebiotic fibers.
Gut bacteria also convert antinutrients like phytic acid into nutrients like inositol. The almond meal-obsessed keto eater would do well to have a powerful gut biome set up to convert all that phytic acid to inositol.
Now, some writers will come up with specific blends of fibers, powders and gums to create the “optimal” prebiotic diet for your gut bacteria, but that’s pretty silly. The gut is a complicated place. We’ve barely begun to even identify all its inhabitants. To think we know the precise blend of isolated fiber that will make them flourish, and then act on that, is a mistake.
1) Almonds and Pistachios
Nuts are usually favored in health-conscious circles for a few reasons. They like the monounsaturated fat. They like the mineral profile, or the complete protein, or their ability to dissemble into nut meals and form baked goods. But what gets short shrift is the fiber content. Now, I can’t speak for other nuts, but almonds and pistachios in particular contain fiber with potent prebiotic effects. People who eat almonds and to an even greater extent pistachios end up with improved gut bacteria profiles.
2) Green Bananas
Ripe bananas are difficult to squeeze into a ketogenic diet. The green banana—an unripe one—is mostly resistant starch, a type of starch that cannot be digested and travels untouched until colonic bacteria metabolize it. It’s one of the best stimulators we know of butyric acid production. And sure, you could do a spoonful of raw potato starch to get your resistant starch, but the beauty of the green banana is that it also provides potassium, another nutrient that some find difficult to obtain and stay keto.
3) Wild Blueberries
Blackberries, boysenberries, raspberries, and strawberries are all loaded with fiber, and you should eat them. They’re lower carb than you think, they’re loaded with polyphenols, and topped with some real whipped cream they make a fantastic dessert. But wild blueberries are special. They’re smaller than other berries, which increases the amount of skin per ounce you get, and skin is where all the polyphenols and fiber lie. Heck, even the blueberry’s polyphenols have prebiotic effects on the gut biome.
A few years ago, I wrote a whole post on mushrooms. Suffice it to say, they’re quite wonderful, bordering on magical. I did not discuss the fiber they contain. It turns out that all the various mushroom polysaccharides/fibers, including beta-glucans, mannans, chitin, xylans, and galactans also act as potent prebiotics that improve the health of the host.
Your standard avocado has about 12-15 grams of fiber, if you eat the whole thing. I
Great with chili powder, salt, and lime juice, jicama is about 11 grams of carbs per cup, but half of those are inulin, a potent prebiotic fiber with a tendency to really ramp up butyrate production.
Onions are another fantastic source of inulin. They go into almost every dish of every cuisine, so there’s no excuse not to be eating onions.
I’ve been known to treat garlic like a vegetable, roasting an entire cast iron pan full until brown and sweet and chewy. They’re another great source of prebiotic fiber.
Broccolini is a major part of my favorite meal of the day—my Big-Ass Keto Salad. Broccoli (and cruciferous vegetables in general) has been shown to have modulatory effects on the gut biome.
12) Dark Chocolate
13) Animal Fiber
Obligate carnivores like cheetahs who don’t eat any plants (willingly) still have gut bacteria. These gut bacteria thrive on “animal fiber,” the gristle and cartilage and other bits of connective tissue that comprise a good 20-30% of the walking weight of a prey animal. Humans are not obligate carnivores, but eating the entire animal has been a mainstay of advanced hominid existence for millions of years. I find it very likely that something, someone, somewhere inside our guts is breaking down the animal fiber we eat—so you’d better be eating some!
Not so tough, is it? It’s not like I’m suggesting you load up on bran muffins, psyllium smoothies. I don’t want you dumping flax meal into everything or munching on those awful fiber gummies. Just eat some basic, healthy, low-carb plant matter—foods that don’t really scream “fiber”—and the rest will take care of itself.
What’s your favorite low-carb source of fiber? Let me know down below.
Thanks for reading, everyone.
Hernández E, Bargiela R, Diez MS, et al. Functional consequences of microbial shifts in the human gastrointestinal tract linked to antibiotic treatment and obesity. Gut Microbes. 2013;4(4):306-15.
Ukhanova M, Wang X, Baer DJ, Novotny JA, Fredborg M, Mai V. Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study. Br J Nutr. 2014;111(12):2146-52.
Jiao X, Wang Y, Lin Y, et al. Blueberry polyphenols extract as a potential prebiotic with anti-obesity effects on C57BL/6 J mice by modulating the gut microbiota. J Nutr Biochem. 2019;64:88-100.
Jayachandran M, Xiao J, Xu B. A Critical Review on Health Promoting Benefits of Edible Mushrooms through Gut Microbiota. Int J Mol Sci. 2017;18(9)
Nielsen ES, Garnås E, Jensen KJ, et al. Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation – a pilot study. Food Funct. 2018;9(10):5323-5335.
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For today’s edition of Dear Mark, I’m answering three questions. First up, what can a person do to help their gut recover its barrier function after too many antibiotics? Are there any foods, supplements, or dietary strategies? Second, what can explain rapid fatigue during sprint sessions on a keto diet? Is this simply part of the deal, or are there modifications you can make? And finally, what do I do when I know I’m going to get a bad night’s sleep?
Mark – any idea how to cure leaky gut caused by overuse of antibiotics. Tried raw dairy for a month to no avail.
First of all, check out my post on leaky gut. Read through it and follow my suggestions for preventing and treating intestinal permeability. It’s a great place to start.
Then, let’s look at some other interventions that have been shown to improve recovery from antibiotic therapy. While most of the studies referenced don’t explicitly describe antibiotic-induced leaky gut, anything that improves gut function and restores healthy gut bacteria will also normalize leaky gut—since it’s the eradication of native gut bacteria that causes antibiotic-induced leaky gut.
Fermented dairy. You tried raw dairy. What about fermented dairy? While raw dairy has its merits, it’s fermented dairy that just works for recovery from antibiotics. Yogurt is a good option to try, although the evidence is a bit inconsistent. Kefir is probably better; it’s been shown to improve patients’ tolerance to triple antibiotic therapy during treatment for H. pylori infection. This is even worth consuming during antibiotic therapy, as many of the probiotic bacteria found in fermented dairy show resistance to common antibiotics.
Fermented vegetables like sauerkraut are also must-eats. The fermented cabbage contains ample amounts of L. plantarum, a bacteria strain that’s been shown to prevent antibiotic-related diarrhea in piglets (another omnivorous mammal). Good options exist in stores (check the refrigerated section; shelf-stable pickles and kraut aren’t lactofermented), and even more are available in farmer’s markets, but the best way to get the most bacteria-rich vegetable ferments is to make your own.
Supplemental probiotics are fantastic here, too: large doses of the desired microorganisms delivered directly to your gut. Some of the strains used in Primal Probiotics, like B. clausii and S. boulardii, have been shown to be effective against antibiotic-related diarrhea, so that could be a good choice.
Don’t forget the food for your gut bugs: prebiotics. You need to eat fermentable fibers and other prebiotics like resistant starch to support the growth and maintenance of the helpful bacteria that improve gut barrier function. Consider eating cooked and cooled potatoes, unheated potato starch, leeks, garlic, onions, green bananas, apples, pears, berries, and pretty much any fruit or vegetable you can get your hands on. Plenty of them are low-carb enough to work on a keto diet, if that’s your desire. Oh, and dark chocolate is a great source of fiber and polyphenols, which have prebiotic effects in the gut.
Incorporate intermittent fasting. Going without food for a spell gives your gut a break and induces autophagy, which can help with tissue healing.
Get dirty, too, to introduce potentially helpful bacteria. Go out and garden. Go barefoot at the park (do your due/doo diligence, of course) and practice tumbling, or roughhouse with your kids (or friends). Don’t immediately rush to wash your hands all the time (unless you’ve been handling raw meat and/or dog poop).
Whatever you do, don’t stress too much about the antibiotics you had to take. Stress is awful for gut health and you’ve already taken the antibiotics—which were probably necessary—so that ship has sailed.
If probiotics with prebiotics aren’t helping (or making things worse), you might want to try going the opposite direction—removing all plant foods and doing a carnivore diet for a few weeks. While I have doubts about the long term viability and safety of eschewing all plant foods, enough people have written to me about their great experiences resolving gut issues with a bout of carnivory that it’s worth trying.
When on a strict keto plan, why do I become so quickly fatigued while attempting a HIT sprint workout?
The first five seconds of a sprint are primarily powered by phosphocreatine (or creatine phosphate), a “quick burst” energy source that burns hot but disappears quickly. This is the stuff used to perform max effort Olympic lifts, short sprints, and other rapid expressions of maximum power. It doesn’t last very long and takes a couple minutes to replenish itself. A keto diet doesn’t affect our creatine phosphate levels. If anything, it should improve them if we’re eating meat.
After five seconds, anaerobic metabolism of muscle glycogen provides the lion’s share of your energy needs. The longer your sprint, the more glycogen you’ll burn. The less glycogen you carry in your muscles, the shorter your sprint. Because once you run out of creatine phosphate and glycogen, you’re left with aerobic metabolism—great for longer distances, not so great for max effort sprints.
Keto dieters tend to walk around with less glycogen in their muscles. If that’s the case, longer sprints will be harder.
If you want to keep sprinting:
Do shorter sprints. Try a 10-second hill sprint rather than a 20-second one. Really go hard. Heck, you can even do 5-second sprints and derive major benefits; just do more of them and make sure to recover in between. There’s no rule saying you have to sprint for 20-30 seconds.
Take longer rest periods. Give your muscles a chance to replenish more creatine phosphate (and take creatine or eat red meat and fish, which are the best sources of dietary creatine).
Eat 20-30 grams of carbs 30 minutes before a sprint session. See if it helps. Alternatively, you can eat the 20-30 grams of carbs after the sprint session to replenish lost glycogen stores (without really impacting your ketone adaptation, by the way).
Most people figure out their sprinting sweet spot while doing keto. They may have to play around with the dosages, durations, and rest periods, but you can usually make it work. Be open to trying new permutations.
If you knew you were going to have a poor nights sleep, what measures would you take to reduce some of the damage?
I would exercise hard that night. Normally, a bad night’s sleep tanks your insulin sensitivity the next day, giving you the insulin resistance and glucose tolerance of a diabetic. A good hard interval session the night before a bad night’s sleep, however, counters the next-day insulin resistance.
I would make the most of it. Don’t dawdle. Don’t beat yourself up because of the impending sleep deprivation. It’s going to happen. You have to accept it, not let it destroy you.
Enjoy it. A little-known acute treatment for depression is sleep deprivation. That’s right: a single night of sleep deprivation has been shown to ameliorate depression in patients with clinical depression. Sometimes the effect lasts up to several weeks. It’s not a long term or sustainable fix for clinical depression, obviously, and you can’t do it every single night—chronic sleep deprivation is a major risk factor for developing depression—but it can improve your mood if you give in to it.
I would set out a jar of cassia cinnamon. I always add cassia cinnamon to my coffee in the morning after bad sleep; cassia cinnamon the day after a bad night’s sleep attenuates the loss of insulin sensitivity and glucose tolerance.
That’s it for today, folks. Thanks for writing in and reading! If you have any input on today’s round of questions, let me know down below.
De vrese M, Kristen H, Rautenberg P, Laue C, Schrezenmeir J. Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J Dairy Res. 2011;78(4):396-403.
Bekar O, Yilmaz Y, Gulten M. Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. J Med Food. 2011;14(4):344-7.
Erginkaya Z, Turhan EU, Tatl? D. Determination of antibiotic resistance of lactic acid bacteria isolated from traditional Turkish fermented dairy products. Iran J Vet Res. 2018;19(1):53-56.
Yang KM, Jiang ZY, Zheng CT, Wang L, Yang XF. Effect of Lactobacillus plantarum on diarrhea and intestinal barrier function of young piglets challenged with enterotoxigenic Escherichia coli K88. J Anim Sci. 2014;92(4):1496-503.
Jitomir J, Willoughby DS. Cassia cinnamon for the attenuation of glucose intolerance and insulin resistance resulting from sleep loss. J Med Food. 2009;12(3):467-72.
The post Dear Mark: Antibiotic Recovery, Sprinting on Keto, Preparing for Bad Sleep appeared first on Mark’s Daily Apple.
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For today’s edition of Dear Mark, I’m answering several questions drawn from the comment board of last week’s post on fasting vs carb restriction. First, how do I square my recommendations with the successful reports of potato dieters losing weight on a high-carb tuber diet? Second, is Leangains optimal for mass gain? Third, how do I use extra virgin olive oil, butter, and ghee? Fourth, could exogenous ketones help a man with dementia, MS, and seizures? Fifth, how should a woman with stalled weight loss integrate fasting?
Walter Sobchak asked:
If “carbs” are so bad, how do people eat only potatoes and lose large amounts of weight? Andrew Taylor (SpudFit.com) and Penn Jillette (Penn & Teller) are two high-profile people, but there are lots more. Of course, I wouldn’t recommend an unbalanced diet of only one food, but the point is that potatoes are a natural food and are not inherently detrimental.
I agree that potato-only diets are a quick weight loss hack.
Potato-only diets work well because they’re so monotonous. When your only option is a plain potato, it’s extremely hard to overeat. It’s the combination of fat and carbohydrates that’s so easy to overeat, and that causes the most metabolic problems.
Potatoes are surprisingly nutrient-dense. They have complete protein, containing all the necessary amino acids. You won’t be bodybuilding on all-potatoes, but there’s enough protein in there to stave off muscle loss for a week or so.
I could recommend the potato-only diet, ditch the keto/low-carb/Primal talk, and people who listened to me would still lose weight. But they’d miss out on all the other benefits, not least of which is the delicious food. In short, the potato-only diet isn’t the worst thing out there, but I wouldn’t recommend it as a long-term strategy.
Mattias Carlsson asked:
I have a question for advice if someone know. According to most sources I find the so called anabolic window persist at least 24 hours after resistance training. How can then an intermittent fasting with 8 hour eating as in lean gains, from what I understand, be optimal on training days. It seems to me that a bit of overeating on carbs and protein during all this time would be most beneficial?
I don’t know that it’s optimal for sheer mass gain. But it does seem to strike a nice balance between “gains” and “staying lean.” You may not bulk up as quickly as you would cramming food in your gullet. You will gain lean mass without gaining so much of the squishy mass that normally accompanies what passes for “gains.”
Michael Levin wondered:
Question: EVOO, Ghee and grass-fed butter–which to use when and for what?
EVOO: salads, marinades, sautéing. It’s actually far more resistant to heat than most people think; the polyphenols protect against oxidative damage.
Butter: Cooking eggs and other breakfast items, melted with broccoli/shrimp, finishing steaks and reduction sauces.
Beth Olson asked:
What are your thoughts on exogenous ketones? My dad has MS and dementia and seizures way too often. Should we try adding these?
I can’t give your dad any medical advice. You can talk to his doctors, however, and show them this study where exogenous ketones reduced seizure activity in mice. You can show them that coconut oil and MCT oil—two other routes for generation of ketones—have shown efficacy against cognitive decline in patients with Alzheimer’s or dementia.
I suspect exogenous ketones can help. I also suspect they’d be far more helpful on top of a low-carb, high-fat diet with plenty of healthy lifestyle modifications.
That’s the thing with dementia: there isn’t a pill that fixes everything, or even a single intervention. In the one study that actually got major results, researchers had Alzheimer’s patients undertake a dramatic diet, exercise, and lifestyle shift. Here’s what each subject did:
- Eliminate all simple carbs and follow a low-glycemic, low-grain (especially refined grains) diet meant to reduce hyperinsulinemia.
- Observe a 12-hour eating window and 12-hour fast each day, including at least three hours before bed.
- Stress reduction (yoga, meditation, whatever works for the individual).
- Get 8 hours of sleep a night (with melatonin if required).
- Do 30-60 minutes of exercise 4-6 days per week.
- Get regular brain stimulation (exercises, games, crosswords).
- Supplement to optimize homocysteine, vitamin B12, CRP levels.
- Take vitamin D and vitamin K2.
- Improve gut health (prebiotics and probiotics).
- Eat antioxidant-rich foods and spices (blueberries, turmeric).
- Optimize hormone balance (thyroid panel, cortisol, pregnenolone, progesterone, estrogen, testosterone).
- Obtain adequate DHA to support synaptic health (fish oil, fish).
- Optimize mitochondrial function (CoQ10, zinc, selenium, other nutrients).
- Use medium chain triglycerides (coconut oil, MCT oil). You could possibly use exogenous ketones here too.
Bring that study to your dad’s doctors and see what they have to say. If they aren’t blown away by the possibilities and open to give it a try, I’d be shocked. Hopefully your dad is game. I’d love to hear how it works.
Lisa Chupity asked:
I went Primal/Paleo back in March of 2012. I lost the 15 pounds I wanted to lose. In 2015, 7 pounds crept on, and for the life of me, I can’t lose ‘em! April of this year, I went Keto. I track my macros, and do my best to keep my carbs to 20 grams per day, tho I don’t beat myself up if I have 24. I haven’t lost an ounce! I’m going to have to do the IF thing, I’m sure. As it is, my breakfast is bone broth (1 1/2 cups) and a mug of Coffee with Brain Octane in it. Lunch is yer basic “Big Ass Salad”. Dinner is good, too, and within Keto guidelines. I try to keep my caloric intake to ~1600 calories/day.
To add to the mess, I have Multiple Sclerosis, so stuff like Cross Fit is outta the picture. I can manage some stationary cycling, and some Pilates, with lighter modifications. Any advice?
If you try IF, do the “early restricted feeding” rather than late. You’re already doing a kind of “fast” in the morning, just drinking broth and coffee with MCTs, and it doesn’t seem to be working.
Eat some fat and protein for breakfast with a few carbs. Eggs and bacon with a side of cantaloupe or berries. An omelet with spinach and onions and cheese. Steak and greens and half a banana. Emphase whole-food fat and protein. Have coffee and broth, too, if you like. This and lunch should be your biggest whack of calories.
Eat your Big Ass Salad for lunch. Drop dinner, or make it really light and no later than 5 or 6 PM.
Terry Wahls has a great Primal-friendly MS protocol. Check out her Ted talk and go from there if it interests you.
Good luck and keep us apprised of your results.
That’s it for today, folks. Take care, be well, thanks for reading and writing!
The post Dear Mark: Potato Diet, Lean Gains, EVOO/Butter/Ghee, Exogenous Ketones, and Early IFing appeared first on Mark’s Daily Apple.
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The tricky thing about fiber is that it’s not a monolith. There are dozens of varieties. Some of them perform similar functions in the body, but others have extremely unique effects. Some rend your colonic lining to stimulate lubrication. Some turn into gelatinous slurries. But we can’t talk about fiber without understanding that the word describes a variety of compounds. As such, anyone making declarative statements about “fiber” without differentiating between the different types and their effects isn’t being accurate (except for me in that exact sentence).
This leads to a lot of confusion. People make blanket statements that might be true for some types of fibers and incorrect for others.
Today’s post will attempt to illuminate the bulk of the matter. I’ll go through some of the most common misconceptions and myths about fiber from all corners of the dietary world. Whether you’re keto, low-carb, vegan, carnivore, or breatharian, you’ll find something to love and hate in today’s post.
1) “Fiber makes you full.”
This is theoretically sound. Mechanoreceptors in the gut respond to physical fullness by triggering satiety hormones. Big loads of insoluble fiber increase intestinal bulk, while some soluble fibers can gel up and increase the size of the stuff moving through your gut. Both result in added pressure on gut mechanoreceptors.
How does it work in practice?
A review found that while soluble fiber reduced appetite more than insoluble fibers, the overall effect on body weight was quite small, unimpressive, and inconsistent. More recently, a soluble fiber supplement failed to have any effect on satiety hormones, appetite, and subsequent food intake for the first 150 minutes after eating in healthy adults. The plucky researchers aren’t giving in, however, promising “further research… to quantify how soluble fiber influences appetite several hours after consumption.”
2) “Every diet needs the same amount of fiber.”
As it turns out, fiber becomes more critical the more carbohydrates you eat.
Soluble fiber slows down digestion, reducing the rate at which energy is absorbed. This can be helpful for people with glucose intolerance or type 2 diabetes by slowing the release of glucose into the blood.
The byproducts of fiber fermentation in the colon by gut bacteria often have beneficial effects on carbohydrate metabolism. Eating resistant starch, for example, lowers the postprandial blood glucose spike. This reduction may also extend to subsequent meals, indicating it’s honing your ability to handle glucose. Everyone can benefit from better glucose management, but it’s far more critical for people eating significant amounts of glucose.
3) “All the healthiest people studied eat fiber!”
Observational studies are fun and all, but they’re not a good way to prove the healthfulness of fiber. Looking at fiber intake is just about the best way to capture the “healthy user”—that person who does everything right, like walk daily, exercise regularly, abstain from tobacco, avoid binge drinking, and eat whole foods rather than refined ones. It doesn’t say anything definitive about the health effects of the specific dietary variable they’re observing.
That said, the fact that most healthy populations eat whole foods containing fiber indicates that fiber probably isn’t actively harmful.
4) “Fiber is just roughage for big impressive poops. No functional use.”
That’s mostly true of insoluble fiber, which is pure waste material that shreds your intestinal lining and increases stool volume.
There’s considerable evidence that people with type 2 diabetes can really benefit from prebiotic fiber supplementation:
- Chicory-derived inulin, a potent prebiotic fiber, reduces liver enzymes and HbA1c, improves blood pressure and fasting glucose, and increases calcium homeostasis.
- Inulin improves immune markers and glycemic control.
- Resistant starch lowers insulin resistance and inflammation.
A review of studies found that while the prebiotic inulin reduces LDL-C (an imperfect biomarker of dubious utility) in all populations, only in type 2 diabetics does inulin improve HDL and blood glucose control.
Prebiotic fiber may also help certain patients with non-alcoholic fatty liver disease (NAFLD). The usual therapy for NAFLD patients is weight loss. You lose enough body fat elsewhere and the fat you’ve accumulated in the liver starts to disappear, too.
What about lean NAFLD patients without any real weight to lose?
In lean patients with NAFLD, a synbiotic—blend of prebiotic fiber with probiotic bacteria—reduces liver fat and fibrosis by improving inflammatory markers. Pre-emptive consumption of prebiotics may even protect against the development of NAFLD.
Another function of fiber that occurs in everyone is the production of short chain fatty acids by gut bacteria. When gut bacteria ferment prebiotic fiber, they produce short chain fatty acids, many of which have beneficial metabolic effects.
Butyrate is the most important short chain fatty acid. It fuels colon cells and may prevent colon cancer. Its relationship with existing colon cancer cells is more controversial. Read more about that here.
One interesting line of research is studying the interaction between the ketone body beta-hydroxybutyrate and the short chain fatty acid butyrate. Initial indications suggest that the two may have synergistic effects on cognition, inflammation, and overall health. That alone may be a reason to make sure you get prebiotic fiber on your ketogenic diet, just to hedge your bets.
Now, might a low-carb or ketogenic diet work better for people with type 2 diabetes than adding fiber to their normal diet? Sure. Could such a diet reduce the need for fiber? Yeah, I could see it. The same goes for NAFLD—low carb diets are also excellent in this population. And perhaps people who aren’t eating so many carbs don’t need the short chain fatty acids to improve their metabolic function and insulin sensitivity. But the evidence for fiber in type 2 diabetes and NAFLD stands, and I suspect short chain fatty acid production matters even in low carb or keto dieters.
5) “Fiber cures constipation.”
In one 2012 study, patients with idiopathic constipation—constipation without apparent physiological or physical causes—had to remove fiber entirely to get pooping again. Those who kept eating a bit or a lot of it continued to have trouble evacuating. The more fiber they ate, the worse their constipation (and bloating) remained.
A 2012 review found that while fiber may increase stool frequency, it doesn’t improve stool quality, treatment success, or painful defecation. Similarly, glucomannan, a soluble fiber, moderately improves defecation frequency in constipated kids, but has no effect on stool quality or overall treatment success.
However, galactooligosaccharides, a class of prebiotic fiber, do appear to improve idiopathic constipation. And inulin, another prebiotic fiber, improves bowel function and stool consistency in patients with constipation.
6) “Fiber aggravates gut issues.”
Some say fiber cures gut issues like IBS and IBD. Others say fiber aggravates them. Who’s right? Maybe both.
Both IBS-D (irritable bowel syndrome with diarrhea) and IBS-C (irritable bowel syndrome with constipation) patients can benefit from soluble fiber (psyllium) while insoluble fiber (bran) is far less effective.
Wheat bran works okay for IBS, if the patients can tolerate it. They tend to tolerate something like hydrolyzed guar gum much better.
For IBD, the evidence is mixed. One survey of Crohn’s patients found that those eating more fiber (23 grams/day) had fewer flareups than those eating less (10 grams/day), while colitis patients reported no difference in symptoms based on fiber intake.
On the other hand, studies indicate that a low-FODMAP diet, which eliminates most sources of fiber, especially fermentable prebiotic fiber, is an effective treatment for IBS and IBD. Low-FODMAP diets have been shown to reduce bloating, abdominal pain, quality of life, and overall symptoms in intestinal disorders.
These contrary results may not even be contradictory. If your gut’s messed up, one solution could be to add back in the fibers you’re missing. Another could be to take all the fiber out and start from scratch.
7) “Fiber reduces nutrient absorption.”
For a long time, the consensus was that fiber tends to bind with minerals in the gut and thus reduce their absorption. These days, researchers understand that many of these fiber-bound minerals become available after fermentation in the colon.
Another wrinkle is that dietary fiber often comes with phytic acid, which binds minerals and prevents their absorption. Take wheat bran. Often deemed “wheat fiber” and lambasted for its tendency to bind minerals, wheat bran isn’t just fiber. It’s also a significant source of mineral-binding phytic acid.
Prebiotics increase absorption of magnesium, heme iron, and calcium. This makes sense. Even if the prebiotics are binding minerals, they release them once they reach the colon for fermentation by gut bacteria.
Fiber may reduce absorption of plant polyphenols, however.
8) “No one needs fiber.”
On the surface, this appears to be a sound conclusion. The human host digestive system cannot digest it. The majority of the fiber we eat gets pooped out as literal waste material. Certain classes of fiber may improve our gut health, but no one is keeling over from a lack of fiber in their diet.
Some have argued that a sterile gut is ideal if you have the right diet, that employing vast hordes of gut bacteria is just an adaptive measure taken to deal with a substandard diet full of roughage. The problem is that most people throughout history and prehistory have eaten that roughage, employed those gut bacteria, utilized the metabolites those bacteria produce. I suspect thinking long and hard before you consider it immaterial to human health.
If that were true, why would breast milk—the only food specifically designed for human consumption—contain loads of indigestible oligosaccharides that feed the growing gut biome? Even if it turns out that feeding the gut biome is only vital during infancy, that’s still a population of humans who truly need fiber.
Here’s where I come down: Fiber is an intrinsic part of many whole plant foods (and even whole animal foods, if it turns out that our gut bacteria can utilize “animal fibers” like other top carnivores). The Primal-friendly plants, the ones our ancestors grew up eating approximations of, like fruits, vegetables, roots, and tubers, are mostly higher in soluble fiber and lower in insoluble fiber. The only way to get huge doses of insoluble fiber these days is with supplementation or by eating grains. I don’t suggest eating grains or supplementing with insoluble fiber. I do suggest eating fruits, vegetables, roots, and tubers (while managing your carbs).
As for the carnivore issue, I’m open to the possibility that a properly-constructed carnivorous diet (which may, remember, include gristly animal fiber) obviates the need for plant fiber, prebiotic or otherwise. I’m not confident enough to try it myself, though.
Do I think everyone should be supplementing with prebiotic fiber? No. I add inulin to my Primal Fuel protein powder, mostly to improve mouth-feel but also to feed beneficial microbes and increase butyrate production. I add prebiotic cassava fiber to my collagen bars, again to improve texture and feed gut bacteria. And I’ll sometimes use raw potato starch for its considerable resistant starch content, often just mixing it into sparkling water and drinking it straight. But for the most part, the fiber I eat is incidental to the foods I consume. Berries, non-starchy vegetables, jicama, garlic, onions, green bananas, nuts—these are all foods rich in fiber, particularly prebiotic fiber, and I eat a fair amount of them while remaining low-carb and often keto.
As you can see, the fiber story isn’t simple. At all. There are many variables to consider. If you’re confused and unsure of how to think about fiber, you’re on the right track.
What do you think, folks? How has fiber helped or harmed you? I’d love to hear from everyone.
Take care and be well.
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