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We are learning increasingly more about the intestinal tract and its impact on overall health. In 2000, Dr. Alesso Fasano, Director of the Mucosal Immunology and Biology Research Center at Massachusetts General Hospital in Boston, discovered a gut protein that regulates the openings between the cell walls and the intestine; this protein is called zonulin(1). Zonulin can widen or tighten openings in the intestinal wall thus altering what nutrients and substances can permeate into the cells. Thus, zonulin can regulate the permeability of the gut.

The term Leaky Gut Syndrome is used to describe the condition of hyperpermeable intestines, a fancy medical term that means the intestinal lining has become more porous, with more holes developing that are larger in size and the nutrient screening process is no longer functioning properly(2). When the GI tract lining is functioning at its best, it is a tight barrier that controls what gets absorbed into the bloodstream. Larger than normal openings (i.e. fissures) within the intestinal wall, allows partially digested food, toxins, and gut microbe to enter the blood stream; triggering an immune response (systemic inflammation) and altering the gut microbiome.

Leaky Gut Syndrome has been associated with many autoimmune diseases. We already know that increased intestinal permeability plays a role in certain gastrointestinal conditions such as Celiac Disease, Crohn’s Disease, and irritable bowel syndrome (IBS)(3). The biggest question is whether a leaky gut can cause problems elsewhere in the body (3). Some studies show that leaky gut may be associated with other autoimmune diseases (Lupus, Type 1 Diabetes Mellitus, Multiple Sclerosis, Thyroiditis), Chronic Fatigue Syndrome, Fibromyalgia, Arthritis, Allergies, Asthma, Acne, Obesity and even Mental Illness (such as Alzheimer’s disease) (3,4)

What Causes Leaky Gut Syndrome? Obviously, more research is needed, and many researchers feel we are just starting to scratch the surface of understanding the complete role of the gastrointestinal tract and its impact on overall health. There are many factors that are thought to contribute to someone having a leaky gut. Diet, medications, infection, stress, hormone imbalance, environmental, Vitamin D deficiency and low glutathione levels are all suspect. Let’s look at these individually:  Diet – The U.S. diet is highly processed and lends itself to many culprits that can permeate the intestinal single layer wall such as gluten, casein (cow’s dairy), sugar, unsprouted grains and alcohol. Many people with autoimmune diseases find themselves with leaky gut and having to eliminate certain foods to manage their conditions.

Medications – the biggest culprits in the pharmacotherapy world are antibiotics and acid reducers. Both create dysbiosis which lends itself to creating SIBO (small intestinal bacterial overgrowth and SIFO (small intestinal fungal overgrowth). Seventy-eight percent of IBS patients test positive for SIBO.

Infection – 75-80% of the immune system resides in the GI tract. When a body gets an infection, this can create dysbiosis within the microbiome. There are numerous studies that have demonstrated the intimate relationship between infection and dysbiosis of the microbiota and have shown that infection is associated not only with the microbiome, but also with viruses(5).

Stress – stress has shown to have an impact on microbiota. A study conducted at Oregon State University in 2017 by Jesse R. Zaneveld et. al. found that when a person is under stress, his or her microbiome will become confused and behave erratically in ways that are unpredictable and can vary from person to person(6).

Hormone Imbalance – Of the 50 million Americans living and coping with autoimmune disease (AD), more than 75 percent of them are women(7). Some researchers do not think this is a coincidence but an association with fluctuating hormone levels throughout the lifespan of women; more research is needed.

Environmental Factors – The infant GI tract is colonized with microorganisms in a complex process that begins during birth(8)¸. Babies delivered vaginally will show different microbial profiles than those babies delivered via C-section(8).  When a child reaches the age of one, their GI tract starts to look more like the microbiota profile of an adult. However, children are not being exposed to enough microbes in countries where there is a high level of hygiene. Thus, children’s immune systems may not be developing to their full potential.

Vitamin D Deficiency – Research is finding that a Vitamin D deficiency is associated with many different malabsorptive conditions such as Celiac disease, Short Bowel Syndrome and Cystic Fibrosis however, other conditions and factors also contribute to Vitamin D deficiency such as obesity, diet, inadequate sun exposure, and some prescription medications. Vitamin D deficiency decreases the production of defensins which are anti-microbial molecules essential to maintaining healthy gut flora(9).

Low Glutathione levels: The gut microbiome regulates the synthesis of glutathione. If dysbiosis is present, less glutathione will be produced. Glutathione is the body’s main antioxidant and it is important for fighting of infections and disease.

Treatment Modalities for Leaky Gut:
Currently there are no medications to treat leaky gut syndrome. Diet is the primary defense for healing a leaky gut. Fecal transplants have also been used to treat certain IBS conditions. A fecal transplant is where clean stool is taken from a healthy GI tract and placed into a diseased GI tract to repopulate good bacteria. In the United States, fecal transplants are currently being used on Ulcerative Colitis patients and in Europe and other countries, fecal transplants are being used to treat Multiple Sclerosis.

There are several foods and supplements that have been proven to help heal a leaky gut:

1. Bone broth – making soup out of chicken and/or beef bones provides some liquid rich in the amino acids proline, glycine and L-glutamate. These are paramount in the healing process.
2. Kefir or Homemade Yogurt (fermented for at least 24 hours) – fermented dairy products have a high level of Lactobacillus. Probiotics introduce good bacteria back into the microbiome.
3. Fermented Vegetables (sauerkraut, kimchi, kvass) – the pH level of these fermented vegetables provides a perfect environment for good bacteria to flourish. They also provide Bacillus subtillis and Lactobacillus plantarum; two probiotics that favor a balanced gut flora.
4. Coconut products – especially coconut oil. Coconut oil has a natural anti-microbial property to it, thus killing off bad bacteria. Coconut oil is also a medium chain triglyceride and it is easy to digest.
5. Wild-Caught Fish (not farmed) such as Salmon, Mackerel and Tuna. These fatty fish species are high in omega 3 fatty acids which are anti-inflammatory and help with systemic inflammation.

6. Sprouted Seeds – Flax, Chia and Hemp Seeds. A major benefit to the sprouting of seeds is to release beneficial enzymes which make digestion easier. They also lend themselves to increasing good bacteria in the gut to help lessen the auto-immune response of bad bacteria.
7. Fresh or steamed vegetables – vegetables of all types provide beneficial substances such as phytochemicals, fiber, antioxidants and more!
8. Vitamin D supplementation (if warranted) – The Vitamin D Council recommends a serum vitamin D Council recommends a serum vitamin D25-OH level of at least 40 ng/ml (40-80 ng/ml) for optimal health. The richest source of Vitamin D is 2 tablespoons of cod liver oil (1300 IU per Tbsp) which many people no longer purchase and use due to its foul taste. A supplement of 2,000 IU per day is typically needed to get a serum level of Vitamin D-25-OH above 40 ng/ml if a deficiency is present.

Although Leaky Gut Syndrome can be healed, the genesis of this syndrome warrants more research, as well as the essential role that the gastrointestinal tract plays in overall health and well-being.

Sources:

1. “Zonzulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity and Cancer. Alessio Fasano. American Physiological Society 91: 151-175, 2011.
2. “Leaky Gut, Autoimmune Disease and Diet” Ginger Schrimer PhD, RD. ceinternational.com March 27, 2018
3. “Leaky Gut: What Is It, and What Does It Mean For You? Marcelo Campos MD. www.health.harcard.edu/blog/leaky-gut-what-it-is-and-what-does-it-mean-for-you?
4. “Gut Reaction: Environmental Effects on the Human Microbiota” Melissa Lee Phillips. Environmental Health Perspectives Vol 117, No 5, May 2009
5. “The Human Microbiota in Health and Disease” B Wang, M Yao, L Lv, Z Ling, L. Li. Elsevier Inc. 2017.
6. “Chronic Stress Discombobulates Gut Microbiome Communities.” Christopher Bergland Psychology Today. August 25, 2017.
7. “Leaky Gut Syndrome: What Is It? Matt McMillen www.Webmd.com
8. “Vitamin D Improves Gut Flora ad Metabolic Syndrome”
www.sciencedaily.com/releases/2016/12/1691221125439.htm
9. “How Does Age at Onset Influence Outcome of Autoimmune Diseases? M. Amador-Patarroyo, A. Rodriguez-Rodriguez, G. Montoya-Ortiz. Autoimmune Diseases Vol. 2012, Article ID 251730, 2011.
10. “The Microbiome: A Key Regulator of Stress and Neuroinflammation” K. Rea, T. Dinan, J. Cryan Elsevier Inc. 2016.
11. “Is Leaky Gut Syndrome Real and Can Probiotics Help?” Markham Heid. Time.com→Health→Medicine. January 13, 2016.
12. “Possible Links Between Intestinal Permeability and Food Processing: A Potential Therapeutic Niche For Glutamine.”J. Rapin, N. Wiernsperger Clinics 2010:65 (6): 635-43.

Rutgers University Researchers, Robyn Miranda and Donald Schaffner examined the effect of time during bacterial transfer from one of four different surfaces: stainless steel, tile, wood, or carpet. Each surface was coated with the same amount of bacteria and allowed to dry before food was exposed to the surface for 1, 5, 30, or 300 seconds. If the five-second rule held up, the scientists expected to see less bacteria transferred during 1 and 5 second exposures than in 30 or 300 second exposures.

As one might expect, different foods picked up different bacterial loads. The foods tested included watermelon, plain bread, buttered bread, and Haribo-brand gummy candy. No matter the exposure time, watermelon picked up the most bacteria, which was measured by plating homogenized food samples for CFUs. Bacterial transfer seemed related to food moisture, so the wetter a dropped food is, the more bacteria stick to it.

Paul Dawson, a professor in Clemson University’s Department of Food, and a team of Clemson researchers found that Salmonella typhimurium “can be transferred to the foods tested almost immediately on contact” and that the bacteria can survive for up to four weeks on dry surfaces in high-enough populations to be transferred to foods.

A 2003 study by then high-school senior Jillian Clarke, during an internship at the University of Illinois at Urbana–Champaign, likewise found that bacteria transfers to food immediately on contact. In her experiment E. coli moved from floor tiles to cookies and gummy bears well within five seconds.

A Contradiction

A UK study is contradicting the conventional wisdom that the five-second rule is mostly bunk.  They are claiming the amount of time food is on the ground really does have an effect on how much bacteria gets on the dropped item. Aston University’s School of Life and Health Sciences in England recently reported that the type of surface on which the food has been dropped has an effect, with bacteria least likely to transfer from carpeted surfaces. Bacteria is much more likely to linger if moist foods make contact for more than five seconds with wood laminate or tiled surfaces.

Food picked up just a few seconds after being dropped is less likely to contain bacteria than if it is left for longer periods of time, according to new research.   Moist foods left longer than 30 seconds, however, contained up to 10 times more bacteria than food picked up after three seconds. Dry foods dropped on the carpet experienced the slowest rate of bacterial migration.

Many Factors should affect your decision on whether to eat that fallen food:

1) What bacteria-virus-parasite spores-pathogenic fungus spores may be on the surface?. (A vast unknown).

2) What is the concentration of organisms particularly at the points of contact?

3) Moistness or texture of the material dropped influencing deformation and contact area of the material to the surface.

4) Does retrieval involve scraping it off the surface, or a straight and simple lif?

5) How long has the microbial life been present on the surface? ( Dried out, active and recent, old spores etc).

6) If it were less time would it be less contamination? ( Suggesting it may be the initial drop contact that applies the contamination).

The take-home message is that bacteria, including potential pathogens, can transfer to food in less than one second.

Sources: Thebigthink.com, Philip Perry ;and Theslate.com, Daniel Politi

Probiotics are live beneficial bacteria and yeast and Prebiotics are food for these bacteria. Both prebiotics and probiotics are important for human health. Eating balanced amounts of both pro- and prebiotics can help ensure that you have the right balance of these bacteria, which should improve your health.

Probiotics: These are live bacteria and yeast found in certain foods or supplements that can provide numerous health benefits.

1) The good bacteria in your digestive tract help protect you from harmful bacteria and fungi.

2) They send signals to your immune system and help regulate inflammation.

3) Some of your gut bacteria form vitamin K and short-chain fatty acids.

4) Short-chain fatty acids are the main nutrient source of the cells lining the colon, promoting a strong gut barrier to keep out harmful substances, viruses and bacteria, and may reduce the risk of cancer.

The following probiotic foods naturally contain helpful bacteria:

1) yogurt

2) fermented foods including: Sauerkraut,  Kimchi, miso (fermented soy) Kombucha tea, Kefir (dairy and non-dairy). Some types of pickles (non-pasteurized).Other pickled vegetables (non-pasteurized).

Prebiotics: These are carbohydrates (mostly fiber) that humans can’t digest.

The beneficial bacteria in your gut eat this fiber. Foods that are high in prebiotic fiber include:  Legumes, the skin of Apples, Wheat bran, Barley, Beans, Peas, Oats,  Bananas,  Berries, Dandelion greens, Garlic, Leeks, Onions, Asparagus.

Prebiotic fiber goes through the small intestine undigested and is fermented when it reaches the large colon.  Some of those foods can also be considered symbiotic, because they contain both beneficial bacteria and a prebiotic source of fiber for the bacteria to feed on.  One example of a symbiotic food is sauerkraut.

Benefits: Research on the effects of probiotics is inconclusive, but it suggests that they may be beneficial in the following areas:

Digestive health: Numerous studies have found that probiotics may improve digestive health in some people.Taking probiotics while using antibiotics reduced the risk of antibiotic-related diarrhea by 60 percent.  24 trials found that probiotics could help prevent the life-threatening disease necrotizing enterocolitis in preterm infants.

Mental health: A smaller body of research suggests that probiotics may improve mental health.  Probiotics may alleviate the symptoms of depression, but the authors note that additional studies are necessary to confirm this. It is possible that probiotics have this effect because there is a link between gut and brain health.

General health: Probiotics may decrease:

• The need for antibiotics
• School absences from colds
• The incidence of ventilator-assisted pneumonia
• Gestational diabetes
• Vaginal infections, such as yeast infections
• Eczema

However, the review did not find high-quality evidence that probiotics can prevent illness, and the authors conclude that more trials are necessary.

A  word of caution about side effects:  According to the same review above, people with Crohn’s disease had a higher risk of adverse events when they took a specific probiotic.  People with weakened immune systems were also more vulnerable to side effects.  A 2018 analysis of probiotic trials warns that many studies do not report safety data, including information on adverse events, even when they claim to prove that probiotics work.

There is less research on prebiotics than on probiotics. As a result, the extent to which prebiotics improve health is unclear. Scientists are not yet entirely sure that they can strengthen the purported benefits of probiotics.

Source: www.medicalnewstoday.com

Update 6/15/20: https://www.medpagetoday.com/gastroenterology/generalgastroenterology/87045?xid=nl_popmed_2020-06-15&eun=g1554870d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=DailyUpdate_061520&utm_term=NL_Daily_Breaking_News_Active

The human body contains more than one type of fat. White fat stores extra energy. Too much white fat, a characteristic of obesity, increases the risk of type 2 diabetes, high blood pressure, and other diseases.

A less common type of fat, called brown fat, breaks down blood sugar and fat molecules to create heat and help maintain body temperature. Brown adipocytes (fat cells) , are prevalent in children as “baby fat,” but much less so in adults.

Around 36% of adults in the U.S. carry too much fat in their bodies and are now considered overweight or obese. Researchers have been looking for ways to activate the body’s brown fat. This could provide a way to fight the negative effects of weight gain. Long exposure to cold temperatures has been shown to boost brown fat activity, but simply exposing people to cold temperatures may not be a practical approach for most people.

Brown fat tissue does offers a glimmer of hope for burning off extra calories, and certain foods, such as coffee, turmeric, thyme, hot pepper and others are thought to activate or increase brown fat tissue.

Research :

Research, using mice, conducted at the Univ. of Pennsylvania, found that deleting or suppressing a particular gene that keeps the “browning programing” turned off, makes the white fat cells visibly be more like brown fat cells with more of the fat burning mitochondria which supply chemical energy to cells and create heat.  A 2012 study found injecting the hormone “irisin” in mice prevented the mice from becoming obese in spite of a high -fat, high calorie diet.

In a small study, a team recruited 14 women, aged 18-40, of diverse ethnicities. The participants took 100 mg of mirabegron every day, for four weeks;  that’s twice the FDA-approved dose to treat overactive bladder.

Results appeared on January 21, 2020, in the Journal of Clinical Investigation.

After four weeks of treatment, the women’s metabolism at rest was almost 6% higher, although their weight or the ratio of fat to muscle—hadn’t changed. Brown fat activity, as measured by PET/CT, had increased during the study, with the largest changes to women who had less brown fat activity to begin with.

These are just two examples of research into how to activate the “browning program,” to make white fat cells act more like brown fat cells.

Sources:

National Institutes of Health, Research Matters report, Feb 4^th   2020

https://medium.com/@DrAyala/activating-brown-fat-and-your-metabolism-with-turmeric-coffee-and-other-goodies-ff251f0a3521