Straight from the Gut

This morning, as I was about to publish, I read a study that linked the Western diet to cognitive decline and neurodegeneration in mice. No surprises there. Hundreds of quality, peer-reviewed studies have found links between the Western diet and obesity, dementia, prostate and breast cancer, sepsis, chronic gut infections, inflammation, depression, anxiety, and insulin resistance. The Western diet increases cytokines, molecules that promote inflammation. The Western diet also promotes oxidative stress. The changes seen in gene expression in people on a Western diet are typical of people with Alzheimer's or Parkinson's disease.

Teaching what matters is my tagline. And what we eat matters.

The Western diet consists mainly of red meat (e.g. steak, pork, etc.) , processed meat (e.g. hotdogs, burgers, bologna, salami, etc.), prepackaged foods (e.g. most of the items found in boxes, plastic containers, or bags), butter, candy, sweets (e.g. donuts, pancakes, waffles, sugary drinks, most cereals, coffee creamers, etc.), and fried foods (e.g. fried chicken, bacon, French fries, etc). The Western diet is low in fruits (e.g. acai, blueberries, blackberries, raspberries, apricots, goji, etc.), vegetables (e.g. kale, spinach, beets, broccoli, collard greens, etc.), whole grains (e.g. bulgur, couscous, barley, brown rice, oatmeal, etc.), nuts (e.g. walnuts, almonds, peanuts, pecans, etc.), fish, seeds (e.g. pumpkin, sesame, chia, flax, etc.), and legumes (e.g. red, white, or black beans, peas, lentils, garbanzos, etc.).

Dr. Uma Naidoo, a nutritional psychiatrist at Harvard Medical School listed 5 foods to avoid to fight inflammation, promote brain health, sharp thinking and good decision-making. All 5 figure prominently in the Western diet.

1. Added sugars. High sugar diets are linked with memory impairments. The American Heart Association recommends women consume no more than 25 grams of sugar and for men no more than 36 grams.

2. Fried foods. Fried foods cause inflammation. Those who consume more fried foods are more likely to develop depression in their lifetime.

3. High glycemic load carbohydrates (e.g. bread, pasta, potatoes, white rice, honey, orange juice). Researchers discovered that people who had the highest score on the carbohydrate-quality index, meaning they were eating better-quality carbs, were 30% less likely to develop depression than those who were eating high-GI carbs.

4. Alcohol

5. Nitrates. Used as a preservative and to enhance color in deli slices and cured meats like bacon, salami and sausage, nitrates may be connected with depression.

60% of Americans have a chronic disease. 40% have two or more chronic diseases. Someone will have a heart attack every 40 seconds. Cancer is the second leading cause of death worldwide. 50 million Americans have an autoimmune disease. Almost half the population of the United States have pre-diabetes or diabetes. Brain health problems are also rising. 20% of adults have a diagnosable mental disorder. Depression is the leading cause of disability around the world. Around 1 in 5 American children ages 3-17 have a diagnosable mental, emotional, or behavioral disorder. Serious depression is worsening especially among teens with suicide among girls reaching a 40 year high. Anxiety impacts more than 40 million Americans, and Alzheimer's Disease is the 6th leading cause of death in the United States. Since 1979, deaths due to brain disease have increased 66% in men and 92% in women. 1 in 59 children are now on the Autism spectrum (Cole, 2019). There is one underlying commonality between all of these health problems explains Dr. Will Cole in The Inflammation Spectrum. Each of these diseases is inflammatory in nature.

When the body recognizes something as foreign, whether an allergen, pathogen (like a virus or bacteria) or chemical, the inflammatory response is triggered. "Inflammation is the body’s response to a problem," writes Edwin McDonald, M.D. of the University of Chicago School of Medicine. "It’s a normal, important reaction that signals to the immune system that something is wrong, so it can then fight off infection or heal injuries. When you have influenza and run a fever, that’s inflammation. When you eat something bad and get diarrhea, that’s inflammation. Swelling after you twist your ankle? That’s inflammation, too. We need a little inflammation. We would die if we did not have inflammation. Chronic inflammation, however, is another story."

The science is clear, but change is hard. My meals are healthy-ish, but not consistently on point. And it took decades to get here. This morning, before running to the gym, I had water with electrolytes and L-leucine (for protein synthesis and muscle repair). I juiced a cup of beetroot (protects liver from inflammation and oxidative stress/enhances endurance and athletic performance). For breakfast [post-workout], I scrambled 3 organic eggs (protein/B-12) in olive oil. I added onion, garlic, kale, asparagus, and mushrooms. I seasoned the omelet with turmeric (anti-inflammatory and antioxidant), pepper (to improve the bioavailability of turmeric), cumin, tarragon, and basil. I had half an avocado (unsaturated fat high in omega-3s- good for the brain) on the side. But I also baked a handful of tater tots from a bag with ingredients I couldn't identify. What's sodium acid pyrophosphate? Or more importantly, how's my body going to react to that? I had a cup of coffee with creatine mixed in (to increase muscle mass and for muscle recovery). But I also poured in creamer containing Mono- and Diglycerides, Dipotassium Phosphate, Natural And Artificial Flavor, Cellulose Gel, and Cellulose Gum. I had Greek yogurt (probiotic for gut health) with granola (low-glycemic food), walnuts and almonds (for fat), honey, cinnamon (a prebiotic that improves gut health/reduces blood sugar) and spirulina (a blue green algae considered gram for gram one of the most nutritious foods on the planet). I prepared a protein shake with blueberries and blackberries (fiber, vitamins, antioxidants), cherry, and kale (another superfood). I added mucuna pruriens (a velvet bean coated in serotonin. Mucuna pruriens is the best known natural source of l-dopa, which increases dopamine concentrations in the brain), maca (carbs, improves energy & stamina), acai (nutrient dense/improves cholesterol levels), ashwagandha, and gingko (focus). But I also added protein powder that contained lots of sugar. I supplemented with 2 grams of Omega-3 fatty acids, B-12 & iron (because I'm vegetarian), a multi-vitamin, and glucosamine/chondroitin (for joint health). For lunch, I had vegetable rice with garbanzo beans, saag paneer, an Indian dish consisting of pureed spinach and cottage cheese, and dal (lentils). I snacked on raw cucumber, pumpkin seeds (rich in tryptophan, an amino acid that converts to serotonin), and a banana. There's room for improvement, and I'm working on it. But this recovering fast food junkie has come a long way.

Update: I ditched the creamer and am putting creatine, protein powder, cinnamon, MCT oil, and ghee in my coffee instead. As for the protein powder, I've replaced it with one that has 1 gram of sugar. I purchased an air fryer and will limit consumption of potatoes, replacing them with plantains, yams, and yucca. I've also replaced my oils. I use mostly olive, coconut, garlic, and avocado oils or ghee for cooking.

My former diet put me at risk for cognitive decline, illness and premature death. But change is hard. Once established, bad habits are hard to undo-even when we know that we are on the wrong path. I learned this early from my father. At 30, he was diagnosed with diabetes. I was a child (7 or 8), but understood the gravity of the doctor's prognosis. One day, I snatched a bag of M&Ms from his hand. "The doctor says you can't eat this!" He yelled at me and snatched them back, "Don't tell me what I can or can't eat!" I retreated to the kitchen. As the tears fell, I remember thinking: "Can't tell people what to do. Screw it! Kill yourself then." He started taking insulin in his 40s. He didn't change his diet. After his kidneys failed, he was on dialysis in his 50s. He made minor changes to his diet and remained surprisingly cavalier about it. "We're all going to die of something," he'd say. But diabetes was a merciless disease that pecked away at its victims rather than killing them outright. His toes were amputated in his early 60s, then his feet, then his legs. Finally, he got serious about nutrition, but it was too late. He suffered several strokes, then blindness and paralysis before his death at 63. My father was a minister. He preached healing. But his faith in miracles was misplaced, for we are all subject to the laws of Nature.

I have seen this play out over and over again... starting with me. Despite seeing what a poor diet could do to me given my genetic inheritance, I was slow to change. I eliminated pork and alcohol in my early 20s, beef in my late 20s, chicken and fish in my mid 30s, and reduced sugar, pasta, bread, dairy, white rice, and most cooking oils in my mid-40s. Half of my uncles and aunts were diabetic. Half died painful deaths due to lifestyle choices, the other half suffered dementia and cognitive decline. Many friends, family members and love ones had gotten sick- and their cupboards looked the same. Given the high probability that I, too, would suffer the same fate if I continued eating what we were conditioned to eat, I forced change. Like most people, I am resistant to change. But, I found a top-down approach to self-regulation most effective for promoting and maintaining the kind of action I needed to take. It starts with knowledge. Giving up favorite foods was hard, but I reframed the choice by acknowledging that what I was really giving up was inflammation, fatigue, low energy, moodiness, stress, and illness.

Our bodies are home to trillions of bacteria. They outnumber our own cells 10 to 1. They’re spread across the digestive system. Most live in the intestines and colon, commonly called the gut. This community of gut bacteria is called the microbiome. The gut microbiome not only regulates digestion, vitamin supplementation and metabolism, but affects brain function, neural development, immune function, pain perception, and mental health. It also plays a key role in the stress response.

The gut is sometimes called the enteric brain or the "second brain.” It has its own independent nervous system, and a network of over 100 million neurons. Ever have a gut reaction, butterflies in your stomach, or a visceral feeling that you felt deep down? All of these expressions point to this knowing.

Research has shown that the gut microbiota modulate gut and brain functions. Gut bacteria produce neurochemicals that the brain uses to regulate physiological and mental processes which affect learning, memory, mood, and by extension behavior. 90 percent of the neurotransmitter serotonin, for example, is produced in the gut. Serotonin, sometimes called the calm molecule, influences both mood and gastrointestinal activity. When serotonin levels are elevated, we feel a sense of contentment. It's the serotonin secreted in the raphe nuclei of the brain, however, which modulates mood. But how well it performs in the brain is impacted by what happens in the gut.

Maintaining gut health is important for both physiological and psychological well-being. The microbiome thrives on fermented foods. Fermented foods are integral to diets around the world (except the West). But you might find some items at the grocery store: kimchi, yogurt (without the sugars), kefir, injera bread, sauerkraut, pickles, kombucha, natto, miso, and tempeh. Many of these foods take getting used to. But I don't let my preferences dictate what I eat. If, in my ignorance, I could force myself to drink and acquire a taste for beer, I can force myself to drink and acquire a taste for kombucha. If I could ingest toxins that poison the body, surely I could ingest foods and drinks that were better for my health.

In another study that I came across today, scientists found an association between personality type and amyloid deposition and tau pathology. The build-up of amyloid plaques and tangles of tau proteins are associated with Alzheimer's disease, dementia, type-2 diabetes, and about 50 other protein-misfolding diseases (Xu et al., 2022).

Personalities high in neuroticism (ones which gravitate toward anxiety, depression or other unsettling emotions) and low in conscientiousness (where subtraits such as self-efficacy, self-discipline, orderliness, and striving predominate) are at greater risk for developing Alzheimer's or dementia. The correlates remain unclear. One doctor explained:

“One potential pathway is inflammation, which is associated with personality and the development of Alzheimer’s biomarkers. Lifestyle is another potential pathway. For example, highly conscientious individuals have been shown to have healthier lifestyles — in terms of physical activity, smoking, sleep, depression, cognitive stimulation, etc. — than those with lower conscientiousness. There is a solid body of research connecting lifestyle, dementia risk, and biomarkers.”

Adopting a more conscientious attitude toward health, the findings suggest, promotes well-being. Meditation, as a skill, promotes qualities of grit, persistence, and conscientiousness. Skilled meditators eat whole, nutrient dense foods. Nutrient dense foods provide the body with the macro and micronutrients the body needs. The integrity of the nerve cells in the brain depends on fats, amino acids, and other nutrients which we get from the foods we eat. We eat until we reach our amino acid threshold. When the body's dietary needs are met, the brain signals satiety. We experience fullness. To support healthy brain metabolism, our brains require at least 30 micronutrients. One reason Westerners tend to overeat is precisely because the foods are so nutrient poor. We get the macronutrients we need (the fats, sugars, carbohydrates), but not the micronutrients (minerals, vitamins, and amino-acids). As a result, we eat more to supply the brain and body with the nutrients we need.

Many of the foods in the Western diet are engineered to taste good. Good for profits, bad for you. Inflammation is the body's response to a problem. And much of what we eat is the problem. Many of the foods we eat trigger inflammation. "All processed foods can cause inflammation," asserts Dr. McDonald. "They can alter the bacteria that live in our gut, and that alteration has the ability to interact with our immune system and eventually trigger it in a way that leads to chronic inflammation." Morganella, Klebsiella, and other gram-negative bacteria in the gut (e.g. Hafnia Alvei, Pseudomonas Aeruginosa, Pseudomonas Putida, Citrobacter Koseri) have been implicated in depression and other diseases. Their presence triggers the activation of the inflammation response system. Once these molecules cross the blood brain barrier and enter the brain, microglia are activated. Microglia, the resident immune cells of the central nervous system, respond to neuronal damage and remove the damaged cells by phagocytosis. Chronic microglial activation is a hallmark of brain pathology. The brain gets flooded in an inflammatory bath. Over time, inflammation causes neuronal damage through the release of toxic molecules such as proinflammatory cytokines, reactive oxygen intermediates, proteinases and complement proteins (Dheen, 2007).

Conversely, other gut bacteriophages particularly in the Caudovirales order may improve executive function and memory (Mayneris-Perxachs et al, 2022). Diet has been shown to alter the composition of the gut biome. (Schulfer et al., 2020). Exercise, sleep, and intermittent fasting are also simple lifestyle choices that reduce pro-inflammatory microglial states (Casaletto et al, 2022).

Change your diet, change the way you feel. Many studies have found improved mood regulation and reduced irritability and explosive rage, including in placebo-controlled randomized trials of children with ADHD (Rucklidge aet al., 2017) and mood dysregulation (Johnstone et al., 2021).

We each have our own unique biochemistry, so this essay is not prescriptive. I eat nuts; some readers may have nut allergies that would provoke inflammation. I eat plain Greek yogurt; some readers may be lactose intolerant. And I ingest supplements that may be harmful to some readers.

To determine which foods were problematic, I started with a complete blood panel to get baseline data, then started an elimination diet: pork, beef, chicken, fish, grains, diary, sugars, and most cooking oils- to determine which foods were beneficial and which were not. But, I found that monthly 3 day fasts provided me the same feedback much faster. By slowly reintroducing foods after a 3 day fast, I can determine which are causing me discomfort. This worked for me; it may or may not work for you. In Fast This Way, Dave Asprey offers science backed suggestions for women and others with different needs.

Eliminating ultra processed foods is a safe bet. "Sugars obtained by chemical synthesis, such as high-fructose corn syrup and invert sugar, are common low-cost ingredients of ultra-processed foods," says Fernanda Rauber, a nutritional epidemiologist at the University of São Paulo.

Many products advertised as sugar-free contain sugary substitutes. Ingesting these foods or beverages can be dangerous for those with diabetes. Many "sugar-free" labels are misleading. Maltitol syrup, for example, has a glycemic index of 52; table sugar has a glycemic index of 60. If a manufacturer substitutes table sugar with a sugar alcohol like maltitol, the pancreas will still secrete more insulin.

Sugar goes by many different names. Here's a short list: dextrose, fructose, galactose, glucose, lactose, maltose, sucrose, beet sugar, brown sugar, cane juice crystals, cane sugar, castor sugar, honey, malt syrup, maple syrup, coconut sugar, confectioner's sugar (aka, powdered sugar), corn syrup solids, crystalline fructose, date sugar, demerara sugar, dextrin, diastatic malt, ethyl maltol, Florida crystals, golden sugar, glucose syrup solids, grape sugar, icing sugar, maltodextrin, muscovado sugar, panela sugar, raw sugar, sucanat, turbinado sugar, yellow sugar, agave nectar/syrup, barley malt, blackstrap molasses, brown rice syrup, buttered sugar/buttercream, caramel, carob syrup, corn syrup, evaporated cane juice, fruit juice, fruit juice concentrate, golden syrup, and high-fructose corn syrup. These sugars are in products where you wouldn't expect to find them from salad dressing and breads to condiments and pet food. Alas, even our pets are becoming diabetic.

Natural flavors are another ingredient I avoid. "Natural" flavors may contain solvents, emulsifiers, flavor enhancers, and preservatives. The term has no formal legal definition. "Unfortunately, the United States has not established clear requirements for natural claims and manufacturers are using this term liberally." (Skubisz, 2016) Out of principle, I don't buy products from companies that mislead with doublespeak. Deceive me once, shame on you. Deceive me again, shame on me.

Consumers must be informed and self-advocate... even an eight year old girl diagnosed as pre-diabetic. Such are the norms of the times. If a child is suckered by false advertising into buying an energy bar and vitamin drink marketed as sugar-free from a school vending machine and becomes diabetic, it's her fault, or we blame her parents. We don't examine poor policy, education, misleading ads that affect consumers' perceptions, or corporate complicity.

Many foods labeled natural and organic are not. Where in nature do we find soy lechtin, potato dextrin, Di Sodium Dihydrogen Diphosphate and Sodium Carbonates, Xantham Gum, Methyl Cellulose, Sodium Stearoyl-2 lactylate, calcium propionate, dextrose or "natural flavors?" These are among the ingredients of 4 items I saw labelled organic and natural.

I eat foods I can pronounce. Do you recognize these ingredients: sesame seeds, cucumber, onions, garlic, ginger root, turmeric root, broccoli, kale, asparagus, eggs, carrots, beets, lentils? Can you pronounce the names of these ingredients: chickpeas, beans, mushrooms, yams, tomatoes, cilantro, cauliflower, black beans, spinach? These are among the ingredients that will be going into the dishes and beverages I'll prepare this week. It is living food. Take a bulb of garlic and plant it in the ground... it grows. Scoop Sodium Stearoyl-2 lactylate in the soil. Will it sprout? Your body knows what to do with a bolus of spinach. How does the body react when it does not recognize something you ingest that you yourself can barely pronounce?

Ultra processed foods use additives – colors, "natural" flavors, thickeners, emulsifiers, and gelling agents to improve the properties of foods that might otherwise taste bland. Ultra-processed foods often lack the antioxidants and phytochemicals we find in whole foods. The nutrients added to foods that have been stripped out during processing are inferior to those found in whole foods, according to Priscila Machado, a public health nutritionist at Deakin University in Geelong, Australia.

Not only what we eat, but when and how often we eat matters. Meditators were fasting intermittently before it was trending. Traditionally, only breakfast and lunch are served on retreat. That practice continues in centers around the world. I eat from around 6AM to around 2PM or 7-3. I eat for 8 hours and fast for 16. This gives the gut a reprieve and aids in digestion, metabolism, and sleep. As a general rule of thumb, consume your last meal 4 hours prior to bed to give the digestive system time to process and shut down.

Eating right to optimize focus and alertness

Habits like sleep, exercise and diet profoundly affect our meditation practice. These practices promote mental clarity, and improve concentration and energy, while keeping the brain, gut and body fit. We call these preconditions and attend to them with intention.

The gut and brain communicate with one another via the vagus nerve. The vagus is a long, branching nerve that sends signals from the gastrointestinal tract up to the brain. The vagus nerve also branches out into the lungs, heart, and nervous system. It has both a sensory and motor pathway. Moment by moment, it senses things happening in the body and sends this data up to brain. Motor signals are sent from the brain down to the organs. Much of this signal processing takes place below conscious awareness. But many sensations – such as tension in the chest, pressure in the head, tightness in the stomach, cold or heat, stiffness in the joints, tingling, throbbing, pulsing, numbness, etc.– are detectable to the conscious mind. This awareness is called interoception. Interoception is a sixth sense. Unlike the 5 outwardly facing senses of sight, sound, touch, smell, and taste, interoception is inward looking. When we meditate, we focus on bodily sensations as they arise and pass away.

Interoceptive awareness affects our capacity to regulate our emotions and behaviors. And how we read and interpret bodily sensations influences our wellbeing. Meditation not only enhances interoceptive awareness, it promotes health. In a recent study (Chandran, 2021), researchers found that meditation can improve the immune response for conditions associated with inflammation. "We found the response to oxidative stress, detoxification, and cell cycle regulation pathways were down-regulated after meditation. 220 genes directly associated with immune response, including 68 genes related to interferon signaling, were up-regulated, with no significant expression changes in the inflammatory genes."

Paying attention to the body, we get feedback and insights. We pay closer attention to what we do and what we eat. The better we get at detecting our body’s signals, the more insight. This in turn helps us make wiser choices from a more embodied place as we respond more mindfully- whether that's choosing what to put in our gut or speaking straight from the gut.

I wish you good health and a sound mind.