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Cabbage Radish Slaw, SCD/GAPS/UMassIBD-AID/PALEO

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Last Updated on February 18, 2017 by Patricia Carter

SUMMARY:  Cabbage Radish Slaw uses a pre-shredded cabbage — kale — carrot — radish — etc  mix from your grocers (or DIY) and coats all with an EASY to prepare vinaigrette dressing. The beauty of this recipe is it makes readily available, for easy frequent consumption, many differing vegetables that are not ordinarily consumed often a total breeze.  Consuming increased variety of vegetables (target 30 a week!) is the cornerstone of how diet can increase both the diversity and richness of the microbiome, both ecological parameters that promote optimal conditions for the microbiome. This translates to the host (that would be you) benefits with both increased immune status and health.  In addition, the vinaigrette also uses the healthy fat, extra virgin olive oil   (EVOO) to ensure absorption of fat-soluble  vitamins and carotenoids. Because there are so many newcomers, under the recipe find  Microbiome →  disease → Crib Notes For Dummies, and a summary of the interesting patterns emerging from the American Gut data.  

Making sense of these concepts for chronic disease prevention and management:

Many Americans are woefully deficient in vegetable intake.  It’s a double whammy contributing to BOTH microbiome decreased diversity and richness, in addition to phytonutrient and other vegetable compound deficiencies.  Both the recipe in this post, and that provided in WHY EAT THE BEETS, CABBAGE, RED COLORS (a roasted vegetable salad recipe), deliciously, easily, & conveniently address this. 

To hammer home this point:  In fact, classification of people as lean or obese can be made solely on the basis of their gut microbiota with 90% accuracy.  People who are obese harbour fewer types of microbes in their gut then lean people, AND have a significantly different abundance of specific taxa and functional genes.

How Many Vegetables Makes for a Happy Microbiome?

You already know that recent gene sequencing technological advances has launched new microbiome studies that are revolutionary in how we view biology; those books, including medical, will need to be rewritten as the PubMed studies connecting microbiome to disease only began to publish in 2013.  One early finding of the “American Gut” crowd source microbiome gathering project showed how incredibly  important a diet containing a variety of differing vegetables was for the health of the microbiome.  Listen up!  We are talking 30 different varieties of plants consumed  each week was found best for microbiome diversity & richness!  This is a MAJOR new mindset for most who shudder with How To Do vegetables.  

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Eat lots of  different plants:  Eating 6 to 10 varieties each week is good, but eating 30 plus different varieties is best as these foods increase host diversity and richness. 

—Dr. Rob Knight’s talk, Saturday, October 18, 2014 as well as American Gut findings, along with this PDF of preliminary data.  

How to practically increase consumption of 30 different vegetables each week

First, I simply suggest counting how many different vegetables you are consuming at each meal; to increase vegetable intake, add more! Check out the loaded phytonutrient breakfast meal below!  Those phytonutrients are all sourced as frozen; crack the eggs into the hot skillet, add the frozen vegetables/berries, lid and cook till eggs are done.  Biggest tip of all for having eggs slide out of the skillet: first heat the skillet; then add your fat of choice; coconut oil works well.

Second, the easiest strategy for How To Do more variety of vegetables is to make them readily available for your frequent noshing.  Having many different pre-cut vegetables stocked in your fridge and freezer helps guarantee they’ll integrate into those greens, into that bone broth based soup (see the Bone Broth section of this post for that How To Do), into egg breakfasts…  An incredible practical option beyond the ordinary stir fry broccoli, cauliflower, cucumber mix, is to purchase the pre-shredded cabbage — kale — carrot — radish — etc mix at your grocers (or DIY) and make this Cabbage Radish Slaw which is coated with an EASY to prepare vinaigrette dressing making availability  a total breeze.  My clan tops greens, burgers, chicken… with this mix.  The vinaigrette uses the healthy fat extra virgin olive oil (unadulterated please).   Recall that soybean, vegetable and corn oil has been indicted for diabetes, metabolic syndrome and IBD associations, and the EVOO  Mediterranean diet has been associated with less risk of breast cancer diagnosis.  Until the dust settles on oils, use proven EVOO.

lightbulb2Bonus TIP:  As the cabbage mixture disappears, if there is ample dressing remaining at the bottom of the bowl, simply add more cabbage mixture, and toss to coat.  True perpetual love!

Cabbage and Radish Slaw

Microbiome →  reduced vegetable fiber substrate → disease. Crib Notes For Dummies

Western societies recent epidemiological and clinical reports have revealed dramatic increases in the incidences of inflammatory (chronic disease) and immune disorders including inflammatory bowel disease, asthma, type 1 diabetes, obesity, autism, SIBO, and multiple sclerosis, pancreatitis, ‘leaky gut’ for Type 2 Diabetes, atherosclerosis, and systemic inflammatory response syndrome, in addition to neurological disorder, cancer, and malnutrition (read full text PDF here).  See the below slide for the sheer magnitude of these epidemic diseases.  The “American Gut” project and other crowd source projects such as “Ubiome“ have documented how different the Western microbiome (see below slide) is from the rest of non-Western microbiomes.  The microbiome → disease connection PubMed studies only began to publish in 2013.  

The hygiene hypothesis proposed two decades ago speculates  that these microbiome changes are the result of lifestyle changes and medical advances that reduce exposure to microbial pathogens AND that knock out our microbiota. 

Astonishingly, the disorders involve a common immunologic defect found in the absence of intestinal bacteria. The question then becomes:  After eons of co-evolution with our microbial partners, have societal advances (including sanitation, ‘western’ diets, antibiotics, C-section deliveries, and lifestyle) paradoxically affected our human health  by skewing our microbiome adversely due to reduced exposure to health-promoting bacteria both from the environment and from our microbiota?  — “Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues,” Martin J. Blaser, MD, 2014

While many compelling questions remain unanswered, one thing for certain is that diet is a major perturbation of both the microbiome’s richness and diversity.  Diet influences the microbiome in the short-term [through extreme changes (73)] and more long-term phenomena (90).  Microbiome diversity and richness are two parameters considered to be ecological earmarks for an optimal ecosystem.  See also  Diversity, stability and resilience of the human gut microbiota.

“Highly specialized diets will change the landscape of the gut microbiome over time. In fact, it takes only a few days of changing diet to alter the micro biotic makeup of the human gut. And if the dietary change involves elimination of one or more macronutrients (think Atkins or Paleo or vegan), humans are essentially selecting for some micro biotic species over others. —Elsevier. “Reduction in dietary diversity impacts richness of human gut microbiota: Dietary diversity necessary for a healthy gastrointestinal microbiome.” ScienceDaily. ScienceDaily, 15 March 2016

 In summary from the course, Gut Check, Exploring Your Microbiome, Dr. Rob Knight:

When the microbiome community diversity and/or those species critical for providing beneficial by-products are reduced, we lack the optimal life sustaining necessities for immunity and thus negatively impact health, wellness, and vitality.  
It is thought that greater diversity means improved immunity since many diseases (including obesity, diabetes, colon cancer, neurological disorders, and IBD…) are associated with reduced microbiome diversity.

Additionally, pathogenic microbiota can slip into the ecosystem void and flourish furthering the risk of disease.

Another way of looking at this, decreased diversity can result in an increase in bacterial strains that cause inflammation representative of obesity, Type 2 Diabetes and cardiovascular disease.  Further, these researchers noted that “one in four had 40% less gut bacteria than average. This is a representative study sample, and the study results can therefore be generalized to people in the Western world.”  Another researcher, Dr. Maria Gloria Dominguez-Bello, estimated that 1/3 of the population has reduced microbiome diversity. The disease epidemic slide from above certainly supports those estimates!  One thing to always keep in mind is that “many disease studies are confounded by extensive use of treatments, such as antibiotics, that may obscure true disease-associated changes, highlighting the urgent need for prospective longitudinal studies that establish cause and effect,” – Diversity, stability and resilience of the human gut microbiota.  In fact, even heartburn drugs (PPI and H2RA) now are understood to adversely alter the microbiome significantly (see the post here).

Why you need to nurture, protect, and support the health of your microbiome

Humans depend on crucial by-products of the microbiome which includes the collection of all the genes of our intestinal microbiota which is the cumulative genes of our intestinal bacteria, arachea, viruses, and eucarya, which outnumbers our human genome.  Their genome performs functions our human genome lacks.  The microbiome harnesses nutrients through fermentation of complex sugars (this comes from the food ingested) passing through the intestine and generates a large array of metabolites.

The host gains products from microbial fermentation conversion of host indigestible components (dietary fibres) into short-chain fatty acids (SCFA); mainly acetate, propionate and butyrate) contributing to an estimated 10% of our energy requirement [4], vitamin K and B12 production [5, 6], and protection against potential pathogens through competitive exclusion [7, 8].  —“The first thousand days – intestinal microbiology of early life: establishing a symbiosis,” and  “The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism“

The main sources of SCFA are carbohydrates (CHO) but amino acids valine, leucine, and isoleucine obtained from protein breakdown can be converted into isobutyrate, isovalerate, and 2-methyl butyrate, known as branched-chain SCFA (BSCFA), which contribute very little (5%) to total SCFA production… butyrate producers are normally low in ulcerative colitis (Machiels et al., 2014) and reduced levels of propionate producers have been detected in children at risk of asthma (Arrieta et al., 2015)… A reduction in fecal butyrate has been found in patients with colorectal adenocarcinoma (Chen et al., 2013), whereas obesity has been related with increases in total fecal SCFA concentration (Fernandes et al., 2014; Rahat-Rozenbloom et al., 2014) which tend to decrease following an anti-obesity treatment (Patil et al., 2012)… Prebiotic substrates that selectively promote the growth of beneficial microbiota also induce changes in SCFA production of healthy individuals (Lecerf et al., 2012) and in patients with irritable bowel syndrome or those receiving enteral nutrition (Majid et al., 2011; Halmos et al., 2015). Interestingly, the consumption of dairy products fermented with beneficial bacteria also modifies the intestinal microbiota toward more butyrate producers in comparison to chemically-acidified milk (Veiga et al., 2014).  –Intestinal Short Chain Fatty Acids and their Link with Diet and Human Health

…bacterial biomass in the lumen, including bacteria that do not actively associate directly with host gastrointestinal tissues, might be more important for the production of key metabolites that can have important physiological effects once they cross into our bloodstream… inflammation can lead to a permeable gut, thereby allowing metabolites produced by gut inhabitants (and even the inhabitants themselves, or fragments of them) to leak into the bloodstream (56, 57), and some metabolites can even pass the blood/brain barrier (58).  –Towards large-cohort comparative studies to define the factors influencing the gut microbial community structure of ASD patients

In summary, SCFAs are very important metabolites affecting immunity, strengthening the intestinal wall, and feeding the cells lining the gut. Many Americans are deficient of SCFAs due to the low fiber consumption inherent in the Standard American Diet. This study from “Nutrition and Diabetes,“ is a goldmine for SCFA discussion.

What about those plant dietary fibers… worth repeating… a key finding for dietary impact on the microbiome is:
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Eat lots of  different plants:  Eating 6 to 10 varieties each week is good, but eating 30 plus different varieties is best as these foods increase host diversity and richness. 

—Dr. Rob Knight’s talk, Saturday, October 18, 2014 as well as American Gut findings, along with this PDF of preliminary data. 

Dr. Knight noted in that October 18, 2014 lecture that this finding is so profound that  American Gut testing will soon change participant food journal requirements to only ask for frequency on consumption of holistic food within the past month, instead of the three week food journal.  This change is warranted since the long term diet, especially meat and fiber consumption, has been shown to have the largest effect on the microbiome.  This article notes that American Gut moved to a two-pronged approach, one using a generalized diet questionnaire asking frequency of consumption (e.g. in an average week, how often do you consume at least 2–3 servings of fruit in a day?), and a second to use a validated food frequency questionnaire through a professional service called Vioscreen.

Still…  A lot of critical unknowns remain

Dr. Knight mentions in this American Society for Microbiology video, that three things remain unknown for the microbiome:

  1. What does a good community look like,
  2. What does a bad community look like, and

  3. How do we get from a bad community to a good community?

Dr. Knight acknowledged as worrisome:  How do we modulate the microbiome when we don’t know enough; and how do we accurately predict what will happen when we introduce a new microbial member into the community?

Spotlighting… How do we get from a bad microbiome community to a good community?  Two thoughts come to mind (phytonutrients and detox)

[While] we do not yet understand how to manipulate diet to guide a microbial community from one state to another (e.g. from disrupted to healthy)… a correlation in diversity with the number of different types of plants consumed was observed [from American Gut data].   —Towards large-cohort comparative studies to define the factors influencing the gut microbial community structure of ASD patients

The below phytonutrient and detox sections are excerpted from the post,  WHY EAT THE BEETS, CABBAGE, RED COLORS which actually is my top post thanks to CNN.  Beyond shoring up the microbiome constituency consuming increased variety of vegetables, the actual compounds within the food itself is a whole other chapter of the how and why increasing vegetables benefits your health.  When you eat whole foods you get much more than the vitamins; you get thousands of compounds that  science has yet to discover and which aren’t present in supplements.

Phytonutrients:  The WHY EAT THE BEETS, CABBAGE, RED COLORS   post detailed the benefits of the phytonutrient subgroup, one category of compounds found in food, and delved into carotenoids (over 600 have been identified),  flavonoids (polyphenols, isoflavens, and phytoestrogens), and others. All work synergistically together to give the cells in your body what they need.  The healing diet, The Wahl’s Protocol, was discussed.  This diet is in clinical trial for MS but, it has been  anecdotal successfully extended for many other health conditions including:

RA. Lupus,  IBD, psoriasis, and neurological such as Parkinson’s and early memory loss/dementia, depression, anxiety, event PTSD (fighter pilots with narcolepsy), traumatic brain injury, as well as diabetes and obesity (to normalize blood sugars), and heart disease atherosclerosis which is now being looked at as possible autoimmune since it is a gut and inflammation issue.

The Wahl’s Protocol was found to statistically significantly increase in micronutrient status from baseline to 12 months (see below slide).  In short, one tenet of The Wahl’s protocol promotes vegetables (3 cups for a man sized frame or taller women, 2 cups for smaller frames) each from three categories: greens (vitamin A,B, C, and K), colorful (ideally 3 different colors each day for antioxidants), and sulfur rich (for toxin removal).

Detox:  This is such an important point; The Wahl’s Protocol incorporates the sulfur rich category such as cabbage, broccoli, cauliflower, onions, garlic, mushrooms and asparagus, because they support the removal of toxins from the body.  This aspect is seconded by the Dana-Farber/Brigham Women’s Cancer Center phytonutrient PDF (also on slides below) which recommends 1 to 2 servings a day of the cruciferous sulfur rich foods for detoxifying enzymes.

The significance of detox becomes apparent when you understand that our main liver detox gene, P450, has been crippling by the industrial seed oils ubiquitous in the food system thus hindering our ability to detox; recent studies (read this post) have found that soybean oil, canola oil, and vegetable oils (they typically contain soybean/canola oil) significantly affect the expression of many genes that metabolize drugs and other foreign compounds that enter the body, suggesting that a soybean oil-enriched diet could affect one’s response to drugs and environmental toxicants. The single most highly represented family of dysregulated genes was that of the [key liver detox] cytochrome P450 (Cyp) genes (30 genes total). 

Last…  A summary of the interesting patterns emerging from the American Gut data

based on Dr. Rob Knight’s talk, Saturday, October 18, 2014, documented in this post, as well as The American Gut website, and the Preliminary Characterization of the American Gut Population PDF.  Dr. Knight did caution that what has been shown thus far to be most beneficial for the microbiome is preliminary.

  1. Eat lots of  plants:  5 to 30 different varieties each week preferably.  Eating 5 to 10 each week is good, but eating 30 plus different varieties is best.
  2. Aging increases microbiome diversity:  Microbiomes are more diverse at age 50 to 60 then populations in their twenties.  As seen in other studies, the elderly resemble infants in certain respects of their microbiomes.
  3. Having an IBD diagnosis means your microbiome is altered significantly.  NOTE:  Many chronic and autoimmune diseases are also now following suit.  Realize, the PubMed studies finding microbiome → disease correlation only began publishing in 2013.  The drop down menu on the right sidebar categorizes these findings by disease type.
  4. The time of year alters the microbiome with a more diverse microbiome being with sun and outdoor exposure.
  5. Antibiotics wipe the microbiome with some folks recovering relatively soon whereas others do not recover the pre-antibiotic microbiome even one year later.  How much of their microbial diversity participants shared with others depended greatly on how recently they had taken antibiotics. Those participants who had taken antibiotics within the last year tended to have less shared diversity.
  6. Males vs females:  The sex for a  given microbiome can now be accurately predicted.
  7. Sleep 8 hours for a more diverse microbiome.  Less than 6 hours yields a less diverse microbiome.
  8. BMI but it only subtly affects the microbiome.
  9. Alcohol:  One drink is helpful, more than one reduces diversity.  Alcohol imbibers tended to have greater microbial diversity than those that don’t drink alcohol at all.
  10. Frequent exercisers have a more diverse microbiome and it is best if exercise is outdoors rather than indoors.
  11. Spikes in microbiome populations seem to occur around holidays: in July, and in November through January.
  12. There is no single organism that is found in every person, but some are more common across the population than others.
  13. People who sleep more, and who exercise outdoors, have more diverse microbiomes.
How do you optimize your microbiome? 

Use the framework above to start implementing some of the factors listed above that impact the microbiome!  Pick what you are comfortable with as every (even small) change is a big plus for the trillions of beasties living in and on you.

Give this Cabbage Radish Slaw a try to increase plant variety for some vegetables that are not routinely consumed to help increase your microbiome diversity and richness.  For diet change to be microbiome stable, consume such long term.

Updated recipe for preference on 1 or 2 limes.   Last updated: February 18, 2017 at 8:57 am

In health through awareness,

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