3 Plates: cardiologist, USDA, healing diets

SCD thoughts given DrOz 3 Day Cleanse, Microbiome

Last Updated on March 22, 2016 by Patricia Carter

SUMMARY:  Finally! A peek into our trillions of innards on a 3 day fruit and vegetable blitz!  Spoiler alert:  There is NOT much impact 10 days after stopping that 3 day cleanse, microbiome resulting from healing diet tenets persist!  

And that, I think, is the lesson to be learned for the healing diets such as SCD, GAPS, PALEO, AIP, WAHLs, to name a few.  Realize, the tenets of these healing diets are for everyone if you want to prevent chronic disease, not just those with chronic disease.  These protocols increase vegetables and fruits beyond what the normal Standard American Diet (SAD) yokel is consuming and adds in healthy fats so fat soluble vitamins are actually absorbed.  This is done concomitant with ditching processed foods,  including processed sugars, and other inflammatory foods.  How powerful are these tenets?  They are healing and inducing remission in messed up impoverished gut microbiomes, and some of those folks are only 80% compliant with the diet!  Nuff said.  Shouldn’t you know what these tenets are?

Check out what a healthy & unhealthy gut lining looks like

The below pictures show a healthy intestinal lining compared to an unhealthy lining (IBD in this case though any inflammatory chronic disease could be substituted.)  A picture truly is worth a thousand words when talking about mucin thickness lining and cytokines, anti-inflammatory and pro-inflammatory.  As strange as it is, understand that the mucin layer disappears as the microbiome feeds upon it if you aren’t eating for your trillion.  Case in point, researchers are using cadaver microbiomes to gain understanding into time of death for criminal cases since the microbiome survives you.  See… it still has ample noshing substrate.  Far from being ‘dead,’ a rotting corpse is teeming with life. A growing number of scientists view a rotting corpse as the cornerstone of a vast and complex ecosystem, which emerges soon after death and flourishes and evolves as decomposition proceeds. That’s food for thought… especially with the Halloween season upon us.

The above gut lining pictures also depict SCFA (butyrate and antioxidant producers) which are depleted in unhealthy gut linings.  It’s incredible but true that IBD patients eating a healing diet, SCD, actually, increases the F.prausnitzii bacteria which is a SCFA producer.  See the post, NICE, SCD INCREASED F. PRAUSNITZII… HUGH?!?  and now the Walters UC Davis Medical Center study for details.

Consider the below three plates; which do you eat?
3 Plates: cardiologist, USDA, healing diets
Source: biomeonboardawareness.com
Their different macronutrient profile details; 
  1. Cardiology tweaks (Dr. Mimi Guarneri, also here, and here.  Also, just goggle her for great YouTubes.
  2. USDA myPlate — it’s associated with a lot of disease epidemics  as shown on the below slide, and which surprisingly, does not include experts inputting microbiome considerations in its creation, and

    Disease Epidemic_PNG file
    Slide source: biomeonboardawareness.com
  3. The final plate which generally depicts the healing diets  that work for so many to manage different chronic diseases.  The SCD studies look at inflammation indices and in the words of Dr. Sandra Kim, in her Dec. 2014 presentation at the Advances in IBD Conference presentation,“Probiotics, Special Diets [SCD], and Complementary Therapies:  We Know Patients Want Them, So What Do We Tell Them?” the bottom line is for SCD:

    embellishment7there really is disease activity indices improvement and mucosal healing taking place with these modalities.embellishment7

It is easy to see the different macronutrient profiles.  Realize what is ditched (processed foods, sugars, and carbs, improperly prepared grains and dairy, and consideration of those foods that are not individually tolerated) and what diet plates add in healthy fats.  These tenets… induce microbiome changes rather quickly and  stabilizes the microbiome over long term eliciting health.  What’s long term eating?  One month of eating SCD allowed persistence of the more healthful microbiome for a full following month of eating pre-diet… seems like a short time of eating SCD to elicit that persistent change.  I suppose though, at some point if the SCD is stopped, the stability of the microbiome would become precarious though no studies yet address this timeline.

embellishment7Actually, the goal of the healing diets, which are nutrient dense, low-toxin, and anti-inflammatory, is to achieve resiliency in a gut microbiome that supports healthy immune function. When the diet and lifestyle is properly individualized, the resultant microbiome immune status often resolves and manages chronic conditions including autoimmunes.  -A great listen is Dr. Amy Shah, double board certified in Internal Medicine and Immunology/Allergy.embellishment7

So… what is a healthy gut microbiome anyway?

Researchers hesitate to define such, but use ecology principles: you want lots of diversity, lots of different species, and lots of some species and less of others.  

Actually, the “healthy” microbiome is being based on the myPlate consumer!  And the state of those microbomes actually resulted from The Human Microbiome Project which gathered microbiomes from  252 medical school graduate students.  Think about that population.  Are they a representative cohort for your microbiome? For that matter, are they really even a healthy microbiome?  Their microbiome determinants would be: age (young) and probable poor diet, sleep, and stress — all of which alter the microbiome! And I haven’t even touched upon their antibiotic history and who among them were vaginally born and bottle fed, all of which hugely impacts microbiome.

Gut MicrobiomeFactors
Slide source: biomeonboardawareness,com

 

Who would be an ideal “healthy microbiome” candidate? Someone who would be vaginally born, breastfed for a year, no antibiotic exposure, and they’d be consuming a diet similar to the cardiology or healing diet tenets, and including live real fermented foods.  Arguably… such a person is likely a rare find.

SCD thoughts given DrOz 3 Day Cleanse, Microbiome.

What microbiome changes would be expected for the healing diets?

If a 3 day cleanse can alter the microbiome (and it does though it reverts back to pre-cleanse state with cessation of the cleanse, details are below) imagine what a sincere commitment to implementing tenets of the healing diets would do to the microbiome.  Another spoiler alert;  We already know this answer through the SCD microbiome studies. and actually there is quite a lot of those as of today — see the mosaic.  The mosaic also includes UMass where in-house programs actually teach SCD!  These studies show the SCD protocol powerful enough and capable of:

  • Altering and significantly increasing microbiome diversity including some players that everyone wants onboard, like F.pruasnutzii who imparts huge short chain fatty acid production, butyrate, and antioxidants. If you and F.prausnitzii are strangers — read the post, NICE, SCD INCREASED F. PRAUSNITZII… HUGH?!? for details.
  • Inducing remission quickly. Stanford’s SCD/IBD clinical trial, now in progress, actually excludes patients who do not reach remission by 4 weeks [eating SCD]!  
  • SCD increased diversity for all the impoverished IBD guts that were in remission on Remicade in the Walters UC Davis Medical Center study.  Repeat: SCD increased diversity for all the impoverished  IBD guts that were in remission on Remicade.  Am I the only one bothered by that… that a gut can be in remission on Remicade but have diversity significantly decreased from that of controls?  How healthy can that really be?  And more importantly, eating a healing nutrient dense low-toxin anti-inflammatory diet like SCD actually significantly changed that microbiome moving it towards health.
  • And most incredible, 30 days eating SCD at about 80% compliance, resulted in persistence or stable microbiome changes as they remained during the 30 day post diet washout where participants consumed their pre-study diet.  Talking about virtual stability of the microbiome which is nice given it has the role of directing structural, protective, and metabolic pathways. 
Who is Angela Durazo?

Lastly,  I welcome and introduce to youAngela Durazoa newcomer to those speaking on diet and lifestyle management for chronic disease as Angela speaks out on RA and her management medication-free using diet and lifestyle.  

Dr. Gale “Morrie” Granger’s thoughts on anti-inflammatory diet

I was mesmerized to hear Angela recollect her face to face with Dr. Gale “Morrie” Granger, the key research pioneer in the field of autoimmune research who helped discover the TNF molecule in cells which led to the major biologic anti-TNF medication breakthroughs that it seems many autoimmunes are using.  She asked him point blank and face to face, his thoughts on using an anti-inflammatory diet instead of the biologics. Angela recollects:

embellishment7Dr. Granger said…if you keep inflammation levels down medication free, he encouraged doing such.  He noted that such is a severely limiting diet and hard to do, but do it if you can.embellishment7

That’s amazing!  You can listen to Angela discussing this at Endurance Athelete improves Rheumatoid Arthritis with Dietary Changes. You can listen to Dr. Granger discussing TNF here. 

How hard is it to eat nutrient dense, low toxin, anti-inflammatory foods?

Kids are able to do it in clinical trials so stop with the negotiation and bellyaching.  Some tools to help them learn the diet included a book with diet details and sample menus along with live support from someone that is knowledgeable in the diet.  Given how simple that is, it is discerning that out of 50 SCD participants, only ONE did not have a college degree.  What’s up with that?  SCD isn’t hard to learn, but apparently efforts need made to offer the healing diet tenets AND opportunities for learning the simple How-To’s such as the UMass in-house programs.  A top GI doc I meet with told me point blank that most of his patients can not read thereby insinuating they would not be able to learn SCD tenets.  Really!?!?! 

Three day cleanse and it’s microbiome impact

AmericanGut answered the cleanse/microbiome impact question nicely.

  1. They sampled the microbiome of three consumers of the Dr. Oz 3-Day Detox Cleanser.  These participants consumed for three days only smoothies of fruits and vegetables, plus a multivitamin and the probiotic VSL#3 (containing Lactobacillus spp.,  Bifidobacterium spp., and Streptococcus thermophilus).
  2. The microbiome did change and the genus Akkermansia increased.  Akkermansia is negatively correlated with obesity (more Akkermansia means less risk of obesity.)  AmericanGut noted:

Akkermansia is thought to help prevent metabolic diseases like diabetes by aiding mucin turnover and production, causing thickening of the gut wall.

Gut wall health is also aided by butyrate, a short-chain fatty acid [SCFA]. Several of the “good” microbes in common probiotics function to maintain health of the gut. These include Lactobacillus  and Faecalibacterium, which ferment lactose and fiber, respectively, in the diet. Fermentation produces acidic compounds, lowering gut pH to a healthier level. For more on the importance of fiber and gut pH, see Human Food Project founder Jeff Leach’s blog posts here and here.

Conclusion:  It seems there is something to the idea of subjecting yourself to a cleanse. Diets high in plants help foster microbes that degrade fiber and keep the gut healthy. But you have to keep up the diet in order to maintain that community of good bacteria. A cleanse may help jump-start your gut to a new microbial state, but everyday fiber intake is the fuel the keeps it going.

Current anti-TNF is ineffective in 2/3 IBD cases; maybe here’s why.

It is a good thing that diet (SCD) and lifestyle can be used to manage IBD since current therapeutics, anti-TNF meds, in addition to having serious long term ramifications, are not effective in 2/3 of IBD patients.  This study just found (in mice) that the common therapeutic target for the anti-TNF medication treatment of IBD, may actually protect against intestinal inflammation by inhibiting pathogenic T-cells. The authors noted:

This study found in mice, tumor necrosis factor receptor 2 (TNFR2) mitigates inflammation.  This was surprising, given that therapies that target tumor necrosis factor (TNF) are the primary treatments for individuals with IBD.  -lead author Shivesh Punit of the Saban Research Institute.

The study conclusions are:

  • TNFR2 protects mice from colitis by inhibiting the expansion of colonic CD8+ T cells.
  • TNFR2 regulates expression of genes that regulate CD8+ T cells and have been associated with susceptibility to IBD.
  • Disruption in TNFR2 signaling might therefore be associated with pathogenesis.
  • Strategies to increase levels or activity of TNFR2 and thereby reduce the activity of CD8+ T cells might be developed to treat IBD patients with CD8+ T cell dysfunction.

To clarify, the anti-TNF medications target TNFR2 which may offer some explanation as to why those medications fail in 2/3 of users; their target compromises TNFR2s ability to mitigate inflammation.  I am no doctor; ask yours for their thoughts regarding these latest studies.  More discussion on this important study can be found at: Tumor necrosis factor in colitis — bad actor or hero? and  at Medical News Today and this Science Daily article.  While I am not getting into TNF science, if you want to understand more, TNF receptor 2 pathway: drug target for autoimmune diseases, as well as TNF receptor 2 and disease: autoimmunity and regenerative medicineas a start, helped me to better understand TNF.

You can lump many other diseases as having TNFR2 pathways and they have increased TNF including: Type1Diabetes, MS, Neuroprotection with potential applications to neurodegeneration, heart disease, FA, IBD, lupus, Ankylosing Spondylitis, and scleroderma — see the below slide.  Any  using anti-TNF medications, may have similar issues.

TNRF2 pathway in health and autoimmune disease
Source: TNF receptor 2 pathway: drug target for autoimmune diseases http://www.faustmanlab.org/docs/academic/FaustmanReview20489699.pdf
Rheumatoid Arthritis and microbiome/diet:

For sure, check out Angela Durazo’s insights.  I’ve written before about RA, ARTHRITIS & GUT HEALTH: DIET & MICROBIOME, which discussed:

  1. The microbiome findings for RA study: “Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis,” Scher et al., Nov 2013, and
  2. dietary modulation and management of RA, which is discussed in the Chicago Tribune article, “A Gut Reaction? Rheumatoid Arthritis Has Confounded Efforts To Identify Its Trigger. Mounting Evidence Points to a New Suspect: A Disturbance in the Bacteria That Live in the Intestines.” and
  3. Tthe protocol that worked for the RA Walker baby, “The Boy With a Thorn in His Joints,” New York Times Magazine, February 2001.  Walker’s protocol, not surprisingly, sounds a lot like PALEO, SCD, or GAPS with a nightshade twist.  It’s very similar to the Autoimmune Protocol (AIP) which makes total sense since RA is an autoimmune. 
lightbulb2You have nothing to lose in implementing tenets of a nutrient dense, low-toxin, anti-inflammatory diet, and you just may discover you can reduce or eliminate some very high risk medications.
 Do microbiome microbiologist experts think the USDA’s dietary MyPlate guidelines are written with the microbiome in mind?

“No” is the correct answer.  Most of the thirty-seven  “microbiome” microbiologists from all over the world and from major research universities and organizations answered that question correctly when presented with a questionnaire concerning the microbiome, diet and health impact.  The originator of the survey felt few of the microbiologists had a horse in the race so to speak. Rather, they are interested in the microbiome and its modulation and impact on its host (you and me); not a particular or popular diet or philosophy. The question:

Q6. Do you believe the current USDA’s Dietary Guidelines for Americans were compiled with a clear understanding of the impact of dietary choices on the microbiome?
(1= Probably not, 10= Yes)
Results 1.3

A quick review of the panel of experts assembled to update the 2005 Dietary Guidelines for Americans to the current 2010 guidelines (myPlate), reveals a diverse group of distinguished researchers within their respective fields. But the omission of researchers who work with the gut microbiome is unfortunate. And unless I missed it, neither the 2010 dietary guidelines or the accompanying 1,375-page report from the Institute of the Office of Medicine, contain the word microbiome anywhere in the text. The respondents to this survey do not think much consideration was given to the microbiome either. Maybe next time. 

That’s a major oversight.  In their defense,  the science of the microbiome only began to break out in the literature in 2011-2012 with correlation to microbiome and disease around 2013!  Those guidelines, written in 2010, do need microbiome based revision.

Microbiome Research Timeline
Source: biomeonboardawareness.com
Summarizing….

Hope you enjoyed learning about vegetable and fruit smoothie impact on the microbiome and that healing diet tenets, SCD in particular, significantly increases microbiome diversity, and that this SCD microbiome persisted for thirty days during a washout period, during which time the participants ate their pre-SCD diet!   Also interesting should be learning that an IBD gut, in remission and on Remicade, lacks microbiome diversity which SCD significantly improved.  Finally, perhaps most interesting, is realizing the SCD participants were only about 80% diet compliant and yet the benefits of eating SCD were still achieved!

Last updated: March 22, 2016 at 21:57 pm for SEO optimization.

In health through awareness,

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