Gut Micro-Biome

Taken from Lecture by Gerard Mullin, MD Johns Hopkins University School of Medicine for OMA 2018 conference in DC

Disruptions in Gut Microbiome are linked to range of chronic conditions

• Certain strains of bacteria predispose you to diseases and you have less of the good stuff

Child and Adult Obesity, Anxiety, Arthritis, Asthma, Autism, Autoimmune disorders, Cardiovascular*, Chronic fatigue, Chronic kidney disease, Depression, Diabetes (type 1 and type 2), Eczema and Most all OTHER IMMUNE ISSUES (i.e increase infections) *Fatty Liver, Fibromyalgia, Hypercholesterolemia, ITP, Metabolic Syndrome, Mood disorders, Multiple Sclerosis, Myoclonus dystonia, *Obesity, Oxalic kidney Stones, Parkinson’s Disease, Senile Dementia, etc

Gastrointestinal Gallstones, Colorectal Cancer, SIBO, Enteropathies, Hepatic Encephalopathy, *IBS, IBD, FMF, Gastric cancer and lymphoma, *Recurrent Clostridium difficile infection Non-GI

• Obesity especially. E.g mouse studies

SO MANY MECHANISMS

One is increase gut permeability

You want a good mucosal layer in your GI tract to protect your body from pathogenic bacteria.

We actually know some of the strains of bacteria predispose to these diseases

Depending on the bacteria you have. One kind of bacteria (firmicutes) are more efficiently at breaking down food / fermenting foods and extracting calories. (tend towards weight gain)

Low carb AND low fat diets decrease firmicutes

High carb and high fat diet (SAD) increases firmicutes and decreases good bacteria.

Whole body chronic inflammation

Disruptions caused by

• Antibiotics (giving antibiotics to cattle make them fat)

1. 1. Also influences people eating the meat

What to do about it

Probiotic pills

Too many options and benefits probably depend on your genetics.

Only take if you are also taking antibiotics or if you are treating something specifically    (like h.pylori)

Watch Diet

• Change the makeup of gut microbiome

Also

• Eat during day. Dysbiosis caused by NIGHT eating.

Pre-biotic

• Support good bacteria

• Only do it short term (8-12 weeks)

One reason Roux-en Y Gastric Bypass Surgery works because of changes in the microbiome.

You can still do low carb or keto healthily but not if you’re living on bacon.

Specialties coming together

“Obesity is a neurobehavioral disorder not a character flaw”, it is disease or hormonal and metabolic dysfunction

It is also at the center of most chronic diseases, thus why so many specialist were in attendance.

Everyone recognizing we (the medical community) told people to do the wrong thing for decades. We have ourselves to blame (and the food industry)

Many of these specialists were leaders in their field. Johns Hopkins, Stanford, Columbia just to name a few.

Obesity is at the center of most chronic diseases but we treat only the diseases and not the underlying metabolic pathway.

We need to treat obesity FIRST and foremost. We need to not stigmatized the word “obesity”. It's just like high blood pressure, cancer, diabetes or any other chronic relapsing disease.

Some crazy facts

Obesity with surpass smoking as the leading cause of preventable cancer

¼ of men applying to be in the army are rejected because of their weight... This is a national security issue

85 % of americans will be overweight or obese by 2020

The fat cell (adipocyte) is the largest  “gland” . it secretes hormones and changes your brain chemistry, metabolism, etc.

There is such thing as “fatty heart” like “fatty liver” which causes heart failure (fluids builds up in lungs) but people will have normal ECHO.

The key to prevent all these issues is in childhood. The food industry is making bank by selling processed food. We assume that our children are healthy because they look health but many already would have signs of metabolic disease if you were to test. Not only that, even if they dont, they probably will by early childhood.

Emmy is learning some really cool stuff while studying for her Obesity Medicine Boards.... 

Pete and Emmy chat about the reality that so many people trying to lose weight face... food addiction. 

You can do any “healthy” diet poorly

Nutrition is not religion

• A “poor healthy” diet will work for a while

Ways that any diet can be unhealthy

1. Vegetable Oils

• In all processed food

1. Added Sugar

• See above

1. Foods that you have an intolerance for

• Grains, dairy

1. Processed Food

• See above (veggie oils, processed carbs, sugar)

1. Weird Ingredients

• E.g the ice cream we got last night

1. Nutrient Deficiencies

• B vitamins NEED to be supplemented

Just because it says “organic”, “paleo”, “low carb”, “vegan”, does not mean its healthy

If it has a label on it, its not real food.

No human population ever ate only plants or only meat, we are omnivores

GERD

What are the symptoms?

• Pressure in chest

What is Gastroesophageal reflux disease? (GE.R.D.)

• Stomach acid is needed for digestion

Anything that relaxes the lower esophageal sphincter makes GERD worse

• Caffeine

When you go to the doctor they will put you on H2 blocker or PPI

• Which blocks acid production

When you block acid with H2 and PPI

• You can’t digest your food well and then you get worsening digestive issues

Other dangers of these medications

PPIs (Proton Pump Inhibitors)

FDA warnings

            long-term use of PPIs: risk of fractures, low magnesium leading to muscle cramping, , Clostridium difficile–associated diarrhea, vitamin B12 , kidney issues (acute interstitial nephritis (AIN), and Lupus,  and stroke

No big deal right?

How do we treat/fix this?

• Don't just put a bandaid on the problem with antacids

Safe natural remedies  things that help (I have found)

• Apple Cider Vinegar / Pickle Juice

https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults

Our very first guest on the podcast over a year ago, Paul Serafino (https://paulserafino.com/) joins Pete to discuss the importance of prioritization vs. accountability and other useful hacks for a busy, overwhelming work life. Paul is an innovator in the world of coaching for busy CEOs and executives. He helps those who need to be on top of their game so their companies can thrive. Balancing one's energy in the right places can make all the difference in the world. 

Our very first guest on the podcast over a year ago, Paul Serafino (https://paulserafino.com/) joins Pete to discuss the importance of prioritization vs. accountability and other useful hacks for a busy, overwhelming work life. Paul is an innovator in the world of coaching for busy CEOs and executives. He helps those who need to be on top of their game so their companies can thrive. Balancing one's energy in the right places can make all the difference in the world. 

Check out work by Dr. Lustig who is a pediatric endocrinologist

Book is called “Fat Chance”

Another example of “A calorie is not a calorie”!! Calories affect your body differently

Glucose vs Fructose

Both carbohydrates

Every cell burns glucose. You either get glucose from diet or you make it yourself from

Gluconeogenesis (liver makes glucose). You can eat NO glucose but still have glucose in your body

We can only metabolize a smaller amount of fructose and we store it primarily. Excess

basically leads to aging of cells

Fructose

In soda, candy, cakes and goodies but also in most breads

Basically all processed food

Does not decrease your hunger hormone (ghrelin) like glucose

Means you can eat and eat and eat

You literally can't eat as much food with no fructose in

Causes NAFLD (non alcoholic fatty liver disease)

We are seeing this in kids younger and younger

More common than alcohol disease

Fructose lights up the “reward center” of brain (dopamine)

Same effect as cocaine, nicotine, etc.

Liver Disease

ALT and AST is what we measure.

ALT of 40 is considered normal

The average (normal level) has increased over the past decade

These are basically markers for sugar intake

Basically everyone has fatty liver.

Genetic differences

E.g latinX population has genetic population where they store more sugar and don’t process it well. Even more important to cut sugar down

Pete’s ALT was 32. Is now normal but would have been abnormal, AST 24

Inflammation

Causes whole body inflammation.

Lustig is a pediatrician so he works with hundreds of families

Epigenetic changes in kids with this consumption (probably - found in animal studies)

We know maternal hyperglycemia changes genetics of baby later on

Causes metabolic issues later in life

How many times does it take to get a baby to eat a savory food?

Need to introduce a new, savory food (Think roasted veggies) 13 times to get child to accept

What about sugar?

Once

Because it is like cocaine there is a huge issue with down regulate dopamine receptor

Hard to experience joy from other things

Because of the down-regulator receptors in brain

Takes more and more sugar

But also more and more of other things

Could this be linked to depression??!!!!!

The problem is that this addiction is socially accepted.

One benefit of fructose (only in athletes)

If your liver if depleted of glycogen, you can replete faster with fructose but fructose (like in energy gels DO NOT replete muscle glycogen)

Fruit

Is technically fructose BUT it comes with fiber.

THE PROBLEM IS PROCESSED FOOD

Its sugar without fiber

If it has a label its not real food

1. I have seen a number of questions at various times regarding refueling during events. I wonder if anyone has used BHBs in this setting? Fat bombs? Electrolytes? I am training for a half marathon-8 mile has been my max run so far without so much as wAter. 

• Older kids and/or adult children (and their families) and conversations on health.