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Your Gut and Your Health
Dianne Rishikof MS, RDN, LDN, IFNCPPresident of Health Takes Guts, Inc.
© Health Takes Guts, Inc https://healthtakesguts.com
Functional Nutrition and Gut Health
• My story• Functional Medicine/Nutrition• Holistic• Resolve problems at the root
• The GUT!
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Today
• Microbiome• Why it is important, signs and symptoms of an unhealthy microbiome• Cancer and the Microbiome• Inflammation and Leaky Gut• Brain• Hormones
• Thyroid• Sex • Stress
• What can you do for your microbiome• What to remove and what to add
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What is the Gut?
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Why is the gut so important? Microbes
nutrient digestion and absorption
protecting the interior lining of
the digestive tract
how hungry or full we feel
what foods we crave
how well we utilize calories
(metabolism)
how we detox inflammation levels
how much neurotransmitters (brain chemicals)
we make
how well we can focus our mood
our weight our behavior our ability to fight germs how tired we are how our genes are
expressed
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Signs and Symptoms of an Unhealthy Microbiome• Bloating• Distension• Belching
• Gas• Heartburn, reflux, (GERD)• Diarrhea
• Constipation• Pain and cramps• Lack of energy• Headaches and migraines
• Frequent colds or illness• Memory problems• Joint pain
• Bad breath• Hormone imbalances• Acne
• Dizziness
• Insomnia• Stuffy nose• Inability to lose weight
• Irritable bowel syndrome (IBS)• Small intestinal bacterial
overgrowth (SIBO)
• Inflammatory bowel disease:Crohn’s and Ulcerative
colitis• Celiac disease
• Multiple sclerosis• Rheumatoid arthritis• Arthritis
• Alzheimer’s disease• Parkinson’s disease• Lupus
• Anxiety• Depression
• Attention deficit hyperactivitydisorder(ADHD/ADD)
• Autism
• Asthma• Allergies• Tantrums in toddlers
• Behavior problems in older kids• Chronic fatigue syndrome• Fibromyalgia• Eczema
• Psoriasis• Cancer• Diabetes (both types)
• Heart disease• Hypothyroid• Hashimoto’s disease
• Grave’s disease
• Polycystic ovary syndrome (PCOS)
• Endometriosis
• Premenstrual syndrome (PMS)• Overweight• Obesity
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Cancer and the Microbiome• “Microbiota can modulate immunity and, therefore, immune therapeutic
responses”• Microbes cause inflammation (or reduce inflammation)• Inflammation is at the root of most cancers
• “Microbes have the potential power to influence tumor progression”• Studies have shown that a more diverse and more abundant microbiota found
in those who responded to treatment compared to those who did not• Strongest research:
• Colon cancer• Prostate cancer
• Langevin L. CANCER PREVENTION: The Role of Inflammation, Phytochemicals, and the Microbiome. Today's Dietitian [serial online]. February 2018;20(2):42-47. Available from: CINAHL Complete, Ipswich, MA.
• Francescone R, Hou V, Grivennikov SI. Microbiome, Inflammation and Cancer. Cancer journal (Sudbury, Mass). 2014;20(3):181-189. doi:10.1097/PPO.0000000000000048.
• Cheng RS, Wong K-K. The hope of modulating microbiome in the management of cancer patients. Adv Mod Oncol Res 2018; 4(2): 289. http://dx.doi.org/10.18282/amor.v4.i2.289.
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Hope• “Modulation of host gut microbiota has a
promising future for cancer intervention”
• “Metagenomic analysis of stool samples might soon be a standard test for monitoring the cancer risk and treatment response of an individual”
• “Potential for microbiome modulation in therapies”
• Scott A, Merrifield C, Alexander J, Marchesi J, Kinross J. Highlights from the
Inaugural International Cancer Microbiome Consortium Meeting (ICMC), 5-6 September 2017, London, UK. Ecancermedicalscience [serial online]. October 2017;11(770-791):1-9. Available from: Academic Search Complete, Ipswich, MA. Accessed June 12, 2018.
• Sfanos KS, Yegnasubramanian S, Nelson WG, Marzo AMD. The inflammatory microenvironment and microbiome in prostate cancer development. Nature Reviews Urology. 2017;15(1):11-24. doi:10.1038/nrurol.2017.167.
• Weimann A. Influence of nutritional status on postoperative outcome in patients
with colorectal cancer – the emerging role of the microbiome. Innovative Surgical Sciences. 2017;3(1):55-64. doi:10.1515/iss-2017-0039.
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Microbiome• Unbalanced and Unhealthy:
• There are more harmful microbes than beneficial ones.
• There is an overgrowth of a pathogen.
• There might not be enough beneficial bacteria.
• There is not enough diversity (a wide variety of species of microbes).
• What causes this?• C-sections• Formula feeding• Antibiotic use• GI infections, body
infections• Poor diet• Chronic Stress • Toxins• Alcohol, smoking• Medications (birth
control, antacids)
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Impaired Intestinal Permeability (Leaky Gut)Causes:
• Dysbiosis
• Infections/pathogens
• Chronic stress: both physical or emotional, including sleep deprivation• Gluten: gluten increases zonulin
• Inflammation
• Medications:• Alcohol/Cigarette smoking
• Chemotherapy and radiation
• Traumatic brain injury
• Surgery• Poor diet
• Food sensitivities
• High intensity exercise © Health Takes Guts, Inc https://healthtakesguts.com
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Leaky gut (intestinal
permeability)
InflammationDysbiosis
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Gut and Brain
• ENS (enteric nervous system)• Exist on its own• People with IBS have a
hypersensitive ENS
• Gut Brain Axis• Two way communication• Vegus nerve • 9 times as many
messages from the gut to the brain
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Gut à Brain• Regulating myelination• Making neurotransmitters: the chemicals responsible for cognitive
and emotional faculties such as focus, attention, mood, aggression, calmness, and agitation.• Producing BDNF (brain-derived neurotrophic factor) • Influencing the degree of stress response.• Influencing moods and thoughts.• Influencing behavior.
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Brain à Gut• Changing motility (how fast
or slow things move through your digestive tract).• Altering intestinal
permeability (leaky gut).• Altering immune function.• Signals from the brain can
actually feed the bacteria! Anxiety feeds the damaging bacteria and a positive mood feeds the beneficial ones.
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Thyroid, Sex, and Stress Hormones
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T4
T3RT3
Understanding Thyroid Tests
Hypothalamus
TRH
Pituitary
TSH
Thyroid Gland
T3 and RT3 compete for cellular binding sites
This document was created by the Institute for Functional Medicine. This document may be copied or printed for your own use but cannot be resold or repurposed for commercial use.
Full Thyroid Panel:• TSH• Total T4• Free T4• Total T3• Free T3• Reverse T3• Antibodies (2)
Hormones: Thyroid
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Thyroid à Gut
• Hypothyroid• Feel cold• Brain fog• Weight gain• Fatigue• Constipation• Poor GI motility• Leaky gut• Sluggish gallbladder• Low stomach acid
• Hyperthyroid• Feel warm• Weight loss• Racing pulse• Anxiety• Diarrhea• Increased GI motility
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Gut à Thyroid
• Gut health (or disorder) is at the root of thyroid issues
• Microbiome converts a percentage of our T4 to T3• Must be beneficial bacteria • Dysbiosis interferes with this conversion
• Gut Infections • Increase RT3
• Low stomach acid -> low thyroid function
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Sex Hormones
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Gut à Sex hormones
• Gut regulates estrogen levels• Estrobolome• Microbes convert estrogen• Elimination of old estrogen (through stool)
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Sex hormones à Gut
• Estrogen affects:
• Gut lining integrity
• Sensitivity of the gut (how much we can feel what is going on in there)
• Motility (how quickly or slowly food moves through our intestines)
• Immune reactions of the gut
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949254/
• Progesterone:
• Too much --> Constipation
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Stress
• Cortisol• Adrenaline
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Effects of Stress/Cortisol• Disrupts other hormones• Can cause changes in intestinal motility • Increase intestinal permeability• Interferes with proper digestion, secretions• Alters your microbiome towards dysbiosis• Affects body’s ability to heal (gut replaces
itself every few days)• Increased sensitivity• Increases inflammation• Disrupts sleep• Suppresses the immune system
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What can you do for your microbiome
• Diet• Supplements • Exercise• Stress management• If suffering, get professional help• 5R protocol
• Remove, replace, repair, reinoculate, relax
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Remove
What you need to remove:
1. Foods that irritate and damage your gut
2. Foods that cause a reaction for you—food sensitivities and foodintolerances
3. Unhealthy microbes-- eliminate dysbiosis.
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What foods negatively affect the gut?• NSAIDs (aspirin,
ibuprofen)• Alcohol• Caffeine• Added sugar and
sugary foods • Processed refined
starches (breads, pasta, crackers, cereal, boxed or packaged foods)
• Processed vegetable oils (corn, soybean) and trans fats
• Additives and preservatives (found in packaged processed food)
• Artificial sweeteners (aspartame, sucralose, sugar alcohols, all found in “sugar free” products)
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Sugar is everywhere• Soda, fruit juice drinks, lemonade• Baked goods, cookies, muffins, pancakes• Bread • Desserts, cake, ice cream, pies• Flavored yogurt• Flavored oatmeal packets• Granola bars• Sauces, tomato sauce, marinades, salad dressing• Canned fruit• Condiments, relish, ketchup, mayonnaise• Flavored specialty coffee drinks, sweetened tea
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Food Sensitivities and Intolerances
• What is the difference between a sensitivity and intolerance?
• How to know if you have one?
• Common:
• Gluten
• Dairy
• Soy
• Corn
• Eggs
• Nuts
• FODMAPs
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Remove unhealthful microbes• Anti-microbials:
• Allicin (garlic)• Caprylic acid (coconut)• Oregano• Thyme• Peppermint oil• Berberine• Wormwood• Grapefruit seed extract• Pau d’arco• Goldenseal• Uva ursi (barberry)• Black walnut• Echinacea• Olive extract
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Replace: Restore or Enhance digestion
Signs of low stomach acid:• Belching• Bloating immediately after meals• Undigested food in stool• Food feels like it is sitting in the
stomach• Iron or B12 deficiencies• Constipation• Nausea after taking supplements
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Replace: Enzymes
Symptoms of low digestive enzymes:• Bloated after meals (one-three hours later)• Feeling like a rock in stomach• Undigested food in stool• Flatulence• Abdominal cramping
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Replace: Bile
Indications you might need to replace bile:• Gallbladder removed• Sluggish gallbladder • Oily foul-smelling stools that float• Diarrhea• Pain in the left side under rib cage
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Repair: Heal the gut lining
• Chewing thoroughly• Digestive enzymes • Gelatin• Bone broth• L-glutamine 1-15gm/day• Colostrum• Omega 3s (fish oil)• Antioxidants: Vitamins A, E, C• Aloe • Zinc Carnosine (75mg)• Vitamin D
• Phosphatidylcholine• Quercetin• Turmeric• Deglycyrrhized licorice• Marshmallow herb• Butyrate• Probiotics• Slippery elm• NAC• Glycine
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Reduce inflammation:
• Omega 3 fatty acids (fish oil)
• Turmeric, Curcumin
• Resveratrol
• Ginger
• Quercetin
• Bromelain
• Green Tea Extract (EGCG)
• White Willow Bark
• Cat's Claw (Uncaria tomentosa)
• Capsaicin (chili pepper)
• Frankincense
• Butyrate
• Probiotics
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Reinoculate
• Probiotics• Beneficial bacteria
• Fermented Foods• Probiotics in them
• Prebiotics• Food for beneficial microbes
• Polyphenols• Positive impact on microbiome
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Probiotic supplements
• Lactobacillus, Bifidobacterium, Bacillus
• Remember there are hundreds of other bacteria that
we can’t get in a pill!
• Essential to go with a high quality company
• Make it thru stomach acid, independent testing to
prove quality
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Fermented Foods
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Reinoculate: Fiber-PrebioticsFeed the beneficial microbes
• Bananas (under ripe)
• Apples
• Jerusalem artichoke
• Chicory root, inulin
• Onion
• Garlic
• Leeks
• Asparagus
• Berries
• Kiwis
• Pears
• Cherries
• Mangoes
• Leafy greens
• Flax seeds
• Lentils
• Quinoa
• Oats
• Chickpeas
• Black beans
• Carrots
• Resistant starch
• Cooked then cooled: potatoes and rice
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Polyphenols• Cranberry
• Pomegranate
• Black elderberry
• Dried herbs: rosemary,
sage, thyme
• Ginger
• Quercetin
• Green tea, EGCG
• Black tea
• Green olives
• Black olives
• Strawberries
• Blueberries
• Blackberries
• Raspberries
• Kale
• Broccoli
• Cherries
• Apples
• Plums
• Dark chocolate
• Hazelnut
• Flax seeds
• Red onions
• Coffee
• Whole wheat flour
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Relax
• HOW to eat• Stress Management• Supplements
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Relax: HOW to eat
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Proper conditions for digestion
Parasympathetic Nervous system• Saliva• Stomach acid• Enzyme + bile production
and secretion• Nutrient absorption• Intestinal motility• Cleansing waves
Pause for 30 seconds before eating
Eat when calm and eat slowly
Chew and chew and chew some more
Fast between dinner and breakfast (12 hours)
Relax: Stress Management
• Adequate sleep• Exercise • Meditation• Supplements: • Magnesium • Passionflower• Lavender oil• CBD oil
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Tips and tricks to fit relaxation breaks into your typical day:• At every red light, between each email or meeting: take a deep breath. Breathe in for a count of 6, and breathe out for a count of 8. Repeat as long as you can.• Set reminders on your phone, for every hour or half hour. When your reminder goes off, practice deep breathing or stand up and do some stretches.• Listen to music. Turn off the social media and the text notifications and listen to a song or two.
• Sit and stare at the wall for five minutes. Seriously, doing nothing does something.• Get some fresh air and sunshine. Go for a walk around the block, even if it is cold.• Laugh. Find something that makes you laugh. Watch a comedy sketch or read a funny book.
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Gut Health
Microbes
Hormones
Stress
Food
Inflammation
Brain
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THANK YOU!
• https://HealthTakesGuts.com
• [email protected]
• Supplements:• https://wellevate.me/dianne-rishikof#/
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Your Gut and Your Health Resources and References:
November 2018
Resources
• Health Takes Guts® Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue
https://healthtakesguts.com//health-takes-guts-ebook
• Bland, Jeffery. The Disease Delusion New York: Harperwave 2014
• Blaser, Martin. Missing Microbes. New York : Henry Holt and Company, 2014.
• Chutkan, Robynne. Gutbliss. New York : Avery. 2013
• Fasano, Alessio. Gluten freedom Nashville, Tennessee.Wiley General Trade 2014
• Gershon, Michael D The second brain New York, NY HarperCollinsPublishers 1998
• Gottschalk, Elaine. Breaking the Vicious Cycle. Baltimore, Ontario, Canada The Kirkton Press 2007
• Hellman, Raphael. The Microbiome Diet. Boston, MA Da Capo Press. 2014
• Jacob, Aglaee. Digestive Health with Real Food. Bend, Oregon. Paleo Media Group. 2013
• Lipski, Elizabeth. Digestive Wellness. New York, NY McGraw-Hill. 2012
• Mullin, Gerard E. The inside tract : your good gut guide to great digestive health New York, NY Rodale 2011
• Mullen, Gerard. The Gut Balance Revolution. New York, NY. Rodale 2015
• Myers, Amy. The Autoimmune Solution. New York, NY. Harper Collins 2015
• Pimentel, Mark. A New IBS Solution. Sherman Oaks, California. Health Point Press 2006
• http://drhyman.com/blog/2014/04/27/foreword-disease-delusion/
• http://drhyman.com/about-2/about-functional-medicine/
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