UCSF Functional Med Conference 2019, Part 2: Top Strategies for an All Star Microbiome, Heart and Brain.

Continuing the discussion of functional approaches to preventing and reversing chronic disease, Dr. Akil Palanisamy, MD,  a Harvard/UCSF/Stanford trained physician specializing in the Paleo diet, Ayurveda, and integrative/alternative medicine, presented an integrated look at heart disease, and the link between “leaky gut” and “leaky heart”. How can inflammation of the digestive tract lead to heart disease and autoimmunity?

To get a better understanding, let’s take a look at the gut. The wall between the gut and the blood vessels is normally a healthy barrier, preventing foreign particles from entering into the blood stream. Dr. Akil described how bacteria living in the gut, release LPS (lipopolysaccharides) when they die. A “leaky” gut wall is not intact (there are essentially spaces between the normally tight junctions) and LPS and other foreign particles/toxins pass through the wall into the blood stream. The body recognizes these particles as foreign, and mounts an immune response against them.  Inflammation escalates. These LPS particles may travel to the heart and vessel walls where they trigger more inflammation and destabilize existing plaques. Strokes and heart attacks can result. Inflammation from the gut can move right to the heart.

Dr. Akil also stressed the importance of Vitamin K2 (180-200mcg/day) in preventing heart and vascular disease. Note, this is different from vitamin K1. This great vitamin, K2, is like a shuttle, directing calcium to the bones and teeth and away from the vessels and organs where calcium can cause lethal blockages. Leaky gut, however, can also inhibit absorption of K2, and thus lead to elevated cardiovascular disease.

He outlined how “leaky” barriers also develop between the brain and the blood, and how undigested food particles/bacterial products can travel from the digestive tract, through an unhealthy gut wall, into the blood, to all parts of the body, including the brain if the blood brain barrier is impaired.

How then do we prevent these “leaky” systems?

In terms of nutrition, steer clear of simple sugars, refined processed foods, lectins, and allergenic foods.

Dr. Akil outlined his favorite gut and heart superfoods;

*Bone broth (from grass fed/pastured animals)

*Wild cold water fish 2x a week (for low mercury fish, choose Sardines, Anchovies, Mackeral, Wild Salmon, Herring. Think “SMASH”!)

*Natto (a K2 superfood)

*Berries (high antioxidant, low glycemic index)

*Nuts (sprouted/soaked to remove antinutrients)

*Herbs and spices; especially garlic and turmeric (high antioxidant, anti-inflammatory, *promote healthy microbiome and blood glucose levels)

*Fermented foods

*Green tea

*Leafy greens

*Dark chocolate (my favorite! Over 85% cacao); improves insulin sensitivity and elevates HDL; a pre- and probiotic!, rich in magnesium

Sonnenburg 2019 UCSF

Erica Sonnenburg, PhD microbiome expert from Stanford, took the stage next, to talk about the power of our gut bacteria.   Did you know that each of us has 100 x more microbial genes than human genes in our body? We are essentially walking petri dishes of bacteria. The strains of bacteria that we host, and the products they create, influence our health in every way. The great thing about this fact, is that we can control the quality of our microbiome through our diet and lifestyle choices.

You’ll want to pay attention to this fact; the microbiome will have great impact on whether you burn fat or store it. That’s right. Your gut bacteria can cause you to be a lean, mean fat burning machine, or to put fat into storage and tend towards obesity. Dr. Sonnenburg explained this in a mouse model (later replicated in humans) where two groups of lean mice, raised in identical environments, were given either, A. a fecal transplant of microbes from obese mice, or B. no transplant. All other variables remained the same, including food sources. Group A became obese. Group B stayed lean. The only variable was the microbiome shift in group A.   The microbiome will have great impact on our fat metabolism. The positive side of this: the quality of that microbiome is within our control.

So what is the microbiome and where is it? It is helpful to understand that when we ingest food, it first passes through the stomach, into the small intestine, and then into the colon where healthy gut bacteria live. These gut bacteria make up our microbiome. When complex plant carbohydrates (hello veggies!) move undigested into the colon, healthy gut microbes feed on them. They make very helpful metabolites called short chain fatty acids, such as butyrate and propionate, which move into the blood and act to decrease inflammation in the body, and to repair the gut wall. So, a quick recap; healthy bacteria in the colon feast on complex carbs like vegetables and make products healing to the gut wall and the body in general.

However, simple carbohydrates/sugars promote the growth of bacteria in the small intestine, which is not the optimal location for our gut bacteria! These bacteria feed on mucous, and actually break down the gut wall. This allows undigested food particles and toxins to pass through the gut wall into the blood and travel throughout the body (“leaky gut”). The body recognizes these as foreign particles, and mounts an immune response, leading to inflammatory cascades.

How do we cultivate a healthy gut microbiome?

*eat whole unprocessed foods

*eat a variety of foods; respect seasonality

*eat fermented foods

*eat vegetables!

*spend time in nature and dirt!

*for mothers; breastfeed to cultivate a healthy microbiome in the child

*avoid simple sugars

*avoid toxins ; plastics, pesticides, herbicides, unfiltered water, chemicals in household products and makeup, sanitizers

*avoid chronic stress; learn recovery and stress resilience tools such as mindfulness, take time to play and be with friends, be in nature, invest in self care.

Statistics show that only 1/10 adults in the US are eating enough veggies to promote health! Why is this happening? How can we move more people towards consuming vegetables, a pillar of health? As a society, we must begin to focus on education and health policy to reverse the addiction to treacherous processed foods and the tumult towards chronic disease.

Dr. Sonnenburg concluded with the statement, “The most powerful medicine is your choice, and you can decide whether or not to take it.”

Gina Serraiocco, MD, was up next with fascinating information about reversing and preventing dementia through Functional Medicine strategies. She alluded to the work Dr. Dale Bredezen is doing with great success in the field, actually reversing Alzheimer’s in 100 patients. “Alzheimer’s is a full body condition”, Serraiocco stated, and “signs can be observed thirty years prior to diagnosis”.

Prevention lies in “building a neurological bank account” and increasing cognitive power early on. How do we do this? Nourishing food, reduction of toxins, exercise, positive mindset and lifestyle.  Do it now and keep your brain in high gear for a long time to come!

Nourishing food: Simply put, avoid labels, packages, and sugar. Improve insulin sensitivity.

Alzheimer’s and dementia are characterized by plaques on imaging, in a failing brain that cannot access glucose due to insulin resistance. There may be plenty of glucose in the blood, but insulin resistance prevents it from moving into the neurons. However, neurons thrive on ketones as fuel. When MCT oil and/or a ketogenic diet is included in treatment, Alzheimer’s patients have had significant increases in cognitive function.   However, these can be tough to implement long term for those with cognitive decline. A good alternate plan is to do a cycle of MCT oil and ketogenic diet, along with other measures to improve insulin sensitivity (exercise, low glycemic diet, intermittent fasting) and then move to a healthy whole food diet that is easier to comply with.

Mindful Living

Dr. Serraiocco reiterated that “leaky gut” and digestive problems can lead to “leaky brain”, where undigested food particles and toxins escape the gut, into the blood and travel to the brain. To prevent and reverse this process, she advocates the following;

*mindful eating; increases digestive enzymes and function

*fermented foods or probiotics

*aim for healthy elimination; daily formed stools, If you aren’t “pooping a snake” every day, work on getting your gut in shape through a gut healing protocol.

*monitor food sensitivities (gluten and other lectins, dairy, nightshades, allergenic foods)

*sleep well! During sleep, waste products and toxins are eliminated. In fact, the brain has it’s own glymphatic system for waste removal. Sleeping on one’s side enhances glymphatic system toxin removal from the brain during sleep.

* “breathe and be happy”; meditation, heart math and visualization have all shown to protect against brain atrophy, increase BDNF (brain derived neurotrophic factor), and increase hippocampal growth

*be positive about aging; positive aging beliefs correlates with a 50% reduction in dementia risk. Be positive and stay sharp!

*Sense of purpose, spirituality and community; Loneliness correlates with a 40% increase in dementia. Prioritize meaningful work and relationships.

*Exercise. The brain shrinks 0.5% each year. Simply walking 15 min a day reduces this by 35%! This is especially important in early intervention.

* Sauna. High heat (170 degF) 20 min sauna sessions, 4-7 x per week, have been correlated with a 65% decreased risk of dementia.

*Brain training exercises; Brain HQ is one example

*Lean body composition; central obesity elevates dementia risk. Go for a lean waistline and stay sharp!

*Detox; avoid plastics, gas, paint, pesticides. Filter your water. Eat cruciferous veggies (hello broccoli, kale, bok choy, cabbage and cauliflower!).

*Move away from Medications; many can increase dementia risk by 50%! Proton pump inhibitors, anicholinergics (Benadryl), benzodiazapines, sleeping pills are villains in this case.

*Decrease Pollution Exposure; living within 50 m of a highway can elevate dementia risk by 40%. Run HEPA filters in your home and the recirculation filter in your car when driving in traffic.

*Detox : avoid mercury laden fish, instead eat low mercury fish such as Sardines, Mackeral, Anchovies, wild caught Salmon, and Herring (SMASH).

Consider removing mercury fillings with a SMART certified dentist.

Clean up mold in the home.

*Floss, brush, and cultivate healthy mouth flora. Oral pathogens can travel to the brain. (I add swishing with coconut oil for excellent oral hygiene).

*Be a conscious consumer. Consult www.consumerlab.com for supplement reviews.Consult www.EWG.com for reviews of toxins in consumer products and water quality in your area.

Studies of the Blue Zone populations have shown 75% less dementia risk than in the US. What can we learn from their exemplary model? How can we move our society towards better cognitive health and longevity? Qualities the Blue Zone cultures share include regular daily movement, life purpose, down shifting from a hectic pace, eating a plant rich diet and stopping when 80% full, a sense of community, tribe and belonging. Let’s start now.

Preventing cognitive decline is within our control. We must make empowered choices to build cognitive reserve and protect our ability to lead productive,  purposeful lives for a lifetime.

If you would like to build a strategy for upgrading your health and wellness, contact me to book a health coaching session and begin the rewarding journey!

Best to all!


Disclaimer; Coaching services include education, guidance and tips on primal living and services are not intended to be medical advice or a substitute for a diagnosis or treatment that a physician, licensed dietitian, physical therapist or health care professional might recommend.

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