Wednesday, December 18, 2013

Crowd-Sourced Science n=4

Allan Folz's Gut Microbiome Study, n=4

I *heart* science and I love places like indiegogo which encourage all kinds of experimentation and projects whether it's techno or food-related.  It's truly a brilliant evolution.

Allan Folz and his family of 4 are doing a gut microbiota study: Resistant Starch & Gut Biome Family Science Project for six weeks, testing pre- and post-microbiome.  Allan cultures his own viili heirloom yogurt, a type of Swedish or Finnish yogurt. As we know yogurt that has live probiotics has many health benefits for us. One study in rodents showed that yogurt with live cultures improved 'rodent swagger', leaner body mass, and testicular size in males and improved fertility (brood size) and nesting instincts (successful weaning) in female rodents. "Mice That Eat Yogurt Have Larger Testicles", Scientific American, 2012.

Besides contributing to the first RS n=4 study with pre- and post-microbiome 16S rRNA pyrrosequencing outcomes,  first-tier funding ($250) for this crowd-sourced experimentation includes a personal tour of Oregon Wine Country in Yamhill County and a hand written thank you.

Allan's goal:
(1) The goal of this project is to measure and compare the effects of resistant starch dose-responses on gut biome in as reasonably controlled a manner as possible by selecting an otherwise typical and healthy family that lives and eats together.
(2) A secondary goal of this project is to provide a proof-of-concept and, perhaps, a template for future crowd-sourced, small-scale diet and health experiments.

Study Design:

Purchased two "Microbes for Four" swab kits from the American Biome Project.

Provided a stool swab -- 2 children, 2 adults

Over the course of a 6 week study period food journal will be maintained for each participant and provide a daily diet supplement of resistant starch in the form of Bob's Red Mill Unmodified Potato Starch. Each participant will follow a unique supplementation regimen:

a) adult 1 - 2 TBSP PS mixed in water, consumed on an empty stomach

b) adult 2 - 4 TBSP PS mixed in water, consumed on an empty stomach

c) child 1 - 1 TBSP PS  plus 1 TSP whole psyllium husk mixed into yogurt

d) child 2 - 1 TBSP PS mixed into yogurt

At the conclusion of the study period the four test subjects will provide a second stool swab for comparison purposes. The lab results from both swabs will be shared publicly on the internet.

Allan: Our current diet is almost entirely home-cooked meals somewhere between primal/paleo-ish and WAPF. None of us has supplemented with potato starch previously. We do eat, a few times a week up to almost daily, an heirloom strain of viili yogurt that I culture myself. More details, including a fairly typical week of meals for us are recorded at the project blog.

Microbiome 16S rRNA pyrrosequencing Testing: PRE v. POST

Additional testing depends on several factors: funding, information garnered and availability.  AmGut is wonderful and provides the bacterial and Archae enteroprofiling. On the other hand, functional medicine laboratory testing provides valuable information about the other gut ecosystem including profiling for fungi, parasites, worms and pathogenic overgrowths, as well digestive enzyme capacities and pH.

Disclaimer: I am working for Allan!

Sample food diary  (follow up HERE)

Food Journal: Thurs, Dec 12
Child 1 - 2 eggs scrambled, melted cheese on top; yogurt w/ granola
Child 2 - ditto
Adult 1 - coffee & half-n-half
Adult 2 - coffee & half-n-half

Child 1 - don't know
Child 2 - don't know
Adult 1 - yogurt w/ granola; 2 egg omelet w/ deli ham; 1 corn tortilla
Adult 2 - ditto

All - roasted pork loin; brown rice, cabbage, onion, etc; sliced up fresh pineapple on the side

Evening snack:
1 c Milk & 6 squares (~0.7oz) 85% dk chocolate

Thursday, December 5, 2013

HOW TO CURE SIBO, Small Intestinal Bowel Overgrowth: Step #7 Heal hormones and immunity -- take adrenal support, liver support, antioxidants etc

Source: Miller, 1999
HOW TO CURE SIBO/SIFO, Small Intestinal Bacterial/Fungal Overgrowth (protocol):

Step #7 Heal hormones and immunity

Take adrenal support, liver support, antioxidants etc 

(I use biocurcumin and berberine to combine with anti-microbials/anti-parasitics). This is particularly imperative for those with reactive hypoglycemia and BG crashes when they go longer than 3-4 hours between meals.

Proposed Causes of Dysbiosis of the Microbiota
Round, Mazmanian 2009
Source: PDF
Gut Feelings?

This is the final step in our 7-Step SIBO series!  Thank you for joining Tim Steele (aka tatertot) and I on this fantastic discussion and opening conversations about our wonderous and fascinating GUT AND OUR MICROCRITTERS!

Has everyone seen Tim's GUTS OF STEELE and assayed via 16S PCR amplification at the American Gut Project???

By now, I hope you have an appreciation for the impact and difference one single organ as simple as the gut can affect our overall health, longevity, digestion and day-to-day brain function.  More importantly, we dream that you feel more confident in identifying, addressing and fixing some of these intestinal issues.

I believe it is truly challenging to deal with all the modern factors that are the proposed causes of dysbiosis of the microbiota (see above)
-- low-grade gut infections (microbial overgrowths, parasites, etc)
-- unbalanced health and immune systems (lack of commensals -- Bifido, SFB, and soil based organisms)
-- our unique genetic vulnerabilities (e.g. HLA DQ2.5 for celiac; HLA B27 for alkylosing spondylitis)
-- lifestyle (lack of dirt exposures, stress, diet, sedentary atrophy, lack of sleep, livestock/dairy grade antibiotics, disjointed relationship with soil and farming)
-- early colonization of pathobionts (birth in hospitals, lack of breastfeeding, compromised maternal biota sources, toxic formula)
-- medical and dental practices (mercury amalgams, vaccines, antibiotics, hyperhygiene)


Estimated Surface Area
of the
Small Intestines

Main Problem with the Small Intestines: GINORMOUS SURFACE AREA

Our small intestines are like head size -- very variable in size!  As we grow, our small intestines grow as we age just like our height or head size. Much is perhaps determined by nutrition by mom and factors after birth.  Our small intestines vary from 5 to 10 meters (average 6-7 m) -- 3-6 times our height.  Indeed by surface area, our small intestines trump even our skin for being the largest organ.

In comparison, the large intestines is only a fraction of the length of the small intestines at  ~1.5 m.

Unfortunately I believe this predisposes us mammals to inherent problems as we frequently encounter digestive disruptors such as all the ones listed above.  These factors in our post-modern industrial neolithic age bombard us from pre-birth, birth and upwards.

I'm grateful that we have simple strategies and technology to address all of the gut disruptors -- fermented foods, whole grains/tubers/legumes, RS, potato starch prebiotics, soil based probiotics, diet, yoga, functional medicine lab testing GDX 2200 stool, ONE organic acids, Am Gut, uBIOME, etc.
Small Intestines: 5-10 meters (~15- 30 feet)
Large Intestine: 1.5 meter (~5 feet)

Stressors, Coz We R Not Zebras

Mental stress directly impacts our gut function.  The vagal nerve (see below) innervates our organs including the gut from head to tail.  This nerve controls calm, cool, rest, repose and digestion.  Look how the connections go between our brain to our gut, neat?  80% of our serotonin, the happy transmitter, are generated here.  Melatonin, our sleep hormone, is then produced from serotonin. What is the first sign of stress?  Insomnia, no wonder.

Who doesn't have stress? Widespread cortisol dysregulation is documented in teenagers (Dr. Briffa).

Vagal Nerve Innervations: Head to Tail (Butt)
Source: Medscape

Gut Brain Adrenal Axis

What are the variety of stressors the human body experience?

 --Sources of stress: gluten, pathogenic organisms, viruses, yeasts, dysbiosis, not enough gastric acid, lack of commensals, refined not-whole-foods, GMO food

Adrenal Glands
--Sources of stress: mental, physical, traumatic, intrauterine

--Sources of stress: perceived, mental, fear, lack of trust, heightened super senses (hear, smell, touch, feel, taste, sense), future fears, past fears

Effects of Stress Breaks the Gut

Stress (cortisol) breaks open our gut, makes the TJs (tight junctions) leaky, and abruptly even changes our gut flora to more pathogenic populations while reducing the numbers of the good flora like Bifido.  Read more about the gut-breaking effects on the Gut-Brain-Axis HERE.

Let's take surgery as an example (top diagram).  Being cut open by a surgical knife, bleeding, opening arteries and veins are one of the most stressful procedures a person may endure.  With any minor or major stressor, the adrenal glands must put out cortisol and adrenaline. With major trauma (surgery) or mental stressor, buckets of cortisol are secreted to maintain homeostasis, blood glucose, heart rate, blood pressure, hormones, etc.

In different gut disorders and SIBO, slightly variable nervous system effects are observed.  Some conditions are more 'turned up' by the sympathetic nervous system (SNS/adrenaline/cortisol) than others.  Some conditions are more deficient or defective in the parasympathetic nervous system (PSNS/calm/oxytocin) than others.

How do you balance?

Adrenal Botanicals and Yoga

In both clinical practice and in studies, certain rhizomes, tubers, and herbs are shown to buffer and balance the function of the adrenal glands.  Recently Robb Wolf and Chris Kresser talked about adrenal function.  Prior animal pharm ADRENAL posts. The funniest physician on adrenal and hormone health is DR. SARA GOTTFRIED!  Love love love this grrrrrl.

My favorite brand of adrenal support is by Gaia Adrenal Health but many exist.  What works for you?  How do you know when your adrenals are f*kcered?  How do you fix it? Does your physician ignore it?

Yoga -- for me yoga is the best tool for putting the SNS to rest and to bring the PSNS back to up to snuff. I don't know why it works!  There are studies but none explain the deep, contemplative, and restorative properties that I get when I'm regularly doing yoga. If you are in adrenal dysregulation, I'd highly suggest considering avoiding ALL Bikram and other extreme activities. The high heat and extreme form (90 minutes of high intensity sweating) is actually super detrimental for marginally functioning adrenals.

Bionic Adrenals
By Yoga
Source: HERE


Other ways to tell if you're 'stressed' is FINGERPRINTS (hat tip: D'adamo).  Our height of our fingerprint ridges may reflect our gut health microvilli height.  We are aware that sometimes skin damage reflects gut damage and bacterial/fungal translocation and their respective toxins  (acne, rosacea, psoriasis (and here), eczema, etc).  More damage, flatter villi, flatter fingerprints, different whorl and loop patterns.

In celiac, with severe SIBO, see the white lines and flatness of the ridges? On a gluten-free diet, these improve.
Figure 2 (white lines on gluten/celiac) versus
Figure 3 (diminished white lines on gluten-free diet)
Source: David TJ et al, 1970


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Weaver LT, Austin S, Cole TJ.
Gut. 1991 Nov;32(11):1321-3.

The relationship between intestinal microbiota and the central nervous system in normal gastrointestinal function and disease.  PDF free.
Collins SM, Bercik P.
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Therapeutic considerations of L-glutamine: a review of the literature.
Miller AL.
Altern Med Rev. 1999 Aug;4(4):239-48.

Magnesium sulfate protects against the bioenergetic consequences of chronic glutamate receptor stimulation.
Clerc P, Young CA, Bordt EA, Grigore AM, Fiskum G, Polster BM.
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Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism.
Vanuytsel T, van Wanrooy S, Vanheel H, Vanormelingen C, Verschueren S, Houben E, Salim Rasoel S, Tóth J, Holvoet L, Farré R, Van Oudenhove L, Boeckxstaens G, Verbeke K, Tack J.
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A cross sectional study of dermatoglyphics and dental caries in Bengalee children.
Sengupta AB, Bazmi BA, Sarkar S, Kar S, Ghosh C, Mubtasum H.
J Indian Soc Pedod Prev Dent. 2013 Oct-Dec;31(4):245-8.

Dermatoglyphics in patients with dental caries: a study on 1250 individuals.
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J Contemp Dent Pract. 2012 May 1;13(3):266-74.

The relation of bruxism and dermatoglyphics.
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