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Gut Health Explained

Atrip down your local dairy aisle and you may be surprised to find the word prebiotic beginning to appear next to probiotic on several labels. Often these words or concepts are introduced to us in the marketplace and while they may become familiar sounding over time, chances are we’re still at a loss to explain how they improve our health (unless you read our blogs of course!). Here we’ll dive into the topic of gut health, defining some of the key terms and our recommendations for a healthy gut.

What is Gut Health?

When we hear the word “gut” we might initially think stomach or that butterfly feeling we get when we’re nervous or anxious, but the subject is incredibly complex and evolving each day. In the simplest form, gut health encompasses our entire digestive system starting with where food enters our mouth and where it exits. You can see why this topic doesn’t come up at dinner parties!

We may not think much about the process of eating, unless of course it doesn’t agree with us, but so much happens within that 25-30 hour window from when we first smell and ingest a food to its excretion from the body. The gastrointestinal (GI) tract, or tube that runs from our mouth to large intestine, is lined with mucus and trillions of microorganisms (a.k.a microbes) that thrive and metabolize the foods we eat. The majority of these reside in our large intestine or colon. We now know that a strong link exists between the microbes (bacteria being a type of microbe) that inhabit our gut and our risk for disease. This is why gut health is such a hot topic.

What are Probiotics?

Probiotics are live bacteria or yeast found in food products that help to promote the maintenance of the beneficial bacteria in our gut1. They aid in keeping the balance between both the good and bad bacteria. This is one reason their use is suggested after we go on antibiotics. In an effort to get rid of the bacteria causing us to be ill, antibiotics can’t discriminate and wipe out both the good and bad. Probiotics such as those found in kefir or yogurt help to provide a stimulus to the immune cells that line the gut to prevent potentially bad bacteria from trying to get into the gut while good bacteria are being re-established. Think of them as immune boosters.

What’s interesting to note, is that it can take almost eight weeks after antibiotic use for the number of bacteria to rebound to baseline2,3, but weeks to months for the diversity of that bacteria (meaning the different types) to return4. This just stresses the importance of not overusing antibiotics as we are still learning about how their use disrupts the balance of bacteria in the gut5 and the long-term implications on our health.

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Common Probiotics Found in Foods:

Lactobacillus, Bifidobacterium, Lactococcus, Enterococcus, Bacillus, Saccharomyces.

What are Prebiotics (a.k.a Fermentable Fiber)?
Prebiotics are the food that stimulates the growth of good bacteria in our gut. They come from non-digestible carbohydrates and are found naturally in foods like leeks, asparagus, artichokes or additives such as inulin or oligosaccharides. Since these aren’t fully digested they are able to reach the colon where they are fermented by good bacteria. This is why you may hear them referred to as fermentable fiber. The result of this fermentation is that it produces beneficial changes in the composition or activity of the bacteria helping to improve our overall health and well-being1,5.

All prebiotics are fiber, but not all fiber is a prebiotic5. One of the primary end products of fermentable fiber is short-chain fatty acids. These have a profound impact on our health including maintaining a strong barrier between the microbes in the gut and limiting their potential entry into our blood. If you don’t have enough fermentable fiber in the diet, you will have a deficiency in short-chain fatty acids. This can lead to a leaky gut, where you get holes in the lining of the gut barrier and bacteria begin to leak into the blood, creating an assortment of health problems.

How to Optimize Gut Health
Gut health requires two essential agents: fermentable fiber to supply energy to the microbes in the gut (primarily in the colon) as well as adequate levels of polyphenols. Think of the polyphenols as gardeners that help to promote good bacterial growth and inhibit the bad. Without adequate levels of either in the diet, the result is increased gut inflammation and an increase in leaky gut which can cause inflammation in the body.

3 Ways to Support a Healthy Gut

1. Eat Fermentable Fiber (Prebiotics)

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Not all fiber is fermentable by the bacteria in the gut. In fact, only about 10-15% of the stated fiber content of a food is fermentable. Since you need about 6 grams of fermentable fiber per day, this means you should be consuming about 40 grams of total fiber per day. Most Americans are nowhere close to that level, but following the Zone helps to get you there.

The best sources of fermentable fiber include non-starchy vegetables (such as onions, garlic, asparagus, and artichokes, selected fruits (berries and apples), legumes (beans and lentils), and nuts (almonds, walnuts, etc.). These are all rich in both fermentable fiber and polyphenols necessary for optimal gut health. The vegetables are harder to digest if you don't have adequate diversity in your gut bacteria.

2. Take Your Polyphenols

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Polyphenols represent the primary defense mechanism to prevent bad bacteria from inhabiting the gut while increasing the production of the good bacteria. They also have gene activation properties that can increase the expression of anti-oxidative, anti-inflammatory, and anti-aging gene products. The more colorful the carbohydrates, the higher the levels of polyphenols. Most Americans get their polyphenols primarily from coffee. Unfortunately, the polyphenols in coffee or tea are not nearly as active as are the polyphenols found in vegetables or fruits.

3. Add Your Omega-3s

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The omega-3 fatty acids EPA and DHA are the starting point for the production of hormones that reduce inflammation in the gut and prevent the development of a "leaky gut". Gut-derived inflammation is a primary source of inflammation for the rest of the body. Ideally consuming a minimum of 2.5 grams of EPA and DHA per day can help maintain a healthy gut. The average American consumes about 5% of that suggested level.

Buyer Beware

Diets that strictly limit the amount of carbohydrates consumed can reduce the diversity of bacteria in the gut since they restrict fermentable fiber and polyphenols. When choosing foods it’s important to think about how the foods you eat help to nourish and support a healthy gut. By following the Zone Diet you’ll consume the right type and amount of carbohydrates to achieve the optimal levels of both fermentable fiber and polyphenols.

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References:

1. Markowiak P, Śliżewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 2017 Sep 15;9(9). pii: E1021. doi: 10.3390/nu9091021. Review.
2. F. Fouhy, C.M. Guinane, S. Hussey, R. Wall, C.A. Ryan, E.M. Dempsey, B. Murphy, R.P. Ross, G.F. Fitzgerald, C. Stanton, and P.D. Cotter, 2012. High-throughput sequencing reveals the incomplete, short-term recovery of infant gut microbiota following parenteral antibiotic treatment with ampicillin and gentamicin. Antim. Agents Chemother. 56:5811-5820
3. Grazul H, Kanda LL, Gondek D. Impact of probiotic supplements on microbiome diversity following antibiotic treatment of mice. Gut Microbes. 2016;7(2):101-14.
4. Langdon A, Crook N. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med. 2016; 8: 39.
5. Gibson G.R., Probert H.M., van Loo J., Rastall R.A., Roberfroid M.B. Dietary modulation of the human colonic microbiota: Updating the concept of prebiotics. Nutr. Res. Rev. 2004;17:259–275.

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062524---Keto-Blog

Ketogenic Diets and Aging

Chances are, you or someone you know has tried the keto diet at some point in time. This high-fat, very low-carbohydrate eating plan appeals to many due to its promise of rapid weight loss. In this blog, Dr. Sears explores some of the latest scientific findings on ketogenic diets and provides caution before hopping on this trend. What is a Ketogenic Diet? The ketogenic diet is a high-fat, very low-carbohydrate eating plan. This significant reduction in carbohydrates to induce a metabolic state is called ketosis. This only occurs when there is not enough carbohydrates in your liver to completely convert fatty acids to carbon dioxide and water. The normal conversion generates the chemical energy (ATP) that keeps us alive. In the absence of ketosis, each fatty acid generates 108 molecules of ATP when oxidized in the mitochondria. Ketone bodies make less ATP when they are metabolized by mitochondria. How much less? About five times less. This is like switching the gasoline in your car from high-octane fuel to low octane fuel as ketone bodies increase in the blood. Furthermore, contrary to popular belief, ketones are not an ideal energy source for the brain, as glucose remains the preferred fuel for ATP production in brain cells. Lack of blood glucose is a highly stressful situation for the brain. This is why the body secretes the stress hormone cortisol from the adrenal glands during ketosis to breakdown protein and convert the amino acids into glucose for the brain. This explains why even under complete starvation for 38 days, the blood glucose levels never dropped below 68 mg/dL. This is still considered as a normal blood sugar level. Where did this blood glucose come from if there was none in the diet for 38 days? The answer is neo-glucogenesis primarily using lean body mass. Ketogenic Diets Pros and Cons Interest in ketogenic diets rises and falls about every 20 years. They’re very low-carbohydrate diets that claim that carbohydrates make you fat and keep you fat. This is simply not true. It is not carbohydrates per se but a disrupted metabolism that makes you fat. To be more specific, it is the inhibition of AMPK, the master regulator of your metabolism that makes you fat. Why? As AMPK activity increases, you burn stored fat faster. Frankly, I’ve always been amazed by the re-emergence of ketogenic diets. Eighteen years ago, I published the premier clinical study demonstrating that, under equal calorie intake in which all the food was provided to the subjects for six weeks, the Zone Diet was better than a ketogenic diet in reducing total weight, excess body fat, and inflammation. Now, a recent study revealed some more very concerning findings about the long-term effects of ketogenic diets. This new study indicated that following a keto diet causes a rise in senescent cells, popularly known as “zombie cells.” Zombie Cells are damaged cells that no longer divide but don't die. That’s bad enough, but zombie cells continue spreading inflammation throughout the body. As the number of zombie cells increases in your body, they become a living nightmare. Why? Zombie cells accelerate aging because they cause the earlier development of many chronic diseases. In this study they found that zombie cells in the animals began to appear while they were on a ketogenic diet. The zombie cells then disappeared when researchers changed the diet to a “non-ketogenic diet” (i.e., the Zone diet). And when the animals were given a Keto diet again, the zombie cells reappeared. Notice a trend? If you want to hear more about this study you can listen to our recent podcast at Dr.Sears.com. Based on earlier blogs, this adds to the list of downsides for following a ketogenic diet versus the Zone Diet. PROS Rapid initial weight loss: This is primarily due to the loss of retained water from the glycogen stores in the liver, which is rapidly used up to maintain blood sugar levels. Since these glycogen stores in the liver contain significant levels of retained water, much of the initial weight loss is water rather than stored body fat. If your main goal is loss retained water, this can be seen as a benefit. Of course, going to a sauna would also work. Reduced hunger: Ketogenic diets are rich in protein. Any increase in protein intake can help reduce hunger. CONS Production of acetone: One of the ketone bodies produced during ketosis is acetone, which is also the main chemical in nail polish. Increased calcium loss: A ketogenic diet can lead to higher calcium loss from bones. Limited fat utilization: High levels of dietary fat reduce the likelihood of using stored body fat for energy unless you also significantly restrict calories. Reduced energy levels: The lack of ATP production on a ketogenic diet can lead to easier fatigue during mild exercise. Damage from cheat meals: After seven days on a keto diet, a single high-carb cheat meal can damage blood vessels. Lack of polyphenols: This makes it difficult to activate genes that optimize metabolism by improving mitochondrial efficiency in converting fat into ATP. No long-term weight loss advantage: Long-term studies show no difference in weight loss between a ketogenic diet and a low-fat, high-carb diet. No short-term metabolic advantage: Careful studies demonstrate that fat loss on a ketogenic diet is the same as on a low-fat, high-carb diet with the same caloric intake. Compromised gut health: A lack of fermentable fiber from carbohydrates can lead to poor gut health and an increased risk of developing a leaky gut, which can cause significant inflammation. Furthermore, short-chain fatty acids (SCFA) are the metabolic product of fermentable fiber. These SCFA are powerful epigenetic signaling agents that enhance gene transcription. Ketosis generates a different type of hydroxylated short fatty acid (3-hydroxyl butyrate, that has no effect on gene transcription. In addition, the lack of SCFA has significant negative consequences on the gut-brain axis. Cortisol build-up: To produce glucose for the brain, cortisol levels increase to breakdown protein to make sufficient glucose via neoglucogenesis. Excess cortisol can lead to insulin resistance that cause regain of some of initially loss body fat. In addition, increased cortisol levels cause a depressed immune system as well as destruction of memory cells in the hippocampus. The initial benefits of following the ketogenic diet result in some initial weight loss (primarily water weight rather than fat loss), long-term studies show no significant differences in overall weight loss. Now new findings show a ketogenic diet may lead to significant adverse health consequences by accelerating the formation of zombie cells. Call me crazy, but I feel the key to longevity and wellness comes down to better metabolic control instead of living in a constant state of ketosis. Following Metabolic Engineering® for a lifetime provides that pathway of losing body fat without ketosis. References 1. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 2006 83:1055-61. 2. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc. 2007 107:1792-1796. 3. Sung-Jen Wei, Joseph R Schell, E Sandra Chocron, Mahboubeh Varmazyad, Guogang Xu, Wan Hsi Chen, Gloria M Martinez, Felix F Dong, Prethish Sreenivas, Rolando Trevino Jr , Haiyan Jiang, Yan Du, Afaf Saliba, Wei Qian, Brandon Lorenzana, Alia Nazarullah, Jenny Chang, Kumar Sharma, Erin Munkácsy, Nobuo Horikoshi, David Gius. Ketogenic diet induces p53-dependent cellular senescence in multiple organs. Sci Adv. 2024 May 17;10(20):eado1463. doi: 10.1126/sciadv.ado1463. 4. Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF Jr. Liver and kidney metabolism during prolonged starvation. J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016. 5. Chriett, S., Dąbek, A., Wojtala, M. et al. Prominent action of butyrate over β-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci Rep 9, 742 (2019). https://doi.org/10.1038/s41598-018-36941-9. 6. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020 Jan 31;11:25. doi: 10.3389/fendo.2020.00025. 

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050824---Tofu-Blog

Tofu: Tips and Recipes Ideas

I have been eating tofu for a very long time, much longer than the 30 or so years I have been following the Zone Diet. Back then many of my favorite recipes came from the Tassajara cookbooks by Edward Espe Brown, the celebrated chef from the kitchen at California’s famous Zen Mountain Center, and cookbooks by Louise Hagler, a.k.a. Wendy Louise, a well-known authority on vegetarian cooking who is associated with a community in Tennessee known as The Farm. Those books are still among the best resources for tofu recipes. My mantra has always been if you don’t like something, don’t eat it. Keep this in mind if you’re new to tofu, start slowly by combining it with flavors and foods you like.    Tips and Suggestions    Firm-sprouted tofu is my preference for the Zone Diet. Unlike traditional tofu, which contains significant amounts of both protein and carbohydrate, sprouted has almost no carbohydrates. It’s lighter tasting, refreshing, and very filling.   Freezing tofu results in a chewy, sponge-like texture. I don’t recommend freezing, but some people prefer it when using tofu to substitute for meat in a recipe.    Baked tofu comes in a variety of flavors and makes an excellent quick meal with some vegetables and fruit added. It’s also great in salads.     Tofu made it into the book “The Top 100 Zone Foods” by Barry Sears.    Some recipes call for draining the tofu first. I find that usually isn’t necessary.   Tofu takes on the flavor of whatever is added to it.    Add nutritional yeast flakes to give a cheesy flavor to vegan tofu scrambles and dips. It’s also rich in protein and vitamin B12.   Cherry Vanilla Tofu “Ice Cream”   Tip: This doesn’t freeze or store well, so prepare only the amount you plan to serve immediately.   Using an immersion blender or a food processor blend equal parts of frozen dark cherries and firm tofu, plus some vanilla extract (preferably alcohol-free for best flavor). Serve immediately.  Tofu Scramble  This is great for breakfast, lunch, or dinner, and we’ve even brought it on long day hikes for a snack.   Crumble some firm tofu and stir in a generous amount of seasonings, taking care not to overdo it with the salt. Heat in a well-seasoned or nonstick skillet with a little Zone-friendly oil to the desired doneness.    Optional: If time allows, sauté some chopped onion in the skillet before adding the tofu and seasonings.    My favorite seasoning combination for this dish at my house is onion powder, garlic powder, turmeric, paprika, some oregano or thyme, nutritional yeast flakes, salt, and ground black pepper. The yellow color of the turmeric makes it somewhat like scrambled eggs.   Tofu Veggie Almond Pasta Salad   Dressing: Thin some smooth almond butter by stirring in some water, a little vinegar, and either soy sauce or Bragg’s Liquid Aminos (an unfermented soy sauce found in the health food section of most grocery stores).    Toss together cooked Dr. Sears’ Zone PastaRx Fusilli, tofu cut into cubes, matchstick cut red bell pepper, chopped green parts of scallions (a.k.a. green onions), and the almond butter dressing. Serve immediately or chill to serve later. It will keep well in the fridge for two or three days.   Use your imagination and see what you can come up with.  Experiment and have fun with it. Try using tofu to make cheesecakes, whipped desserts, tofu chocolate pudding, tofu “cream” based soups, tofu pot pie (think chicken pot pie), tofu burgers, tofu burritos, Buffalo tofu (like Buffalo wings), layered Mediterranean dips, tofu “meatballs”, grilled tofu, and more.    Enjoy! 

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