#i love dietary fiber i love gut health i love fermented food

[luvtxt]

Eating chia seeds is easily the best thing I've started doing for myself this year. 50% of your daily fiber intake in a single tablespoon. Absolutely incredible.

[ketoguy40]

Beef Kielbasa and Kraut: A Perfect Slow-Cooked Comfort Meal

There’s something undeniably comforting about the savory combination of beef kielbasa and kraut, especially when slow-cooked to perfection. This traditional Eastern European dish packs a flavorful punch and offers nutritional benefits, making it both delicious and hearty.

Why Beef Kielbasa and Kraut?

The rich, smoky flavor of beef kielbasa pairs perfectly with the tangy, fermented goodness of sauerkraut. When slow-cooked, the kielbasa absorbs the briny, tart flavor of the kraut, while the kraut takes on a savory richness from the sausage. This cooking method ensures that every bite is tender, flavorful, and well-balanced.

Nutritional Benefits

Beef Kielbasa:

• Protein Powerhouse: Beef kielbasa is a good source of protein, which helps with muscle repair and growth. A typical 2-ounce serving has around 8-10 grams of protein.

• Rich in B Vitamins: Beef kielbasa provides several B vitamins, especially B12, which supports energy levels and brain function.

• Fats: It contains about 12-15 grams of fat per serving, most of which is saturated fat. While it’s calorie-dense, enjoying it in moderation fits into various diets, including keto.

• Calories: Depending on the brand, 2 ounces of beef kielbasa can range between 180-200 calories.

Sauerkraut:

• Low-Calorie and High-Fiber: Sauerkraut is extremely low in calories, with about 27 calories per cup, while being rich in dietary fiber, which helps with digestion and satiety.

• Probiotics: Sauerkraut is a fermented food, meaning it’s packed with probiotics that support gut health and boost the immune system.

• Vitamins and Minerals: Sauerkraut is high in vitamin C and vitamin K, supporting immune health and bone strength. It’s also a good source of iron and manganese.

The Magic of Slow Cooking

When you slow cook beef kielbasa and kraut, the low, steady heat allows the flavors to meld together, creating a deeply satisfying dish. The kraut’s acidity tenderizes the kielbasa, while the natural fats in the sausage enrich the kraut. Cooking it on low for 4-6 hours ensures everything is perfectly melded, and the aroma that fills the kitchen is mouth-watering!

How I Prepare It

I personally love using beef kielbasa in this dish. It brings a heartier, more robust flavor compared to pork or chicken kielbasa. Here’s my go-to method:

1. Ingredients: Beef kielbasa, sauerkraut (I use a 32-ounce jar), a bit of mustard, and caraway seeds.

2. Slow Cooker Prep: Slice the kielbasa into thick rounds, drain the sauerkraut slightly (but leave some juice for flavor), and toss both into the slow cooker. Add a teaspoon of mustard and a sprinkle of caraway seeds for that extra layer of flavor.

3. Cooking Time: Let it cook on low for about 4-6 hours or on high for 2-3 hours.

4. Enjoy: The result is tender, juicy kielbasa with tangy, flavorful kraut that’s perfect for any meal.

A Comforting, Low-Carb Meal

For those following a low-carb or keto lifestyle, this dish is a great choice. Both beef kielbasa and sauerkraut are low in carbs, making it ideal for anyone looking to reduce their carbohydrate intake while still enjoying a filling, tasty meal.

Conclusion

Beef kielbasa and kraut is a comforting, hearty meal that’s easy to prepare and loaded with flavor. Whether you’re enjoying it as a weeknight dinner or serving it for a gathering, this dish will surely impress with its rich, savory taste and health benefits.

Want to see my kielbasa? Just ask me :). No one reads these.

[microbiomeclub-blog]

Why Gut Health IS Mental Health

Healthcare entrepreneurs have something in common. Each one shares a Narrative of a private health scare or concern for a loved one's health that spurred their vision to not only heal themselves, but to set up companies that aim to help others function at their finest.

So what Does this have to do with your stomach and psychological wellness? Within my 90-day journey to recover my health and wellbeing, I interviewed a few of these health care pioneers to help me discover what I needed to do to biohack my body and mind, and my journey started by healing my gut.

Researchers such as Dr. Michael Gershon, a professor of pathology and cell biology and daddy of neurogastroenterology, adamantly believe that we have another brain in our gut. In reality, he says there's bidirectional communication between the gut and the brain. With more than 100 million nerve cells lining our intestinal walls, it is no wonder that when we disrupt the bacteria within this region with antibiotics, poor diet and toxic environment, it creates a neuropsychiatric impact  impacting our disposition and mental wellness.

Suffering From depression, nervousness, fatigue, brain fog, insomnia and intestinal distress, I could not put the pieces together until I interviewed Richard Lin, CEO of microbiome wellness company Thryve Inside. His narrative was very much like mine, and so I had him send me Thryve's easy-to-use home test kit. Thryve then decided my wellness based on several bowel health parameters: just how varied the species of bacteria had been in my gut, the balance of good versus poor bacteria and the way I compared with healthy individuals. I was shocked when my results came . I had been depleted at a bacterium called bacteroides. The latest research has shown patients with depression have significantly fewer bacteroides in their intestine.

Thryve Then gave me dietary recommendations to reduce inflammation, as well as  prescribed me customized probiotics to target my wellbeing goals and DNA results. I felt the difference in days. Probiotics will be the next revolution in healthcare. By initiating healthy strains into my system, my body was able to start healing, which helped strengthen my immune functions. This all leads to a much better metabolic impact within my body's digestive system, making it a much better burning system. A bonus has been also losing a couple of added pounds!

As more intriguing new research Finds that probiotics have a neuropsychological effect on the mind by ameliorating depression and anxiety-like behaviours, it's well worth keeping in mind that these seven signs your gut is affecting your emotional wellbeing.

1. Bloating

When gut Microbiota are overrun by antibiotics, medicines, inadequate diet and stress, gas and bloating are the initial signs your bacteria is out of equilibrium. Overpopulation of specific strains may cause your good bacteria to perish, prompting them to give off gas. Adding whole plant foods, as well as raw fermented foods such as raw sauerkraut or lombucha, can help re-feed your good bacteria.

2. Fatigue

This Symptom is most often overlooked when getting to the root problem of your gut problems. Although Candida albicans are a natural bacterium in our body, as it becomes overpopulated in our intestine, it induces severe symptoms of fatigue. Candida live off of sugar, causing acute cravings. This becomes the perfect storm for the own body to spike in glucose and insulin, then crashing and requiring more sugar for quick energy. Going onto a 30-day Candida diet by ridding your system of simple sugars can assist your gut wracking and cure your good bacteria to repopulate.

3. Irritable Bowels

Over 45 million people Suffer from some degree of irritable bowels, which is exacerbated by the stress it can cause in their daily life. Since Susan McQuillan writes for Pyscom,"There's no doubt that IBS causes patients significant distress and is associated with higher levels of mood disorders, anxiety and other psychiatric ailments. A report on 100 IBS patients found that more than  one-third had contemplated suicide as a result of their symptoms."

She Continues,"Research on probiotic bacteria for those who have IBS centers on various strains of the species called Bifidobacterium and Lactobacillus, both believed crucial to replenishing the gut with good bacteria and restoring a wholesome balance to the microbiota."

4. Sleep Disturbances

What we put in our intestine might affect the quality of sleep we receive. As reported by researchers For Frontiers in Psychiatry,"There is considerable evidence showing that the intestine microbiome not only impacts the metabolic, digestive, and immune purposes but also regulates sleep and mental states through the microbiome-gut-brain axis." Inflammation, emotion and bodily stress may also have an impact on the composition of the gut microorganisms, causing an array of mental disorders to occur. Ensuring your diet has healthy fiber, diverse, plant-based carbohydrates and foods helps strengthen your microbiota.

5. Skin Irritations

Infection  Within our gut causes an increased permeable intestinal wall, which can leak proteins which affect our skin, causing discomforts to emerge (e.g. eczema, psoriasis or rosacea). Now referred to as the gut-skin axis, scientists are learning that general gut health or disturbances reveal themsdelves in the caliber of the skin.

6. Autoimmune Conditions

Although still in its infancy, studies are now indicating The connection between intestinal autoimmune disorders and microbiota imbalance. If you are suffering from any autoimmune condition and also have mental health issues, healing your gut would be overriding.

7. Food Intolerances

This Seems like such an obvious fix, but it took me taking a food allergy evaluation to discover a seemingly innocuous ingredient like Brewer's Yeast was causing me excruciating intestinal distress, brain fog and fatigue. Getting a food allergy or intolerance test can help you figure out if something is impacting your gut that you might not know about. Helping your gut heal by eliminating the offender can help your mental state too.

Remember that requirement is the Mother of invention, and our pioneering health care entrepreneurs are Onto something. They uncovered solutions that gave them enough  Biochemical energy to fuel their brain to give them the capacity to Research a solution.

[vegansoon]

Plant Based Protein Powder List Part 1

(All of the following have close to 5 star ratings when i posted this)

Garden Of Life Sport Organic Plant-Based Protein - BCAA Amino Acid Protein Powder, Chocolate 29.6oz (1lb 14oz / 840g) Powder

ORGANIC SPORT PROTEIN: Certified USDA Organic, Non-GMO Project Verified, NSF Certified for Sport, Informed-Choice for Sport Certified, Vegan, Gluten Free, Dairy Free, Soy Free, No added sugars

POST WORKOUT RECOVERY: Our Garden of Life Vegan Protein helps you refuel & repair muscles after a hard workout with 30g of Complete Protein and over 5g BCAA amino acids, Glutamine & Glutamic Acid

RECOVERY DRINK: This sport protein powder promotes faster recovery with a Organic High Antioxidant Blend of Organic Tart Cherries, Organic Apples, Organic Turmeric, Organic Gogi berries and Organic Blueberries

IMMUNE SYSTEM SUPPORT: This BCAAs amino acids powder contains 2 Billion CFU probiotic blend to keep your immune system strong during training

CERTIFIED CLEAN: Breath easy knowing this vegan amino acids powder is clean and free of any banned substances

Comes in chocolate or vanilla

https://www.amazon.com/Garden-Life-Organic-Plant-Based-Protein

KOS Organic Plant Based Protein Powder – Raw Organic Vegan Protein Blend, 2.6 Pound, 30 Servings (Chocolate or Vanilla)

AMAZING CHOCOLATE FLAVOR: Infused with organic Peruvian cacao, organic Himalayan pink salt, organic coconut milk, a dash of organic stevia and organic monk fruit, this vegan chocolate protein blend is simply delicious!5 

ANILLA FLAVOR: Infused with organic vanilla, organic Himalayan pink salt, organic coconut milk, a dash of organic stevia and organic monk fruit, this vegan vanilla protein blend is simply delicious! 

 PROTEIN BLEND: We incorporate 100% non-GMO Pea, Flax Seed, Quinoa, Pumpkin Seed and Chia Seed Protein into our proprietary formula, all of which are USDA organic, gluten, soy and dairy free.

DIGESTIVE MOJO: Our raw vegan protein powder is composed of healthy fibers and digestive enzymes that help your digestive system run efficiently.SUSTAINABLE ENERGY: Plant based products require less resources than animal products to manufacture, leaving behind a smaller environmental footprint during production. Enjoy a vegan protein shake and make a difference!

ALL NATURAL INGREDIENTS: We are dedicated to bringing you the best quality vegan organic protein powder ingredients. Add 2 scoops to cold water for delicious plant based protein shakes, include in your favorite smoothie, or bake something tasty for a healthy vegan snack.

https://www.amazon.com/KOS-Organic-Plant-Protein-Powder/dp/B076B8F1C6 W7QJG4TY6QF5EJ1WH&qid=1576131406&th=1

OPTIMUM NUTRITION GOLD STANDARD 100% Organic Plant Based Protein Powder, Vanilla, 1.51 Pound

Complete Amino Acid Profile to support muscle recovery

24 grams of complete, organic, plant based protein sourced from a blend of Organic Pea, Organic Rice, and Organic Sacha Inchi proteins

USDA Organic & Non GMO, No artificial flavors, colors or sweeteners Gluten free, all grain complex made with ancient grains Amaranth, Quinoa, Buckwheat, Millet and Chia

Organic Pomegranate Powder

comes in: strawberry orange, unflavored, Vanilla, Watermelon Citrus, https://www.amazon.com/Optimum-Nutrition-Standard-Organic-Servings/dp/B075KGR37C

or:Chocolate + more:https://www.amazon.com/NUTRITION-STANDARD-Complete-Chocolate-Servings/dp/B075KGKM1J 

or strawberry and/or bannana mixes: https://www.amazon.com/Optimum-Nutrition-Standard-Complete-Servings/dp/B07CL72LXX 

Genius Vegan Protein Powder – Plant Based Lean Muscle Building Shake | Best Pea + Pumpkin Protein Sources – Ideal Lean Body Shake for Men & Women – All in One Nutritional Sport Drink (Dairy Free)

BEST TASTING VEGAN PROTEIN ON THE PLANET – We’ve officially cracked the code & delivered a creamy, smooth plant based protein. Thanks to modern science, the gritty chalky profile associated with plant protein will officially be a thing of the past

MAKE FASTER VEGAN GAINS – Plant based muscle building just got a lot easier! By fortifying our nutrition profile with the renown proteina supercharger, Velositol, building quality, lean muscle is now easier than ever

LACTOSE FREE – Our plant protein is 100% clear of all dairy & it’s byproducts (lactose), even if you aren’t following a strict vega diet, it’s become clear that dairy doesn’t have much of a place & replacing whey with elite plant muscle building fuel makes sense

GREAT ANYTIME OF DAY – Whether you choose to use this as a post workout supplement or as a simple meal replacement shake, the nutrition profile touts numerous benefits & you can enjoy it whenever you may need

https://www.amazon.com/Genius-Vegan-Protein-Powder-Nutritional/dp/B07W6KS4QQ/ 

USDA Organic Vegan Protein Powder - Great Tasting Vanilla Flavor W/ 24g of Protein -100% Organic Plant Based Protein Blend of Pea, Hemp, Rice Protein +Chia Seed, Flax Seed -760g - ORGANIC MUSCLE

Chocolate or vanilla:

UPGRADED FORMULA & TASTE: Blend of the Highest Quality, Organic Certified Plant-Based Proteins – Mixes better, tastes better, digest better, and works better!

24 GRAMS OF PROTEIN PER SERVING: Formulated to Build Lean Muscle and Speed Recovery- Fast Absorbing - High in Fiber

CERTIFIED USDA ORGANIC: Non-GMO ~ Vegan ~Gluten Free ~Dairy Free ~ Hormone Free ~ Preservative Free

INGREDIENTS: Organic Pea Protein ~ Organic Rice Protein ~ Organic Hemp Protein ~ Organic Sacha Inchi Protein ~ Organic Chia Seed ~ Organic Quinoa Sprout ~ Organic Jerusalem Artichoke ~ Organic Amaranth Sprout ~ Organic Flaxseed Sprout

COMPLETE PROTEIN: All 9 types of essential Amino Acids | Easy Mixibility and Digestion – Great Tasting Naturally Sweetened Vanilla Flavor

https://www.amazon.com/USDA-Organic-Vegan-Protein-Powder/dp/B01GQPTMSS/ref=sr_1_14?keywords=plant+based+protein&qid=1576131406&sr=8-14

Amazing Grass Organic Vegan Protein & Kale Powder: 20g of Plant Based Protein per serve plus 1 cup of Greens, Chocolate Flavor, 15 Servings

Protein: 20 Grams of complete vegan plant-based protein

Clean: No Stevia & Free from Dairy, Grains & Gluten

Nutrition: 1 Full Serving of Leafy Greens

With a smooth chocolate flavor and satisfying texture, this dynamic duo of protein + greens is a convenient way to get the whole-food nutrition your body needs with an amazing flavor your taste buds will love!

Mix one serving with 12 or more oz. of water, juice, or mixed into your favorite smoothie. Scoop, stir, smile!

comes in 3 other flavors too

https://www.amazon.com/Amazing-Grass-Organic-Protein-Powder/dp/B078H4J14R/ 

Organic Paleo Grain Free Plant Based Protein Powder. Complete Raw Organic Vegan Protein Powder. Amazing Amino Acid Profile and Less Than 1g of Sugar. Hemp Protein Powder, Pea Protein Powder Chocolate

Size: Chocolate

NOT ALL PLANT PROTEINS ARE CREATED EQUAL. Many plant protein supplements on the market are rice based or heavy on grains and just altogether insufficient in their amino acid profile to build lean muscle. Until now. With Peak Performance COMPLETE Organic Plant Protein you can get a diverse blend of plant protein amino acids that are rich in antioxidants, fibers and omega 3’s to promote muscle building + lean muscle tissue and help maintain a healthy immune system.

IMPORTANT - MOST SUPPLEMENTS ARE NOT 3RD PARTY TESTED! This is a dirty secret that many supplement companies don't want you to know that their products are NOT independently 3rd party tested outside of their own facilities. Why? Because it's an extra out of pocket expense to conduct 3rd party testing and most companies will not sacrifice their profit. But NOT us. Peak Performance is committed to the HIGHEST STANDARDS and this product is 3rd party tested to ensure it is 100% SAFE FOR YOU.

WHAT’S IN YOUR PLANT PROTEIN POWDER? Unlike traditional plant protein powders packed with grains and rice (which are the lowest quality of plant protein), we focus on Organic Pea Protein, Organic Hemp Protein, Organic Sacha Inchi, Organic Pumpkin Protein, Organic White Chia Protein, Organic Moringa - all of which contain a diverse blend of muscle building amino acids, antioxidants, fibers, omega 3’s. The Peak Performance Plant Protein mixes well, tastes great and is very digestible.

HIGHEST QUALITY INGREDIENTS WITH NO ARTIFICIAL FLAVORS + LESS THAN 1 GRAM SUGAR. We NEVER use artificial sugars, added sweeteners or refined flour. We ONLY use the highest quality REAL Food ingredients that are Non GMO, Gluten free, easily digestible & gut friendly. Comes in tasty CHOCOLATE and VANILLA flavor.

100% HAPPINESS GUARANTEED. If you don’t absolutely LOVE this protein supplement.. For ANY reason whatsoever, simply send us a message and we will be happy to offer you a fast, prompt refund. NO QUESTIONS ASKED. Made for busy professionals, moms on-the-go, entrepreneurs, and health conscious individuals who want to MENTALLY and PHYSICALLY perform at their highest levels everyday.

https://www.amazon.com/Organic-Protein-Powder-Complete-Chocolate/dp/B07JFMT53V 

Power Plant Protein Powder by PranaOn - Great Tasting Vegan Plant Based Protein Supplement - Non Dairy, Gluten Free, Keto Friendly, Non GMO - Rich Chocolate, 15 Servings

PREMIUM PLANT BASED PROTEIN POWDER OPTIMIZED FOR MUSCLE REPAIRING AND BUILDING — Power Plant Protein’s advanced protein source of organic Pea, Rice and Sacha Ichi is enriched with amino acids, probiotics and natural enzymes to give you a deliciously complete protein formulation to replenish and strengthen your muscles.

HIGHEST QUALITY INGREDIENTS THAT ARE CERTIFIED VEGAN, ORGANIC, ALL NATURAL, NON-GMO, GLUTEN FREE, NON-DAIRY AND KETO FRIENDLY — Optimally formulated with the very best raw, organic, sprouted and fermented proteins to provide you a supplement that fuels your body with proper dietary proteins. Its all natural formula is free from GMOs, gluten, soy, dairy, peanuts, fillers, additives and preservatives for all your vegan diet needs.

GREAT TASTING DAILY WORKOUT DRINK — While most plant based protein supplements taste bland and are gritty in texture, PranaOn’s Power Plant Protein tastes incredibly smooth. The right consistency makes it the ideal drink that keeps your body hydrated- rebuilding and repairing your muscles. Simply add one scoop to water or add fruits, nuts and other ingredients for a delightful and nutritional smoothie.

FAST-ABSORBING FOR MAXIMUM EFFECTIVENESS — Packed with beneficial digestive enzymes and probiotics, Power Plant Protein is crafted to increase the overall bioavailability and assimilation of protein into your body for faster recovery and maximum muscle build-up. No more hours of preparation. The perfect drink while you’re on the go!

ENRICHED WITH BCAA AMINO ACIDS FOR RAPID MUSCLE REPAIR AND GROWTH — Formulated with an optimal ratio of BCAA amino acids to fuel the process of muscle repair and growth (hypertrophy) to help you perform at your best every single day.

comes in 4 other flavors too

https://www.amazon.com/Power-Plant-Protein-Powder-PranaOn/dp/B07TJBNSHD/

Alaya Naturals Organic Plant Based Protein Powder - Vegan Protein Powder with Pea Protein, Hemp Protein, Spirulina - Non-GMO, USDA Organic, Vanilla or chocolate

ORGANIC PLANT-BASED PROTEIN - Treat your body to clean & pure plant protein with absolutely nothing artificial added. Certified USDA Organic, Non-GMO, Dairy-Free, Vegan, Gluten-Free, Soy-Free, & No Added Sugar. Cruelty-Free, Ethically-Sourced, & Sustainable.

FUEL FOR YOUR BODY - 22 grams of plant-based protein, complete with the nine essential amino acids (including branched-chain amino acids) in every serving.

WHOLESOME INGREDIENTS - Our plant-based protein powder is a blend of certified organic pea, hemp, and sprouted brown rice proteins along with a hit of energizing organic spirulina. Added DigeZyme enzyme blend enhances absorption & digestion.

EASY TO PREPARE - Mix with water, milk, or milk alternative for a quick pre or post-workout boost, light breakfast, or a delicious snack.

RISK-FREE - As with all Alaya Naturals products, shop with confidence knowing that your order is always backed by a 100% money-back guarantee if you're not satisfied.

https://www.amazon.com/Alaya-Organic-Plant-Protein-Powder/dp/B07HZ41WGJ/

EarthChimp Plant Based Vegan Protein Powder (26 Servings, 32 Ounces) with Superfoods, Probiotics & Organic Fruit & Veg, No Added Sugar, Gluten Free, Gum Free, Lactose Free, Non GMO (Vanilla or chocolate)

NATURAL TASTE – Not too sweet, not artificial and so balanced even Goldie Locks would find it "just right". That's because we take our time to craft our shakes with botanical ingredients for a natural taste you'll love

NUTRITIONIST RECOMMENDED – Our vegan protein Supershake boasts 20g of vegan protein per serving, Organic Fruits & Veggies, and Superfoods like Baobab, Flax, Turmeric & Cinnamon. In other words, our Irish-Made blend will help you feel as good about your body as we do about the earth.

TUMMY FRIENDLY​ – 1 billion Probiotics, Digestive Enzymes and 4g of fiber per serving will make your tummy happy. Gum-free and Erythritol-free; not to mention no soy, dairy, gluten, GMOs or added sugar in sight will make your tummy even happier. Choose a happy tummy.

VERSATILE – Whether it's a nutritious breakfast smoothie, a grab-and-go shake at work or a post-workout recovery shake... we've got you covered with 20g of complete vegan protein from Organic Plant Proteins

NO NASTIES​ - Nothing that your mother warned you about.... No Sugar Alcohols (Erythritol), No Gums, No Carageenan, No Added Sugar, No Added Salt, No Soya, Dairy Free, Gluten Free, Lactose Free. And it's made in Ireland!

https://www.amazon.com/EarthChimp-Probiotics-Superfoods-Gluten-Free-Plant-Based/dp/B07HCGMWFL

Ripple Vegan, Dairy-Free Protein Powder, Chocolate | 20g Clean, Plant-Based Protein | Perfect for Smoothies, Post Workout Recovery and Meal Replacement

20g plant-based protein per scoop

Zero Sugar

15 servings

Chocolate, Vanilla, Unflavored, or Greens

https://www.amazon.com/Ripple-Dairy-Free-Chocolate-Plant-Based-Replacement/dp/B07WQZ2LKX 

New! Plant Based Protein Powder w 18 SUPERFOODS, Veggies & Probiotics: Kale, Beets, Spirulina & More. Vegan, All BCAA’s, Organic, Non-GMO, Gluten Free (2 Pouches)

*THE ONLY 100% CLEAN PLANT BASED PROTEIN GREENS ON THE MARKET* Our SUPER PURE vegan, vegetarian, unflavored complete plant protein powder contains 18 organic, non-GMO, superfoods, fruits, vegetables & probiotics. It's 100% sugar free, gluten free, lactose free, soy free, with ZERO fillers & additives.

*NO OTHER SUPERGREENS, GREENS POWDER OR GREEN JUICE COMPARES - WE GUARANTEE IT* Read their fine print. You’ll find lab created binders, thickeners, sweeteners, guar gum, lecithin, xanthan, so called “natural flavors”, stevia extracts & more. NOT ONE additive is in PlantVital. The perfect 2 for 1. Both Protein AND Superfoods - Greens Supplement.

*GIVE YOUR BODY THE PUREST PROTEIN & GREENS ON THE MARKET* PlantVital meets the highest 3rd party industry certifications. Our nutrient dense whole foods superfood powder delivers 24g protein, 9.1g essential amino acids, 4.8g BCAA’s, 4.1g glutamic acid, 6mcg B12 (150% daily dose), powerful antioxidants, 1 billion CPU probiotics & 0g sugar.

*YOUR DAILY SUPER GREENS NUTRITIONAL SAFETY NET* PlantVital Complete Plant Based Protein Powder is crafted to be as close to perfect as we can get. 18 ALL NATURAL ingredients work harmoniously to give you maximum benefit. Boost work & gym performance, support lean muscle, reduce stress, improve sleep hygiene, adaptogen support, and aid in cholesterol/blood sugar levels. Also pregnancy safe.

*100% RISK-FREE PURCHASE* We believe deeply in what we’ve created. That’s why we stand behind our gluten free, dairy free vegan, vegetarian green superfood protein powder with a Lifetime Guarantee. If you’re not happy with your purchase, simply call or email.

https://www.amazon.com/Protein-Powder-SUPERFOODS-Veggies-Probiotics/dp/B07YL8PM7J/ 

IMSOALPHA | ALPHA VEGAN | Plant Based Protein With Glutamine & BCAA'S | 2.2 lbs (Natural Vanilla or chocolate)

21 GRAMS OF PROTEIN: Alpha Vegan is a one of a kind protein blend unlike anything on the market. It provides 21 grams of easily digested protein from our ALPHA VEGAN matrix blend without the grainy, bitter taste of the typical plant protein.

HEALTH AND DIGESTIVE BENEFITS: Plant based protein is a whole lot healthier for you because it generally contains lower levels of saturated fat compared to meat or dairy based protein. Plant based proteins contain no hormonal additives and are exponentially easier to digest than meat and dairy.

BCAA’S & GLUTAMINE: Alpha Vegan is a one of a kind protein blend. It contains 6.2 grams of muscle saving BCAA's, and 3.4 grams of muscle repairing glutamine, to ensure you don’t lose any hard-earned muscle.

100% VEGAN AND VEGETARIAN FORMULA: Alpha Vegan contains NO GLUTEN, SOY, DAIRY, OR WHEAT. This non-GMO plant protein is virtually free of artificial flavors, colors, sweeteners & preservatives. This non-GMO plant protein mixes easily & tastes great.

THE ALPHA CHOICE: This is the true bodybuilder’s go-to plant protein. It will provide you with the appropriate amount of essential nutrients. We have added sachi inchi and chia seed for essential omega support.

https://www.amazon.com/IMSOALPHA-Protein-Glutamine-Natural-Vanilla/dp/B01LA0O1AS/ 

Vega Sport Nighttime Rest & Repair US Vanilla Caramel (or Chocolate Strawberry) (15 servings, 14oz) - Vegan Plant-Based Post Workout Fuel with Protein, Melatonin, Magnesium, and Calcium - Non GMO, No Dairy, No Soy, Gluten Free

SLEEP SMART, TRAIN HARD: Take recovery as seriously as training – with Vega Sport Nighttime Rest & Repair.

MELATONIN & MORE: 3mg non-habit-forming melatonin to help you sleep. Magnesium and calcium. 18g plant-based protein to help your muscles repair, plus l-leucine to help promote muscle protein synthesis and repair muscle breakdown while you sleep

DRINK BEFORE BED: Drink 30-60 minutes before bed to set yourself up for tomorrow’s training

0G ADDED SUGAR*: Wind down after a tough session with rewarding new flavors, Chocolate Strawberry and Vanilla Caramel – both with no artificial flavors or sweeteners. *Not a low-calorie food

CERTIFIED: NSF Certified for Sport, vegan certified, Non-GMO Project Verified, and gluten-free. Contents may settle during shipping. Don’t worry, that’s normal. You’re still getting all the servings listed on your product

https://www.amazon.com/Vega-Nighttime-Vanilla-Caramel-servings/dp/B07ZJSDDW3 

[billioncheers]

The Mighty Gut Microbiome: How to Save it? (Part 3)

Till now we have extensively discussed what the need is, and the threats to the Mighty Gut Microbiome. So we are well aware of the role of the gut microbiome in our body. With all the threat lurking around us, let’s discuss how to save gut microbiome. It takes very simple changes in life to correct what we have deteriorated.

11 Changes to Make Gut Microbiome Healthy

For your waning gut microbiome, I bring you 11 simple and easy changes which will boost the good bacteria of the gut microbiome: Start by opening your doors

Let the air in, it’s the simplest change to make. Our building and complexes that we live in are designed in an air-tight manner. Due to this, the ‘bacterial-soup’ gets stagnant like water puddle and starts to stink, i.e., starts to harm us. The simple and small exercise of opening our doors and windows air free air flow helps. Add the fiber crunch

Low-Fiber diets are making us obese, and we know that! But do you know, that fiber is very important for the growth of good gut bacteria. In fact, some fiber acts as prebiotics, which is the only source of food for the good bacteria. By eating a low-fiber diet, we are depriving good bacteria of their food, we are starving them to death. Adding dietary fiber in our diet improves the digestion and feeds the good bacteria, improving the gut microbiome. Organic is the way to life Be more mindful of what you feed your gut. Start by avoiding additives, preservatives, emulsifiers, etc. in short avoid processed food as much as you can. Prefer seasonal foods over cold-stored items. Add more organic, and whole foods instead of canned items. Try not to consume too much of pasteurized dairy. And if you can’t avoid it, try adding probiotic supplements with it. And if you are still not sure where to start, find good cookbooks that contain more gut-friendly recipes. Don’t run away from microbes, eat them

The fact that we cling away from germs is good. But clinging away from good germs is not good. It is healthy to involve good bacteria in your diet. Start by included fermented food, and probiotic foods. You can also follow the new found diet plan if you cannot decide what to eat on your own. This new found diet plan is – “Microbial diet”. And as the name suggests, it includes all the good ways to make your good microbes happy. Do not “Sugar”

Donuts, cakes, pastries, candies, packed fruit juices, and sweet beverages, snack, cereal bars, chocolate bars, and a lot more items I can name, which contains “ever-sweet” sugar. But behind this “ever-sweet” nature, sugar is the deadliest poison available to mankind. It is the number one cause of death today. It causes what not- From weight gain to heart disease, acne to diabetes, cancer to depression, fatty-liver to aging, gout to cavities and drain of energy, every major problem can be linked to sugar. Your gut microbiome also gets badly affected by high-sugar. So to save yourself from such a poison, use its substitute like palm-sugar, maple-syrup, honey, jaggery, stevia, etc. De-stress [caption id="attachment_2471" align="aligncenter" width="700"]

Stress management is not as hard as it might sound to some. Do yoga, meditation, and some relaxation techniques to lower your stress levels.[/caption] Have a sound sleep With all the work, pressure and stress around you, the least you can do for yourself is to sleep peacefully. Have a minimum of 6-8 hours of sound, undisturbed sleep to keep your gut healthy. Do not overuse antibiotics It is not advisable to tell your doctor to not prescribe you antibiotics. It will be highly irresponsible. But what to do is to start using more natural remedies whenever you can for at least mild problems. Pets are your friends

Are you allergic to pets, or scared or something! If not, then you must play with your pets more and let them play outside more. Try not to over clean those dear little creatures. And if you do not have pets, caress the strays one a while. Stop obsessing over hygiene By over obsessing on hygiene, we are killing the good bacteria as well. Hygiene is good, and if you really love a super clean house, switch to natural substitutes of antibacterial cleaning agents. Natural substitutes include white vinegar, borax, baking soda, natural salt, hydrogen peroxide, lemons, etc. Stop being a tree [caption id="attachment_2475" align="aligncenter" width="700"]

Exercise, dance, walk, run, do some yoga[/caption] What is the major difference between plants and animal? Plants cannot move from one place to another, and animals can. But now a day, most of us are becoming trees, not in a literal sense. The “Temporary-Trees”, they move but only when absolutely necessary. And thus their bodies are becoming trunk-like. Stop becoming trees for your own sake. Move your body more. Exercise, dance, walk, run, do some yoga, go for Zumba!! Do all or at least one of it for a minimum of 20 minutes a day. Don’t do cardio or very harsh and extensive form of physical labor. Do mild to moderate exercises. It helps more than you think. Its better safe than sorry! It’s never too late to start, but not when it comes to our health. The gut microbiome could be and should be saved only if you decide to act now. Billion cheers synbiotic are the perfect call of the moment. It contains all the major necessary probiotics and the prebiotic fiber food for the gut microbiome. It not only contains 24 Billion CFU of bacteria, but it is sugar-free as well. It is prepared to have zero calorie count and by a refrigeration free technology. The all-in-one combo for perfect health. Read the full article

[raiseveganus]

Drink Your Way To Health: Fermented Vegan Kanji

Craving for a tangy refreshing drink? Kanji can make you fall in love with it, not just for the savoriness but its amazing health benefits too. Zingy and tart in taste, this pro-biotic rich fermented drink might be an acquired taste for those who want an overall sweet after-taste, however subtle.

With the festival of colors- Holi, just round the corner, Kanji is a must in my house during this time. No family gatherings, dinner or weekend brunches are considered complete without a generous helping of the carrot fermented drink before the meals.

Credits: tsumi466/ Shutterstock

In popular Indian culture, Kanji is also favored for the health benefits it offers. A dark purple-black variety of carrots, accompanied by beet-root, is used in making Kanji which imparts it anti-inflammatory properties that can help prevent diseases and illness. Being rich in anthocyanins, the tangy kanji also make up for an excellent anti-oxidant laden drink. Since it is allowed to ferment under natural conditions, the dark red-hued kanji make up for a gut-friendly drink. Low in calories but rich in nutrients like potassium, manganese, vitamin A, vitamin C, vitamin K and dietary fiber, there isn’t a reason to say no to a cup of Kanji.

Credits: Dheeraj Arora/ shutterstock

You might also like:

Mouth-watering Pumpkin dessert- Vegan Pumpkin Halwa

Delicious Aromatic Vegan Semolina Fudge (Suji Halwa)

Red Kidney Beans Curry- All Things Spicy, Tangy And Savory

Dessert That Melts In Your Mouth- Vegan Gulab Jamun

Drink Your Way To Health: Fermented Vegan Kanji

Kanji is very easy to make vegan. All you need is a ceramic or glass jar to store the kanji and let it sit in the sun to ferment naturally. You won’t need to add yeast or any other artificial fermenting aid. At my house, because of the usually high temperature and direct exposure to sunlight for a major part of the day, it usually takes 2-3 days, for the drink to get ready. In case you live in an area not exposed to direct sunlight, it might take 4-5 days for the drink to get ready. I prefer full-bodied strong aroma, hence I allow it to sit through for 6 days.

Without much ado, let’s get to the recipe.

Ingredients:

3-4 medium sized purple black carrots

1 medium sized beetroot

5 cups of boiled purified water

1.5 teaspoon black salt

1 teaspoon black pepper powder

2 tablespoon dry split mustard seed powder

Instructions for Fermented Vegan Kanji

Rinse and peel the carrots and beetroot.

Slice them into medium thick long pieces.

Boil them in 5 cups of water for around two minutes. Take care not to turn the carrots and beetroot into mushy pulp. They should be 3/4 done.

Mix all the ingredients- water, spices and veggies in a ceramic or glass jar.

Stir with a wooden spoon and allow it to sit under direct sunlight for at least 2-3 days.

If the kanji tastes sour and tangy, it is ready. You can either store it in the refrigerator to prevent further fermenting or let it sit in a cool dark place allowing it to ferment gradually.

You kanji is ready to drink. Enjoy as an appetizer before or after meals. Bon appetit!

Credits: mdsharma/ Shutterstock Fermented Vegan Kanji

Did you like the recipe? Would you like to know more about such fermented pro-biotic rich vegan foods? Let me know in the comments below.

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The post Drink Your Way To Health: Fermented Vegan Kanji appeared first on Raise Vegan.

source https://raisevegan.com/drink-your-way-to-health-fermented-vegan-kanji/

[gethealthy18-blog]

How to Reverse MS Symptoms With the Wahls Protocol

New Post has been published on http://healingawerness.com/news/how-to-reverse-ms-symptoms-with-the-wahls-protocol/

How to Reverse MS Symptoms With the Wahls Protocol

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Are you or a loved one looking for a way to reverse MS or autoimmune disease symptoms? Dr. Terry Wahls is a widely celebrated physician and researcher who was able to turn back the clock on her own progressive multiple sclerosis with lifestyle changes and a specifically tailored Paleo-type diet.

(To hear Dr. Wahls explain her story in person, listen to this Wellness Mama podcast when I had the privilege of interviewing her.)

Her journey started as it does for many of us… searching for answers to the puzzling health problems that can turn our lives upside down.

Dr. Terry Wahls and How She Found a Way to Reverse MS

Dr. Wahls started to experience symptoms of MS while she was in medical school. Her first official diagnosis of relapsing-remitting multiple sclerosis came in 2000.

It started with episodes of facial nerve pain that were ultimately diagnosed as trigeminal neuralgia.

Over the years, these episodes increased in frequency and severity. In 2000, after developing weakness in her left leg, she was diagnosed with relapsing-remitting multiple sclerosis (MS). She went to an internationally recognized MS center, saw the best doctors, and took the newest drugs, costing tens of thousands of dollars each month.

Unfortunately, these efforts did not stop her decline.

By 2003, this former national tae-kwon-do competitor needed a tilt-recline wheelchair. Her illness converted to the progressive phase, secondary progressive MS. Her physicians told her that functions once lost would not return. She agreed to take more potent drugs but continued to worsen.

The future looked grim. Dr. Wahls feared she would end up bedridden and demented, suffering from uncontrollable face pain triggered by light, sounds, touch, speaking, and swallowing. But she had two young children and was a devoted wife, and decided not to give up.

Fighting Her Way Back

Dr. Wahls began reading everything she could find about the science behind MS, ancestral health principles, evolutionary biology, and functional medicine.

Then, she began designing a diet and lifestyle program around those principles. Dr. Wahls had switched from a low-fat vegetarian diet to a Paleo diet four years earlier, giving up all grain and dairy and eating meat again. The Paleo diet did not prevent her from needing a wheelchair, but she continued on thinking it might take years for the change in nutrition to change the course of her disease.

Based on her theories that mitochondrial dysfunction was at the heart of progressive MS symptoms and decline, she began experimenting with a mitochondria-boosting cocktail of vitamins and supplements. Those supplements eased the fatigue and appeared to slow the rate of decline somewhat.

In the summer of 2007, she had her “aha!” moment: what if she redesigned her Paleo diet to focus on getting the specific nutrients she had been taking in supplement form from food?

After intensive research, she started this new, highly structured, modified Paleo diet.

The Results

The results stunned her, her family, and her medical team. Here’s what happened:

Within three months, her fatigue, brain fog and face pain were gone. She began walking with a cane.

After six months on the protocol, she rode her bike around the block.

After one year, she completed an 18.5 mile bike ride with her family.

Dr. Terry Wahls knew she was onto something, and that millions of other MS sufferers needed what she had learned.

What Is Multiple Sclerosis?

What is this dreaded disease that strikes seemingly out of nowhere?

There’s still a long way to go in understanding MS, but it starts with the microglia, the brain’s immune cells, creating inflammation in the brain. This damages the brain and spinal cord.

Immune cells target the myelin, the fatty shield around nerve fibers in the brain, impeding communication between cells in the body and brain. This breakdown results in many debilitating symptoms, including problems with vision, pain, and/or muscle weakness.

Although the precise cause of MS is still unknown, there is increasing recognition that MS is the result of a genetic vulnerability combined with environmental triggers. These triggers likely include an infection that is not properly cleared by the immune cells, low vitamin D level, smoking history, and other environmental toxins, physical activity level, adverse childhood events, hormone levels, and other unknown environmental factors.

Dr. Wahls’ dietary and lifestyle protocol addresses many of these potential triggers.

The Wahls Diet Protocol: Hope for MS Sufferers

I met Dr. Wahls when I happened to sit next to her during a session at a health event we both attended. I found her so energetic and inspirational.

Her work now focuses on researching the impact of the protocol on others with MS and communicating her findings to the world. She conducts clinical trials at the University of Iowa and wrote a book, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles, to explain her complete protocol of how she got better. The advice in this book is great for anyone struggling with an autoimmune disorder of any kind.

The newly updated and expanded version of Dr. Wahls’ book gives detailed guidance for meat eaters, vegetarian, and ketogenic eaters. It’s one of my guides on topics like ketone testing, various approaches to fasting, calorie restriction, and time-restricted eating.

She has also written a cookbook, Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions, with recipes that follow the protocol and can help restore health.

So what’s in her plan to reverse the symptoms of MS and go from barely surviving to thriving again?

Here are the highlights:

Dr. Wahls’ Dietary Protocol to Reverse MS

Mitochondria are the body’s power producers. They are inside each of our cells, driving the work of our cells, organs, and body. So it makes sense that Dr. Wahls pinpoints their role in optimizing brain and immune system health. The basic tenets of her protocol for MS and autoimmune-specific conditions are:

Remove processed foods.

Remove foods that trigger abnormal immune system response, especially these three: gluten (the protein in wheat and many ancient grains), casein (the protein in dairy), and albumin (the protein in egg whites).

Eat 9 cups of vegetables and fruits daily (fresh, blended, or lightly steamed). Specifically:

3 cups of leafy green vegetables (spinach, kale, lettuce, etc.)

3 cups of bright fruits or vegetables, each different colors, and colored all the way through (like beets, blueberries, and carrots) Bananas, apples, and pears do not count.

3 cups of sulfur-rich vegetables like broccoli, cauliflower, onions, and garlic.

Consume bone broth and fermented foods daily.

Eat high quality, wild-caught fish or grass-fed meat for dinner.

I love that Dr. Wahls focuses not so much on removing foods but on consuming nutrient-dense foods that support mitochondria function, which is so important for MS and autoimmune sufferers. Basically her message is: eat veggies, eat veggies, eat MORE veggies!

This protocol can not only help reverse symptoms of MS but can help anyone suffering from chronic disease, leaky gut, fibromyalgia, chronic fatigue, lupus, arthritis, psoriasis, chronic pain, diabetes, traumatic brain injury, depression, PTSD… and the list goes on. Food really is medicine!

Of course, getting support from your medical team is always key when you consider any protocol or dietary changes. Functional medicine practitioners and Wahls Protocol® certified health professionals can also be very helpful. They can assist with assessing your specific health concerns and personalizing the protocol to your unique issues.

Research, Help, and Hope on the Horizon

Dr. Wahls’ research is now receiving attention from the mainstream medical world. In 2016 the National MS Society awarded her a $1 million grant to conduct further research, a very exciting development for MS sufferers and the real food movement in general! You can read her research publications and see before and after videos showing improved walking abilities in study participants here.

More neurologists and neuroscientists are now recommending that all patients with multiple sclerosis begin dietary and lifestyle interventions to protect their brains and reduce the risk of early memory loss and dementia. The recommendations include improving diet quality, stopping smoking and reducing toxin exposures, adding a meditative practice, and increasing physical activity and exercise.

Sounds a lot like what Dr. Wahls recommends! Coincidence? I think not!

If you can’t tell, I am a huge fan of Dr. Wahls. If you want to check her out, take a few minutes to watch Dr. Terry’s viral TEDx talk from 2011. It’s worth the watch!

This article was medically reviewed by Dr. Terry Wahls, a clinical professor of medicine and clinical researcher and has published over 60 peer-reviewed scientific abstracts, posters, and papers. As always, this is not personal medical advice and we recommend that you talk with your doctor.

This article was medically reviewed by Dr. Scott Soerries, MD, Family Physician and Medical Director of SteadyMD. As always, this is not personal medical advice and we recommend that you talk with your doctor.

What do you think of Dr. Wahls’ protocol? Do you struggle with an autoimmune condition or even MS, and have dietary changes helped you? 

Sources: 

Source: https://wellnessmama.com/13357/wahls-protocol/

[poop4u]

FIBER: A Friendly Food for your Dog’s Health

#Poop4U

The post FIBER: A Friendly Food for your Dog’s Health by Diana Laverdure-Dunetz, MS appeared first on Dogster. Copying over entire articles infringes on copyright laws. You may not be aware of it, but all of these articles were assigned, contracted and paid for, so they aren't considered public domain. However, we appreciate that you like the article and would love it if you continued sharing just the first paragraph of an article, then linking out to the rest of the piece on Dogster.com.

And, did you know that our canine companions also benefit from fiber? While there is no recommended daily allowance (RDA) for dogs, getting the right amount — and the right type —  can help keep your dog in tip-top shape. Let’s take a closer look at fiber, its benefits and some fiber-rich foods your dog will enjoy.

©allFOOD | Getty Images

What is fiber?

Fiber is a type of carbohydrate found in the cell walls of plants. Like all carbohydrates, fiber is made up of chains of glucose (sugar) molecules bound together. When we eat carbohydrates, digestive enzymes break down these chains of glucose molecules into simple sugars that are used as energy. Animals and humans lack the digestive enzymes to break down the bonds in fiber, so it passes through the stomach and small intestine largely intact.

Fiber is found in plant foods, including fruits, vegetables, whole grains, nuts, beans and seeds. Refined grains are not a good source of fiber because the bran, the fiber-rich outer layer, has been removed during milling. Animal meat does not contain fiber.

Types of fiber

Fiber is categorized as either soluble or insoluble. Soluble fiber dissolves in liquid. As it travels through the gastrointestinal tract, soluble fiber absorbs water, swelling into a gel-like substance that slows down the digestive process.

Insoluble fiber does not dissolve in liquid and passes through the GI tract largely intact. Insoluble fiber adds bulk to the stool and speeds up the passage of food and waste through the digestive system. Most foods contain a combination of soluble and insoluble fiber, with one type dominating.

Health benefits

Fiber offers a wide variety of health benefits, including:

Controls large-bowel diarrhea (soluble)

Lowers cholesterol by attaching to it in the digestive tract and removing it from the body (soluble)

Manages diabetes mellitus by slowing the absorption of sugar into the bloodstream (soluble)

Optimizes colon health and may reduce the risk of colon cancer (soluble and insoluble)

Promotes optimum weight by providing a low-calorie feeling of fullness (soluble and insoluble)

Reduces constipation and straining (insoluble)

Promotes healthy gut bacteria (soluble fiber)

Which fiber is best?

Both soluble and insoluble fibers offer benefits, so healthy dogs should eat a combination of both types.

At one time or another, most dogs suffer from acute diarrhea. In these situations, adding soluble fiber can help manage the situation by absorbing water in the intestinal tract and slowing down the digestive process. Those of you who have used canned pumpkin to help with occasional bouts of doggie diarrhea have experienced the benefits of soluble fiber.

If your dog suffers from chronic diarrhea, it’s important to determine whether the problem originates in the large intestine (colon) or the small intestine. Large-intestinal diarrhea is shown to benefit from added dietary fiber, but small-intestinal diarrhea is not fiber-responsive.

A dog who races to go outside, has accidents in the house or passes stool with mucus or fresh blood is likely suffering from large intestinal diarrhea. A trip to the veterinarian can confirm the diagnosis and underlying cause.

For dogs suffering from constipation, adding foods higher in insoluble fiber may “get things going” a little easier, as it helps food pass more quickly through the stomach and intestines. Avoid giving insoluble fiber to dogs with diarrhea, as it can act as a natural laxative. Insoluble fiber has also been shown to worsen symptoms in people suffering from IBS.

A note on fiber and poop

When I work with clients to incorporate more fiber-rich foods into their dog’s diet, by far the most common question I receive concerns the increased volume of the dog’s stools.

Proper elimination and stool volume help maintain healthy anal glands, but that’s not the only benefit. Dead bacteria and other undesirable substances make up a large portion of the stool’s dry matter. Larger stools that occur when fiber is initially increased can be a sign of detoxification.

So, don’t be concerned if adding fiber-rich foods increases your dog’s stool volume. As long as everything else looks good, this is a normal change. Just go slowly and give his digestive system time to adjust, especially if he currently eats a low-fiber diet high in animal ingredients.

There’s a whole world of healthy, fiber-rich foods your dog will enjoy — just check with your veterinarian before giving your dog new foods.

Focus on FODMAPS

Certain fibers are high in FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), carbohydrates that pass through the small intestine and serve as “food” for the good bacteria in the large intestine (colon). As the bacteria in the colon digest these fibers, rapid fermentation takes place. This fermentation process offers many health benefits, including increasing the number of beneficial bacteria in the colon; however, it can also create gas, bloating, diarrhea, stomach pain, cramping and other symptoms in individuals suffering from IBS (irritable bowel syndrome), GERD (gastrointestinal reflux disease) and similar gastrointestinal conditions. It may be necessary to temporarily eliminate high-FODMAP foods for dogs suffering from these conditions and then slowly reintroducing them when symptoms subside to determine which ones are problematic.

To learn more about FODMAPS, visit monashfodmap.com.

Editor’s note: This article first appeared in Dogster magazine. Have you seen the new Dogster print magazine in stores? Or in the waiting room of your vet’s office? Subscribe now to get Dogster magazine delivered straight to you!

Tell us: What supplements or superfoods for dogs are you a fan of?

Thumbnail: Photography ©chendongshan | Thinkstock.

Read more about dog food and dog nutrition on Dogster.com: 

Could Grain-Free Diets Cause Issues for Dogs?

Can Dogs Eat Mushrooms? What to Know About Dogs and Mushrooms

What to Feed a Dog With Diarrhea or Other Stomach Issues

The post FIBER: A Friendly Food for your Dog’s Health by Diana Laverdure-Dunetz, MS appeared first on Dogster. Copying over entire articles infringes on copyright laws. You may not be aware of it, but all of these articles were assigned, contracted and paid for, so they aren't considered public domain. However, we appreciate that you like the article and would love it if you continued sharing just the first paragraph of an article, then linking out to the rest of the piece on Dogster.com.

Poop4U Blog via www.Poop4U.com Diana Laverdure-Dunetz, MS, Khareem Sudlow

[weightlos6]

Paleo, Resistant Starch, and TMAO: New Study Warning Worth Heeding

Paleo, Resistant Starch, and TMAO: New Study Warning Worth Heeding:

SCIENCE SIMPLIFIED:

A human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and production of TMAO, which is linked to cardiovascular disease and some forms of cancer.

The study demonstrates that a low-carb Paleo diet increases TMAO, attributable to a decrease in probiotic bacteria from the Bifidobacterium and Roseburia genera and an increase in Hungatella species in the gut.

The dietary factors most strongly associated with the undesirable gut microbiome shift and TMAO production were total carbohydrate intake and resistant starch intake.

While the authors conclude that lack of grains are to blame, the study participants were eating mostly non-starchy vegetables (about 7 servings per day, averaging 28 grams of fiber but only 90 grams of total carbohydrates).  Starchy roots and tubers are a healthy alternative to grains and would have increased the participant’s total carbohydrate intake (all slow-burning nutrient-dense carbs) as well as resistant starch intake.

The results of this study are relevant to our community and offer a stern warning against long-term low-carb implementations of the Paleo diet.

RELATED READING:

What Is the Gut Microbiome? And Why Should We Care About It?

The Case for More Carbs: Insulin’s Non-Metabolic Roles in the Human Body

Why Root Veggies Are Great for the Gut Microbiome

Whenever a new Paleo study comes out, it’s sure to stir up controversy—no matter what the findings are. “Good” findings are met with cheers from the Paleo community, while “bad” findings tend to explode in media headlines and send the Paleo community rushing to find reasons the study is poorly conducted, inaccurate, or otherwise worth dismissing.

As you know, I don’t believe in dismissing scientific findings (except for the rare occasion where flaws in how the study was designed or conducted result in retraction).  Instead, I seek to understand the data in the context of the research field as a whole, seeking context and nuance while being open to adjusting my conclusions and recommendations. (I discuss the merits of different types of scientific studies as well as the problem with cherry-picking data in my Introduction to Nutritional Sciences online course.)

Recently, a human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and TMAO.  And, the headlines (both mainstream media and outlets targeting physicians) have not been flattering, for example: “Paleo Diet Increases Risk for Heart Disease”, “Paleo Diet Study Links ‘Caveman’ Regime to Heart Disease Biomarker”, and “Study Linking Paleo Diet to Increased Heart Disease Risk Strengthens Diet Industry Concerns”.

As you’re probably aware by now, I’m all about the gut microbiome, and believe it will continue to prove itself as a massive missing piece in our health puzzle! For that reason, this study is particularly interesting and important to look at (and not dismiss!).

Before we dive into the study itself, let’s review the things we need to know to make sense of the findings!

A Refresher on Fiber, Resistant Starch, and the Microbiome

The gut is a biological niche, home to a diverse array of microbes that influence nearly all aspects of human biology through their interactions with our bodies. We have a symbiotic relationship with these microbes, collectively referred to as our gut microbiome—in exchange for food and shelter, they contribute to our wellbeing by performing diverse functions essential to our health.

When we don’t have a healthy diversity of the right kinds of microbes in our gut, our entire body suffers. An unfavorable gut microbiome has been linked to conditions as wide-ranging as cancer, obesity and other metabolic problems, heart disease, anxiety, depression, autism, autoimmunity, ulcers, IBD, liver disease, systemic infections, and more.  See What Is the Gut Microbiome? And Why Should We Care About It?.

I’m writing a book on the gut microbiome, so I could expound for days, but let’s focus on a few specifics that are particularly important to understanding this new paper.

Fiber Is Food for Our Gut Microbiome

If there’s one thing our gut microbes love, it’s fiber. In fact, out of all the dietary factors that can impact the gut, fiber may be the most important.

Carbohydrates, including fiber, are chains of monosaccharides (simple sugars) and of chemical derivatives of monosaccharides. Both the types of simple sugar (and their derivatives) in the chain and the ways they link together to form chains (both overall structure and the types of chemical bonds between sugar molecules) determine what type of carbohydrate it is. What separates fiber from other carbohydrates is that the way the sugars link together are not compatible with our digestive enzymes; our bodies just aren’t capable of breaking apart those types of molecular bonds. Instead, fiber passes through the digestive tract mainly intact. And once it reaches the colon, the magic begins: fiber serves as a substrate (food) for a wide range of bacteria, including some of the most important species we can harbor!

Why Different Fiber Types Feed Different Bacteria

The bacteria that live in our guts are collectively capable of producing over ten thousand different enzymes that can break down complex carbohydrates like fiber, which is pretty remarkable when you consider that we only produce about 17 different enzymes that digest carbohydrates! These enzymes belong to at least 206 different families of CAZymes (which stands for “Carbohydrate-Active enZymes”). Enzymes are typically highly specialized, breaking apart only specific molecular bonds, which is why different types of carbohydrates require different enzymes to break them apart (and why we can’t digest fiber but our gut bacteria can).

When it comes to carbohydrate degradation, some bacteria are highly specialized, producing only a few dozen CAZymes, whereas others are multitaskers, producing hundreds of CAZymes which allows them to grow on a variety of substrates and adapt to changing nutritional circumstances, thereby giving them a competitive advantage in the gut ecosystem.

Bacteria from the Bacteroides genus in general tend to be multitaskers, producing enzymes that can break down starch, pectin, hemicelluloses, and other plant carbohydrates (galactomannan, arabinogalactan, alginate, laminarin and xylans xyloglucan, rhamnogalacturonans I and II, β-glucans and glucomannan, to name a few!). Bacteroides thetaiotaomicron is an example of multitasker, considered a diet insensitive strain thanks to its ability to produce around 400 CAZymes (at least 260 of which are glycoside hydrolases) that help it thrive on pectins as well as complex carbohydrates that are produced by our own intestinal cells, such as mucin (a glycoprotein that is a major component of mucus).

In contrast, Bifidobacterium species are more specialized, producing an average of 45 CAZymes that make them highly effective at degrading high amylose starches, including resistant starch, as well as fructooligosaccharides, galactooligosaccharides, and inulin fiber. The critical consequence is that Bifidobacterium don’t survive if our diet doesn’t include sufficient amounts of these starches and fiber types.

Importance of Fiber Variety in the Diet

One of the consequences of this diversity in CAZyme production by various resident microbes is that different fermentable carbohydrates support different species in the gut. Therefore, consuming a variety of dietary fibers—various cellulose, hemicellulose, pectins, gums, fructans, glucans, mucilage, chitin, chitosan, and resistant starch fiber—best supports a diverse microbial community compared to a diet comprised of less varied fermentable carbohydrates like the Standard American Diet which is rich in refined carbohydrates.

Which foods are rich in which fiber sources?

Cellulose is found in all plants, but foods that contain particularly large amounts of cellulose include bran, legumes, nuts, peas, root vegetables, celery, broccoli, peppers, cabbage and other substantial leafy greens like collards, and apple skins. See The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

Hemicellulose is particularly high in bran, nuts, legumes, and whole grains, as well as many green and leafy vegetables.

Pectin is found in all fruits and vegetables but are particularly rich in certain fruits, including apples and citrus fruits, and are also found in legumes and nuts. See Why Fruit is a Good Source of Carbohydrates

Lignin is most commonly a component of wood, but food sources include root vegetables, vegetable filaments (like the stems of leafy greens and the strings in celery), many green, leafy vegetables, wheat, and the edible seeds of fruit (such as berry seeds and kiwi seeds). See Polyphenols: Magic Bullet or Health Hype?

Chitin is found not only in plants and fungi but also in the exoskeletons of insects and in the shells of crustaceans. See Elevating Mushrooms to Food Group Status and Why Crickets Are Great for the Gut Microbiome.

Chitosan is naturally found in the cell walls of fungi but are also produced as a functional fiber by treating shrimp and other crustacean shells with sodium hydroxide. See Elevating Mushrooms to Food Group Status.

Beta-glucans are found in some grains (mainly oats and barley, but also rye and wheat), fungi (yeast and mushrooms, particularly those mushrooms that are used medicinally like shiitake and maitake), and some types of seaweed (mainly algae). Beta-glucans are the fiber in oats that are largely responsible for their unique health benefits among grains. See Why Seaweed is Amazing! and Elevating Mushrooms to Food Group Status.

Fructans are naturally occurring in a variety of plants and are particularly high in chicory, Jerusalem artichoke and alliums (the onion family). Cruciferous vegetables contain modest amounts of fructans. See What about the Goitrogens in Cruciferous Veggies?.

Gums are a diverse group of fibers that plants secrete when they are damaged. Isolated versions are used in food manufacturing as thickening and gelling agents (like guar gum and xanthum gum). See Is It Paleo? Guar Gum, Xanthan Gum and Lecithin, Oh My!.

Mucilages are particularly concentrated in cacti and other succulents (like aloe), many types of seaweed (like agar agar algae), flax, chia and psyllium. They can also be found in relatively large amounts in a variety of fruits and vegetables, including plantains, bananas, taro root, cassava, and berries. See Mucilaginous Fiber: The Good, the Bad, and the Gooey and The Verdict on Psyllium Husks: Not Paleo!.

Resistant starch is divided into four subgroups: RS1 is rich in grains, legumes, and seeds; RS2 is found in most roots and tubers, and particularly high in green bananas, green plantains, and raw potatoes; RS3 is rich in cooked and cooled roots and tubers, particularly potatoes, as well as cooked and cooled rice; RS4 is the product of enzymatically or chemically modified starches sold under various brand names. See also Resistant Starch: It’s Not All Sunshine and Roses.

Because of their varying fiber types (and other food compounds that influence gut microbial composition like micronutrients, phytochemicals, proteins and fats), different families of fruits and vegetables are independently beneficial for the gut microbiome.  See also The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

That means that beyond aiming for 8+ servings of fresh vegetables and fruits daily (see also The Importance of Vegetables), it’s important to hit as many of the different families of vegetables and fruits each day, ideally cycling through all of them every two days: cruciferous vegetables, leafy vegetables, roots and tubers, mushrooms, alliums, apple family, citrus, berries, nuts and seeds, etc.

Resistant Starch-Rich Foods as Microbiome Superfoods

Resistant starch is classified as a fiber because amylase, the enzyme that breaks starch into individual glucose units, doesn’t work on this type of starch.

Resistant starch is insoluble yet highly fermentable, and is divided into four subgroups: RS1, which is physically inaccessible due to being bound within cell walls; RS2, which is tightly packed ungelatinized granules found in certain raw starchy foods; RS3 (retrograded amylose), which is formed when certain starchy foods are cooked and then cooled down; and RS4, which is formed via a manmade chemical process. See also Resistant Starch: It’s Not All Sunshine and Roses

In general, resistant starch is famous for feeding short-chain-fatty-acid-producing bacteria and enhancing levels of butyric acid. In a human study, RS2 was shown to increase the abundance of Ruminococcus bromii and Eubacterium rectale, whereas RS4 increased Bifidobacterium adolescentis and Parabacteroides distasonis. Long-term feeding of RS1 and RS2 in rats showed that both types increased the abundance of anaerobes, the levels of Bifidobacteria, and total SCFAs in the cecum; meanwhile, RS2 (but not RS1) enhanced levels of Lactobacillus, Streptococci, and Enterobacteria. In pigs, RS3 has been shown to increase the abundance of Faecalibacterium prausnitzii while reducing levels of E. coli and Pseudomonas species. Interestingly, Ruminococcus bromii plays a keystone role in the degradation of resistant starch, releasing breakdown products that are then utilized by other microbes in the gut.

Two Important Probiotic Bacteria: Bifidobacteria and Roseburia

Hundreds of beneficial probiotic species of bacteria (as well as fungi like yeast and archaea, which we’ll come back to) have been well studied in terms of their roles in the gut microbiome and human health in general.  I want to focus in on two genera of bacteria that are particularly relevant to this new paper.

The Bifidobacteria genus exerts a range of beneficial effects on human health, including producing vitamins, inhibiting pathogens from colonizing or infecting the gut mucosa, helping regulate the microbiome’s homeostasis, modulating local and systemic immune responses, repressing potentially carcinogenic enzymatic activities among different bacteria, and facilitating the bioconversion of various dietary compounds into bioactive forms. In a variety of studies, Bifidobacteria have been shown to improve the gut barrier function, suppress E. coli, improve glucose tolerance, reduce low-grade inflammation, and reduce endotoxemia induced by high-fat diets. As another benefit, because Bifidobacteria produce lactic acid instead of gas, people with higher levels tend to have less flatulence and digestive problems!

There are 39 identified species of Bifidobacteria, which represent 3-6% of health adult fecal flora.  Their favorite foods are resistant starch 2, resistant starch 4, oligosaccharides from plants and milk, and hexose.

Let me emphasize: Bifidobacterium are critically important to human health.  If you see an argument dismissing this paper because somehow low-carb diets or low-carb Paleo benefits make up for missing Bifidobacteria, that is unequivocally false.

The Roseburia genus are butyrate-producing bacteria that are implicated in maintaining gut barrier health and immune regulation, with strong anti-inflammatory properties.  Reduced levels of Roseburia are associated with inflammatory bowel disease (Roseburia actually suppress the pathogenesis of Crohn’s disease), irritable bowel syndrome, obesity, type 2 diabetes, cardiovascular disease, neurological diseases, autoimmune disease, asthma and allergies—likely mediated through higher intestinal permeability and inflammation.

There are five known species of Roseburia (R. intestinalis, R. hominis, R. inulinivorans, R. faecis and R. cecicola) and their favorite foods are beta-glucans, fructans, pectin and resistant starch.

The Deal with TMAO

So, where does TMAO fit into the microbiome?

In recent years, trimethylamine-N-oxide (TMAO) has emerged as a possible new risk factor for cardiovascular disease, with potential to other conditions as well (such as chronic kidney disease, chronic heart failure, and colorectal cancer). For instance, a meta-analysis using 11 prospective studies found that higher circulating levels of TMAO were associated with a 23% increased risk of cardiovascular events and a 55% increased risk of all-cause mortality. This little molecule gets produced from the microbial metabolism of choline, lecithin, and carnitine (from our diet) into trimethylamine (TMA), which the liver then oxidizes into TMAO. Once it’s in our bodies, TMAO gets transported to different tissues and can potentially accumulate.

However, our levels of TMAO aren’t just a matter of how much free TMAO or TMAO precursors we ingest! Gut bacteria, especially the genus Prevotella, is a key mediator between diet and the amount of TMAO in our blood. In one study, researchers found that participants with gut microbiomes dominated by Prevotella were the ones who produced the most TMA (and therefore TMAO, after it reached the liver) from the carnitine they consumed. Those with microbiomes high in Bacteroides rather than Prevotella saw dramatically less conversion to TMA and TMAO.

So far, the list of TMAO-producing bacteria also includes multiple Clostridium species, Desulfovibrio desulfuricans, Providencia rettgeri, Edwardsiella targa, Escherichia fergusonii, Anaerococcus hydrogenalis, Proteus penneri, Firmicutes, and Proteobacteria. In other words, we can’t look at TMAO without also looking at the composition of our gut microbiota!

TMAO: Symptom or Cause of Heart Disease?

Despite some compelling associations with disease and mortality, there’s still a lot of controversy over whether TMAO has a causal relationship with the conditions it’s been associated with. On one hand, we have identified some plausible mechanisms for its role in disease, especially heart disease. For example, TMAO appears to increase the number of scavenger receptors in macrophages, resulting in greater binding to LDL particles and subsequent foam cell formation (foam cells play a major role in the progression of atherosclerotic plaque buildup!). TMAO also interferes with sterol transportation and bile acid metabolism, which can further contribute to the development of heart disease. And, TMAO may increase platelet activity, which can raise the risk of thrombosis by promoting excessive coagulation in the blood.

But despite these possible mechanisms, the literature is still mixed when it comes to how elevated TMAO plays out in real life! Along with studies showing a link between high TMAO levels and disease or mortality, many studies have failed to find any predictive value for TMAO on cardiovascular events, chronic kidney disease, or heart failure.

It’s possible that high TMAO occurs as a result of some of these diseases, rather than as a causative factor (high TMAO makes sense in the case of kidney failure, for instance, because the kidneys are the major site of circulating TMAO clearance, and their compromised function would naturally lead to a buildup of TMAO).

It’s also very possible that gut microbiota compositions that contribute to chronic disease also happen to result in more TMA and TMAO production, making TMAO a marker for disease states rather than a causal risk factor. Overall, the jury’s still out!

The Fish Paradox

One of the major monkey wrenches in the whole TMAO story is a fishy one (pun intended). Seafood—famously considered heart-healthy—is one of the most abundant sources of free TMAO, and also contains TMAO precursors. And we’d be hard pressed to find a study that shows seafood is bad for our cardiovascular health (indeed, the vast majority of research shows that fish is one of the best things we can eat for our hearts!). Physiologically, TMAO helps fish survive in their marine environments by increasing buoyancy, acting as a form of antifreeze (by increasing osmotic concentration), and protecting tissue proteins against destabilizing forces. The degradation of TMAO into TMA is also what gives seafood its characteristic fishy odor! TMAO levels can vary dramatically between different species of fish (and even vary within the same species depending on the season), but in general, deep-sea fish and shellfish tend to be higher in TMAO than shallow water fish and shellfish, likely because of the role TMAO plays in protecting against pressure-induced protein damage.

Research has shown that following the consumption of seafood, blood levels of TMAO levels rise to significantly higher levels than after the consumption of beef or eggs. In one study, 40 participants were fed meals containing cod fish, eggs, beef, or a fruit control in random order, with week-long washout periods between each intervention. After the fish meal, participants’ plasma TMAO rose up to 62 times higher than after the beef, eggs, or fruit meals. These levels peaked at 2 hours post-meal and remained elevated for the remainder of the 6-hour study period. The rise in TMAO levels started within 15 minutes following fish consumption, indicating the TMAO was being directly absorbed rather than undergoing conversion in the gut by bacteria. This same study found dramatic variations in TMAO response after eating eggs or beef. Compared to baseline, TMAO levels ranged anywhere from a 30% decrease to a 270% increase!

Food vs. Microbiome Sources of TMAO

So, why would we see such extreme variations in TMAO levels after eating the same foods? The answer is, not surprisingly, bacteria! Stool analysis showed that compared to low TMAO producers, high TMAO producers had some important microbiota differences, including lower alpha-diversity, different species compositions, and a higher ratio of Firmicutes to Bacteroidetes (about 2:1, versus a 1:1 ratio for the low producers). And very importantly, as we’ll see in a moment, the Archaea phylum was completely absent in the microbiota of the high TMAO producers, but was represented among the low TMAO producers.

This study provided some important pieces for the TMAO puzzle. Along with demonstrating that fish (at least in the form of cod) yields vastly higher levels of TMAO and TMAO metabolites than beef or eggs, the study demonstrated that TMAO can be absorbed intact from foods like fish without involvement of the gut microbiota. That means that the level of TMAO we have in our bodies isn’t just a result of our gut microbiota churning it out from precursors, but can also be influenced by the direct consumption of TMAO from food. And, that could mean that high circulating TMAO from seafood potentially indicates a much different (AKA lower!) risk profile than high TMAO produced by disease-associated microbes.

So, as much as is still up in the air about TMAO, one thing seems pretty likely: we don’t want a gut microbiome that produces a lot of it. Whether or not TMAO itself turns out to be a major risk factor or just a red herring, and whether or not our circulating levels are a cause or consequence of specific health conditions, a high-TMAO-generating microbiota seems to be consistent with greater disease risk.

Archaea: A Microbiome Missing Piece

Whenever we hear about the microbiota, it’s usually all about the bacteria, bacteria, and more bacteria! But, while bacteria might be numerically dominant among the microbes in our gut, they’re definitely not the only residents there. Another type of single-celled organism that call our GI tracts home are archaea. And, these little guys are incredibly important!

Archaea (sometimes called archaebacteria) are strict anaerobes that live in various mucosal sites throughout the body, including the intestinal mucosa. We aren’t born with archaea inside us, but we acquire them from the environment throughout life: by the time children are school-aged, archaea are almost universally present in the gut, and levels continue to increase with age (with the highest occurrence and diversity of archaea being found in older adults). Along with lacking lipopolysaccharide (meaning archaea won’t contribute to our endotoxin load), archaea is also the only domain of life that doesn’t include any known pathogens, which is pretty cool!

Archaea degrade TMA and TMAO

One important subtype of archaea are the methanogens, which produce methane gas as a byproduct of hydrogen reduction. Up to 95% of human guts harbor the methanogenic archaea Methanobrevibacter smithii and Methanosphaera stadtmanae, at varying levels. While the idea of producing methane might not sound very pleasant, some of these archaea (in particular, an order of methanogens called the Methanomassiliicoccales) actually play an integral role in reducing our TMAO production. Along with being able to use carbon dioxide, formate, and methanol (all released by bacteria breaking down food and other organic matter in the gut), these archaea can use methyl compounds like TMA and TMAO to generate methane. And that means that the archaea in our gut actually deplete the pool of TMA we have available to be converted into TMAO (along with any free TMAO from foods like seafood). So, all that TMA generated by Prevotella, or entering our body from fish consumption? Archaea can help wipe some of it out!

The TMAO-reducing effects of archaea is far from just speculative, too. In a study of ELDERMET subjects, the fecal TMA concentration in people with TMA-metabolizing archaea was significantly lower than in those without this archaea—and the difference was particularly dramatic when the abundance of Methanomassiliicoccales was greater than 10^8 cells per gram of stool. This role of archaea is so exciting that some scientists are proposing a new class of probiotics called archaeabiotics, which could help reduce our TMAO levels without us needing to cut back on choline and other important nutrients!

Importantly, methanogenic archaea have an important interactive relationship with bacteria in the gut, which often takes the form of what scientists call syntrophy (where two organisms participate in consuming a substance that neither one can catabolize on its own). And, it appears that archaea are particularly chummy with the important probiotic bacteria Bifidobacteria. For example, mixed cultures of M. smithii and Bifidobacteria bifidum have been shown to collectively produce methane from glucose, and in females with gut Methanobacteriales levels higher than 0.71%, there’s a significantly higher mean abundance of Bifidobacteriaceae. And as we’ve already seen, healthy levels of Bifidobacteria are super important!

Archaea Thrive When We Eat Carbs!

So, how do we keep our archaea happy and thriving? Scientists are just at the beginning stages of understanding how diet impacts our archaea colonies (after all, archaea are relative newcomers to the microbiota research scene compared to bacteria!), but here’s what we know so far. In children, organic dairy (especially organic yogurt and organic milk) has been associated with the initial colonization of M. smithii, due to organic dairy serving as a vehicle for delivering it to our guts. And, some methanogens degrade methanol, which gets produced when bacteria degrade pectin in fruits—thus suggesting that archaea might benefit from including fruit in our diets! In Chinese goats, eating a high-grain diet appears to suppress methanogenic archaea relative to a high-hay diet—possibly due to the pH-lowering effect of grains in the rumen (which can then suppress methanogenic archaea that are sensitive to low pH environments). Obviously, we’re not Chinese goats, but it would certainly be interesting if a high-grain diet in humans had a similar effect!

More broadly, though, in humans, Methanobrevibacter abundance is positively associated with higher carbohydrate consumption (both recent and long-term), and negatively associated with recent consumption of fat (especially vegetable fat and polyunsaturated fat intake) and amino acids. Although more research is definitely needed, the picture getting painted so far is that archaea benefit from a variety of plant polysaccharides, and not so much from animal-based diets.

However, this isn’t because the archaea themselves eat carbohydrate. In fact, methanogenic archaea have an almost complete lack of enzymes for breaking down complex carbohydrates into simple sugars. What does appear to be happening is that archaea thrive off the metabolic products of carbohydrate-loving bacteria, and therefore are still dependent on dietary carbohydrate for their own survival!

The Study: Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations

Whew! Now that we’ve covered the necessary background, let’s take a look at what this study is all about!

Researchers recruited a total of 44 participants who self-reported following a Paleo diet for over a year, along with 47 controls who more or less followed the national dietary recommendations of Australia (where the study was conducted). Within the Paleo group, participants were further divided based on how strictly they followed the Paleo framework (as gauged by the exclusion of grain and dairy products): 22 people fell into the “strict Paleo” group (less than one serving of grains and/or dairy per day), and 22 people fell into the “pseudo-Paleo” group (more than one serving of grains and/or dairy per day). (This is important, because “real-world” Paleo includes a variety of interpretations about what Paleo actually means, including how strictly to adhere to the diet—so a pseudo-Paleo group might be closer to reality for a lot of people!)

The study excluded anyone who’d taken antibiotics within the past six months, who had any type of GI tract surgery, who had past or present digestive disorders, who used cholesterol or blood pressure lowering medications, or who had been diagnosed with cardiovascular disease. This helped make sure the results weren’t confounded by preexisting health conditions or drugs, and allowed the researchers to better isolate the effects of the participants’ diets.

To ensure accurate dietary data, the researchers had participants undergo three-day weighed diet records (including two weekdays and one weekend day), which were then validated using urine nitrogen tests (which could detect whether participants were over- or under-reporting their protein intake) and the Goldberg cut point (which can identify which participants were under-reporting their energy intake, through the ratio of energy intake to basal metabolic rate). Participants who appeared to inaccurately report both their protein and energy intake were deemed unreliable dietary reporters (this ended up being two people from the strict Paleo group and three people from the control group).

Paleo Diet Adherents Had Increased TMAO

Now, the headline-grabbing finding. In the strict Paleo group, serum TMAO was a whopping 9.53 µM, the pseudo-Paleo group averaged 5.47 µM, and the control group averaged 3.93 µM. Higher TMAO levels were associated positively with red meat intake and negatively with grain intake.

Whether TMAO is a causative agent for disease or a marker for a disease-associated microbiota, those are some scary numbers—especially for the strict Paleo group!

What Study Participants Were Actually Eating

So, what were the Paleo groups actually eating? Here’s what the data showed!

Not surprisingly, both Paleo groups ate more protein than the controls (118 and 102.7 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 92 grams for the controls), less carbohydrate (99 and 81.4 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 202.6 grams for the controls), less sugar (51.8 and 44 grams per day for the Paleo groups, and 75.6 grams for the controls), and more fat—with the increase mostly coming from saturated and monounsaturated forms (117.9 total fat grams per day for the strict Paleo group, 133.1 grams for the pseudo-Paleo group, and 82.5 grams for the controls).

Importantly, total dietary fiber was adequate (and very similar!) for both the control group and the strict Paleo group—29.7 grams and 27.4 grams daily, respectively, which falls within the recommended daily intake of 25-30 grams for adults. The pseudo-Paleo group averaged 20.8 grams of fiber each day, which is still more than most people consume! For the Paleo groups, much of their fiber came from vegetables, with the strict Paleo group eating 6.7 servings of veggies per day and the pseudo-Paleo group averaging 4.3, compared to the control group’s 3.93. (We could definitely argue that the official recommendations for fiber are still too low for optimal health, but the point here is, these study participants weren’t slacking on the non-starchy veggies!)

While the control group averaged 4.5 – 14.2 grams of resistant starch per day, largely from grains (those are estimated minimum and maximum amounts, since the same foods can vary in resistant starch content), the strict Paleo group averaged only 2.6 – 6.1 grams per day, and the pseudo-Paleo group got a mere 1.3 – 2.9 grams of resistant starch. That’s a significant drop off!

Low-Carb Paleo Effects on the Microbiome

Remember that one of the favorite foods of Bifidobacteria is resistant starch? And that Roseburia also likes to munch on carbohydrates like beta-glucans? Maybe we shouldn’t be surprised that this study showed a significant decrease in these important bacteria among both Paleo groups.

Likewise, the relative abundance of Hungatella was significantly higher among the Paleo subjects. After adjusting for age, gender, stool frequency, and body fat, Hungatella abundance was significantly negatively associated with grain intake among the study’s participants, and was also significantly negatively correlated with Bifidobacteria and Roseburia abundance. Although we don’t have a lot of information about Hungatella in relation to human health (not yet, anyway!), we do know that some species originating from the genus Hungatella are associated with choline consumption and TMA production, including at least one species identified in this study. The researchers speculated that some components of grains and/or whole grains either interfere with Hungatella’s TMA production or prevent it from dominating in the gut. And, these components might not be resistant starch, since neither Hungatella nor TMAO was significantly associated with resistant starch intake!

  Resistant Starch and Total Carb Intake Are Important!

One of the things that makes this study so interesting (and important!) is the fact that fiber and vegetable intake was relatively high for both Paleo groups. Often, when we talk about how ketogenic diets or low-carb or low-starch Paleo might affect the gut microbiome, we’re given a false sense of security thinking we’ll be fine as long as we eat plenty of fiber from leafy greens; see also How Ketogenic Diet Wreaks Havoc on Your Gut. As this study indicates, low-starch veggies alone are not enough to maintain a robust, diverse gut microbiome! The Paleo subjects clearly weren’t ingesting a broad enough array of fibers and starches to support some very important bacterial populations.

Given all that, can we just add some supplemental resistant starch to otherwise low-carb diet and call it a day?

Actually, the answer here seems to be no! Consistent with my post Resistant Starch: It’s Not All Sunshine and Roses, the research shows that isolated resistant starch doesn’t bring the same range of benefits as resistant starch from whole-food sources. And what’s more, when it comes to TMAO, supplemental resistant starch may even be counterproductive in the context of a low-carb and/or high fat diet. In a human cross-over trial from 2016, for example, 52 adults consumed four different diets in random orders—a low resistant starch, higher carbohydrate diet; a low resistant starch, lower carbohydrate diet; a high resistant starch, higher carbohydrate diet; and a high resistant starch, lower carbohydrate diet (with resistant starch coming from Hi-Maize 260, supplying RS2). Intriguingly, the highest TMAO levels occurred when subjects were eating the high resistant starch, lower carbohydrate diet, despite dietary levels of carnitine and choline being less on that diet compared to the low resistant starch periods. The researchers proposed that a high isolated resistant starch intake, in the presence of an overall lower carbohydrate diet, shifted the microbiota towards greater TMAO generation. Likewise, studies in rodents have shown that high fat consumption (which often goes hand-in-hand with low-carbohydrate diets), in the amount of of 42% of total energy, partially counteracts the beneficial effects of RS2 by suppressing levels of beneficial bacteria. So, low-carb diets can be a double whammy against our gut microbiota, both by failing to supply a wide range of fiber and starch types and by overloading our guts with levels of fat that become harmful to bacteria. (Don’t worry; we aren’t calling fat bad here—but a balanced intake of macronutrients seems to be where the evidence is pointing for optimal health!)

Other studies support the idea that resistant starch is most health-promoting in conjunction with other dietary carbohydrates. In pigs, resistant starch alone (in the form of RS2) was shown to get rapidly fermented in the proximal (beginning part) of the colon, while failing to reach further down into the distal (lower) colon—resulting in only a small portion of the colon receiving fermentation benefits. But, when additional carbohydrate in the form of wheat bran (a soluble non-starch polysaccharide) was included in the pigs’ diets, the amount of resistant starch getting fermented between the lower colon and feces nearly doubled—indicating that the bulk from the wheat bran was helping spread fermentation further down through the colon, flooding a much greater area with cancer-protective butyrate. The addition of wheat seed (RS1) to supplemental green banana flour and high-amylose starch (RS2) has been shown to help spread fermentation throughout the entire colon, as indicated by a decrease in fecal pH (which is a good thing!).

When it comes to low-carb Paleo diets, it’s easy to see how a similar effect could occur. Cutting out sources of bulky fermentable carbohydrate (like root veggies and legumes) limits how far isolated resistant starch can spread, resulting in bacteria in the proximal colon gobbling it up and leaving none for microbes further down the colon. Likewise, given what we know about the role of methanogenic archaea in regulating TMAO levels and interacting with other microbes like Bifidobacteria (as well as how much methanogenic archaea likes carbohydrates and doesn’t like fat!), we might suspect that low-carb diets can also enhance TMAO production by suppressing archaea growth.

As further confirmation, the main study we’ve been discussing in this article found that TMAO levels were more strongly negatively associated with grain intake than with resistant starch intake. That doesn’t mean we all need to eat grains to be healthy, but it does imply that diverse components of starchy plant foods (such as the other forms of fiber and carbohydrate they contain) contribute to a healthy microbiome, even more so than resistant starch on its own.

Short-Term Vs. Long-Term Microbiome Shifts

We should also stress the importance of the long-term nature of this study! While shorter dietary trials can be very useful (and in some cases, are the only studies we have at our disposal), they can’t capture potential health issues that develop months or years down the line (such as gradual changes in the core gut microbiota composition). That’s particularly relevant here, because the same researchers who conducted this study previously published a similar one, randomizing 22 women to a Paleo diet for four weeks and 17 women to a diet in line with Australian health recommendations. In that study, there wasn’t a significant change in TMAO concentration compared to the control group, despite a lower intake of resistant starch and higher intake of meat and eggs among the Paleo dieters. While those findings could have been due to the small sample size and limited data for resistant starch content of foods (making it difficult to precisely calculate resistant starch intake), it’s also possible that the Paleo group hadn’t yet exhibited some longer-term microbiota shifts that lead to higher TMAO generation as seen in the more recent study.

Indeed, the field of microbiota research has shown us that while some microbial changes happen rapidly when we alter our diet, others can occur on a more gradual basis. So, only using participants who had been eating Paleo for over a year gives this study greater insight into the full effects that low-carb Paleo has on the gut microbiota.

The Bottom Line: Paleo Should Not Be Low-Carb

Some people have seen this paper as an attack on red meat, which, given the TMAO link, is a valid concern (see also The Link Between Meat and Cancer). But what this paper is actually making a case for is that starch-free diets are a problem. Don’t get me wrong: fibrous, low-starch veggies are fantastic, and we should be filling our plates with them on the daily—but not at the exclusion of Paleo starches! Root veggies rich in resistant starch are consistently showing up as a vital component of a nutrient-dense Paleo diet, and there are no real “hacks” to get around that (see also Why Root Veggies Are Great for the Gut Microbiome and Resistant Starch: It’s Not All Sunshine and Roses).

When we combine this information with an examination of the non-metabolic roles that insulin plays (another rationale for moderate [not low] carb intake, see The Case for More Carbs: Insulin’s NonMetabolic Roles in the Human Body and How Many Carbs Should We Eat?), the potential problems of too-high-fat intake (not that we wan’t to eat low-fat; see Saturated Fat: Healthful, Harmful, or Somewhere In Between?, Adverse Reactions to Ketogenic Diets: Caution Advised), and understanding that micronutrient sufficiency is most easily attained with a balanced macronutrient diet (see The Diet We’re Meant to Eat, Part 3: How Much Meat versus Veggies?, The Importance of Nutrient Density, and Carbs Vs. Protein Vs. Fat: Insight from Hunter-Gatherers), it’s becoming harder and harder to make a compelling case against moderate carbohydrate intake, 30 to 60% of total calories, from whole food sources.

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Vanderhaeghen S, Lacroix C, Schwab C. “Methanogen communities in stools of humans of different age and health status and co-occurrence with bacteria.” FEMS Microbiol Lett. 2015 Jul;362(13):fnv092. doi: 10.1093/femsle/fnv092.

Vanessa DN, et al. “Archaea: Essential inhabitants of the human digestive microbiota.” Human Microbiome Journal, 2017 3:1-8. doi.org: 10.1016/j.humic.2016.11.005.

from https://www.thepaleomom.com/paleo-resistant-starch-and-tmao-new-study-warning-worth-heeding/ from https://myfunweightloss.tumblr.com/post/186961759247

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Paleo, Resistant Starch, and TMAO: New Study Warning Worth Heeding

SCIENCE SIMPLIFIED:

A human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and production of TMAO, which is linked to cardiovascular disease and some forms of cancer.

The study demonstrates that a low-carb Paleo diet increases TMAO, attributable to a decrease in probiotic bacteria from the Bifidobacterium and Roseburia genera and an increase in Hungatella species in the gut.

The dietary factors most strongly associated with the undesirable gut microbiome shift and TMAO production were total carbohydrate intake and resistant starch intake.

While the authors conclude that lack of grains are to blame, the study participants were eating mostly non-starchy vegetables (about 7 servings per day, averaging 28 grams of fiber but only 90 grams of total carbohydrates).  Starchy roots and tubers are a healthy alternative to grains and would have increased the participant’s total carbohydrate intake (all slow-burning nutrient-dense carbs) as well as resistant starch intake.

The results of this study are relevant to our community and offer a stern warning against long-term low-carb implementations of the Paleo diet.

RELATED READING:

What Is the Gut Microbiome? And Why Should We Care About It?

The Case for More Carbs: Insulin’s Non-Metabolic Roles in the Human Body

Why Root Veggies Are Great for the Gut Microbiome

Whenever a new Paleo study comes out, it’s sure to stir up controversy—no matter what the findings are. “Good” findings are met with cheers from the Paleo community, while “bad” findings tend to explode in media headlines and send the Paleo community rushing to find reasons the study is poorly conducted, inaccurate, or otherwise worth dismissing.

As you know, I don’t believe in dismissing scientific findings (except for the rare occasion where flaws in how the study was designed or conducted result in retraction).  Instead, I seek to understand the data in the context of the research field as a whole, seeking context and nuance while being open to adjusting my conclusions and recommendations. (I discuss the merits of different types of scientific studies as well as the problem with cherry-picking data in my Introduction to Nutritional Sciences online course.)

Recently, a human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and TMAO.  And, the headlines (both mainstream media and outlets targeting physicians) have not been flattering, for example: “Paleo Diet Increases Risk for Heart Disease”, “Paleo Diet Study Links ‘Caveman’ Regime to Heart Disease Biomarker”, and “Study Linking Paleo Diet to Increased Heart Disease Risk Strengthens Diet Industry Concerns”.

As you’re probably aware by now, I’m all about the gut microbiome, and believe it will continue to prove itself as a massive missing piece in our health puzzle! For that reason, this study is particularly interesting and important to look at (and not dismiss!).

Before we dive into the study itself, let’s review the things we need to know to make sense of the findings!

 A Refresher on Fiber, Resistant Starch, and the Microbiome

The gut is a biological niche, home to a diverse array of microbes that influence nearly all aspects of human biology through their interactions with our bodies. We have a symbiotic relationship with these microbes, collectively referred to as our gut microbiome—in exchange for food and shelter, they contribute to our wellbeing by performing diverse functions essential to our health.

When we don’t have a healthy diversity of the right kinds of microbes in our gut, our entire body suffers. An unfavorable gut microbiome has been linked to conditions as wide-ranging as cancer, obesity and other metabolic problems, heart disease, anxiety, depression, autism, autoimmunity, ulcers, IBD, liver disease, systemic infections, and more.  See What Is the Gut Microbiome? And Why Should We Care About It?.

I’m writing a book on the gut microbiome, so I could expound for days, but let’s focus on a few specifics that are particularly important to understanding this new paper.

Fiber Is Food for Our Gut Microbiome

If there’s one thing our gut microbes love, it’s fiber. In fact, out of all the dietary factors that can impact the gut, fiber may be the most important.

Carbohydrates, including fiber, are chains of monosaccharides (simple sugars) and of chemical derivatives of monosaccharides. Both the types of simple sugar (and their derivatives) in the chain and the ways they link together to form chains (both overall structure and the types of chemical bonds between sugar molecules) determine what type of carbohydrate it is. What separates fiber from other carbohydrates is that the way the sugars link together are not compatible with our digestive enzymes; our bodies just aren’t capable of breaking apart those types of molecular bonds. Instead, fiber passes through the digestive tract mainly intact. And once it reaches the colon, the magic begins: fiber serves as a substrate (food) for a wide range of bacteria, including some of the most important species we can harbor!

Why Different Fiber Types Feed Different Bacteria

The bacteria that live in our guts are collectively capable of producing over ten thousand different enzymes that can break down complex carbohydrates like fiber, which is pretty remarkable when you consider that we only produce about 17 different enzymes that digest carbohydrates! These enzymes belong to at least 206 different families of CAZymes (which stands for “Carbohydrate-Active enZymes”). Enzymes are typically highly specialized, breaking apart only specific molecular bonds, which is why different types of carbohydrates require different enzymes to break them apart (and why we can’t digest fiber but our gut bacteria can).

When it comes to carbohydrate degradation, some bacteria are highly specialized, producing only a few dozen CAZymes, whereas others are multitaskers, producing hundreds of CAZymes which allows them to grow on a variety of substrates and adapt to changing nutritional circumstances, thereby giving them a competitive advantage in the gut ecosystem.

Bacteria from the Bacteroides genus in general tend to be multitaskers, producing enzymes that can break down starch, pectin, hemicelluloses, and other plant carbohydrates (galactomannan, arabinogalactan, alginate, laminarin and xylans xyloglucan, rhamnogalacturonans I and II, β-glucans and glucomannan, to name a few!). Bacteroides thetaiotaomicron is an example of multitasker, considered a diet insensitive strain thanks to its ability to produce around 400 CAZymes (at least 260 of which are glycoside hydrolases) that help it thrive on pectins as well as complex carbohydrates that are produced by our own intestinal cells, such as mucin (a glycoprotein that is a major component of mucus).

In contrast, Bifidobacterium species are more specialized, producing an average of 45 CAZymes that make them highly effective at degrading high amylose starches, including resistant starch, as well as fructooligosaccharides, galactooligosaccharides, and inulin fiber. The critical consequence is that Bifidobacterium don’t survive if our diet doesn’t include sufficient amounts of these starches and fiber types.

Importance of Fiber Variety in the Diet

One of the consequences of this diversity in CAZyme production by various resident microbes is that different fermentable carbohydrates support different species in the gut. Therefore, consuming a variety of dietary fibers—various cellulose, hemicellulose, pectins, gums, fructans, glucans, mucilage, chitin, chitosan, and resistant starch fiber—best supports a diverse microbial community compared to a diet comprised of less varied fermentable carbohydrates like the Standard American Diet which is rich in refined carbohydrates.

Which foods are rich in which fiber sources?

Cellulose is found in all plants, but foods that contain particularly large amounts of cellulose include bran, legumes, nuts, peas, root vegetables, celery, broccoli, peppers, cabbage and other substantial leafy greens like collards, and apple skins. See The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

Hemicellulose is particularly high in bran, nuts, legumes, and whole grains, as well as many green and leafy vegetables.

Pectin is found in all fruits and vegetables but are particularly rich in certain fruits, including apples and citrus fruits, and are also found in legumes and nuts. See Why Fruit is a Good Source of Carbohydrates

Lignin is most commonly a component of wood, but food sources include root vegetables, vegetable filaments (like the stems of leafy greens and the strings in celery), many green, leafy vegetables, wheat, and the edible seeds of fruit (such as berry seeds and kiwi seeds). See Polyphenols: Magic Bullet or Health Hype?

Chitin is found not only in plants and fungi but also in the exoskeletons of insects and in the shells of crustaceans. See Elevating Mushrooms to Food Group Status and Why Crickets Are Great for the Gut Microbiome.

Chitosan is naturally found in the cell walls of fungi but are also produced as a functional fiber by treating shrimp and other crustacean shells with sodium hydroxide. See Elevating Mushrooms to Food Group Status.

Beta-glucans are found in some grains (mainly oats and barley, but also rye and wheat), fungi (yeast and mushrooms, particularly those mushrooms that are used medicinally like shiitake and maitake), and some types of seaweed (mainly algae). Beta-glucans are the fiber in oats that are largely responsible for their unique health benefits among grains. See Why Seaweed is Amazing! and Elevating Mushrooms to Food Group Status.

Fructans are naturally occurring in a variety of plants and are particularly high in chicory, Jerusalem artichoke and alliums (the onion family). Cruciferous vegetables contain modest amounts of fructans. See What about the Goitrogens in Cruciferous Veggies?.

Gums are a diverse group of fibers that plants secrete when they are damaged. Isolated versions are used in food manufacturing as thickening and gelling agents (like guar gum and xanthum gum). See Is It Paleo? Guar Gum, Xanthan Gum and Lecithin, Oh My!.

Mucilages are particularly concentrated in cacti and other succulents (like aloe), many types of seaweed (like agar agar algae), flax, chia and psyllium. They can also be found in relatively large amounts in a variety of fruits and vegetables, including plantains, bananas, taro root, cassava, and berries. See Mucilaginous Fiber: The Good, the Bad, and the Gooey and The Verdict on Psyllium Husks: Not Paleo!.

Resistant starch is divided into four subgroups: RS1 is rich in grains, legumes, and seeds; RS2 is found in most roots and tubers, and particularly high in green bananas, green plantains, and raw potatoes; RS3 is rich in cooked and cooled roots and tubers, particularly potatoes, as well as cooked and cooled rice; RS4 is the product of enzymatically or chemically modified starches sold under various brand names. See also Resistant Starch: It’s Not All Sunshine and Roses.

Because of their varying fiber types (and other food compounds that influence gut microbial composition like micronutrients, phytochemicals, proteins and fats), different families of fruits and vegetables are independently beneficial for the gut microbiome.  See also The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

That means that beyond aiming for 8+ servings of fresh vegetables and fruits daily (see also The Importance of Vegetables), it’s important to hit as many of the different families of vegetables and fruits each day, ideally cycling through all of them every two days: cruciferous vegetables, leafy vegetables, roots and tubers, mushrooms, alliums, apple family, citrus, berries, nuts and seeds, etc.

Resistant Starch-Rich Foods as Microbiome Superfoods

Resistant starch is classified as a fiber because amylase, the enzyme that breaks starch into individual glucose units, doesn’t work on this type of starch.

Resistant starch is insoluble yet highly fermentable, and is divided into four subgroups: RS1, which is physically inaccessible due to being bound within cell walls; RS2, which is tightly packed ungelatinized granules found in certain raw starchy foods; RS3 (retrograded amylose), which is formed when certain starchy foods are cooked and then cooled down; and RS4, which is formed via a manmade chemical process. See also Resistant Starch: It’s Not All Sunshine and Roses

In general, resistant starch is famous for feeding short-chain-fatty-acid-producing bacteria and enhancing levels of butyric acid. In a human study, RS2 was shown to increase the abundance of Ruminococcus bromii and Eubacterium rectale, whereas RS4 increased Bifidobacterium adolescentis and Parabacteroides distasonis. Long-term feeding of RS1 and RS2 in rats showed that both types increased the abundance of anaerobes, the levels of Bifidobacteria, and total SCFAs in the cecum; meanwhile, RS2 (but not RS1) enhanced levels of Lactobacillus, Streptococci, and Enterobacteria. In pigs, RS3 has been shown to increase the abundance of Faecalibacterium prausnitzii while reducing levels of E. coli and Pseudomonas species. Interestingly, Ruminococcus bromii plays a keystone role in the degradation of resistant starch, releasing breakdown products that are then utilized by other microbes in the gut.

Two Important Probiotic Bacteria: Bifidobacteria and Roseburia

Hundreds of beneficial probiotic species of bacteria (as well as fungi like yeast and archaea, which we’ll come back to) have been well studied in terms of their roles in the gut microbiome and human health in general.  I want to focus in on two genera of bacteria that are particularly relevant to this new paper.

The Bifidobacteria genus exerts a range of beneficial effects on human health, including producing vitamins, inhibiting pathogens from colonizing or infecting the gut mucosa, helping regulate the microbiome’s homeostasis, modulating local and systemic immune responses, repressing potentially carcinogenic enzymatic activities among different bacteria, and facilitating the bioconversion of various dietary compounds into bioactive forms. In a variety of studies, Bifidobacteria have been shown to improve the gut barrier function, suppress E. coli, improve glucose tolerance, reduce low-grade inflammation, and reduce endotoxemia induced by high-fat diets. As another benefit, because Bifidobacteria produce lactic acid instead of gas, people with higher levels tend to have less flatulence and digestive problems!

There are 39 identified species of Bifidobacteria, which represent 3-6% of health adult fecal flora.  Their favorite foods are resistant starch 2, resistant starch 4, oligosaccharides from plants and milk, and hexose.

Let me emphasize: Bifidobacterium are critically important to human health.  If you see an argument dismissing this paper because somehow low-carb diets or low-carb Paleo benefits make up for missing Bifidobacteria, that is unequivocally false.

The Roseburia genus are butyrate-producing bacteria that are implicated in maintaining gut barrier health and immune regulation, with strong anti-inflammatory properties.  Reduced levels of Roseburia are associated with inflammatory bowel disease (Roseburia actually suppress the pathogenesis of Crohn’s disease), irritable bowel syndrome, obesity, type 2 diabetes, cardiovascular disease, neurological diseases, autoimmune disease, asthma and allergies—likely mediated through higher intestinal permeability and inflammation.

There are five known species of Roseburia (R. intestinalis, R. hominis, R. inulinivorans, R. faecis and R. cecicola) and their favorite foods are beta-glucans, fructans, pectin and resistant starch.

 The Deal with TMAO

So, where does TMAO fit into the microbiome?

In recent years, trimethylamine-N-oxide (TMAO) has emerged as a possible new risk factor for cardiovascular disease, with potential to other conditions as well (such as chronic kidney disease, chronic heart failure, and colorectal cancer). For instance, a meta-analysis using 11 prospective studies found that higher circulating levels of TMAO were associated with a 23% increased risk of cardiovascular events and a 55% increased risk of all-cause mortality. This little molecule gets produced from the microbial metabolism of choline, lecithin, and carnitine (from our diet) into trimethylamine (TMA), which the liver then oxidizes into TMAO. Once it’s in our bodies, TMAO gets transported to different tissues and can potentially accumulate.

However, our levels of TMAO aren’t just a matter of how much free TMAO or TMAO precursors we ingest! Gut bacteria, especially the genus Prevotella, is a key mediator between diet and the amount of TMAO in our blood. In one study, researchers found that participants with gut microbiomes dominated by Prevotella were the ones who produced the most TMA (and therefore TMAO, after it reached the liver) from the carnitine they consumed. Those with microbiomes high in Bacteroides rather than Prevotella saw dramatically less conversion to TMA and TMAO.

So far, the list of TMAO-producing bacteria also includes multiple Clostridium species, Desulfovibrio desulfuricans, Providencia rettgeri, Edwardsiella targa, Escherichia fergusonii, Anaerococcus hydrogenalis, Proteus penneri, Firmicutes, and Proteobacteria. In other words, we can’t look at TMAO without also looking at the composition of our gut microbiota!

TMAO: Symptom or Cause of Heart Disease?

Despite some compelling associations with disease and mortality, there’s still a lot of controversy over whether TMAO has a causal relationship with the conditions it’s been associated with. On one hand, we have identified some plausible mechanisms for its role in disease, especially heart disease. For example, TMAO appears to increase the number of scavenger receptors in macrophages, resulting in greater binding to LDL particles and subsequent foam cell formation (foam cells play a major role in the progression of atherosclerotic plaque buildup!). TMAO also interferes with sterol transportation and bile acid metabolism, which can further contribute to the development of heart disease. And, TMAO may increase platelet activity, which can raise the risk of thrombosis by promoting excessive coagulation in the blood.

But despite these possible mechanisms, the literature is still mixed when it comes to how elevated TMAO plays out in real life! Along with studies showing a link between high TMAO levels and disease or mortality, many studies have failed to find any predictive value for TMAO on cardiovascular events, chronic kidney disease, or heart failure.

It’s possible that high TMAO occurs as a result of some of these diseases, rather than as a causative factor (high TMAO makes sense in the case of kidney failure, for instance, because the kidneys are the major site of circulating TMAO clearance, and their compromised function would naturally lead to a buildup of TMAO).

It’s also very possible that gut microbiota compositions that contribute to chronic disease also happen to result in more TMA and TMAO production, making TMAO a marker for disease states rather than a causal risk factor. Overall, the jury’s still out!

The Fish Paradox

One of the major monkey wrenches in the whole TMAO story is a fishy one (pun intended). Seafood—famously considered heart-healthy—is one of the most abundant sources of free TMAO, and also contains TMAO precursors. And we’d be hard pressed to find a study that shows seafood is bad for our cardiovascular health (indeed, the vast majority of research shows that fish is one of the best things we can eat for our hearts!). Physiologically, TMAO helps fish survive in their marine environments by increasing buoyancy, acting as a form of antifreeze (by increasing osmotic concentration), and protecting tissue proteins against destabilizing forces. The degradation of TMAO into TMA is also what gives seafood its characteristic fishy odor! TMAO levels can vary dramatically between different species of fish (and even vary within the same species depending on the season), but in general, deep-sea fish and shellfish tend to be higher in TMAO than shallow water fish and shellfish, likely because of the role TMAO plays in protecting against pressure-induced protein damage.

Research has shown that following the consumption of seafood, blood levels of TMAO levels rise to significantly higher levels than after the consumption of beef or eggs. In one study, 40 participants were fed meals containing cod fish, eggs, beef, or a fruit control in random order, with week-long washout periods between each intervention. After the fish meal, participants’ plasma TMAO rose up to 62 times higher than after the beef, eggs, or fruit meals. These levels peaked at 2 hours post-meal and remained elevated for the remainder of the 6-hour study period. The rise in TMAO levels started within 15 minutes following fish consumption, indicating the TMAO was being directly absorbed rather than undergoing conversion in the gut by bacteria. This same study found dramatic variations in TMAO response after eating eggs or beef. Compared to baseline, TMAO levels ranged anywhere from a 30% decrease to a 270% increase!

Food vs. Microbiome Sources of TMAO

So, why would we see such extreme variations in TMAO levels after eating the same foods? The answer is, not surprisingly, bacteria! Stool analysis showed that compared to low TMAO producers, high TMAO producers had some important microbiota differences, including lower alpha-diversity, different species compositions, and a higher ratio of Firmicutes to Bacteroidetes (about 2:1, versus a 1:1 ratio for the low producers). And very importantly, as we’ll see in a moment, the Archaea phylum was completely absent in the microbiota of the high TMAO producers, but was represented among the low TMAO producers.

This study provided some important pieces for the TMAO puzzle. Along with demonstrating that fish (at least in the form of cod) yields vastly higher levels of TMAO and TMAO metabolites than beef or eggs, the study demonstrated that TMAO can be absorbed intact from foods like fish without involvement of the gut microbiota. That means that the level of TMAO we have in our bodies isn’t just a result of our gut microbiota churning it out from precursors, but can also be influenced by the direct consumption of TMAO from food. And, that could mean that high circulating TMAO from seafood potentially indicates a much different (AKA lower!) risk profile than high TMAO produced by disease-associated microbes.

So, as much as is still up in the air about TMAO, one thing seems pretty likely: we don’t want a gut microbiome that produces a lot of it. Whether or not TMAO itself turns out to be a major risk factor or just a red herring, and whether or not our circulating levels are a cause or consequence of specific health conditions, a high-TMAO-generating microbiota seems to be consistent with greater disease risk.

 Archaea: A Microbiome Missing Piece

Whenever we hear about the microbiota, it’s usually all about the bacteria, bacteria, and more bacteria! But, while bacteria might be numerically dominant among the microbes in our gut, they’re definitely not the only residents there. Another type of single-celled organism that call our GI tracts home are archaea. And, these little guys are incredibly important!

Archaea (sometimes called archaebacteria) are strict anaerobes that live in various mucosal sites throughout the body, including the intestinal mucosa. We aren’t born with archaea inside us, but we acquire them from the environment throughout life: by the time children are school-aged, archaea are almost universally present in the gut, and levels continue to increase with age (with the highest occurrence and diversity of archaea being found in older adults). Along with lacking lipopolysaccharide (meaning archaea won’t contribute to our endotoxin load), archaea is also the only domain of life that doesn’t include any known pathogens, which is pretty cool!

Archaea degrade TMA and TMAO

One important subtype of archaea are the methanogens, which produce methane gas as a byproduct of hydrogen reduction. Up to 95% of human guts harbor the methanogenic archaea Methanobrevibacter smithii and Methanosphaera stadtmanae, at varying levels. While the idea of producing methane might not sound very pleasant, some of these archaea (in particular, an order of methanogens called the Methanomassiliicoccales) actually play an integral role in reducing our TMAO production. Along with being able to use carbon dioxide, formate, and methanol (all released by bacteria breaking down food and other organic matter in the gut), these archaea can use methyl compounds like TMA and TMAO to generate methane. And that means that the archaea in our gut actually deplete the pool of TMA we have available to be converted into TMAO (along with any free TMAO from foods like seafood). So, all that TMA generated by Prevotella, or entering our body from fish consumption? Archaea can help wipe some of it out!

The TMAO-reducing effects of archaea is far from just speculative, too. In a study of ELDERMET subjects, the fecal TMA concentration in people with TMA-metabolizing archaea was significantly lower than in those without this archaea—and the difference was particularly dramatic when the abundance of Methanomassiliicoccales was greater than 10^8 cells per gram of stool. This role of archaea is so exciting that some scientists are proposing a new class of probiotics called archaeabiotics, which could help reduce our TMAO levels without us needing to cut back on choline and other important nutrients!

Importantly, methanogenic archaea have an important interactive relationship with bacteria in the gut, which often takes the form of what scientists call syntrophy (where two organisms participate in consuming a substance that neither one can catabolize on its own). And, it appears that archaea are particularly chummy with the important probiotic bacteria Bifidobacteria. For example, mixed cultures of M. smithii and Bifidobacteria bifidum have been shown to collectively produce methane from glucose, and in females with gut Methanobacteriales levels higher than 0.71%, there’s a significantly higher mean abundance of Bifidobacteriaceae. And as we’ve already seen, healthy levels of Bifidobacteria are super important!

Archaea Thrive When We Eat Carbs!

So, how do we keep our archaea happy and thriving? Scientists are just at the beginning stages of understanding how diet impacts our archaea colonies (after all, archaea are relative newcomers to the microbiota research scene compared to bacteria!), but here’s what we know so far. In children, organic dairy (especially organic yogurt and organic milk) has been associated with the initial colonization of M. smithii, due to organic dairy serving as a vehicle for delivering it to our guts. And, some methanogens degrade methanol, which gets produced when bacteria degrade pectin in fruits—thus suggesting that archaea might benefit from including fruit in our diets! In Chinese goats, eating a high-grain diet appears to suppress methanogenic archaea relative to a high-hay diet—possibly due to the pH-lowering effect of grains in the rumen (which can then suppress methanogenic archaea that are sensitive to low pH environments). Obviously, we’re not Chinese goats, but it would certainly be interesting if a high-grain diet in humans had a similar effect!

More broadly, though, in humans, Methanobrevibacter abundance is positively associated with higher carbohydrate consumption (both recent and long-term), and negatively associated with recent consumption of fat (especially vegetable fat and polyunsaturated fat intake) and amino acids. Although more research is definitely needed, the picture getting painted so far is that archaea benefit from a variety of plant polysaccharides, and not so much from animal-based diets.

However, this isn’t because the archaea themselves eat carbohydrate. In fact, methanogenic archaea have an almost complete lack of enzymes for breaking down complex carbohydrates into simple sugars. What does appear to be happening is that archaea thrive off the metabolic products of carbohydrate-loving bacteria, and therefore are still dependent on dietary carbohydrate for their own survival!

 The Study: Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations

Whew! Now that we’ve covered the necessary background, let’s take a look at what this study is all about!

Researchers recruited a total of 44 participants who self-reported following a Paleo diet for over a year, along with 47 controls who more or less followed the national dietary recommendations of Australia (where the study was conducted). Within the Paleo group, participants were further divided based on how strictly they followed the Paleo framework (as gauged by the exclusion of grain and dairy products): 22 people fell into the “strict Paleo” group (less than one serving of grains and/or dairy per day), and 22 people fell into the “pseudo-Paleo” group (more than one serving of grains and/or dairy per day). (This is important, because “real-world” Paleo includes a variety of interpretations about what Paleo actually means, including how strictly to adhere to the diet—so a pseudo-Paleo group might be closer to reality for a lot of people!)

The study excluded anyone who’d taken antibiotics within the past six months, who had any type of GI tract surgery, who had past or present digestive disorders, who used cholesterol or blood pressure lowering medications, or who had been diagnosed with cardiovascular disease. This helped make sure the results weren’t confounded by preexisting health conditions or drugs, and allowed the researchers to better isolate the effects of the participants’ diets.

To ensure accurate dietary data, the researchers had participants undergo three-day weighed diet records (including two weekdays and one weekend day), which were then validated using urine nitrogen tests (which could detect whether participants were over- or under-reporting their protein intake) and the Goldberg cut point (which can identify which participants were under-reporting their energy intake, through the ratio of energy intake to basal metabolic rate). Participants who appeared to inaccurately report both their protein and energy intake were deemed unreliable dietary reporters (this ended up being two people from the strict Paleo group and three people from the control group).

Paleo Diet Adherents Had Increased TMAO

Now, the headline-grabbing finding. In the strict Paleo group, serum TMAO was a whopping 9.53 µM, the pseudo-Paleo group averaged 5.47 µM, and the control group averaged 3.93 µM. Higher TMAO levels were associated positively with red meat intake and negatively with grain intake.

Whether TMAO is a causative agent for disease or a marker for a disease-associated microbiota, those are some scary numbers—especially for the strict Paleo group!

What Study Participants Were Actually Eating

So, what were the Paleo groups actually eating? Here’s what the data showed!

Not surprisingly, both Paleo groups ate more protein than the controls (118 and 102.7 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 92 grams for the controls), less carbohydrate (99 and 81.4 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 202.6 grams for the controls), less sugar (51.8 and 44 grams per day for the Paleo groups, and 75.6 grams for the controls), and more fat—with the increase mostly coming from saturated and monounsaturated forms (117.9 total fat grams per day for the strict Paleo group, 133.1 grams for the pseudo-Paleo group, and 82.5 grams for the controls).

Importantly, total dietary fiber was adequate (and very similar!) for both the control group and the strict Paleo group—29.7 grams and 27.4 grams daily, respectively, which falls within the recommended daily intake of 25-30 grams for adults. The pseudo-Paleo group averaged 20.8 grams of fiber each day, which is still more than most people consume! For the Paleo groups, much of their fiber came from vegetables, with the strict Paleo group eating 6.7 servings of veggies per day and the pseudo-Paleo group averaging 4.3, compared to the control group’s 3.93. (We could definitely argue that the official recommendations for fiber are still too low for optimal health, but the point here is, these study participants weren’t slacking on the non-starchy veggies!)

While the control group averaged 4.5 – 14.2 grams of resistant starch per day, largely from grains (those are estimated minimum and maximum amounts, since the same foods can vary in resistant starch content), the strict Paleo group averaged only 2.6 – 6.1 grams per day, and the pseudo-Paleo group got a mere 1.3 – 2.9 grams of resistant starch. That’s a significant drop off!

Low-Carb Paleo Effects on the Microbiome

Remember that one of the favorite foods of Bifidobacteria is resistant starch? And that Roseburia also likes to munch on carbohydrates like beta-glucans? Maybe we shouldn’t be surprised that this study showed a significant decrease in these important bacteria among both Paleo groups.

Likewise, the relative abundance of Hungatella was significantly higher among the Paleo subjects. After adjusting for age, gender, stool frequency, and body fat, Hungatella abundance was significantly negatively associated with grain intake among the study’s participants, and was also significantly negatively correlated with Bifidobacteria and Roseburia abundance. Although we don’t have a lot of information about Hungatella in relation to human health (not yet, anyway!), we do know that some species originating from the genus Hungatella are associated with choline consumption and TMA production, including at least one species identified in this study. The researchers speculated that some components of grains and/or whole grains either interfere with Hungatella’s TMA production or prevent it from dominating in the gut. And, these components might not be resistant starch, since neither Hungatella nor TMAO was significantly associated with resistant starch intake!

  Resistant Starch and Total Carb Intake Are Important!

One of the things that makes this study so interesting (and important!) is the fact that fiber and vegetable intake was relatively high for both Paleo groups. Often, when we talk about how ketogenic diets or low-carb or low-starch Paleo might affect the gut microbiome, we’re given a false sense of security thinking we’ll be fine as long as we eat plenty of fiber from leafy greens; see also How Ketogenic Diet Wreaks Havoc on Your Gut. As this study indicates, low-starch veggies alone are not enough to maintain a robust, diverse gut microbiome! The Paleo subjects clearly weren’t ingesting a broad enough array of fibers and starches to support some very important bacterial populations.

Given all that, can we just add some supplemental resistant starch to otherwise low-carb diet and call it a day?

Actually, the answer here seems to be no! Consistent with my post Resistant Starch: It’s Not All Sunshine and Roses, the research shows that isolated resistant starch doesn’t bring the same range of benefits as resistant starch from whole-food sources. And what’s more, when it comes to TMAO, supplemental resistant starch may even be counterproductive in the context of a low-carb and/or high fat diet. In a human cross-over trial from 2016, for example, 52 adults consumed four different diets in random orders—a low resistant starch, higher carbohydrate diet; a low resistant starch, lower carbohydrate diet; a high resistant starch, higher carbohydrate diet; and a high resistant starch, lower carbohydrate diet (with resistant starch coming from Hi-Maize 260, supplying RS2). Intriguingly, the highest TMAO levels occurred when subjects were eating the high resistant starch, lower carbohydrate diet, despite dietary levels of carnitine and choline being less on that diet compared to the low resistant starch periods. The researchers proposed that a high isolated resistant starch intake, in the presence of an overall lower carbohydrate diet, shifted the microbiota towards greater TMAO generation. Likewise, studies in rodents have shown that high fat consumption (which often goes hand-in-hand with low-carbohydrate diets), in the amount of of 42% of total energy, partially counteracts the beneficial effects of RS2 by suppressing levels of beneficial bacteria. So, low-carb diets can be a double whammy against our gut microbiota, both by failing to supply a wide range of fiber and starch types and by overloading our guts with levels of fat that become harmful to bacteria. (Don’t worry; we aren’t calling fat bad here—but a balanced intake of macronutrients seems to be where the evidence is pointing for optimal health!)

Other studies support the idea that resistant starch is most health-promoting in conjunction with other dietary carbohydrates. In pigs, resistant starch alone (in the form of RS2) was shown to get rapidly fermented in the proximal (beginning part) of the colon, while failing to reach further down into the distal (lower) colon—resulting in only a small portion of the colon receiving fermentation benefits. But, when additional carbohydrate in the form of wheat bran (a soluble non-starch polysaccharide) was included in the pigs’ diets, the amount of resistant starch getting fermented between the lower colon and feces nearly doubled—indicating that the bulk from the wheat bran was helping spread fermentation further down through the colon, flooding a much greater area with cancer-protective butyrate. The addition of wheat seed (RS1) to supplemental green banana flour and high-amylose starch (RS2) has been shown to help spread fermentation throughout the entire colon, as indicated by a decrease in fecal pH (which is a good thing!).

When it comes to low-carb Paleo diets, it’s easy to see how a similar effect could occur. Cutting out sources of bulky fermentable carbohydrate (like root veggies and legumes) limits how far isolated resistant starch can spread, resulting in bacteria in the proximal colon gobbling it up and leaving none for microbes further down the colon. Likewise, given what we know about the role of methanogenic archaea in regulating TMAO levels and interacting with other microbes like Bifidobacteria (as well as how much methanogenic archaea likes carbohydrates and doesn’t like fat!), we might suspect that low-carb diets can also enhance TMAO production by suppressing archaea growth.

As further confirmation, the main study we’ve been discussing in this article found that TMAO levels were more strongly negatively associated with grain intake than with resistant starch intake. That doesn’t mean we all need to eat grains to be healthy, but it does imply that diverse components of starchy plant foods (such as the other forms of fiber and carbohydrate they contain) contribute to a healthy microbiome, even more so than resistant starch on its own.

Short-Term Vs. Long-Term Microbiome Shifts

We should also stress the importance of the long-term nature of this study! While shorter dietary trials can be very useful (and in some cases, are the only studies we have at our disposal), they can’t capture potential health issues that develop months or years down the line (such as gradual changes in the core gut microbiota composition). That’s particularly relevant here, because the same researchers who conducted this study previously published a similar one, randomizing 22 women to a Paleo diet for four weeks and 17 women to a diet in line with Australian health recommendations. In that study, there wasn’t a significant change in TMAO concentration compared to the control group, despite a lower intake of resistant starch and higher intake of meat and eggs among the Paleo dieters. While those findings could have been due to the small sample size and limited data for resistant starch content of foods (making it difficult to precisely calculate resistant starch intake), it’s also possible that the Paleo group hadn’t yet exhibited some longer-term microbiota shifts that lead to higher TMAO generation as seen in the more recent study.

Indeed, the field of microbiota research has shown us that while some microbial changes happen rapidly when we alter our diet, others can occur on a more gradual basis. So, only using participants who had been eating Paleo for over a year gives this study greater insight into the full effects that low-carb Paleo has on the gut microbiota.

 The Bottom Line: Paleo Should Not Be Low-Carb

Some people have seen this paper as an attack on red meat, which, given the TMAO link, is a valid concern (see also The Link Between Meat and Cancer). But what this paper is actually making a case for is that starch-free diets are a problem. Don’t get me wrong: fibrous, low-starch veggies are fantastic, and we should be filling our plates with them on the daily—but not at the exclusion of Paleo starches! Root veggies rich in resistant starch are consistently showing up as a vital component of a nutrient-dense Paleo diet, and there are no real “hacks” to get around that (see also Why Root Veggies Are Great for the Gut Microbiome and Resistant Starch: It’s Not All Sunshine and Roses).

When we combine this information with an examination of the non-metabolic roles that insulin plays (another rationale for moderate [not low] carb intake, see The Case for More Carbs: Insulin’s NonMetabolic Roles in the Human Body and How Many Carbs Should We Eat?), the potential problems of too-high-fat intake (not that we wan’t to eat low-fat; see Saturated Fat: Healthful, Harmful, or Somewhere In Between?, Adverse Reactions to Ketogenic Diets: Caution Advised), and understanding that micronutrient sufficiency is most easily attained with a balanced macronutrient diet (see The Diet We’re Meant to Eat, Part 3: How Much Meat versus Veggies?, The Importance of Nutrient Density, and Carbs Vs. Protein Vs. Fat: Insight from Hunter-Gatherers), it’s becoming harder and harder to make a compelling case against moderate carbohydrate intake, 30 to 60% of total calories, from whole food sources.

 Citations

Bergeron N, et al. “Diets high in resistant starch increase plasma levels of trimethylamine-N-oxide, a gut microbiome metabolite associated with CVD risk.” Br J Nutr. 2016 Dec;116(12):2020-2029. doi: 10.1017/S0007114516004165. Epub 2016 Dec 20.

Borrel G, et al. “Genomics and metagenomics of trimethylamine-utilizing Archaea in the human gut microbiome.” ISME J. 2017 Sep;11(9):2059-2074. doi: 10.1038/ismej.2017.72. Epub 2017 Jun 6.

Charrier JA, et al. “High fat diet partially attenuates fermentation responses in rats fed resistant starch from high-amylose maize.” Obesity (Silver Spring). 2013 Nov;21(11):2350-5. doi: 10.1002/oby.20362. Epub 2013 Jul 2.

Cho, CE, et al. “Trimethylamine‐N‐oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial” M. A., Mol. Nutr. Food Res. 2016, 1600324. Doi: 10.1002/mnfr.201600324

Dridi B, et al. “High prevalence of Methanobrevibacter smithii and Methanosphaera stadtmanae detected in the human gut using an improved DNA detection protocol.” PLoS One. 2009 Sep 17;4(9):e7063. doi: 10.1371/journal.pone.0007063.

Dridi B, et al. “High prevalence of Methanobrevibacter smithii and Methanosphaera stadtmanae detected in the human gut using an improved DNA detection protocol.” PLoS One. 2009 Sep 17;4(9):e7063. doi: 10.1371/journal.pone.0007063.

Genoni, A, et al.  “Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations.” European Journal of Nutrition, 2019; DOI: 10.1007/s00394-019-02036-y

Genoni A, et al. “A Paleolithic diet lowers resistant starch intake but does not affect serum trimethylamine-N-oxide concentrations in healthy women.” Br J Nutr. 2019 Feb;121(3):322-329. doi: 10.1017/S000711451800329X. Epub 2018 Nov 13.

Govers MJ, et al. “Wheat bran affects the site of fermentation of resistant starch and luminal indexes related to colon cancer risk: a study in pigs.” Gut. 1999 Dec;45(6):840-7.

Hoffmann C, et al. “Archaea and fungi of the human gut microbiome: correlations with diet and bacterial residents.” PLoS One. 2013 Jun 17;8(6):e66019. doi: 10.1371/journal.pone.0066019.

Jin W, Cheng Y, Zhu W. “The community structure of Methanomassiliicoccales in the rumen of Chinese goats and its response to a high-grain diet.” J Anim Sci Biotechnol. 2017 Jun 1;8:47. doi: 10.1186/s40104-017-0178-0.

Qi J, et al. “Circulating trimethylamine N-oxide and the risk of cardiovascular diseases: a systematic review and meta-analysis of 11 prospective cohort studies.” J Cell Mol Med. 2018 Jan;22(1):185-194. doi: 10.1111/jcmm.13307. Epub 2017 Aug 7.

Raymann K, et al. “Unexplored Archaeal Diversity in the Great Ape Gut Microbiome.” mSphere. 2017 Feb 22;2(1). pii: e00026-17. doi: 10.1128/mSphere.00026-17.

Tamanai-Shacoori Z, et al. “Roseburia spp.: a marker of health?” Future Microbiol. 2017 Feb;12:157-170. doi: 10.2217/fmb-2016-0130.

van de Pol JA, et al. “Gut Colonization by Methanogenic Archaea Is Associated with Organic Dairy Consumption in Children.” Front Microbiol. 2017 Mar 10;8:355. doi: 10.3389/fmicb.2017.00355. eCollection 2017.

Vanderhaeghen S, Lacroix C, Schwab C. “Methanogen communities in stools of humans of different age and health status and co-occurrence with bacteria.” FEMS Microbiol Lett. 2015 Jul;362(13):fnv092. doi: 10.1093/femsle/fnv092.

Vanessa DN, et al. “Archaea: Essential inhabitants of the human digestive microbiota.” Human Microbiome Journal, 2017 3:1-8. doi.org: 10.1016/j.humic.2016.11.005.

from https://www.thepaleomom.com/paleo-resistant-starch-and-tmao-new-study-warning-worth-heeding/ from https://myfunweightloss.blogspot.com/2019/08/paleo-resistant-starch-and-tmao-new.html

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SCIENCE SIMPLIFIED:

A human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and production of TMAO, which is linked to cardiovascular disease and some forms of cancer.

The study demonstrates that a low-carb Paleo diet increases TMAO, attributable to a decrease in probiotic bacteria from the Bifidobacterium and Roseburia genera and an increase in Hungatella species in the gut.

The dietary factors most strongly associated with the undesirable gut microbiome shift and TMAO production were total carbohydrate intake and resistant starch intake.

While the authors conclude that lack of grains are to blame, the study participants were eating mostly non-starchy vegetables (about 7 servings per day, averaging 28 grams of fiber but only 90 grams of total carbohydrates).  Starchy roots and tubers are a healthy alternative to grains and would have increased the participant’s total carbohydrate intake (all slow-burning nutrient-dense carbs) as well as resistant starch intake.

The results of this study are relevant to our community and offer a stern warning against long-term low-carb implementations of the Paleo diet.

RELATED READING:

What Is the Gut Microbiome? And Why Should We Care About It?

The Case for More Carbs: Insulin’s Non-Metabolic Roles in the Human Body

Why Root Veggies Are Great for the Gut Microbiome

Whenever a new Paleo study comes out, it’s sure to stir up controversy—no matter what the findings are. “Good” findings are met with cheers from the Paleo community, while “bad” findings tend to explode in media headlines and send the Paleo community rushing to find reasons the study is poorly conducted, inaccurate, or otherwise worth dismissing.

As you know, I don’t believe in dismissing scientific findings (except for the rare occasion where flaws in how the study was designed or conducted result in retraction).  Instead, I seek to understand the data in the context of the research field as a whole, seeking context and nuance while being open to adjusting my conclusions and recommendations. (I discuss the merits of different types of scientific studies as well as the problem with cherry-picking data in my Introduction to Nutritional Sciences online course.)

Recently, a human study was published looking at how long-term adherence to a Paleo diet affects the gut microbiota and TMAO.  And, the headlines (both mainstream media and outlets targeting physicians) have not been flattering, for example: “Paleo Diet Increases Risk for Heart Disease”, “Paleo Diet Study Links ‘Caveman’ Regime to Heart Disease Biomarker”, and “Study Linking Paleo Diet to Increased Heart Disease Risk Strengthens Diet Industry Concerns”.

As you’re probably aware by now, I’m all about the gut microbiome, and believe it will continue to prove itself as a massive missing piece in our health puzzle! For that reason, this study is particularly interesting and important to look at (and not dismiss!).

Before we dive into the study itself, let’s review the things we need to know to make sense of the findings!

  A Refresher on Fiber, Resistant Starch, and the Microbiome

The gut is a biological niche, home to a diverse array of microbes that influence nearly all aspects of human biology through their interactions with our bodies. We have a symbiotic relationship with these microbes, collectively referred to as our gut microbiome—in exchange for food and shelter, they contribute to our wellbeing by performing diverse functions essential to our health.

When we don’t have a healthy diversity of the right kinds of microbes in our gut, our entire body suffers. An unfavorable gut microbiome has been linked to conditions as wide-ranging as cancer, obesity and other metabolic problems, heart disease, anxiety, depression, autism, autoimmunity, ulcers, IBD, liver disease, systemic infections, and more.  See What Is the Gut Microbiome? And Why Should We Care About It?.

I’m writing a book on the gut microbiome, so I could expound for days, but let’s focus on a few specifics that are particularly important to understanding this new paper.

Fiber Is Food for Our Gut Microbiome

If there’s one thing our gut microbes love, it’s fiber. In fact, out of all the dietary factors that can impact the gut, fiber may be the most important.

Carbohydrates, including fiber, are chains of monosaccharides (simple sugars) and of chemical derivatives of monosaccharides. Both the types of simple sugar (and their derivatives) in the chain and the ways they link together to form chains (both overall structure and the types of chemical bonds between sugar molecules) determine what type of carbohydrate it is. What separates fiber from other carbohydrates is that the way the sugars link together are not compatible with our digestive enzymes; our bodies just aren’t capable of breaking apart those types of molecular bonds. Instead, fiber passes through the digestive tract mainly intact. And once it reaches the colon, the magic begins: fiber serves as a substrate (food) for a wide range of bacteria, including some of the most important species we can harbor!

Why Different Fiber Types Feed Different Bacteria

The bacteria that live in our guts are collectively capable of producing over ten thousand different enzymes that can break down complex carbohydrates like fiber, which is pretty remarkable when you consider that we only produce about 17 different enzymes that digest carbohydrates! These enzymes belong to at least 206 different families of CAZymes (which stands for “Carbohydrate-Active enZymes”). Enzymes are typically highly specialized, breaking apart only specific molecular bonds, which is why different types of carbohydrates require different enzymes to break them apart (and why we can’t digest fiber but our gut bacteria can).

When it comes to carbohydrate degradation, some bacteria are highly specialized, producing only a few dozen CAZymes, whereas others are multitaskers, producing hundreds of CAZymes which allows them to grow on a variety of substrates and adapt to changing nutritional circumstances, thereby giving them a competitive advantage in the gut ecosystem.

Bacteria from the Bacteroides genus in general tend to be multitaskers, producing enzymes that can break down starch, pectin, hemicelluloses, and other plant carbohydrates (galactomannan, arabinogalactan, alginate, laminarin and xylans xyloglucan, rhamnogalacturonans I and II, β-glucans and glucomannan, to name a few!). Bacteroides thetaiotaomicron is an example of multitasker, considered a diet insensitive strain thanks to its ability to produce around 400 CAZymes (at least 260 of which are glycoside hydrolases) that help it thrive on pectins as well as complex carbohydrates that are produced by our own intestinal cells, such as mucin (a glycoprotein that is a major component of mucus).

In contrast, Bifidobacterium species are more specialized, producing an average of 45 CAZymes that make them highly effective at degrading high amylose starches, including resistant starch, as well as fructooligosaccharides, galactooligosaccharides, and inulin fiber. The critical consequence is that Bifidobacterium don’t survive if our diet doesn’t include sufficient amounts of these starches and fiber types.

Importance of Fiber Variety in the Diet

One of the consequences of this diversity in CAZyme production by various resident microbes is that different fermentable carbohydrates support different species in the gut. Therefore, consuming a variety of dietary fibers—various cellulose, hemicellulose, pectins, gums, fructans, glucans, mucilage, chitin, chitosan, and resistant starch fiber—best supports a diverse microbial community compared to a diet comprised of less varied fermentable carbohydrates like the Standard American Diet which is rich in refined carbohydrates.

Which foods are rich in which fiber sources?

Cellulose is found in all plants, but foods that contain particularly large amounts of cellulose include bran, legumes, nuts, peas, root vegetables, celery, broccoli, peppers, cabbage and other substantial leafy greens like collards, and apple skins. See The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

Hemicellulose is particularly high in bran, nuts, legumes, and whole grains, as well as many green and leafy vegetables.

Pectin is found in all fruits and vegetables but are particularly rich in certain fruits, including apples and citrus fruits, and are also found in legumes and nuts. See Why Fruit is a Good Source of Carbohydrates

Lignin is most commonly a component of wood, but food sources include root vegetables, vegetable filaments (like the stems of leafy greens and the strings in celery), many green, leafy vegetables, wheat, and the edible seeds of fruit (such as berry seeds and kiwi seeds). See Polyphenols: Magic Bullet or Health Hype?

Chitin is found not only in plants and fungi but also in the exoskeletons of insects and in the shells of crustaceans. See Elevating Mushrooms to Food Group Status and Why Crickets Are Great for the Gut Microbiome.

Chitosan is naturally found in the cell walls of fungi but are also produced as a functional fiber by treating shrimp and other crustacean shells with sodium hydroxide. See Elevating Mushrooms to Food Group Status.

Beta-glucans are found in some grains (mainly oats and barley, but also rye and wheat), fungi (yeast and mushrooms, particularly those mushrooms that are used medicinally like shiitake and maitake), and some types of seaweed (mainly algae). Beta-glucans are the fiber in oats that are largely responsible for their unique health benefits among grains. See Why Seaweed is Amazing! and Elevating Mushrooms to Food Group Status.

Fructans are naturally occurring in a variety of plants and are particularly high in chicory, Jerusalem artichoke and alliums (the onion family). Cruciferous vegetables contain modest amounts of fructans. See What about the Goitrogens in Cruciferous Veggies?.

Gums are a diverse group of fibers that plants secrete when they are damaged. Isolated versions are used in food manufacturing as thickening and gelling agents (like guar gum and xanthum gum). See Is It Paleo? Guar Gum, Xanthan Gum and Lecithin, Oh My!.

Mucilages are particularly concentrated in cacti and other succulents (like aloe), many types of seaweed (like agar agar algae), flax, chia and psyllium. They can also be found in relatively large amounts in a variety of fruits and vegetables, including plantains, bananas, taro root, cassava, and berries. See Mucilaginous Fiber: The Good, the Bad, and the Gooey and The Verdict on Psyllium Husks: Not Paleo!.

Resistant starch is divided into four subgroups: RS1 is rich in grains, legumes, and seeds; RS2 is found in most roots and tubers, and particularly high in green bananas, green plantains, and raw potatoes; RS3 is rich in cooked and cooled roots and tubers, particularly potatoes, as well as cooked and cooled rice; RS4 is the product of enzymatically or chemically modified starches sold under various brand names. See also Resistant Starch: It’s Not All Sunshine and Roses.

Because of their varying fiber types (and other food compounds that influence gut microbial composition like micronutrients, phytochemicals, proteins and fats), different families of fruits and vegetables are independently beneficial for the gut microbiome.  See also The Fiber Manifesto-Part 2 of 5: The Many Types of Fiber

That means that beyond aiming for 8+ servings of fresh vegetables and fruits daily (see also The Importance of Vegetables), it’s important to hit as many of the different families of vegetables and fruits each day, ideally cycling through all of them every two days: cruciferous vegetables, leafy vegetables, roots and tubers, mushrooms, alliums, apple family, citrus, berries, nuts and seeds, etc.

Resistant Starch-Rich Foods as Microbiome Superfoods

Resistant starch is classified as a fiber because amylase, the enzyme that breaks starch into individual glucose units, doesn’t work on this type of starch.

Resistant starch is insoluble yet highly fermentable, and is divided into four subgroups: RS1, which is physically inaccessible due to being bound within cell walls; RS2, which is tightly packed ungelatinized granules found in certain raw starchy foods; RS3 (retrograded amylose), which is formed when certain starchy foods are cooked and then cooled down; and RS4, which is formed via a manmade chemical process. See also Resistant Starch: It’s Not All Sunshine and Roses

In general, resistant starch is famous for feeding short-chain-fatty-acid-producing bacteria and enhancing levels of butyric acid. In a human study, RS2 was shown to increase the abundance of Ruminococcus bromii and Eubacterium rectale, whereas RS4 increased Bifidobacterium adolescentis and Parabacteroides distasonis. Long-term feeding of RS1 and RS2 in rats showed that both types increased the abundance of anaerobes, the levels of Bifidobacteria, and total SCFAs in the cecum; meanwhile, RS2 (but not RS1) enhanced levels of Lactobacillus, Streptococci, and Enterobacteria. In pigs, RS3 has been shown to increase the abundance of Faecalibacterium prausnitzii while reducing levels of E. coli and Pseudomonas species. Interestingly, Ruminococcus bromii plays a keystone role in the degradation of resistant starch, releasing breakdown products that are then utilized by other microbes in the gut.

Two Important Probiotic Bacteria: Bifidobacteria and Roseburia

Hundreds of beneficial probiotic species of bacteria (as well as fungi like yeast and archaea, which we’ll come back to) have been well studied in terms of their roles in the gut microbiome and human health in general.  I want to focus in on two genera of bacteria that are particularly relevant to this new paper.

The Bifidobacteria genus exerts a range of beneficial effects on human health, including producing vitamins, inhibiting pathogens from colonizing or infecting the gut mucosa, helping regulate the microbiome’s homeostasis, modulating local and systemic immune responses, repressing potentially carcinogenic enzymatic activities among different bacteria, and facilitating the bioconversion of various dietary compounds into bioactive forms. In a variety of studies, Bifidobacteria have been shown to improve the gut barrier function, suppress E. coli, improve glucose tolerance, reduce low-grade inflammation, and reduce endotoxemia induced by high-fat diets. As another benefit, because Bifidobacteria produce lactic acid instead of gas, people with higher levels tend to have less flatulence and digestive problems!

There are 39 identified species of Bifidobacteria, which represent 3-6% of health adult fecal flora.  Their favorite foods are resistant starch 2, resistant starch 4, oligosaccharides from plants and milk, and hexose.

Let me emphasize: Bifidobacterium are critically important to human health.  If you see an argument dismissing this paper because somehow low-carb diets or low-carb Paleo benefits make up for missing Bifidobacteria, that is unequivocally false.

The Roseburia genus are butyrate-producing bacteria that are implicated in maintaining gut barrier health and immune regulation, with strong anti-inflammatory properties.  Reduced levels of Roseburia are associated with inflammatory bowel disease (Roseburia actually suppress the pathogenesis of Crohn’s disease), irritable bowel syndrome, obesity, type 2 diabetes, cardiovascular disease, neurological diseases, autoimmune disease, asthma and allergies—likely mediated through higher intestinal permeability and inflammation.

There are five known species of Roseburia (R. intestinalis, R. hominis, R. inulinivorans, R. faecis and R. cecicola) and their favorite foods are beta-glucans, fructans, pectin and resistant starch.

  The Deal with TMAO

So, where does TMAO fit into the microbiome?

In recent years, trimethylamine-N-oxide (TMAO) has emerged as a possible new risk factor for cardiovascular disease, with potential to other conditions as well (such as chronic kidney disease, chronic heart failure, and colorectal cancer). For instance, a meta-analysis using 11 prospective studies found that higher circulating levels of TMAO were associated with a 23% increased risk of cardiovascular events and a 55% increased risk of all-cause mortality. This little molecule gets produced from the microbial metabolism of choline, lecithin, and carnitine (from our diet) into trimethylamine (TMA), which the liver then oxidizes into TMAO. Once it’s in our bodies, TMAO gets transported to different tissues and can potentially accumulate.

However, our levels of TMAO aren’t just a matter of how much free TMAO or TMAO precursors we ingest! Gut bacteria, especially the genus Prevotella, is a key mediator between diet and the amount of TMAO in our blood. In one study, researchers found that participants with gut microbiomes dominated by Prevotella were the ones who produced the most TMA (and therefore TMAO, after it reached the liver) from the carnitine they consumed. Those with microbiomes high in Bacteroides rather than Prevotella saw dramatically less conversion to TMA and TMAO.

So far, the list of TMAO-producing bacteria also includes multiple Clostridium species, Desulfovibrio desulfuricans, Providencia rettgeri, Edwardsiella targa, Escherichia fergusonii, Anaerococcus hydrogenalis, Proteus penneri, Firmicutes, and Proteobacteria. In other words, we can’t look at TMAO without also looking at the composition of our gut microbiota!

TMAO: Symptom or Cause of Heart Disease?

Despite some compelling associations with disease and mortality, there’s still a lot of controversy over whether TMAO has a causal relationship with the conditions it’s been associated with. On one hand, we have identified some plausible mechanisms for its role in disease, especially heart disease. For example, TMAO appears to increase the number of scavenger receptors in macrophages, resulting in greater binding to LDL particles and subsequent foam cell formation (foam cells play a major role in the progression of atherosclerotic plaque buildup!). TMAO also interferes with sterol transportation and bile acid metabolism, which can further contribute to the development of heart disease. And, TMAO may increase platelet activity, which can raise the risk of thrombosis by promoting excessive coagulation in the blood.

But despite these possible mechanisms, the literature is still mixed when it comes to how elevated TMAO plays out in real life! Along with studies showing a link between high TMAO levels and disease or mortality, many studies have failed to find any predictive value for TMAO on cardiovascular events, chronic kidney disease, or heart failure.

It’s possible that high TMAO occurs as a result of some of these diseases, rather than as a causative factor (high TMAO makes sense in the case of kidney failure, for instance, because the kidneys are the major site of circulating TMAO clearance, and their compromised function would naturally lead to a buildup of TMAO).

It’s also very possible that gut microbiota compositions that contribute to chronic disease also happen to result in more TMA and TMAO production, making TMAO a marker for disease states rather than a causal risk factor. Overall, the jury’s still out!

The Fish Paradox

One of the major monkey wrenches in the whole TMAO story is a fishy one (pun intended). Seafood—famously considered heart-healthy—is one of the most abundant sources of free TMAO, and also contains TMAO precursors. And we’d be hard pressed to find a study that shows seafood is bad for our cardiovascular health (indeed, the vast majority of research shows that fish is one of the best things we can eat for our hearts!). Physiologically, TMAO helps fish survive in their marine environments by increasing buoyancy, acting as a form of antifreeze (by increasing osmotic concentration), and protecting tissue proteins against destabilizing forces. The degradation of TMAO into TMA is also what gives seafood its characteristic fishy odor! TMAO levels can vary dramatically between different species of fish (and even vary within the same species depending on the season), but in general, deep-sea fish and shellfish tend to be higher in TMAO than shallow water fish and shellfish, likely because of the role TMAO plays in protecting against pressure-induced protein damage.

Research has shown that following the consumption of seafood, blood levels of TMAO levels rise to significantly higher levels than after the consumption of beef or eggs. In one study, 40 participants were fed meals containing cod fish, eggs, beef, or a fruit control in random order, with week-long washout periods between each intervention. After the fish meal, participants’ plasma TMAO rose up to 62 times higher than after the beef, eggs, or fruit meals. These levels peaked at 2 hours post-meal and remained elevated for the remainder of the 6-hour study period. The rise in TMAO levels started within 15 minutes following fish consumption, indicating the TMAO was being directly absorbed rather than undergoing conversion in the gut by bacteria. This same study found dramatic variations in TMAO response after eating eggs or beef. Compared to baseline, TMAO levels ranged anywhere from a 30% decrease to a 270% increase!

Food vs. Microbiome Sources of TMAO

So, why would we see such extreme variations in TMAO levels after eating the same foods? The answer is, not surprisingly, bacteria! Stool analysis showed that compared to low TMAO producers, high TMAO producers had some important microbiota differences, including lower alpha-diversity, different species compositions, and a higher ratio of Firmicutes to Bacteroidetes (about 2:1, versus a 1:1 ratio for the low producers). And very importantly, as we’ll see in a moment, the Archaea phylum was completely absent in the microbiota of the high TMAO producers, but was represented among the low TMAO producers.

This study provided some important pieces for the TMAO puzzle. Along with demonstrating that fish (at least in the form of cod) yields vastly higher levels of TMAO and TMAO metabolites than beef or eggs, the study demonstrated that TMAO can be absorbed intact from foods like fish without involvement of the gut microbiota. That means that the level of TMAO we have in our bodies isn’t just a result of our gut microbiota churning it out from precursors, but can also be influenced by the direct consumption of TMAO from food. And, that could mean that high circulating TMAO from seafood potentially indicates a much different (AKA lower!) risk profile than high TMAO produced by disease-associated microbes.

So, as much as is still up in the air about TMAO, one thing seems pretty likely: we don’t want a gut microbiome that produces a lot of it. Whether or not TMAO itself turns out to be a major risk factor or just a red herring, and whether or not our circulating levels are a cause or consequence of specific health conditions, a high-TMAO-generating microbiota seems to be consistent with greater disease risk.

  Archaea: A Microbiome Missing Piece

Whenever we hear about the microbiota, it’s usually all about the bacteria, bacteria, and more bacteria! But, while bacteria might be numerically dominant among the microbes in our gut, they’re definitely not the only residents there. Another type of single-celled organism that call our GI tracts home are archaea. And, these little guys are incredibly important!

Archaea (sometimes called archaebacteria) are strict anaerobes that live in various mucosal sites throughout the body, including the intestinal mucosa. We aren’t born with archaea inside us, but we acquire them from the environment throughout life: by the time children are school-aged, archaea are almost universally present in the gut, and levels continue to increase with age (with the highest occurrence and diversity of archaea being found in older adults). Along with lacking lipopolysaccharide (meaning archaea won’t contribute to our endotoxin load), archaea is also the only domain of life that doesn’t include any known pathogens, which is pretty cool!

Archaea degrade TMA and TMAO

One important subtype of archaea are the methanogens, which produce methane gas as a byproduct of hydrogen reduction. Up to 95% of human guts harbor the methanogenic archaea Methanobrevibacter smithii and Methanosphaera stadtmanae, at varying levels. While the idea of producing methane might not sound very pleasant, some of these archaea (in particular, an order of methanogens called the Methanomassiliicoccales) actually play an integral role in reducing our TMAO production. Along with being able to use carbon dioxide, formate, and methanol (all released by bacteria breaking down food and other organic matter in the gut), these archaea can use methyl compounds like TMA and TMAO to generate methane. And that means that the archaea in our gut actually deplete the pool of TMA we have available to be converted into TMAO (along with any free TMAO from foods like seafood). So, all that TMA generated by Prevotella, or entering our body from fish consumption? Archaea can help wipe some of it out!

The TMAO-reducing effects of archaea is far from just speculative, too. In a study of ELDERMET subjects, the fecal TMA concentration in people with TMA-metabolizing archaea was significantly lower than in those without this archaea—and the difference was particularly dramatic when the abundance of Methanomassiliicoccales was greater than 10^8 cells per gram of stool. This role of archaea is so exciting that some scientists are proposing a new class of probiotics called archaeabiotics, which could help reduce our TMAO levels without us needing to cut back on choline and other important nutrients!

Importantly, methanogenic archaea have an important interactive relationship with bacteria in the gut, which often takes the form of what scientists call syntrophy (where two organisms participate in consuming a substance that neither one can catabolize on its own). And, it appears that archaea are particularly chummy with the important probiotic bacteria Bifidobacteria. For example, mixed cultures of M. smithii and Bifidobacteria bifidum have been shown to collectively produce methane from glucose, and in females with gut Methanobacteriales levels higher than 0.71%, there’s a significantly higher mean abundance of Bifidobacteriaceae. And as we’ve already seen, healthy levels of Bifidobacteria are super important!

Archaea Thrive When We Eat Carbs!

So, how do we keep our archaea happy and thriving? Scientists are just at the beginning stages of understanding how diet impacts our archaea colonies (after all, archaea are relative newcomers to the microbiota research scene compared to bacteria!), but here’s what we know so far. In children, organic dairy (especially organic yogurt and organic milk) has been associated with the initial colonization of M. smithii, due to organic dairy serving as a vehicle for delivering it to our guts. And, some methanogens degrade methanol, which gets produced when bacteria degrade pectin in fruits—thus suggesting that archaea might benefit from including fruit in our diets! In Chinese goats, eating a high-grain diet appears to suppress methanogenic archaea relative to a high-hay diet—possibly due to the pH-lowering effect of grains in the rumen (which can then suppress methanogenic archaea that are sensitive to low pH environments). Obviously, we’re not Chinese goats, but it would certainly be interesting if a high-grain diet in humans had a similar effect!

More broadly, though, in humans, Methanobrevibacter abundance is positively associated with higher carbohydrate consumption (both recent and long-term), and negatively associated with recent consumption of fat (especially vegetable fat and polyunsaturated fat intake) and amino acids. Although more research is definitely needed, the picture getting painted so far is that archaea benefit from a variety of plant polysaccharides, and not so much from animal-based diets.

However, this isn’t because the archaea themselves eat carbohydrate. In fact, methanogenic archaea have an almost complete lack of enzymes for breaking down complex carbohydrates into simple sugars. What does appear to be happening is that archaea thrive off the metabolic products of carbohydrate-loving bacteria, and therefore are still dependent on dietary carbohydrate for their own survival!

  The Study: Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations

Whew! Now that we’ve covered the necessary background, let’s take a look at what this study is all about!

Researchers recruited a total of 44 participants who self-reported following a Paleo diet for over a year, along with 47 controls who more or less followed the national dietary recommendations of Australia (where the study was conducted). Within the Paleo group, participants were further divided based on how strictly they followed the Paleo framework (as gauged by the exclusion of grain and dairy products): 22 people fell into the “strict Paleo” group (less than one serving of grains and/or dairy per day), and 22 people fell into the “pseudo-Paleo” group (more than one serving of grains and/or dairy per day). (This is important, because “real-world” Paleo includes a variety of interpretations about what Paleo actually means, including how strictly to adhere to the diet—so a pseudo-Paleo group might be closer to reality for a lot of people!)

The study excluded anyone who’d taken antibiotics within the past six months, who had any type of GI tract surgery, who had past or present digestive disorders, who used cholesterol or blood pressure lowering medications, or who had been diagnosed with cardiovascular disease. This helped make sure the results weren’t confounded by preexisting health conditions or drugs, and allowed the researchers to better isolate the effects of the participants’ diets.

To ensure accurate dietary data, the researchers had participants undergo three-day weighed diet records (including two weekdays and one weekend day), which were then validated using urine nitrogen tests (which could detect whether participants were over- or under-reporting their protein intake) and the Goldberg cut point (which can identify which participants were under-reporting their energy intake, through the ratio of energy intake to basal metabolic rate). Participants who appeared to inaccurately report both their protein and energy intake were deemed unreliable dietary reporters (this ended up being two people from the strict Paleo group and three people from the control group).

Paleo Diet Adherents Had Increased TMAO

Now, the headline-grabbing finding. In the strict Paleo group, serum TMAO was a whopping 9.53 µM, the pseudo-Paleo group averaged 5.47 µM, and the control group averaged 3.93 µM. Higher TMAO levels were associated positively with red meat intake and negatively with grain intake.

Whether TMAO is a causative agent for disease or a marker for a disease-associated microbiota, those are some scary numbers—especially for the strict Paleo group!

What Study Participants Were Actually Eating

So, what were the Paleo groups actually eating? Here’s what the data showed!

Not surprisingly, both Paleo groups ate more protein than the controls (118 and 102.7 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 92 grams for the controls), less carbohydrate (99 and 81.4 grams per day for the strict Paleo group and pseudo-Paleo group, respectively, compared to 202.6 grams for the controls), less sugar (51.8 and 44 grams per day for the Paleo groups, and 75.6 grams for the controls), and more fat—with the increase mostly coming from saturated and monounsaturated forms (117.9 total fat grams per day for the strict Paleo group, 133.1 grams for the pseudo-Paleo group, and 82.5 grams for the controls).

Importantly, total dietary fiber was adequate (and very similar!) for both the control group and the strict Paleo group—29.7 grams and 27.4 grams daily, respectively, which falls within the recommended daily intake of 25-30 grams for adults. The pseudo-Paleo group averaged 20.8 grams of fiber each day, which is still more than most people consume! For the Paleo groups, much of their fiber came from vegetables, with the strict Paleo group eating 6.7 servings of veggies per day and the pseudo-Paleo group averaging 4.3, compared to the control group’s 3.93. (We could definitely argue that the official recommendations for fiber are still too low for optimal health, but the point here is, these study participants weren’t slacking on the non-starchy veggies!)

While the control group averaged 4.5 – 14.2 grams of resistant starch per day, largely from grains (those are estimated minimum and maximum amounts, since the same foods can vary in resistant starch content), the strict Paleo group averaged only 2.6 – 6.1 grams per day, and the pseudo-Paleo group got a mere 1.3 – 2.9 grams of resistant starch. That’s a significant drop off!

Low-Carb Paleo Effects on the Microbiome

Remember that one of the favorite foods of Bifidobacteria is resistant starch? And that Roseburia also likes to munch on carbohydrates like beta-glucans? Maybe we shouldn’t be surprised that this study showed a significant decrease in these important bacteria among both Paleo groups.

Likewise, the relative abundance of Hungatella was significantly higher among the Paleo subjects. After adjusting for age, gender, stool frequency, and body fat, Hungatella abundance was significantly negatively associated with grain intake among the study’s participants, and was also significantly negatively correlated with Bifidobacteria and Roseburia abundance. Although we don’t have a lot of information about Hungatella in relation to human health (not yet, anyway!), we do know that some species originating from the genus Hungatella are associated with choline consumption and TMA production, including at least one species identified in this study. The researchers speculated that some components of grains and/or whole grains either interfere with Hungatella’s TMA production or prevent it from dominating in the gut. And, these components might not be resistant starch, since neither Hungatella nor TMAO was significantly associated with resistant starch intake!

    Resistant Starch and Total Carb Intake Are Important!

One of the things that makes this study so interesting (and important!) is the fact that fiber and vegetable intake was relatively high for both Paleo groups. Often, when we talk about how ketogenic diets or low-carb or low-starch Paleo might affect the gut microbiome, we’re given a false sense of security thinking we’ll be fine as long as we eat plenty of fiber from leafy greens; see also How Ketogenic Diet Wreaks Havoc on Your Gut. As this study indicates, low-starch veggies alone are not enough to maintain a robust, diverse gut microbiome! The Paleo subjects clearly weren’t ingesting a broad enough array of fibers and starches to support some very important bacterial populations.

Given all that, can we just add some supplemental resistant starch to otherwise low-carb diet and call it a day?

Actually, the answer here seems to be no! Consistent with my post Resistant Starch: It’s Not All Sunshine and Roses, the research shows that isolated resistant starch doesn’t bring the same range of benefits as resistant starch from whole-food sources. And what’s more, when it comes to TMAO, supplemental resistant starch may even be counterproductive in the context of a low-carb and/or high fat diet. In a human cross-over trial from 2016, for example, 52 adults consumed four different diets in random orders—a low resistant starch, higher carbohydrate diet; a low resistant starch, lower carbohydrate diet; a high resistant starch, higher carbohydrate diet; and a high resistant starch, lower carbohydrate diet (with resistant starch coming from Hi-Maize 260, supplying RS2). Intriguingly, the highest TMAO levels occurred when subjects were eating the high resistant starch, lower carbohydrate diet, despite dietary levels of carnitine and choline being less on that diet compared to the low resistant starch periods. The researchers proposed that a high isolated resistant starch intake, in the presence of an overall lower carbohydrate diet, shifted the microbiota towards greater TMAO generation. Likewise, studies in rodents have shown that high fat consumption (which often goes hand-in-hand with low-carbohydrate diets), in the amount of of 42% of total energy, partially counteracts the beneficial effects of RS2 by suppressing levels of beneficial bacteria. So, low-carb diets can be a double whammy against our gut microbiota, both by failing to supply a wide range of fiber and starch types and by overloading our guts with levels of fat that become harmful to bacteria. (Don’t worry; we aren’t calling fat bad here—but a balanced intake of macronutrients seems to be where the evidence is pointing for optimal health!)

Other studies support the idea that resistant starch is most health-promoting in conjunction with other dietary carbohydrates. In pigs, resistant starch alone (in the form of RS2) was shown to get rapidly fermented in the proximal (beginning part) of the colon, while failing to reach further down into the distal (lower) colon—resulting in only a small portion of the colon receiving fermentation benefits. But, when additional carbohydrate in the form of wheat bran (a soluble non-starch polysaccharide) was included in the pigs’ diets, the amount of resistant starch getting fermented between the lower colon and feces nearly doubled—indicating that the bulk from the wheat bran was helping spread fermentation further down through the colon, flooding a much greater area with cancer-protective butyrate. The addition of wheat seed (RS1) to supplemental green banana flour and high-amylose starch (RS2) has been shown to help spread fermentation throughout the entire colon, as indicated by a decrease in fecal pH (which is a good thing!).

When it comes to low-carb Paleo diets, it’s easy to see how a similar effect could occur. Cutting out sources of bulky fermentable carbohydrate (like root veggies and legumes) limits how far isolated resistant starch can spread, resulting in bacteria in the proximal colon gobbling it up and leaving none for microbes further down the colon. Likewise, given what we know about the role of methanogenic archaea in regulating TMAO levels and interacting with other microbes like Bifidobacteria (as well as how much methanogenic archaea likes carbohydrates and doesn’t like fat!), we might suspect that low-carb diets can also enhance TMAO production by suppressing archaea growth.

As further confirmation, the main study we’ve been discussing in this article found that TMAO levels were more strongly negatively associated with grain intake than with resistant starch intake. That doesn’t mean we all need to eat grains to be healthy, but it does imply that diverse components of starchy plant foods (such as the other forms of fiber and carbohydrate they contain) contribute to a healthy microbiome, even more so than resistant starch on its own.

Short-Term Vs. Long-Term Microbiome Shifts

We should also stress the importance of the long-term nature of this study! While shorter dietary trials can be very useful (and in some cases, are the only studies we have at our disposal), they can’t capture potential health issues that develop months or years down the line (such as gradual changes in the core gut microbiota composition). That’s particularly relevant here, because the same researchers who conducted this study previously published a similar one, randomizing 22 women to a Paleo diet for four weeks and 17 women to a diet in line with Australian health recommendations. In that study, there wasn’t a significant change in TMAO concentration compared to the control group, despite a lower intake of resistant starch and higher intake of meat and eggs among the Paleo dieters. While those findings could have been due to the small sample size and limited data for resistant starch content of foods (making it difficult to precisely calculate resistant starch intake), it’s also possible that the Paleo group hadn’t yet exhibited some longer-term microbiota shifts that lead to higher TMAO generation as seen in the more recent study.

Indeed, the field of microbiota research has shown us that while some microbial changes happen rapidly when we alter our diet, others can occur on a more gradual basis. So, only using participants who had been eating Paleo for over a year gives this study greater insight into the full effects that low-carb Paleo has on the gut microbiota.

  The Bottom Line: Paleo Should Not Be Low-Carb

Some people have seen this paper as an attack on red meat, which, given the TMAO link, is a valid concern (see also The Link Between Meat and Cancer). But what this paper is actually making a case for is that starch-free diets are a problem. Don’t get me wrong: fibrous, low-starch veggies are fantastic, and we should be filling our plates with them on the daily—but not at the exclusion of Paleo starches! Root veggies rich in resistant starch are consistently showing up as a vital component of a nutrient-dense Paleo diet, and there are no real “hacks” to get around that (see also Why Root Veggies Are Great for the Gut Microbiome and Resistant Starch: It’s Not All Sunshine and Roses).

When we combine this information with an examination of the non-metabolic roles that insulin plays (another rationale for moderate [not low] carb intake, see The Case for More Carbs: Insulin’s NonMetabolic Roles in the Human Body and How Many Carbs Should We Eat?), the potential problems of too-high-fat intake (not that we wan’t to eat low-fat; see Saturated Fat: Healthful, Harmful, or Somewhere In Between?, Adverse Reactions to Ketogenic Diets: Caution Advised), and understanding that micronutrient sufficiency is most easily attained with a balanced macronutrient diet (see The Diet We’re Meant to Eat, Part 3: How Much Meat versus Veggies?, The Importance of Nutrient Density, and Carbs Vs. Protein Vs. Fat: Insight from Hunter-Gatherers), it’s becoming harder and harder to make a compelling case against moderate carbohydrate intake, 30 to 60% of total calories, from whole food sources.

  Citations

Bergeron N, et al. “Diets high in resistant starch increase plasma levels of trimethylamine-N-oxide, a gut microbiome metabolite associated with CVD risk.” Br J Nutr. 2016 Dec;116(12):2020-2029. doi: 10.1017/S0007114516004165. Epub 2016 Dec 20.

Borrel G, et al. “Genomics and metagenomics of trimethylamine-utilizing Archaea in the human gut microbiome.” ISME J. 2017 Sep;11(9):2059-2074. doi: 10.1038/ismej.2017.72. Epub 2017 Jun 6.

Charrier JA, et al. “High fat diet partially attenuates fermentation responses in rats fed resistant starch from high-amylose maize.” Obesity (Silver Spring). 2013 Nov;21(11):2350-5. doi: 10.1002/oby.20362. Epub 2013 Jul 2.

Cho, CE, et al. “Trimethylamine‐N‐oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial” M. A., Mol. Nutr. Food Res. 2016, 1600324. Doi: 10.1002/mnfr.201600324

Dridi B, et al. “High prevalence of Methanobrevibacter smithii and Methanosphaera stadtmanae detected in the human gut using an improved DNA detection protocol.” PLoS One. 2009 Sep 17;4(9):e7063. doi: 10.1371/journal.pone.0007063.

Dridi B, et al. “High prevalence of Methanobrevibacter smithii and Methanosphaera stadtmanae detected in the human gut using an improved DNA detection protocol.” PLoS One. 2009 Sep 17;4(9):e7063. doi: 10.1371/journal.pone.0007063.

Genoni, A, et al.  “Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations.” European Journal of Nutrition, 2019; DOI: 10.1007/s00394-019-02036-y

Genoni A, et al. “A Paleolithic diet lowers resistant starch intake but does not affect serum trimethylamine-N-oxide concentrations in healthy women.” Br J Nutr. 2019 Feb;121(3):322-329. doi: 10.1017/S000711451800329X. Epub 2018 Nov 13.

Govers MJ, et al. “Wheat bran affects the site of fermentation of resistant starch and luminal indexes related to colon cancer risk: a study in pigs.” Gut. 1999 Dec;45(6):840-7.

Hoffmann C, et al. “Archaea and fungi of the human gut microbiome: correlations with diet and bacterial residents.” PLoS One. 2013 Jun 17;8(6):e66019. doi: 10.1371/journal.pone.0066019.

Jin W, Cheng Y, Zhu W. “The community structure of Methanomassiliicoccales in the rumen of Chinese goats and its response to a high-grain diet.” J Anim Sci Biotechnol. 2017 Jun 1;8:47. doi: 10.1186/s40104-017-0178-0.

Qi J, et al. “Circulating trimethylamine N-oxide and the risk of cardiovascular diseases: a systematic review and meta-analysis of 11 prospective cohort studies.” J Cell Mol Med. 2018 Jan;22(1):185-194. doi: 10.1111/jcmm.13307. Epub 2017 Aug 7.

Raymann K, et al. “Unexplored Archaeal Diversity in the Great Ape Gut Microbiome.” mSphere. 2017 Feb 22;2(1). pii: e00026-17. doi: 10.1128/mSphere.00026-17.

Tamanai-Shacoori Z, et al. “Roseburia spp.: a marker of health?” Future Microbiol. 2017 Feb;12:157-170. doi: 10.2217/fmb-2016-0130.

van de Pol JA, et al. “Gut Colonization by Methanogenic Archaea Is Associated with Organic Dairy Consumption in Children.” Front Microbiol. 2017 Mar 10;8:355. doi: 10.3389/fmicb.2017.00355. eCollection 2017.

Vanderhaeghen S, Lacroix C, Schwab C. “Methanogen communities in stools of humans of different age and health status and co-occurrence with bacteria.” FEMS Microbiol Lett. 2015 Jul;362(13):fnv092. doi: 10.1093/femsle/fnv092.

Vanessa DN, et al. “Archaea: Essential inhabitants of the human digestive microbiota.” Human Microbiome Journal, 2017 3:1-8. doi.org: 10.1016/j.humic.2016.11.005.

from https://www.thepaleomom.com/paleo-resistant-starch-and-tmao-new-study-warning-worth-heeding/

[howellrichard]

Your Guide to Healthy Poop

Hiya Gorgeous!

I love talking turd, and I’m not ashamed to say it! Turd, turd, turd. It’s time we all stop hiding behind our toilet paper squares and start understanding one of the most important parts of our everyday well-being—healthy poop! Sure, it’s not the sexiest of subjects, but vibrant health is pretty darn hot, in my opinion. And whether you like it or not, your poo is part of that picture.

Without further a-doodoo …

The Scoop on Poop

Poop is made up of dead gut cells, leftover indigestible fiber and bacteria. As you know, your chow is processed in your intestines, which are lined with some very smart cells. These cells allow essential nutrients, such as sugars, amino acids, fats, vitamins and minerals to be absorbed into your bloodstream. The leftovers (aka the waste) are shuttled through the rest of your digestive system, out of your body and into the toilet.

How often should you poop?

How often you poop probably varies, and each person has their own normal. You may go as often as two to three times per day (basically after each meal) or as little as every other day. However, if you’re going more than four times a day with loose or watery stools, only going a couple times per week and feel bloated/backed up on non-poop days, or if your poop “normal” suddenly changes, you should probably consult your doctor.

How should pooping feel?

Your poops should slide out pretty easily with a fairly effortless push. Chances are, if you’re regularly grabbing a book or magazine as you head into the WC, or if you’re getting red in the face, you’re working too hard to get that little waste log out of there. It shouldn’t be painful or difficult to produce a BM. Later in this article, you’ll get some great tips to help you grease the tracks, but please consult with your doc if you’re experiencing persistent discomfort.

The Glamour Shot: What Does Healthy Poop Look Like?

Decoding the shape of poop.

Ready for an anatomy lesson? Since poop curves around and around inside your winding intestines, a healthy poop should look like an “S” or a “C” as it lands in your toilet. Small round pellets, thick logs without curvature, shapeless mounds and pencil-thin wormy poops mean that your diet, stress level, hydration status or something else might be out of whack.

What does the color of your poop mean?

Healthy poop should be a medium-brown color, courtesy of the leftover bile from your gallbladder (which helps break down your food). White or grey poop can indicate a problem with your pancreas or gallbladder. Yellow stool may be a sign of an infection or inflammation in your intestines, especially if you observe mucus in your poop. I encourage you to talk with your doc if your poop is any of those colors!

Green poop typically means you’re eating a LOT of veggies (bravo!) and some have slipped through undigested. This isn’t a cause for concern unless your stool is watery and green for several days.

Black poops can result from iron supplements, but could also be a sign of blood in your stools. Now I know that sounds a bit scary, but it’s not necessarily cause for concern. It could be the result of hemorrhoids, which can be tender and start bleeding if you’re straining too much while pooping (Ouchies! Ease up, hotshot). In that case, you may see a couple of drops of bright red blood in the toilet water, on your toilet paper or on the outside of your poop.

But blood in your poop could be serious, so please don’t ignore it!

If you’re consistently seeing bright red blood (whether or not you have hemorrhoids), or if your poop is blackish-red or contains dark red blood, the blood is likely coming from higher up in your gut. This could be more serious, so I encourage you to check in with your doc post-haste.

And a final note on the color of your number twos: If you’ve eaten beets within the last 24 hours, you might have reddish poop or pee. This isn’t anything to worry about—just thank those deliciously colorful root veggies for adding some extra pizzazz to your poo.

Healthy poop is a part of your overall #wellness. Let’s stop being shy & start talkin’ toilet trips! @Kris_Carr

What texture should your poop be?

A healthy poop will be formed but soft—think toothpaste consistency (sans the mint). Hard, dry, pellet poop indicates constipation. Loose, unformed or watery poop is diarrhea. If it’s foamy poop or floating on top of the toilet water, this could mean that you are not absorbing the fat in your diet very well—especially if it’s incredibly foul-smelling. This is another reason to trot to your doc. If the texture of your poop suddenly changes (becomes much thinner or thicker, or if mucus is present) and you haven’t recently made any dietary or activity changes, it might be a good time to check in with your doc.

How to be a Gold Star Pooper

The Four Fs are a general rule of thumb for happy bowel movements: fiber, fluids, flora and fitness!

Fiber:

What foods help you poop? Ones with dietary fiber for starters. As you learned in my guide to fabulous fiber, it comes in two forms: soluble and insoluble. Lack of either creates pooper pandamonium.

Soluble fiber absorbs water and forms a gel in your intestines, which bulks up your poop and makes it smooth enough to keep the trains moving. Soluble fiber also helps regulate blood sugar and can lower cholesterol levels. Add these foods to increase soluble fiber: oatmeal, apples, oranges, pears, berries, flax, beans, peas, lentils and psyllium (corn husk).

Insoluble fiber does not absorb water, so it acts like the bristles in a broom to sweep poop along. It also has a mild laxative effect, which helps with healthy elimination. Add these foods to increase insoluble fiber: whole grains, nuts, seeds, dark leafy greens, celery, broccoli, cabbage, onions, dried fruit and root vegetable skins.

You’ll know you’re getting too much fiber (or an imbalance of soluble to insoluble fiber) if you have diarrhea. It’s also important to include whole grains in your diet because they add bulk and movement to your fibrous stools. You can get still get constipated on a high-fiber diet if your diet lacks sufficient whole grains!

Find out how to supercharge your favorite meals with fiber and lots of other health-giving ingredients! Download your free 10 Recipe Boosters Cheat Sheet here:

Fluids:

When you increase fiber, you also need to increase your fluid intake. Remember, soluble fiber absorbs water, which means you’ll need more H2O to stay hydrated and prevent constipation. There are two easy ways to estimate how much water you need each day:

Divide your body weight in pounds by two. This gives you the approximate amount of water in ounces that you need to drink per day. For example, a 140-lb woman should drink about 70 oz. For those using the metric system, divide your weight in kilograms by 30 to determine how many liters of water you need per day.

Look at your pee—it should be a light straw color. The darker your pee gets, the more concentrated it has become, which indicates that you need to drink more fluids.

Flora:

Your intestines are home to over 100 trillion bacteria and a great deal of this bacteria (good guys and bad guys) end up in your poop. Good bacteria (also known as probiotics) are very important to help keep us regular. We need probiotics to work alongside our digestive enzymes and help break down food to release the nutrients our bodies need. In return, probiotics survive and multiply in our gut when they dine on the leftover fiber from our digested food.

To increase good bacteria in your gut:

Eat fermented foods like tempeh, miso, kombucha and sauerkraut.

Eat high-fiber foods (prebiotics). Learn about the best prebiotic foods to add to your diet in my blog, 3 Ways to Boost Your Digestion & Improve Gut Health.

Take a high-quality probiotic supplement (check out My Top Supplement Recommendations blog for some good brands).

For more tips on building strong belly bacteria, check out my Essential Guide to Gut Health.

Fitness:

If you want your poop to move, YOU need to move too! Exercise helps stimulate the natural contractions of your intestines. It also tones the muscles in your core that help create healthy elimination. Gentle activities such as taking a walk or yoga can help ease constipation, but moderate aerobic activity on a regular basis is a more effective way to keep constipation at bay in the long run. Score!

A Word About Constipation and Diarrhea

Occasional constipation and diarrhea are very common and nothing to worry about. But if you’re experiencing either for more than a week, it’s a good time to make sure you’re getting the Four Fs. And if the symptoms persist, it might be time for a visit to the doc.

There are certain health conditions and medications that can make your poops extra pesky. If you’ve had your gallbladder removed, for example, too much fat at one meal can cause diarrhea because the bile normally stored in your gallbladder isn’t available to break it down. For more deets on diarrhea (plus lots of tips to help you stop it!) check out my blog here. And if constipation’s got you down, check out my blog on that here.

It’s your turn, don’t be shy! Now that I’ve opened the bathroom door and started the poop-ersation, light a match and share your tips for healthy elimination.

Peace & terrific turds,

The post Your Guide to Healthy Poop appeared first on KrisCarr.com.

[clarencebfaber]

How to Choose the Best SIBO Diet to Heal

SIBO diet is a combination the SCD diets and low FODMAPs. This restrictive diet may help relieve more symptoms in some people. Read this post to learn more about SIBO diet and all the food categories.

How to Choose the Best SIBO Diet—Keto, AIP, Low FODMAP & Beyond

Let food be thy medicine…especially when it comes to your SIBO diet. Here’s an overview of the best diets for treating SIBO—Keto, AIP, low FODMAP included—and a 3-step approach for choosing the best SIBO diet for your individual needs. 

SIBO 101

SIBO, or small intestinal bacterial overgrowth, is a condition, affecting the small intestine, wherein bacteria that normally grow in other parts of the gut start growing in the small intestine.

SIBO Symptoms

Common symptoms include:

bloating after meals

loose stools

IBS

constipation

food intolerances

nutrient deficiencies (like anemia, brittle nails and hair, pale skin, cold hands or feet). 

However, it’s important to be aware that SIBO can also manifest as many non-gut-related symptoms (such as skin conditions, high cholesterol markers, poor immune function, allergies (seasonal), blood sugar or hormone imbalances, and a slow metabolism).

Because of this, SIBO often goes under the radar in traditional healthcare settings. 

SIBO Diagnosis

SIBO is currently diagnosed through both:

An analysis of your signs and symptoms

At-home breath testing

Currently, an at home lactulose or glucose breath test is the gold standard. Although its not perfect and some cases SIBO may still be missed, this test is the best measure for assessing whether or not you have abnormal amounts of hydrogen or methane gas in your body (related to abnormal growth of gut bacteria). 

Stool testing, organic acids urine testing (OATS) and inflammatory blood markers are also helpful test tools that may contribute to your clinical picture. Under the guidance of a trained functional medicine provider or other knowledgable practitioner, you can better determine whether or not you have the condition. 

5 Essentials for SIBO Treatment

So what to do if you’ve been diagnosed with SIBO?!

Successful SIBO treatment involves a five-pronged approach including:

Proper Diagnosis & Testing Breath testing and/or working with a skilled clinician experienced in assessing and diagnosing SIBO.

Lifestyle Factors Addressing stress and lifestyle factors to promote SIBO healing, such as getting enough sleep and proper exercise—not too much, but not too little.

Appropriate Supplementation & Anti-microbial Treatment Beyond probiotics and pre-biotics, a supplement protocol and/or prescribed SIBO medication by your doctor that helps decrease the overgrowth of bacteria is essential. (Fun fact: studies show that herbal anti-microbial treatment can be just as effective, if not more, than prescription medications) (1).

Nutrient-Dense, SIBO-Reduction Diet Foods that help decrease your SIBO symptoms, and support gut healing.

Re-testing & Reestablishing a Healthy Gut Flora After SIBO is eradicated, a “plan of attack” to both re-assess if your treatment worked, and gameplan for adding back in a balance of healthy gut bacteria. 

While there is NO one-size-fits-all treatment protocol for kicking SIBO to the curb, these 5 essentials are “non-negotiables” for kicking SIBO to the curb. 

The best part?

SIBO healing and the remission of your symptoms is greatly within your own control!

In fact, there is no question that one of the greatest influences in your SIBO healing is what you are feeding your gut bugs (i.e. your SIBO diet).  (In other words: You cannot supplement your way out of a poor diet). 

Thus, a nutrition plan that works for your body’s unique needs is ESSENTIAL to not only feeling good, but helping your total SIBO protocol work for you.  

SIBO Diet Recommendations

The 4 most popular dietary recommendations for treating SIBO are:

The “Low Fermentation Diet”

The Low FODMAP Diet http://atxwoman.com/fodmap-diet/ 

Specific Carbohydrate Diet

Elemental Diet

Generally, the Low-FODMAP, Low Fermentation and/or Specific Carbohydrate Diets have helped many people over the years improve their symptoms. Then you have the Elemental Diet—more of a “last resort” 2-week diet, consisting of drinking an elemental formula. Elemental formulas are pre-digested, easily absorbed forms of nutrients to help starve gut bacteria.

All four of these SIBO diets are very similar, however, in that they restrict carbohydrates—specifically“fermentable fibers” and sugars that your gut bacteria LOVE to feast on (i.e. carbohydrates).

While certain foods may be “allowed” on one program, but not the other, generally the top foods to eliminate include:

SIBO Diet Foods to Eliminate 

Grains (breads, pastas, rice)

Starches (potato, sweet potato, yucca, taro)

Beans, Soy & Peas

Industrial Seed Oils (sunflower, grapeseed, cottonseed, soybean, canola)

Dairy (cheese, milk)

Sugar & Sweeteners (agave, honey, corn syrup, sweeteners)

Alcohol 

Corn

Cruciferous Veggies (cabbage, cauliflower, broccoli, brussels sprouts)

Garlic

Onion

Many fruits (apples, cherries, pears, bananas, watermelon, plums, nectarines, mangos, peach, pears)

Mushrooms

For some: Avocado, Coconut

The result? SIBO symptom relief from gut upset that typically happens when you eat a sweet potato, Brussels sprouts or quinoa—at least in the short term. 

The Problem with SIBO Diet Recommendations

The research is still out as to whether these diets help people improve in the long term—particularly once you’ve started a SIBO treatment protocol (supplements or medication). 

While all 3 SIBO diets are safe and can be helpful for gut issues like eliminating bloating, gas and IBS, a problem many people run into with these approaches is HOW and WHEN to reintroduce eliminated foods (if at all)—often discovering that their SIBO symptoms soon return when carbohydrates are allowed back in to the diet. 

“Will I ever be able to eat broccoli (or rice, or sweet potatoes, or apples) again?!” They cry. 

Unfortunately, long-term prebiotic fiber (carb) and FODMAP restriction can also backfire—since it not only decreases unhealthy bacteria, but healthy gut bacteria too. 

So what should you do?!

Mix and match!

Here are 6 novel (no-long-term-restrictive) SIBO diet approaches for healing your gut (and SIBO) for good— taking the most effective strategies from various gut-healing diets, and forming them together—all in one. 

The ultimate goal? Least restrictive diet as possible—all within the context of nutrient-dense foods of course (with the occasional Friday night pizza night if you must).

6 Non-Restrictive SIBO Diet Approaches

Start with Establishing a Real Food Base Simply put: Eat real food—as close to its natural state as possible. If it didn’t grow on the land, roam the earth, or swim in the sea, it’s not real food.  Real food includes:

Meats, poultry and fish. 

Healthy fats. 

Veggies & Fruits

Minimal starch

No added sugar

Lots of clean, filtered water

Supporting local, responsible producers and organic as much as possible

Phase 1: Short-Term Low Carb Diet (14-30 Days) Once you realize what “real food” is, you’re now ready to attack your SIBO diet in phases—starting with a lower carb or lower FODMAP reset.One consideration many people find short-term effectiveness from as a “therapeutic diet” is the ketogenic diet—a popular low carb (or “very low carb”) approach to eating that includes plenty of nutrient-dense healthy fats (ghee, coconut oil, coconut butter, olive oil, avocado, raw nuts/seeds), moderate amounts of organic protein, and 20-grams of “net carbs” or less per day.Many people with SIBO symptoms, find that a short-term break from many of the gut-bacteria-feeding foods (i.e. carbs and sugars found in carbs) can be a great relief from their SIBO symptoms while they get their personal SIBO treatment protocol (supplement supports and lifestyle factors) in place. Call it “keto,” “low carb,” or yes, “low FODMAP” or “specific carbohydrate diet,” the bottom line here is to confirm that for a short term (2-4 weeks), going “low carb” can be effective.The key for the effectiveness of these “low carb” approaches however is to ensure you are eating ENOUGH.  A common roadblock SIBO sufferers run into is unwanted weight loss, low energy and frail health due to the malabsorption of nutrients and IBS symptoms. Hence, reason why a keto approach may be more effective for curbing SIBO symptoms (in lieu of just going “low FODMAP” or “low carb) is that the emphasis on healthy fats can help boost energy stores (given your gallbladder and liver are healthy and able to digest these fats in the first place).Check out the sample SIBO kickstart meal plan below for a sample day on a “short term” lower-carb phase.

Phase 2: Eat 1-2 Prebiotics Per Day After your “short-term” reset, and once your full SIBO treatment protocol (i.e. supplement https://amzn.to/2xLJkmO or medication digestive support) is underway, it’s crucial to also feed healthy gut bacteria—to make sure the good guys stick around while you kill off the overgrown “bad guys” Enter: prebiotics—fibers found in certain carbohydrates that “feed” beneficial gut bacteria.Prebiotic foods include:Green-tipped bananas and plantains Cooked & cooled sweet potatoes/potatoes Cooked & cooled long-grain white rice, parboiled Asparagus Seaweed Cabbage (sauerkraut) Dandelion Greens Artichoke Leeks Jicama Onions & Garlic Chia/Flaxseeds Coconut/Coconut Flour Yucca/Cassava Berries Raw Manuka Honey https://amzn.to/2ztx2Se Endive Apple Cider Vinegar Soluble Fibers (cooked carrots, butternut squash, acorn squash, delicata squash, beets) Supplements (like Sunfiber https://amzn.to/2QYXzO0 or Glucomannan https://amzn.to/2IeIfso )Aim to incorporate 1-2 prebiotic based foods into your diet, as tolerated after your short-term low carb reset.

Inflammatory Considerations Beyond just FODMAP and carbohydrate foods, consideration of other “gut inflammatory” foods that may contribute to your personal symptoms may be warranted—particularly these suspects:

Eggs

Dairy (cheese, yogurt, milk, etc.) 

Nuts

Peanuts

Soy

Corn

Beans/Peas 

Shellfish

Instant Coffee

Cocoa/Chocolate

Nightshades (spices like chili and paprika, bellpepper, tomato sauce, tomatoes, eggplant)

If any of these are regular additions in your diet and your symptoms or SIBO is still present—particularly at the end of your SIBO treatment protocol, a short term 30-day AIP (autoimmune protocol) may help further support gut healing. This is especially true for individuals with “leaky gut.” In other words: There is more to SIBO eating than just “low FODMAP” foods, and broccoli may not be as big of a culprit as you’ve been made to believe.

Don’t Forget the Digestive Support!Once you’ve established a real-food diet, with moderate carbohydrate introduction (prebiotic), and potentially the short-term elimination of any inflammatory foods you may suspect (like almonds, yogurt or hummus), adding in some “gut loving” support is the extra 1-2 punch to take your SIBO treatment to the next level.If you’re working with a skilled practitioner (https://drlauryn.com/work-with-me), that individual should be able to help create and guide you through a custom SIBO protocol—established specifically for you—with pharmaceutical-grade, high-quality formulas that can support not only gut health, but the elimination of overgrown gut bacteria.Here are a few top general recommendations:SIBO Baseline Antimicrobial Support: Dysbiocide https://amzn.to/2IfMSCF  + FC Cidal https://amzn.to/2ztIJIl from Biotics Lauracidin https://amzn.to/2xQTAu9 Biofilm Disruptor: Interfase Plus https://amzn.to/2IgezLA Soil-Based Probiotic https://amzn.to/2IgBNRJ Prebiotic (Partially Hydrolyzed Guar Gum) https://amzn.to/2IfMZ13

Bloating Atrantil https://amzn.to/2DDs1ua

IBS Iberogast https://amzn.to/2IkbJ8w

Constipation IB Guard https://amzn.to/2zuhfCq

General Digestive Support Digest Enzymes https://amzn.to/2xQLnGi HCL (Hydrochloric Acid) (Aids in stomach acid production): https://amzn.to/2OaHw0P

Liver/Gallbladder Support (for digesting healthy fats) Beta TCP by Biotics https://amzn.to/2IeR7hI Beta Plus (if no gallbladder)  https://amzn.to/2QYZ0vS

Immune Support Tumero Active (Liposomal Curcumin) https://www.apexenergetics.com/turmero-active Liposomal Glutathione https://www.apexenergetics.com/trizomal-glutathione

Nutrient Support B-Complex https://amzn.to/2xRm8n9 Basic Nutrients (Thorne) https://amzn.to/2DvllOK Cod Liver Oil https://amzn.to/2Dx2ovc

ReintroductionFollow your practitioner’s instructions as to how long to be on your personal SIBO protocol. Treatment length will depend on the severity of your SIBO, typically ranging 30-90 days. During your SIBO protocol, it is imperative you stick as closely to real food as possible—particularly limiting the Western diet influences of wheat, conventional dairy, sugar/sweeteners, industrial seed oils, corn and soy.However, as noted earlier, sticking to a strict low carb or low FODMAP diet is not advised for the longevity of your SIBO diet plan—given your symptoms are not severe when you do eat a little bit of prebiotic fiber or grass-fed, fermented yogurt.Once more: There is NO one-size-fits-all approach to the ideal SIBO diet, but as your treatment plan ensues during Phase 2, the “least restrictive as possible” approach tends to work best for people’s sanity and relationship with the healing process.To “reintroduce” foods that you may have eliminated during your Phase 1 or “Anti-inflammatory” food considerations, reintroduce foods 1 food at a time in this fashion:

Day 1 Re-introduction: Eat a small portion of the food alone (2-3 bites). Day 2 Re-introduction: Eat a little bit more of a portion/a serving of the food, alone. Day 3 Re-introduction: Add the food in alongside a meal or appropriate pairing foods.

If symptoms are noted during reintroduction, it may mean your body is not ready yet for it, or it is simply an inflammatory food for you. 

SIBO Diet Sample Meal Plans

Phase 1: Low Carb SIBO Diet (7-21 Days)

Pre-Breakfast 16 oz. Warm Lemon Water

Apple Cider Vinegar shot

Breakfast Turkey Sausage (4-6 oz.) 1/2 Avocado Sauteed Greens & Bell Peppers in Coconut oil 

Lunch Mixed Greens Chicken Breast 2 Tbsp. Paleo Cesar Dressing https://amzn.to/2N4eQCa Olives Pastured Strip of Bacon or Turkey Bacon (bits) Mixed Veggies: Roasted Carrots, Cucumbers, Cherry Tomatoes

Dinner

Baked Wild Salmon Rainbow Chard sautéed in Ghee Roasted Yellow & Zucchini Squash, drizzled in avocado oil

Snack

Handful Macadamia Nuts

Phase 2: Real-Food, Nutrient Dense, Anti-Inflammatory SIBO Diet (30-90 Days, during supplement protocol)

Pre-Breakfast 16 oz. Warm Lemon Water

Apple Cider Vinegar shot

Breakfast Smoothie: Lite Coconut Milk (watered down for smoother consistency) Beef Isolate Protein Powder https://amzn.to/2OaGz8L Blueberries

1 Tbsp. Sun-butter

Coconut Flakes Greens or Greens Powder https://amzn.to/2NGjE5R 

Lunch Chicken Salad with Avocado Mayo Pickled Cucumbers Roasted Carrot “Fries”

Dinner

Ground Bison “Tacos” (Turmeric, Oregano, Sea Salt, Garlic, Onion Seasoning)

Roasted Summer Squash

Olives

Collard Green Wrap

Guacamole

Snacks 1 Cup Bone Broth Eating Evolved 100% Dark Chocolate Square https://amzn.to/2DulDpl 

Customize Your SIBO Healing

Want your own custom SIBO diet plan and supplement protocol? Contact Dr. Lauryn https://drlauryn.com/work-with-me to get started to feeling really good. Inside and out. 

Resources

1. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., … Mullin, G. E. (2014). Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth. Global Advances in Health and Medicine, 3(3), 16–24. http://doi.org/10.7453/gahmj.2014.019;  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/ 

The post How to Choose the Best SIBO Diet to Heal appeared first on Meet Dr. Lauryn.

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[billioncheers]

The Mighty Gut Microbiome: Part 3 – How to Save It.

Till now we have extensively discussed what the need is, and the threats to the Mighty Gut Microbiome. So we are well aware of the role of the gut microbiome in our body. With all the threat lurking around us, let’s discuss how to save gut microbiome. It takes very simple changes in life to correct what we have deteriorated.

11 Changes to Make Gut Microbiome Healthy

For your waning gut microbiome, I bring you 11 simple and easy changes which will boost the good bacteria of the gut microbiome:

Start by opening your doors

Let the air in, it’s the simplest change to make. Our building and complexes that we live in are designed in an air-tight manner. Due to this, the ‘bacterial-soup’ gets stagnant like water puddle and starts to stink, i.e., starts to harm us. The simple and small exercise of opening our doors and windows air free air flow helps.

Add the fiber crunch

Low-Fiber diets are making us obese, and we know that! But do you know, that fiber is very important for the growth of good gut bacteria. In fact, some fiber acts as prebiotics, which is the only source of food for the good bacteria. By eating a low-fiber diet, we are depriving good bacteria of their food, we are starving them to death. Adding dietary fiber in our diet improves the digestion and feeds the good bacteria, improving the gut microbiome.

Organic is the way to life

Be more mindful of what you feed your gut. Start by avoiding additives, preservatives, emulsifiers, etc. in short avoid processed food as much as you can. Prefer seasonal foods over cold-stored items. Add more organic, and whole foods instead of canned items.

Try not to consume too much of pasteurized dairy. And if you can’t avoid it, try adding probiotic supplements with it. And if you are still not sure where to start, find good cookbooks that contain more gut-friendly recipes.

Don’t run away from microbes, eat them

The fact that we cling away from germs is good. But clinging away from good germs is not good. It is healthy to involve good bacteria in your diet. Start by included fermented food, and probiotic foods. You can also follow the new found diet plan if you cannot decide what to eat on your own. This new found diet plan is – “Microbial diet”. And as the name suggests, it includes all the good ways to make your good microbes happy.

Do not “Sugar”

Donuts, cakes, pastries, candies, packed fruit juices, and sweet beverages, snack, cereal bars, chocolate bars, and a lot more items I can name, which contains “ever-sweet” sugar. But behind this “ever-sweet” nature, sugar is the deadliest poison available to mankind. It is the number one cause of death today. It causes what not- From weight gain to heart disease, acne to diabetes, cancer to depression, fatty-liver to aging, gout to cavities and drain of energy, every major problem can be linked to sugar. Your gut microbiome also gets badly affected by high-sugar. So to save yourself from such a poison, use its substitute like palm-sugar, maple-syrup, honey, jaggery, stevia, etc.

De-stress

Stress management is not as hard as it might sound to some. Do yoga, meditation, and some relaxation techniques to lower your stress levels.

Have a sound sleep

With all the work, pressure and stress around you, the least you can do for yourself is to sleep peacefully. Have a minimum of 6-8 hours of sound, undisturbed sleep to keep your gut healthy.

Do not overuse antibiotics

It is not advisable to tell your doctor to not prescribe you antibiotics. It will be highly irresponsible. But what to do is to start using more natural remedies whenever you can for at least mild problems.

Pets are your friends

Are you allergic to pets, or scared or something! If not, then you must play with your pets more and let them play outside more. Try not to over clean those dear little creatures. And if you do not have pets, caress the strays one a while.

Stop obsessing over hygiene

By over obsessing on hygiene, we are killing the good bacteria as well. Hygiene is good, and if you really love a super clean house, switch to natural substitutes of antibacterial cleaning agents. Natural substitutes include white vinegar, borax, baking soda, natural salt, hydrogen peroxide, lemons, etc.

Stop being a tree

What is the major difference between plants and animal? Plants cannot move from one place to another, and animals can. But now a day, most of us are becoming trees, not in a literal sense. The “Temporary-Trees”, they move but only when absolutely necessary. And thus their bodies are becoming trunk-like. Stop becoming trees for your own sake. Move your body more. Exercise, dance, walk, run, do some yoga, go for Zumba!! Do all or at least one of it for a minimum of 20 minutes a day. Don’t do cardio or very harsh and extensive form of physical labor. Do mild to moderate exercises. It helps more than you think

Its better safe than sorry! It’s never too late to start, but not when it comes to our health. The gut microbiome could be and should be saved only if you decide to act now.

  Billion cheers synbiotic are the perfect call of the moment. It contains all the major necessary probiotics and the prebiotic fiber food for the gut microbiome. It not only contains 24 Billion CFU of bacteria, but it is sugar-free as well. It is prepared to have zero calorie count and by a refrigeration free technology. The all-in-one combo for perfect health.

  The post The Mighty Gut Microbiome: Part 3 – How to Save It. appeared first on GUT University.

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[brian-cdates]

How to Choose the Best SIBO Diet to Heal

SIBO diet is a combination the SCD diets and low FODMAPs. This restrictive diet may help relieve more symptoms in some people. Read this post to learn more about SIBO diet and all the food categories.

How to Choose the Best SIBO Diet—Keto, AIP, Low FODMAP & Beyond

Let food be thy medicine…especially when it comes to your SIBO diet. Here’s an overview of the best diets for treating SIBO—Keto, AIP, low FODMAP included—and a 3-step approach for choosing the best SIBO diet for your individual needs. 

SIBO 101

SIBO, or small intestinal bacterial overgrowth, is a condition, affecting the small intestine, wherein bacteria that normally grow in other parts of the gut start growing in the small intestine.

SIBO Symptoms

Common symptoms include:

bloating after meals

loose stools

IBS

constipation

food intolerances

nutrient deficiencies (like anemia, brittle nails and hair, pale skin, cold hands or feet). 

However, it’s important to be aware that SIBO can also manifest as many non-gut-related symptoms (such as skin conditions, high cholesterol markers, poor immune function, allergies (seasonal), blood sugar or hormone imbalances, and a slow metabolism).

Because of this, SIBO often goes under the radar in traditional healthcare settings. 

SIBO Diagnosis

SIBO is currently diagnosed through both:

An analysis of your signs and symptoms

At-home breath testing

Currently, an at home lactulose or glucose breath test is the gold standard. Although its not perfect and some cases SIBO may still be missed, this test is the best measure for assessing whether or not you have abnormal amounts of hydrogen or methane gas in your body (related to abnormal growth of gut bacteria). 

Stool testing, organic acids urine testing (OATS) and inflammatory blood markers are also helpful test tools that may contribute to your clinical picture. Under the guidance of a trained functional medicine provider or other knowledgable practitioner, you can better determine whether or not you have the condition. 

5 Essentials for SIBO Treatment

So what to do if you’ve been diagnosed with SIBO?!

Successful SIBO treatment involves a five-pronged approach including:

Proper Diagnosis & Testing Breath testing and/or working with a skilled clinician experienced in assessing and diagnosing SIBO.

Lifestyle Factors Addressing stress and lifestyle factors to promote SIBO healing, such as getting enough sleep and proper exercise—not too much, but not too little.

Appropriate Supplementation & Anti-microbial Treatment Beyond probiotics and pre-biotics, a supplement protocol and/or prescribed SIBO medication by your doctor that helps decrease the overgrowth of bacteria is essential. (Fun fact: studies show that herbal anti-microbial treatment can be just as effective, if not more, than prescription medications) (1).

Nutrient-Dense, SIBO-Reduction Diet Foods that help decrease your SIBO symptoms, and support gut healing.

Re-testing & Reestablishing a Healthy Gut Flora After SIBO is eradicated, a “plan of attack” to both re-assess if your treatment worked, and gameplan for adding back in a balance of healthy gut bacteria. 

While there is NO one-size-fits-all treatment protocol for kicking SIBO to the curb, these 5 essentials are “non-negotiables” for kicking SIBO to the curb. 

The best part?

SIBO healing and the remission of your symptoms is greatly within your own control!

In fact, there is no question that one of the greatest influences in your SIBO healing is what you are feeding your gut bugs (i.e. your SIBO diet).  (In other words: You cannot supplement your way out of a poor diet). 

Thus, a nutrition plan that works for your body’s unique needs is ESSENTIAL to not only feeling good, but helping your total SIBO protocol work for you.  

SIBO Diet Recommendations

The 4 most popular dietary recommendations for treating SIBO are:

The “Low Fermentation Diet”

The Low FODMAP Diet http://atxwoman.com/fodmap-diet/ 

Specific Carbohydrate Diet

Elemental Diet

Generally, the Low-FODMAP, Low Fermentation and/or Specific Carbohydrate Diets have helped many people over the years improve their symptoms. Then you have the Elemental Diet—more of a “last resort” 2-week diet, consisting of drinking an elemental formula. Elemental formulas are pre-digested, easily absorbed forms of nutrients to help starve gut bacteria.

All four of these SIBO diets are very similar, however, in that they restrict carbohydrates—specifically“fermentable fibers” and sugars that your gut bacteria LOVE to feast on (i.e. carbohydrates).

While certain foods may be “allowed” on one program, but not the other, generally the top foods to eliminate include:

SIBO Diet Foods to Eliminate 

Grains (breads, pastas, rice)

Starches (potato, sweet potato, yucca, taro)

Beans, Soy & Peas

Industrial Seed Oils (sunflower, grapeseed, cottonseed, soybean, canola)

Dairy (cheese, milk)

Sugar & Sweeteners (agave, honey, corn syrup, sweeteners)

Alcohol 

Corn

Cruciferous Veggies (cabbage, cauliflower, broccoli, brussels sprouts)

Garlic

Onion

Many fruits (apples, cherries, pears, bananas, watermelon, plums, nectarines, mangos, peach, pears)

Mushrooms

For some: Avocado, Coconut

The result? SIBO symptom relief from gut upset that typically happens when you eat a sweet potato, Brussels sprouts or quinoa—at least in the short term. 

The Problem with SIBO Diet Recommendations

The research is still out as to whether these diets help people improve in the long term—particularly once you’ve started a SIBO treatment protocol (supplements or medication). 

While all 3 SIBO diets are safe and can be helpful for gut issues like eliminating bloating, gas and IBS, a problem many people run into with these approaches is HOW and WHEN to reintroduce eliminated foods (if at all)—often discovering that their SIBO symptoms soon return when carbohydrates are allowed back in to the diet. 

“Will I ever be able to eat broccoli (or rice, or sweet potatoes, or apples) again?!” They cry. 

Unfortunately, long-term prebiotic fiber (carb) and FODMAP restriction can also backfire—since it not only decreases unhealthy bacteria, but healthy gut bacteria too. 

So what should you do?!

Mix and match!

Here are 6 novel (no-long-term-restrictive) SIBO diet approaches for healing your gut (and SIBO) for good— taking the most effective strategies from various gut-healing diets, and forming them together—all in one. 

The ultimate goal? Least restrictive diet as possible—all within the context of nutrient-dense foods of course (with the occasional Friday night pizza night if you must).

6 Non-Restrictive SIBO Diet Approaches

Start with Establishing a Real Food Base Simply put: Eat real food—as close to its natural state as possible. If it didn’t grow on the land, roam the earth, or swim in the sea, it’s not real food.  Real food includes:

Meats, poultry and fish. 

Healthy fats. 

Veggies & Fruits

Minimal starch

No added sugar

Lots of clean, filtered water

Supporting local, responsible producers and organic as much as possible

Phase 1: Short-Term Low Carb Diet (14-30 Days) Once you realize what “real food” is, you’re now ready to attack your SIBO diet in phases—starting with a lower carb or lower FODMAP reset.One consideration many people find short-term effectiveness from as a “therapeutic diet” is the ketogenic diet—a popular low carb (or “very low carb”) approach to eating that includes plenty of nutrient-dense healthy fats (ghee, coconut oil, coconut butter, olive oil, avocado, raw nuts/seeds), moderate amounts of organic protein, and 20-grams of “net carbs” or less per day.Many people with SIBO symptoms, find that a short-term break from many of the gut-bacteria-feeding foods (i.e. carbs and sugars found in carbs) can be a great relief from their SIBO symptoms while they get their personal SIBO treatment protocol (supplement supports and lifestyle factors) in place. Call it “keto,” “low carb,” or yes, “low FODMAP” or “specific carbohydrate diet,” the bottom line here is to confirm that for a short term (2-4 weeks), going “low carb” can be effective.The key for the effectiveness of these “low carb” approaches however is to ensure you are eating ENOUGH.  A common roadblock SIBO sufferers run into is unwanted weight loss, low energy and frail health due to the malabsorption of nutrients and IBS symptoms. Hence, reason why a keto approach may be more effective for curbing SIBO symptoms (in lieu of just going “low FODMAP” or “low carb) is that the emphasis on healthy fats can help boost energy stores (given your gallbladder and liver are healthy and able to digest these fats in the first place).Check out the sample SIBO kickstart meal plan below for a sample day on a “short term” lower-carb phase.

Phase 2: Eat 1-2 Prebiotics Per Day After your “short-term” reset, and once your full SIBO treatment protocol (i.e. supplement https://amzn.to/2xLJkmO or medication digestive support) is underway, it’s crucial to also feed healthy gut bacteria—to make sure the good guys stick around while you kill off the overgrown “bad guys” Enter: prebiotics—fibers found in certain carbohydrates that “feed” beneficial gut bacteria.Prebiotic foods include:Green-tipped bananas and plantains Cooked & cooled sweet potatoes/potatoes Cooked & cooled long-grain white rice, parboiled Asparagus Seaweed Cabbage (sauerkraut) Dandelion Greens Artichoke Leeks Jicama Onions & Garlic Chia/Flaxseeds Coconut/Coconut Flour Yucca/Cassava Berries Raw Manuka Honey https://amzn.to/2ztx2Se Endive Apple Cider Vinegar Soluble Fibers (cooked carrots, butternut squash, acorn squash, delicata squash, beets) Supplements (like Sunfiber https://amzn.to/2QYXzO0 or Glucomannan https://amzn.to/2IeIfso )Aim to incorporate 1-2 prebiotic based foods into your diet, as tolerated after your short-term low carb reset.

Inflammatory Considerations Beyond just FODMAP and carbohydrate foods, consideration of other “gut inflammatory” foods that may contribute to your personal symptoms may be warranted—particularly these suspects:

Eggs

Dairy (cheese, yogurt, milk, etc.) 

Nuts

Peanuts

Soy

Corn

Beans/Peas 

Shellfish

Instant Coffee

Cocoa/Chocolate

Nightshades (spices like chili and paprika, bellpepper, tomato sauce, tomatoes, eggplant)

If any of these are regular additions in your diet and your symptoms or SIBO is still present—particularly at the end of your SIBO treatment protocol, a short term 30-day AIP (autoimmune protocol) may help further support gut healing. This is especially true for individuals with “leaky gut.” In other words: There is more to SIBO eating than just “low FODMAP” foods, and broccoli may not be as big of a culprit as you’ve been made to believe.

Don’t Forget the Digestive Support!Once you’ve established a real-food diet, with moderate carbohydrate introduction (prebiotic), and potentially the short-term elimination of any inflammatory foods you may suspect (like almonds, yogurt or hummus), adding in some “gut loving” support is the extra 1-2 punch to take your SIBO treatment to the next level.If you’re working with a skilled practitioner (https://drlauryn.com/work-with-me), that individual should be able to help create and guide you through a custom SIBO protocol—established specifically for you—with pharmaceutical-grade, high-quality formulas that can support not only gut health, but the elimination of overgrown gut bacteria.Here are a few top general recommendations:SIBO Baseline Antimicrobial Support: Dysbiocide https://amzn.to/2IfMSCF  + FC Cidal https://amzn.to/2ztIJIl from Biotics Lauracidin https://amzn.to/2xQTAu9 Biofilm Disruptor: Interfase Plus https://amzn.to/2IgezLA Soil-Based Probiotic https://amzn.to/2IgBNRJ Prebiotic (Partially Hydrolyzed Guar Gum) https://amzn.to/2IfMZ13

Bloating Atrantil https://amzn.to/2DDs1ua

IBS Iberogast https://amzn.to/2IkbJ8w

Constipation IB Guard https://amzn.to/2zuhfCq

General Digestive Support Digest Enzymes https://amzn.to/2xQLnGi HCL (Hydrochloric Acid) (Aids in stomach acid production): https://amzn.to/2OaHw0P

Liver/Gallbladder Support (for digesting healthy fats) Beta TCP by Biotics https://amzn.to/2IeR7hI Beta Plus (if no gallbladder)  https://amzn.to/2QYZ0vS

Immune Support Tumero Active (Liposomal Curcumin) https://www.apexenergetics.com/turmero-active Liposomal Glutathione https://www.apexenergetics.com/trizomal-glutathione

Nutrient Support B-Complex https://amzn.to/2xRm8n9 Basic Nutrients (Thorne) https://amzn.to/2DvllOK Cod Liver Oil https://amzn.to/2Dx2ovc

ReintroductionFollow your practitioner’s instructions as to how long to be on your personal SIBO protocol. Treatment length will depend on the severity of your SIBO, typically ranging 30-90 days. During your SIBO protocol, it is imperative you stick as closely to real food as possible—particularly limiting the Western diet influences of wheat, conventional dairy, sugar/sweeteners, industrial seed oils, corn and soy.However, as noted earlier, sticking to a strict low carb or low FODMAP diet is not advised for the longevity of your SIBO diet plan—given your symptoms are not severe when you do eat a little bit of prebiotic fiber or grass-fed, fermented yogurt.Once more: There is NO one-size-fits-all approach to the ideal SIBO diet, but as your treatment plan ensues during Phase 2, the “least restrictive as possible” approach tends to work best for people’s sanity and relationship with the healing process.To “reintroduce” foods that you may have eliminated during your Phase 1 or “Anti-inflammatory” food considerations, reintroduce foods 1 food at a time in this fashion:

Day 1 Re-introduction: Eat a small portion of the food alone (2-3 bites). Day 2 Re-introduction: Eat a little bit more of a portion/a serving of the food, alone. Day 3 Re-introduction: Add the food in alongside a meal or appropriate pairing foods.

If symptoms are noted during reintroduction, it may mean your body is not ready yet for it, or it is simply an inflammatory food for you. 

SIBO Diet Sample Meal Plans

Phase 1: Low Carb SIBO Diet (7-21 Days)

Pre-Breakfast 16 oz. Warm Lemon Water

Apple Cider Vinegar shot

Breakfast Turkey Sausage (4-6 oz.) ½ Avocado Sauteed Greens & Bell Peppers in Coconut oil 

Lunch Mixed Greens Chicken Breast 2 Tbsp. Paleo Cesar Dressing https://amzn.to/2N4eQCa Olives Pastured Strip of Bacon or Turkey Bacon (bits) Mixed Veggies: Roasted Carrots, Cucumbers, Cherry Tomatoes

Dinner

Baked Wild Salmon Rainbow Chard sautéed in Ghee Roasted Yellow & Zucchini Squash, drizzled in avocado oil

Snack

Handful Macadamia Nuts

Phase 2: Real-Food, Nutrient Dense, Anti-Inflammatory SIBO Diet (30-90 Days, during supplement protocol)

Pre-Breakfast 16 oz. Warm Lemon Water

Apple Cider Vinegar shot

Breakfast Smoothie: Lite Coconut Milk (watered down for smoother consistency) Beef Isolate Protein Powder https://amzn.to/2OaGz8L Blueberries

1 Tbsp. Sun-butter

Coconut Flakes Greens or Greens Powder https://amzn.to/2NGjE5R 

Lunch Chicken Salad with Avocado Mayo Pickled Cucumbers Roasted Carrot “Fries”

Dinner

Ground Bison “Tacos” (Turmeric, Oregano, Sea Salt, Garlic, Onion Seasoning)

Roasted Summer Squash

Olives

Collard Green Wrap

Guacamole

Snacks 1 Cup Bone Broth Eating Evolved 100% Dark Chocolate Square https://amzn.to/2DulDpl 

Customize Your SIBO Healing

Want your own custom SIBO diet plan and supplement protocol? Contact Dr. Lauryn https://drlauryn.com/work-with-me to get started to feeling really good. Inside and out. 

Resources

1. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., … Mullin, G. E. (2014). Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth. Global Advances in Health and Medicine, 3(3), 16–24. http://doi.org/10.7453/gahmj.2014.019;  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/ 

The post How to Choose the Best SIBO Diet to Heal appeared first on Meet Dr. Lauryn.

Source/Repost=> https://drlauryn.com/gut-health/how-to-choose-the-best-sibo-diet-to-heal/ ** Dr. Lauryn Lax __Nutrition. Therapy. Functional Medicine ** https://drlauryn.com/ How to Choose the Best SIBO Diet to Heal via http://drlaurynlax.tumblr.com/

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10 Things We All Hate About Kurma Malaysia

Our dates are of superior quality, according to our trucks with traditionalfarming methods, and hand selected to guarantee the standard of every piece. A version of this date palm and cultivated because somewhere around 6000 B.C, the date fruit is one of the sweetest fruits round and also happens to emerge in many unique varieties. By the outcomes it might be reasoned that sexy water and also sundry treatment was the very best technique for reducing blood sugar levels out of date fruit.

Instantly after eating the fruit, they replenish power and rejuvenate the entire human anatomy. With no many blossoms, animal and insect species are without having food and other essentials for shelter and healthful lives. Understanding the symbols creates and Enlightened age where have equipment to understand and also create fruitfully as an alternative of replicating the misinterpretation of the past.

I also love to provide advice about healthy fruits less known beyond the Asian sub continent. Generally in many date forms, the glucose material of a date is virtually totally of these inverted types glucose and fructose (except for deglet noor dates along with thoory dates that have greater proportions of glucose at the sort of sucrose).

10 fruit diameter and weight were quantified by electrical balance of fresh fruit afterward fruit were soil by grinder and then juice had been extracted from cheese material mesh and also expressed juice has been retained in the suspend for short-time for examination of sugars, sugar and inverted sugar 1st time.

The most effective selections of fruit diabetics are any which are clean, frozen or canned without added sugars. Eating 2 dates supplies Kurma Green Diamond you with 6 per cent of the every day value for b 6 and 4 per cent of the everyday values such as lactic acid and niacin. When the seed of this date-palm germinates, the book of food kept up in it's changed to sugar by means of ferment c-all cytase, produced by the very first green leaves of this plant.

A lot of beta-carotene - D Gac fruit includes 20 times more beta carotene than carrots making it great for attention health, boosting immunity, and growing white blood cell creation, raising semen creation and much more. Because the first date tree was made up of precisely the very same mud from which Adam was born. " Perhaps his phrases really are a sign that date palms are superior to any additional plant.

Back in North Africa, Ghana and India the sap from Your Date Palm Tree has been collected and used during the conversion of sugaralcoholic beverage, along with molasses. Also, processed and canned fruits are not healthy because they comprise artificial sweeteners, so often swallow fruits to reap maximum rewards.

What's more, the fiber dates may be helpful for blood sugar control. Even the USDA notes which the high quantities of dietary fiber present in fruit will certainly help you drop fat or maintain a nutritious weight. Sulfites had been banned for used in fresh fruits and veggies from 1986 from the Food and Drug Administration, but they are still permitted in dehydrated fruits, according to the Cleveland Clinic.

Despite their own little changes in proportion, feel, and flavor, all of dates are rich in health gains and may easily be incorporated in a daily diet. The American Cancer Society admits that utilization of 1 date in daily basis assists in sustaining healthy eyes for a single 's living time.

You can find various kinds of foods you are able to try to help increase your sexdrive and combat impotence problems, & most of the fruits which help raise your sex drive will contain high levels of certain vitamins on minerals which might help increase hormone levels, boost nitric oxide levels or ramp your testosterone up levels

Dietary fiber slows the absorption of these natural sugar levels. Dates incorporate elevated levels of fiber that's crucial in promoting healthy gut movements and relaxed passage of food through the intestinal tract. A lot of the diabetics are bemused on the type of fruits they are able to eat without elevating their blood sugar .

Dried or fresh, dates maintain very nicely - for atleast a couple of months at a cool, dark cabinet. That's the fig, since we all see it rise, and in some regions these flowers are never pollinated, the fruit never forms, and the flower-head stays a flower-head, although, when eaten once freshly assembled from the fall, it is yummy.