Tag Archive for: prebiotic

Resolving Gas Problems

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Whatever the cause, the question is how you can control any issues you have with intestinal gas. Once you realize how probiotics do what they do, and by that I mean via fermentation with the resultant gas, there are several strategies you can use to deal with it.

Strategies for Gas

Digestive enzymes can often help if the culprit is a specific food. For many people, beans cause gas while for others, excess protein can do it. With so many people doing keto these days, gas can be a substantial problem for them.

The solution may be to use a multi-purpose digestive enzyme before eating food you know causes you issues. Beans are obvious, as is protein. But for those who are lactose intolerant, milk and cheese can cause issues. Cellulases, proteases, and a lactase can help digest those macronutrients. For carbohydrates such as grains, amylases can be helpful.

The next question is whether taking digestive enzymes help with gas caused by supplements or pharmaceuticals. I can’t answer that because there’s no evidence one way or the other. Because your body naturally releases digestive enzymes, it’s doubtful they’ll interfere with the processing of the medication or supplement. It could be that your body isn’t making enough digestive enzymes to fully break down the substance, so adding or changing a digestive enzyme supplement is worth a try.

The second approach would be to identify which foods cause you problems, and it may not be as obvious as beans or dairy. It could actually be a spice that reacts with the microbes in your microbiome, and that’s not always easy to identify. Some foods such as sugar alcohols that are often used as sweeteners in processed food can cause gas. Once you’ve discovered which foods cause problems, sometimes the best policy is to limit them or avoid them entirely.

The third approach goes hand in glove with the second and that’s to change your diet. Research continues to show that people who eat more plant-based foods have different and perhaps better functioning microbiomes than those who do not. That’s a tough sell in this keto world we live in, but the carbs a person eats should lean toward vegetables with some fruit rather than starchy vegetables and grains.

Finally, if you take a probiotic supplement, stop it for a couple of weeks and see what happens. Remember in Tuesday’s Memo, the excess gas stopped when the person stopped taking the probiotic. It may be that a different probiotic blend might work better. There are over 6,500 different microbes that have been identified, and it may take trial and error as well as newly developed probiotic blends before you get it right.

The Bottom Line

There are a couple of other things that can contribute to gas such as drinking carbonated beverages and simply swallowing too much air. For most people, it’s still an issue of fermentation in the microbiome. The best approach is trial and error until you get the diet, prebiotic, and probiotic in balance.

Unlike other health issues, excess gas can be uncomfortable and can result in embarrassing situations, but as long as you’re not standing next to a flame, shouldn’t be fatal.

What are you prepared to do today?

        Dr. Chet

The Magic of Chicory

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Because this is my birthday week, I thought I would indulge myself and talk about some personal research I recently did. Today it’s all about chicory—it’s everywhere. The little purple flowers can be found alongside just about every road in Michigan. I’m pretty sure it’s probably that way across the U.S. where the climate is similar at this latitude. Those little lavender-purple flowers are chicory, officially known as Cichorium intybus, a member of the Aster family. This absolutely phenomenal lavender-flowered plant is one of those plants that are classified as weeds in some areas, but in others are cultivated for their nutritious parts.

Chicory as a Fiber Source

I first became aware of chicory when I found out the root is the source of one of my favorite types of fiber called inulin. The reason that I like that particular type of fiber so much is that it can act as a prebiotic and feed many of the bacteria of the microbiome. But first, it acts like any other type of soluble fiber: it absorbs fluid to help food move through the small intestine. Then when it gets to the large intestine, it can supply the thousands of microbes with food.

Chicory is not the only source of inulin, but it’s the greatest source. Here are some of the other major sources of inulin if you wanted to get it by eating plants; all of these amounts are per 100 grams of a serving; that works out to about 3.3 ounces:

  • Chicory root contains about 40 grams
  • Jerusalem artichoke has 16–20 grams
  • Garlic has 9–16 grams
  • Raw asparagus has 2–3 grams

It might be relatively easy to eat 3.3 ounces of artichokes or asparagus. But I’m not sure many people are going to want to be around you if you eat 3.3 ounces of raw garlic every day, although it could be a big assist in social distancing. Just a thought.

Chicory as Food

I was surprised to find out that almost the entire chicory plant can be eaten; it has been cultivated as food in Europe since the 1600s. Depending on the age of the plant, as well as the time within the growing season, the leaves of the plant can be considered a salad delicacy. I don’t usually stop and eat or even nibble when I’m out for a walk/run, but chicory is in the endive family and the flavor is supposed to be somewhat bitter and crunchy like endive. That’s if eaten raw. When cooked, the flavor mellows out quite a bit, as it does for dandelion greens, another relative. When used in foods, it appears that chicory is often eaten like celery. The leaves, the roots, and the leaf buds are boiled and added to foods. Chicory seems to get more intriguing as a potential food all the time.

Chicory has also been used as an additive to or a substitute for coffee. Evidently when dried and roasted it has a very distinctive flavor that enhances coffee. In fact, after World War II, England and Germany roasted chicory root as a substitute for coffee beans. While I’ve never tasted it, I know that there are several brands of American coffee that contain roasted chicory root. What I don’t know is how that might impact the ability to act as a fiber and prebiotic. Because you’re trying to extract flavor from the root plus roasting the root, there may not be any of the desired digestive qualities available.

Chicory as a Nutrient

Because it’s a plant, you know that it must have phytonutrients. I’ve talked about the benefits as it relates to the microbiome, but there may be other benefits from consuming the plant or extracts from the plant. For example, in some of my background research on this, it seems that some people apply a paste of chicory leaves on the skin for swelling and inflammation. In another trial on rodents, chicory was used in combination with a variety of other herbs to see if it would lower blood pressure. It did, but it’s still a long way from a very small study on rats to developing natural ways of dealing with blood pressure.

One thing is for sure: using the parts of the plant that we know are the most effective for the digestive system is probably a good idea. We know that adults should be getting 25 to 30 grams of fiber per day, but most people seem to be able to hit only between 12 and 13 grams. So if taking this type of fiber known as inulin sourced from chicory root or eating more artichokes and asparagus is possible, you’ll get a lot of benefit from this plant. Maybe this will inspire you to taste the leaves of the plant with the little purple flowers on the side of the road in your next salad.

That’s exactly what I did on a trip to the store before writing this Memo. I noticed some chicory growing on the side of the road in an area that had a little bit of parking. So I stopped my car, got out, picked several different sized leaves, and then ate them. The plant had blossoms so that may have made a difference in the flavor. It was extraordinarily bitter but left no aftertaste. It would be interesting to be able to get some chicory that was specifically designed to be used in salads to see if it would taste similar. I would say this: if you can drink an IPA, I think you could eat salad with chicory in it. That’s my experience with eating chicory leaves to date. I’ll stick with inulin from the root for now.

New Info and Some Time Off

There’s a new Basic Health Info posted on the Health Info page at drchet.com about the myths and facts of face masks as described in actual scientific research. If you’re tired of people throwing fantastic tales of masks’ effects at you, here’s where you can go to get the facts: Cloth Masks: What the Research Says

We’re taking next week off to catch up on some big chores around the house, maybe even relax an hour or two, so expect to hear from me again on August 4.

What are you prepared to do today?

        Dr. Chet

Reference: BMC Complement Altern Med. 2017 (3) 7;17(1):142.

Resistant Starch and Your Gut

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After last week’s Memos on resistant starches, I received a couple of emails asking me to talk about related topics. I think they’re both important, so here we go.

The first was something I mentioned but didn’t focus on. You may remember that I said that resistant starches can act as prebiotic to produce short-chain fatty acids. The process is by fermentation, so that means it will produce gas. For some people, the gas production is so uncomfortable, it can negatively impact their life; they have to avoid some resistant starches. The good news is that the variety of foods that contain resistant starches is vast, so there are some foods that are less intrusive.

That leads to the second question about resistant starches and leaky gut syndrome. One of the issues with leaky gut is that the mucus layer on the inner gut is not as developed in some areas, and that leads to problems with nutrients and bacteria entering the blood stream directly. Resistant starches have been shown to be beneficial for leaky gut. However, the same issue with fermentation may happen until the bacterial colony grows sufficiently. The approach would be to slowly increase resistant starches to prevent over-fermentation.

There have been many questions, but I’ll wrap this up on Saturday and keep some questions for another time.

What are you prepared to do today?

        Dr. Chet

The End of Constipation

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I had a question recently about the difference between a laxative such as Miralax and fiber. While they’re both safe, there are similarities and there are differences.

They are similar in that they draw fluid into the intestines. Miralax uses chemicals while fiber uses plant sources; both draw fluid into the gut to soften the stool.

Where they’re different is that fiber can help two more ways. It can add bulk to the stool to aid in transport and be used as a prebiotic and feed the probiotics or good microbes. And if those microbes are fed better, they work better.

If you have a chronic issue with constipation, time to check in with your healthcare provider. If it’s an occasional issue, as can affect us all, check out this Health Info titled The Constipation Solution. It has worked well for both adults and children.

What are you prepared to do today?

        Dr. Chet

Dealing with Keto Breath and Other Odors

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Quick question: what side effect do you typically assign to eating asparagus? I bet you took less than a second to come up an answer: a different odor to your urine, sometimes quite pungent. Asparagus is a cruciferous vegetable with phytonutrients that produce the effect.

On Tuesday and Thursday, we looked at digestive problems with going keto; today we’ll look at odor issues.

Ketosis, the result of metabolizing fat into ketones for use as a fuel, also has a specific odor associated with it: your breath can smell like nail polish remover. The ketones may have complicated names such as acetoacetate, beta-hydroxybutyrate, and acetone, but they do one thing: they cause an odor in your mouth and as you breathe out. Our bodies always make those odors, but because we’re forcing the body to produce more ketones, the odor is more noticeable as ketone remnants exit the body via breath and urine.

In this case, there’s no real solution. If you want to use fat as a fuel almost exclusively, you learn to live with the smell. Just make sure to drink plenty of water, because water is important to get rid of these chemicals and protect the kidneys. Drinking water and brushing more frequently may help compensate for keto breath.

Health news has recently become full of eye-catching headlines about something termed “keto crotch.” While it can affect men, it seems to especially impact women by changing the odor of the vagina and vaginal discharges. It seems obvious that it’s the result of the diet, although there’s no research that I could find that has examined it. Gynecologists speculate that it’s the change in the vaginal pH that can contribute to increased odors. If that’s true, it would radically change the vaginal microbiome and that could change the odor. At this point, we don’t know.

One thing that may help is taking probiotics that contain Lactobacilli strains; some research has demonstrated benefits for bacterial vaginosis. Whether probiotics will help with the odor associated with the keto diet or not is unknown, but it’s possible. A prebiotic would also be needed to feed the probiotic because on a keto diet, there’s no fruit with its special sugar to feed the bacteria.

The Bottom Line

Going keto has side effects. Some people may not get any of them. Genetics, the microbiome, and other factors no doubt will have an impact on the extent of the side-effects. I’ve tried to cover the obvious ones this week but there are others, from depression to fatigue.

Which brings me to a question I’m often asked: what do I think about the ketogenic diet? I think it’s a good tool to use fat as a fuel for a limited time, and together with the right exercise program, it can be effective in helping people lose body fat; that’s why it’s part of the Fat-Burning Plan in the Optimal Performance Program.

I assess diets this way: what has to be added to make it healthy? Veganism requires most people get vitamin B12 from somewhere other than meat. The keto diet lacks vitamins, minerals, fiber, and probiotics typically found in vegetables. Both diets lack essential nutrients. If you decide to go keto, it’s important to add these supplements to your diet: a multivitamin-multimineral, probiotics, prebiotics, and fiber.

Because of the side effects, I just don’t think going keto is sustainable. Use it as a tool, as a means to an end for a specific goal. The goal is to stay healthy by learning to always do these three things: Eat better. Eat less. Move more.

What are you prepared to do today?

        Dr. Chet

Why I’ll Keep Taking My Probiotics

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One thing I try never to do is to take cheap shots at research studies. I’ve acknowledged that my expertise in the methodologies of microbiome analysis is limited. I think that these research groups did something unique in their approach to assessing the microbiome. That doesn’t prevent me from pointing out some obvious issues with the studies that could have impacted the outcomes.
 

The Problems

The first issue was the lack of diet control in either study; diets vary between people, and that could have significantly impacted the results. The foods you eat can directly impact your microbiome for hours, and what the subjects ate the days before the sampling may have skewed the results. Before the study, they used a Food Frequency Questionnaire and determined there were no unique dietary issues that could have impacted the results, but not using a diet record during the entire 28-day study is curious. For the thousands of data points they did collect, they ignored the most basic.

What shocks me is that they knew better: these are the same laboratories that have shown both foods and synthetic additives can substantially impact the microbiome. Without studying the diet of the subjects, and only eight subjects at that, you don’t know who had a diet conducive to the restoration of the microbiome after antibiotics or not.

Second, they used a novel approach. They collected samples from the digestive system using endoscopic techniques in addition to the fecal samples typically collected. Very interesting, but they also used the typical colonoscopy prep which means no food and the complete cleansing of the colon. To their credit, they did test two subjects with and without the typical pre-colonoscopy prep and found few differences. Two subjects. I don’t need to say anything more. While the prep is not going to erase all the bacteria and other microbes, it will eliminate the food supply and could impact what bacteria are growing at the time of the sampling.

Third, they gave healthy people antibiotics; that may bear no resemblance to the microbiome of someone who has a serous infection. The best we can say is that taking antibiotics when you’re not sick may not be a good idea.

Finally, I’ve read research by this group in Israel before. They’re developing a weight loss program based on their microbiome research. It may have no relationship to these studies but it does demonstrate a willingness to monetize their research results, and that always raises my suspicions.

Sure enough, the purpose of these studies was to support a patent application. It may be for the collection technique or more likely, a test to ascertain what probiotics might benefit specific groups of people while healthy or with specific conditions. While they claim no conflicts of interest in the paper, I can’t think of a bigger one than this. While there’s nothing wrong with establishing tests and treatments based on your research, the procedures need to be tested in other laboratories before rushing to market. This strikes me as premature.
 

The Bottom Line

I think these two studies illustrate where we are with microbiome research: at the very beginning. They contribute to the body of knowledge but little else. Probiotics will impact everyone differently, and they may not be desirable for everyone under every condition. But unless we get a radical change in our diet that encourages the microbiome to grow healthy and strong, taking a probiotic every day is still a good idea. My family and I, including my grandson Riley, will continue taking our probiotics because nothing in this research raises any questions about the safety or potential everyday benefit of regularly taking a probiotic supplement, preferably with a prebiotic.

What are you prepared to do today?

Dr. Chet

 

References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

Potatoes and Your Microbiome

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A Cherokee legend talks of two wolves inside us, one good and one evil. Which one will win? The one you feed. It applies to our microbiome as well. We have good and bad microbes within us at all times. Which ones dominate? It depends on how we feed them.

In a recent study, researchers tested a prebiotic made up of a harder-to-metabolize starch extracted from potatoes. The subjects were a group of elderly and middle aged men and women. The objective was to compare the types of bacteria that responded positively to the prebiotic.

At baseline, the elderly subjects had higher amounts of the bad microbes, proteobacteria such as E. coli, compared to middle-aged subjects. After three months of using the prebiotic, there was a decrease in the bad microbes in the elderly subjects while both groups experienced in increase in bifidobacteria, the good microbes. The conclusion was that the prebiotic helped create a better microbiome balance.

While this was a small study that focused on one type of prebiotic, there’s a lesson. If you have a diet that includes vegetables, beans, and some starchy root vegetables such as potatoes, you will get a variety of prebiotics including the type used in this study. They will help you feed the good microbes to create the right balance in your digestive system. Which microbes will win? Your diet determines which ones dominate.

What are you prepared to do today?

Dr. Chet

 

Reference: DOI: http://dx.doi.org/10.1016/j.clnu.2017.03.025