Tag Archive for: probiotic

Resolving Gas Problems

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

Prehab Is Over

One of the tests I took in preparation for surgery was to measure my levels of Staphylococcus aureus. In this case, they tested the nasal area, a common area for this serious pathogen. The test came back at zero. I was pleased because for the past three years I’ve been taking a Bacillus probiotic called Bacillus coagulans. You can check out the research by reading this Memo from 2018. It doesn’t mean I couldn’t get an infection, but zero is a good starting point.


Now on to Surgery

I’ve stretched and strengthened my legs about as much as I can in preparation for my knee replacement. My core is as strong as it ever has been. I’ve gotten as fit as I can within the limitations my knee has given me. As I said a while ago, the more pain you put in before the surgery, the less you’ll have after the surgery.

We’ll put that to the test beginning Monday afternoon. Many, many surgeries have been cancelled here in Grand Rapids because the hospitals are overrun with COVID patients; if I had not prepared by being a regular exerciser and doing the prehab, I might have had to spend the night rather than having outpatient surgery, and then my surgery might have been cancelled, too, but we got confirmation Friday that it’s on.

I’m really eager to get this done and get on with life; I’m ready for rehabilitation. My goal is to walk into the hospital and then to walk out. The medical staff probably won’t allow that but as long as I know I could, that’s fine with me.

Thanks for all the prayers and good wishes—keep them coming. I won’t write Tuesday’s Memo until I’ve recovered from the anesthesia and taken the first steps. I still plan on doing the Insider Conference call on Wednesday night so all Insiders will get the first-hand Dr. Chet version of the knee replacement experience.

What are you prepared to do today?

        Dr. Chet

Artificial Sweeteners and Your Digestive System

Before I address the concerns of the study on artificial sweeteners I talked about on Tuesday, be assured that I’m bringing you the facts as I interpret them. If you don’t use artificial sweeteners, I’m not trying to convert you, but I’m not going to let slide inflammatory headlines that only seek to raise fear where none should exist. The problem with the artificial sweeteners study is that it didn’t use a systems approach.

Bench Science

What the researchers did would be considered bench science. It’s basic in its approach: create a medium where the bacteria will grow, throw in various quantities of the artificial sweeteners, and see what happens. That’s a good first step in any type of research to see an impact on an entire organism. The same is true for examining the effect of the artificial sweeteners on the bacteria in the cancer cell medium. They established that chronic exposure to artificial sweeteners cause two probiotics to become pathogenic.

However, that’s where it ends. Trying to explain an increase in the obesity and diabetic epidemics because of how artificial sweeteners may impact a couple of gut bacteria doesn’t make any sense. It’s stretching things way too far with no evidence that what they’re describing happens at all. In effect, they’re trying to explain a health issue by looking at potential causes. Fine, good start—but now there’s a whole lot of animal and human clinical research that has to take place in order to prove whether it’s true, because what happens in a lab is often not what happens in a human.

Bench science has its place for sure, but it has serious limitations. In our headline-a-minute world, everyone is too eager to claim credit for something that hasn’t been proved.

The Digestive System

The human body is made up of various systems; the digestive system is one of them, but it doesn’t begin and end with the epithelial cells of the intestine. Food (including artificial sweetener) starts in the mouth with its salivary glands, goes down the esophagus, enters the stomach with its specialized fluids, travels the 20 to 30 feet of small intestine where more unique fluids do their jobs, and then the 10 to 15 feet of large intestine before it exits the body. The digestive system doesn’t act alone; it requires input from other organs and systems along the way: the pancreas, the liver, and so on. Every one of those could have an impact on the metabolism and elimination of artificial sweeteners and could impact how bacteria behave in the digestive system.

I could write a book on this subject, but let me just point out one thing that should be obvious: they tested two probiotic lines. Two. As of the last count, there are at least 6,500 different microbes that coexist within our digestive system. There are also trillions of them, each with a role to play, and we still don’t know what each and every one does. As I said, it’s complicated.

The Bottom Line

This study illustrates where good research begins: in bench science. There’s a lot more science that has to happen before we become alarmed about whether or not artificial sweeteners directly impact our microbiome, but their approach does raise a question that I’ll talk about next week: a systems approach to Aging with a Vengeance. We look at pain or other conditions as something that stands alone, but in reality, we may need a systems approach to deal with it.

What are you prepared to do today?

        Dr. Chet

Reference: Int. J. Mol. Sci. 2021, 22, 5228. https://doi.org/10.3390/ ijms22105228

The End of Constipation

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

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

Keto: Clearing the Air and Your Colon

The next keto diet issues are still related to the digestive system: excessive gas and constipation. Let’s address the issue of gas first so that maybe the next time you bend over, you won’t have to worry about challenging the strength of your anal sphincter muscles.

The protein content of the revised keto diet may be lower than prior versions, but the body still has to break it down. If you don’t make enough digestive enzymes to breakdown the protein, it produces gas as it ferments in the microbiome. A lot of it. The simplest thing to do may be take a digestive enzyme that contains proteases to breakdown proteins before every meal. Taking a probiotic may also be a good idea, but we don’t know the specific strains of bacteria that will work on protein.

On the other hand, probiotics in general may help ease the constipation that can occur while on the ketogenic diet. The problem is this: the colon doesn’t have enough to do—waste products from foods are simply not there. Fats don’t have anything left after digestion; almost all protein sources don’t have much residue either. But your digestive system still has to repair and rebuild the digestive system on a regular basis. In addition to the probiotics, soluble fiber may again be the solution for the same reason as with diarrhea: it adds bulk to the stool.

I’ll wrap this up on Saturday with the topic that seems to still be making headlines: the odors associated with going keto.

What are you prepared to do today?

        Dr. Chet

Winterize Yourself

The official start to winter is quickly approaching, but for most of us the cold, wet, snowy, rainy weather has already begun. Today’s Memo contains some tips on how to winterize your body by focusing on basic nutritional supplementation.

Water: Make sure you increase fluid intake during the winter. The humidity is lower because the heat is on in your home, work, and school. You breathe out more water as a result. You have to replace those fluids. Every day drink one-half your body weight in ounces of water or any other fluid; if you weigh 150 pounds, drink 75 ounces of water daily.

Multivitamin-mineral (MVMM): If you haven’t been consistent in taking your MVMM, this is a good time to begin. Your immune system needs some basic nutrients and a MVMM is a good place to start, especially if it’s one that contains plant concentrates and extracts.

Probiotics: The immune system starts in the gut. Taking a probiotic every day can help your immune system function better. In addition, taking fiber with the probiotic can help feed all the good bacteria in your digestive system.

Vitamin D: Consider adding vitamin D to your regimen because we get a lot less sun during the winter. Ask your physician to test your vitamin D levels; if it’s below 30 ng/ml, add 2,000 IU vitamin D to your supplementation. There’s no real danger in taking vitamin D, so make sure you’re getting some even without a test.

Antioxidants: Help your immune system; add additional vitamins C, E, and beta-carotene to your supplementation.

Supplementation may or may not help you avoid getting a cold or the flu, but it may help reduce the severity and duration of a respiratory infection if you do get one. That’s worth the small expense of the supplements in my opinion.

 

Happy Thanksgiving!

Paula and I wish you all a Happy Thanksgiving. We are grateful for your support throughout the year. This week is one to spend with family and friends, so this will be the only Memo of the week. Thanks for being a member of the Dr. Chet family.

What are you prepared to do today?

Dr. Chet

 

Why I’ll Keep Taking My Probiotics

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.

 

New Probiotics Research Results

The methodology used in the two studies I’m reviewing is complicated. I mentioned the endoscopic biopsies on Tuesday (and a big thanks to the people who volunteered for an endoscopy); subsequent analysis of the actual microbiome utilizes very complex techniques. I’m not an expert in those techniques so I can’t assess the results the way I normally would, but here are the results published by the authors.

The first study examined the changes in the microbiome when subjects were given either a placebo or commercially available probiotic for 28 days. The most significant finding was that the results were highly specific to the individual. That’s no surprise for one reason: no two microbiomes are the same, even in people who live in the same household. That a probiotic with 11 different bacteria would have different effects on the 14 subjects in the intervention group is no surprise. Some showed no growth of any of the strains of the probiotic, while other subjects’ tests showed strains that took up residence.

The second study examined the effects of antibiotics when taken by healthy subjects under three conditions: no intervention (seven subjects), the commercially available probiotics used in the first study (eight subjects), and a self-donated fecal transplant (six subjects). They found that the microbiome of the subjects who took the probiotics was not restored to their pre-antibiotic state; the supplemental probiotics seemed to colonize, leading the authors to suggest that they impaired the re-colonization of the original microbiome. The microbiome of the other two groups seemed to recover.

Should we avoid probiotics as a result of these studies? I’m taking mine and explain why I’ll keep taking them on Saturday.

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.

 

The Bottom Line on a Probiotic for Weight Loss: Misdirection

One of the basic tenets of magic is misdirection. The magician gets you to look at his right hand when it’s actually his left hand that’s hiding something. I’m going to use that analogy as we finish our look at the probiotic Akkermansia muciniphila.

Let’s start with this. The microbiome of people who weigh less is different from the microbiome of those who weigh more. It seems if we could figure out what bacteria are different between those groups, we might be able to help those who weigh more lose weight. It makes sense . . .

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