This gut thing has really been on my mind lately. How it connects to acute and chronic disease, how it affects our mood and mental health, and how it impacts the way we feel.
I just finished reading The Psychobiotic Revolution by John Cryan, Scott Anderson and Ted Dinan. I think that overall it was a pretty solid read. Two of the writers have Ph.D.s giving them some solid credibility in my book. However, I did go into it with a skeptical mind because of the controversy the Western medical community has had about concepts like leaky-gut and the true effectiveness of probiotics. What these writers did well was address this very issue. They acknowledged that research is lacking in some areas and support from the medical community here in America has been less than stellar, but also cited several studies that supported their ideas. At the end of the reading, my takeaway was to do what works best for me and what I believe in as a trained medical professional.
So here is what I learned:
- There are probiotics, prebiotics and psychobiotics.
Probiotics are our healthy gut bacteria that help ward off and control the “bad” gut bacteria. Prebiotics are what we ingest to feed these healthy gut bacteria, or probiotics. Psychobiotics are a relatively new concept and are simply specific probiotics that have positive mental health benefits when working through the gut.
- There are different types and strains of psychobiotics that offer specific benefits for specific reasons:
- Bifidobacterium: There are several strains of this bacteria in existence and in probiotic supplements. This bacteria has been shown to reduce inflammation, anxiety, depression and cortisol levels. It has also indicated an improved stress response and improved cognition. The various strains work to manage IBS, constipation and diarrhea as well.
- Lactobacillus: Again, various strains exist with some of the following properties: prevents diarrhea, decreases inflammation and gut pain, and lowers blood pressure, anxiety and depression. Each strain works on a different mechanism in the brain including the serotonin and GABA pathways to promote mental well-being. Lactobacillus reuteri, interestingly, can increase levels of our satiety hormone and decrease levels of our hunger hormone, potentially assisting in decreasing caloric intake.
Fortunately, lactobacillus can be found in fermented foods including yogurt, kefir, sauerkraut, kimchi, cheese and pickles, You can also find any combination of these in various probiotic supplements.
**While probiotics are a quick and easy way to add probiotics/psychobiotics to our diets, and I take them myself, there are many things we can do without their use:
- Stop eating processed foods
This includes processed meats, white grains/breads, sugary drinks and snacks, and salty snacks such as chips. Some studies have shown that these foods damage the gut lining and ramp up the bad bacteria in our guts leading to depression and anxiety. There are healthier alternatives to this list of foods, hopefully making it a simple change to make. Focus on a diet of fresh vegetables and fruit, fermented foods, fish, high-fiber whole grains, nuts and eggs.
Fiber alone has been shown to improve the diversity of our gut microbiome and that is what we want for health!! The average American gets only 15 grams of fiber each day, but the minimal recommendation by the American Heart Association is 25-30 gm each day. Some sources of good fiber: blackberries, lentils, chickpeas, raspberries, chia seeds, flax seeds, broccoli, squash, sweet potatoes and whole grain breads.
- Add Omega-3s
Either in supplement form or dietary form, omega-3s are polyunsaturated fats, making them a healthy option that balances the gut microbiome by improving inflammation and supporting your numbers of bifido bacteria. Food sources include: nuts, olives, fish and oils made from these products such as olive oil.
- Add antioxidants to your daily intake
Some studies have shown that antioxidants can improve depression. Antioxidant sources include: berries, coffee, turmeric and green tea.
- Minimize use of proton-pump inhibitors and histamine-2 blockers.
These are medications often prescribed for heartburn/GERD and peptic ulcer disease. I see many patients on these medications chronically, including protonix, pepcid and zantac. Unfortunately, while they may be making you feel better, there are many drawbacks.
They aren’t meant to be taken long-term. If you have been taking them for more than 12-weeks without improvements, it might be time to see another provider or try to make a dietary change yourself. If you are showing improvements, it may be time to taper off of your dose (with your provider’s guidance) and still make some dietary changes. If there is anything I have learned between this book and my nurse practitioner studies, it is that a dietary change can go a long way when we are talking about heartburn, esophageal reflux and many other chronic diseases.
Taking a PPI or H2 blocker can inhibit symptoms that may be caused be something else needing treatment. For example, if you are a carrier of the bacteria H. pylori, and many people are, you need antibiotics to treat it. Taking these medications also alters the pH level in your gut, which is necessary for the absorption of other medications, vitamins and minerals, and the breakdown/destruction of “bad” bacteria.
- Exercise, while good for your for numerous reasons, can improve your gut health too.
Even taking a walk makes you use your muscles, naturally releasing anti-inflammatory markers that brighter your mood. Like, endorphins!
The gut microbiome is its own entity, while also interacting with our brains and having numerous effects on our bodies. It has a job to do, which includes breaking down our food and absorbing the nutrients we ingest, balancing “good” and “bad” bacteria, and providing a barrier between the rest our body and harmful pathogens. A lot of what we ingest and the lifestyles many of us lead are harmful to this body system that has a distinct purpose. It can even impact our mentation and psychiatric health. More studies are showing that depression and anxiety lead to irritable bowel syndrome, not the other way around as previously suspected.
So, maybe some of this is not fully accurate or “science-backed”, but in my opinion, nutrition is always changing and science is always evolving. The recommendations I have found for improving my gut health also improve other areas of my health and I think it is worth a shot if it might mean great benefits to my body.
Anderson, S.C., Cryan, J.F., Dinan, T. (2017). The psychobiotic revolution: mood, food, and the new science of the gut-brain connection.