Category: Microbiome and gut health

The human body, including the gastrointestinal tract and other body sites such as skin, inhabits a diverse ecosystem of microorganisms, collectively known as the microbiota. There is still a lot to learn about it but we know that it plays a crucial role in human health. The constantly growing microbiome research and findings are very impressive. In prepration to write this blog, I was literally overwhelmed as to which microbiome related topic should I chose to write about because the microbiome studies are so extensive. 

Fast reading:

1. What you need to know about human microbiome?
2. Will microbiome analysis provide clear answers to your health problems?
3. How our microbiome interacts with us?
   • Human microbiome - barrier level
   • Human microbiome - immune system modulation level
   • Human microbiome - growth inhibition of harmful organisms aka colonization resistance level
   • Human microbiome - development level

What you need to know about human microbiome?

For instance, we can investigate various microbiome niches in our body, such as our gut microbiota, the mouth microbiota, the skin microbiota, the lungs or the vaginal microbiota. We can look at the microbiota globally and we can look into specific species of bacteria (bacteriota/bacteriome), into groups of bacteria and even go beyond that, by looking at the mycobiota/mycobiome (yeast, fungus), virome (viruses), and parasites residing in our guts. Then, we have different “stages” of the microbiota development staring with the infancy microbiota, the adulthood microbiota, and ending with the elderlyhood microbiota profile. We can explore the microbiota by looking at its composition, diversity, homeostatis (balance) or a degree of dysbiosis (imbalance). We have the good microbes, the “neutral” ones and the bad ones; and at the end it’s all about balance. We can look at the genetic profiles of microbes (microbiome genomes), at their metabolites (microbial products refering to microbiome metabolome); we can investigate the function of these metabolites and look at the effect of these metabolites on human physiology; and we can look at how microbial genes are regulated (switched on and switched off). On the top of it, we can study the microbiome’s role in various diseases, we can investigate the effects of medications, various dietary regimens and lifestyles on the microbiome’s fintess.

Sounds complex, right? And it is. 

Will microbiome analysis provide clear answers to your health problems?

If someone is telling you that they can - based on the list of fecal microbes – fix your gut health and your overall health, they probably do not comprehend the microbiome complexity and its interactions. It does not mean you should not do a fecal test to learn about your microbial-self. The fecal microbiome analysis can be insightful but because the gut microbiome research became such a hot topic, people get easily traped in an idea that the microbiome analysis will provide clear answers to their health problems and it’s not that simple. 

The complexity of the microbiome ecosystem itself and how it communicates with our body, makes it clinicaly exciting. Nevertheless, it is still challenging to properly understand all these interactions and to put our understanding into practice and into therapeutic intervantions. 

If you are confused with the microbiome terminology (microbiome, microbiota, microbes etc), do check the basic gut glossary here.  

Now, let’s dive a bit into how the human microbiota interacts with us. 

How our microbiome interacts with us

Main interactions with the human microbiota happen at four levels, inluding: 

Human microbiome - barrier level

We have physical barriers and chemical barriers, which selectively separate the gut microbiota and our immune system and ensure that contents within the intestine are contained. The best-studied interface for host-microbiota interactions is the intestinal mucosa and a layer of epithelial cells that separates the intestinal lumen from underlying tissues. A dense mucus layer separates the intestinal epithelium from resident intestinal microbes. These barriers prevent the leakage of microbial organisms or their products into the underlying tissues, which could inappropriately stimulate our immune system and lead to inflammation.The microbes residing along our mucosal lining (in our GI tract, reproductive tract, or our respiratory system) make products (metabolites) that help keeping the epithelial cells intact, that stimulate mucus production, and that promote wound healing. 

Human microbiome - immune system modulation level

The microbiota plays a key role in the training and the development of our innate and adaptive immune system, while the immune system governs the maintenance of human-microbe homeostatis (balance). 

The members of the gut microbiota make various molecules that can modulate our immune responses by regulating the production of immunological mediators, such as cytokines and chemokines, secreted from intestinal epithelial cells. It supports either tolerant immune pathways or inflammatory pathways. The microbial immune modulation takes place locally at the sites where the microbes reside, such as the gut, mouth, skin, vagina, and lungs, and it has systemic effects on the brain, lymph nodes, and various organs. The intestinal immune system constantly performs surveillance towards the gut microorganisms to create adequate responses and the microbiota and the innate immunity engage in an extensive bidirectional communication, a sort of crosstalk. 

Human microbiome - growth inhibition of harmful organisms aka colonization resistance level

Colonization resistance refers to resistance against colonization (overgrowth) of harmful organisms that could cause imbalance, infection, inflammation and disease. Our gut and other microbiome sites are home for various types of microbes, the good ones, the bad ones and the opportunistic ones. The beneficial ones help us resist against the colonization by the bad ones because they make certain molecules with antimicrobial effects, such as SCFAs (short chain fatty acids), secondary bile acids and bacteriocins. These compounds are vital in inhibiting the growth of pathogens and opportunistic pathogenes. Perturbations to the microbiota, such as antibiotic treatments, can alter microbial composition (lead to dysbiosis) and can result in the (temporal) loss of colonization resistance. Consequently, we might be more susceptible to colonization (overgrowth) by pathogens which can for example be manifested as diarrhea. 

Human microbiome - development level

The microbiota mode of action goes beyond the gut and the tissues the microbes reside at, the effects can be extrapolated to extraintestinal organs. Microbiome members can impact the development and function of cells within various tissues thanks to the activity of their products. The effects relate to the immune system and immune cells as mentioned above but they can also influence the physiology of other organs such as brain, pancrease, liver, and endocrine organs. Moreover, the activity of microbes can influence the bone mass and skeletal function; and the development of a healthy brain depends also (apart from other prenatal and postnatal factors) on molecular signals generated in the gut by the gut microbiota. 

Microbial molecules as the messengers that influence our physiology 

As you may have noticed, I refer here often to the effect of molecules produced by microbes and not so much to the types of microbes themselves. The reason why I do it is because it’s not only about the microbes themselves but about the products (aka metabolites, compunds, molecules) they make. It’s these “products” that powerfully influence our physiology. Gaining a better understanding in this area will keep scientists busy for years. 

A reference list: 

1. The intestinal neuro-immune axis: crosstalk between neurons, immune cells, and microbes. Jacobson, A., Yang, D., Vella, M. et al. Mucosal Immunol 14, 555–565 (2021). 
2. Gut Microbiota and Colonization Resistance against Bacterial Enteric Infection.Ducarmon QR, Zwittink RD, Hornung BVH, van Schaik W, Young VB, Kuijper EJ. Microbiol Mol Biol Rev. 2019;83(3):e00007-19. 
3. The intestinal microbiota: Antibiotics, colonization resistance, and enteric pathogens. Kim S, Covington A, Pamer EG. Immunol Rev. 2017;279(1):90-105. 
4. Commensal Gut Microbiota Immunomodulatory Actions in Bone Marrow and Liver have Catabolic Effects on Skeletal Homeostasis in Health. Novince CM, Whittow CR, Aartun JD, et al. Sci Rep. 2017;7(1):5747. 
5. Signals from the gut microbiota to distant organs in physiology and disease.Schroeder BO, Bäckhed F. Nat Med. 2016 Oct;22(10):1079-1089. 
6. Intestinal barrier and gut microbiota: Shaping our immune responses throughout life. Takiishi T, Fenero CIM, Câmara NOS. Tissue Barriers. 2017 Oct 2;5(4):e1373208. 
7. Zheng D, Liwinski T, Elinav E. Interaction between microbiota and immunity in health and disease. Cell Res. 2020;30(6):492-506. 
8. The microbiome and regulation of mucosal immunity. McDermott AJ, Huffnagle GB. Immunology. 2014 May;142(1):24-31. 
9. Enterocyte death and intestinal barrier maintenance in homeostasis and disease. Vereecke L, Beyaert R, van Loo G. Trends Mol Med. 2011 Oct;17(10):584-93. 
10. The Intestinal Barrier and Current Techniques for the Assessment of Gut Permeability. Schoultz I, Keita ÅV. Cells. 2020 Aug 17;9(8):1909. 
11. Intestinal barrier and gut microbiota: Shaping our immune responses throughout life. Takiishi T, Fenero CIM, Câmara NOS. Tissue Barriers. 2017 Oct 2;5(4):e1373208. 
12. Links Between the Microbiome and Bone. Hernandez CJ, Guss JD, Luna M, Goldring SR. J Bone Miner Res. 2016 Sep;31(9):1638-46. 
13. Role of the microbiome in human development. Dominguez-Bello MG, Godoy-Vitorino F, Knight R, Blaser MJ. Gut. 2019 Jun;68(6):1108-1114. 
14. Microbiome programming of brain development: implications for neurodevelopmental disorders. Forssberg H. Dev Med Child Neurol. 2019 Jul;61(7):744-749.

My clients are often surprised that changing their eating habits alone can relieve the acid reflux symptoms. The key strategy is to do it right and to be consistent. 

Many people around the globe and some of my clients struggle with the symptoms of acid reflux but not many know that acid reflux is not necessarily caused by having too much gastric acid but rather the acid is in the wrong place. It’s a common misconception about acid reflux to think that we have too much of gastric acid. On the contrary, the plentiful of people suffering from acid reflux have rather hypochlorhydria (too little stomach acid) than hyperchlorhydria (too much stomach acid). 

Fast reading:

1. What is acid reflux?
2. Acid reflux symptoms
3. How to stop acid reflux?
4. What causes acid reflux?

What is acid reflux?

Acid reflux is a common gastrointestinal complain with symptomology of heartburn, a burning pain in the lower chest. It’s driven by stomach acid flowing back up to the esophagus (the food pipe). It can happen for example when increased intra-abdominal pressure overpowers the lower esophageal sphincter (LES, a ring muscle), as seen in people with hiatal hernia or obesity. The esophageal sphincter acts as a valve preventing stomach acid, stomach content from backing up into esophagus. When this system fails, we may experience the symptoms of acid reflux. Noteworthy, reflux of gastric contents into the esophagus is normal physiology. However, when reflux (occurring frequently) leads to symptoms, esophageal mucosal injury or both, we talk about gastroesophageal reflux disease (GERD).

Acid reflux symptoms

Heartburn is a common symptom of acid reflux and some patients perceive it as an angina-like chest pain. Functional heartburn has the same symptoms without signs of reflux. Some people experience regurgitation which is a rise of gastric content into the mouth with sour/bitter tasting, without associated nausea or retching. Other symptoms of reflux may include hoarseness, cough, and asthma as well as pharyngitis, sinusitis, pulmonary fibrosis, recurrent otitis media, and sleep apnea. Some individuals will also experience bloating, burping, difficulty swallowing, hiccups, or nausea. Interpret these symptoms as your body sending you signals that there is something going on. “Treating” them with anti-acids and over-the-counter drugs (H2 blockers, aginate drugs, or proton pomp inhibitors), may help relieving the symptoms however will not address the underlying cause.

How to stop acid reflux?

The best to stop acid reflux is to find the underlying cause. Sometimes your own detective work will be enough and sometimes you may need some testing to find out what’s behind it. 

Regardless of the cause, one of the most effective ways to reduce acid reflux is to invest in healthy eating habits. 

• Eat healthy foods. I am sure you have heard many times to eat healthy and you might  be tired of it but if you want your digestive system to function at its best, a healthy diet is a must. Make your own meals by using fresh, real foods and by skipping processed foods. Go mentally back in time, before the convenient foods existed, what would you eat then? A home-made soup or an instant powder soup? A lollipop or a handful of berries? There is a difference not only in their taste, but also in their nutrient content. Keep it simple and avoid CRAP: processed foods, alcohol, sodas, artificial sweeteners, fried foods; and TRIGGER foods such as spicy foods, garlic, onion, tomatoes, chocolate and coffee. 
• Go for cooked over raw. When having digestive complaints, it’s often better to eat cooked (and warm if you like) foods over raw and cold foods, they are more soothing and easier to digest. 
• Chew well. Eat mindfully without rushing, CHEW your food properly (20 times before swallowing). Make eating moments mindful, look at your food, smell it, taste and savor it. It’s not only important what we eat but also how we eat. Proper chewing promotes better digestion. Be consistent with it.  
• Drink chamomile, peppermint, or ginger tea, or cabbage juice. Some people find a relief after having yoghurt or milk. 
• Avoid large meals. Don’t overeat, eat 4 to 6 small meals at fixed times. Don’t eat 2-4 hours before going to bed, especially heavy to digest meals.
• Stay well hydrated BUT do not drink a lot with your meals as this increases the volume of the stomach and its contents. Drink mostly between meals. 
• Try slippery elm bark tea or chew on the bark, it has been used for generations to relief acid reflux.
• Be physically active but keep it moderate, do something you enjoy.
• Sleep with your head and upper body slightly elevated.
• Consider stress management activities such as yoga, psychological therapy, relaxation, exercise, mindfulness – if you feel like stress is overtaking your life.
• Consider chiropractic adjustment, osteopathic care or acupuncture.

What causes acid reflux?

• Eating unhealthy and eating too much. A typical western diet rich in simple carbohydrates (sugars and starches), processed foods, and little vegetables promotes dysfunction of the digestive system and as a consequence acid reflux may occur. Often, when we eat convenient foods, we also have a tendency to overeat.  
• Obesity. Obesity is commonly associated with acid reflux and GERD. The access weight can put extra pressure on the valves and sphincter causing stomach acid release.
• Hiatal hernia. Hiatal hernia is an abdominal abnormality observed when the upper part of the stomach and lower esophageal sphincter (LES) move above the diaphragm. In this scenario, acid can move up into the esophagus causing acid reflux symptoms. The diaphragm is a muscle helping to keep gastric acid in our stomach. Consider osteopathic or chiropractic care.
• Overtraining. High impact exercises and overtraining can put extra pressure on your abdomen triggering acid reflux.
• Wearing tight-fitting clothes, lying down, bending over.
• Smoking cigarettes. Smoking increases acid production and can contribute to GERD or acid reflux.
• Certain medications and supplements such as antibiotics, muscle relaxers, blood pressure drugs, ibuprofen, potassium and iron supplements can affect the functioning of the digestive system and cause acid reflux.
• Helicobacter pylori infection. Infection with H. pylori can manifest itself with heartburn. If you suspect it may play a role in your complaints, get yourself tested.
• Low magnesium. Low magnesium can influence muscle tension and impair the function of the esophageal sphincter by not retaining the acid in the gastric cavity.
• Chronic cough, stress, food sensitivities foods can also contribute to acid reflux.
• Digestive issues. Think of reduced saliva causing decreased digestive buffering, poor digestive esophageal motor function causing reduced food clearance, or poor gastric emptying causing increased refluxate.
• Underdeveloped GI tract as by babies, may also promote acid reflux because the digestive tract does not work optimally yet.
• Pregnancy. During the pregnancy growing fetus can put extra pressure on the esophageal valve and this may promote the release of gastric acid and symptoms of heartburn.

If your symptoms do not subside after improving your eating habits and lifestyle, please seek medical help to properly evaluate the underlying cause. Long-term acid reflux (GERD) can lead to Barrett’s esophagus, manifested as esophageal scarring and constriction which leads to swallowing disorders.

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

A reference list:

• https://pubmed.ncbi.nlm.nih.gov/28146448/
• https://pubmed.ncbi.nlm.nih.gov/32578044/
• https://pubmed.ncbi.nlm.nih.gov/29199165/
• https://pubmed.ncbi.nlm.nih.gov/25956834/

As may know, my last blog was devoted to 5 common signs of an unhealthy gut. 

I have emphasized there that our gut works in a top-to-bottom sequence and that when you are struggling with digestive issues, the problem may lie anywhere along the digestive system, so simply taking probiotics will often not be the best fix.  

Today, we will talk about . Oftentimes, they are related to our lifestyle and to our diet, sometimes however there might be an underlying cause such as hormonal imbalance, neurodegeneration, auto-immunity, or chronic infection. In these cases, dietary interventions may have a lower therapeutic impact but still are valuable health-wise. 

IBS, or something else? 

I want to share a true story so you know that a popular “leaky gut” fix will not always work. Recently, one of my clients came in with common GI complaints including abdominal discomfort and too frequent bowel movements. He was diagnosed 2 years ago with Irritable Bowel Syndrome (IBS) and then he implemented some common interventions for IBS and a healthy gut, however with little success. After our initial consult, I have provided few basic tips to start with while we were waiting for the fecal and blood test results. The tips were helpful enough to improve the bowel quality and frequency but not to solve an underlying problem. When we received the results, we had additional insights on what’s going on. The most relevant findings included intestinal inflammation, an auto-immune reactivity to gluten, and a protozoan parasite. No surprise, he suffered from chronic gut issues. Yet, without the additional lab workup we would miss important pieces of the puzzle. With results at hand, we could initiate a targeted action plan. 

How to fix abdominal bloating? 

Abdominal bloating is when your abdomen feels bloated, swollen, tight, or hard. 

First, experiment by eating slowly, chewing properly, avoiding drinking during meals, eliminating processed and junk foods, eliminating sugar, sodas, artificial sweeteners, lactose, and processed foods. If you are a fruit lover, reduce your fruit intake to one serving daily. A very powerful and simple tip now, just do not overeat. Don’t overload your stomach with more food than it can handle. For occasional bloating, you can have peppermint, ginger, fennel or chamomile tea, or digestive bitters. 

If after doing a basic detective work, you still experience persistent abdominal bloating, get tested. A different cause may require a different approach, thus experimenting too much and too long might not deliver a desired effect. Test and don’t guess. 

How to fix diarrhea?

Diarrhea happens when you experience loose and watery stools and when your bowel transit is too fast. 

Acute diarrhea. During acute diarrhea you will not be very hungry. Just take care to stay properly hydrated (8-10 glasses per day) and sip small amounts of fluids often (water, electrolytes, vegetable juices, bone broths, soups). Have easy to digest, cooked and soft foods such as cooked rice, cooked veggies, banana, applesauce. 

Chronic diarrhea

Because chronic diarrhea can have profound health consequences, it needs to be investigated. Your doctor can refer you for a stool testing to rule out parasitic or bacterial infection, occult blood, or gut inflammation; run a blood test to rule out allergies, celiac disease, or refer you for a colonoscopy. You can also opt for a comprehensive, functional stool testing to evaluate your gut health and to look for possible imbalances. Test results will dictate a best approach but incorporating binding foods such as bananas, rice, mashed potatoes, simply cooked chicken or meat, yogurt or oatmeal; and avoiding processed foods, excess sugar, sweeteners, caffeine containing drinks (coffee, green tea), alcohol, fruit juices, dry fruits - might be helpful in some cases.

If you have severe symptoms, including severe abdominal or rectal pain, severe weakness, blood in your stool, high fever, or signs of dehydration (dry mouth, anxiety, excessive thirst, little or no urination), call your doctor right away. Be more cautious with elderly and small children suffering from diarrhea as they are at higher risk of dehydration. 

How to fix constipation?

Constipation is defined as bowel movements that are less frequent, often dry and hard. 

Before we go into the tips you can implement when dealing with constipation, I want to give a brief attention to bowel transit time. The optimal defecation frequency is considered to be at least one bowel movement every 1-2 days, with bowel transit time within 12-48 hours. Individuals with constipation have often the bowel transit that’s longer than 48 hours. 

In reality, everyone experiences some variations in bowels frequency but ideally, we want that most of our bowels happen within the 12-48 hours window. Menstruation, vigorous physical exercise, diet, travel, and stress can also temporarily influence your bowel behaviors. Apart from looking at the number and frequency of bowel movements, look at their consistency, the effort needed to expel them and any associated symptoms. In order to assess how long it takes from the time you eat a food until it gets eliminated in a bowel movement, you can do a Bowel Transit Time Test at home, see below.

As you have learned from my previous blog on 5 signs of an unhealthy gut, adequate hydration and fiber are the colon’s best friends and essential for its health, so they are one of the best remedies to address constipation. 

There is no single magic constipation remedy that works for everyone. The efficacy may depend on the cause of constipation. 

Here are several tips to consider when you want to fix constipation: 

• Drink enough water/liquids (2,5 – 3 liter daily). 
• Be physically active, if possible.  
• Use a squatty potty every day. The better angle for pooping decreases straining, and makes pooping easier and more comfortable.
• Have plenty of veggies (up to 800 - 1000 gram daily), have fruits, whole grains and legumes as a source of fiber. 
• Have 1-2 tablespoon of olive oil (optionally with squeezed lemon juice) after waking up and before bed time to lubricate the digestive tract. 
• Use 200 mg to 600 mg of magnesium citrate daily, in divided doses. 
• Take Vitamin C (buffered vit-C, liposomal or Esther-c form preferred). You can take 2,000 to 4,000 mg or more a day, along with magnesium citrate supplementation. The simple principle applies here: If you begin to get loose stools, just back off a bit.
• Have bulking forming agent such as psyllium or barn. It takes a day or so to work but can be quite effective and safe to take on a daily basis. Follow the directions on the label carefully and take it with plenty of liquid, it’s very important. You may have a second glass of water after having psyllium or bran to boost their effectiveness.
• Have berries, chia and flax seeds, cooked leafy greens, artichokes, sweet potatoes and squash. 
• Drink 1-3 cups of coffee or green tea, if tolerated and if you do not suffer from insomnia. 
• Stimulate the vagus nerve tone (to improve the brain-gut axis and bowel motility) by regular throat gargling, loud singing, or (water/coffee) enemas.
• Occasionally, you may use glycerin suppositories to stimulate the reflex to defecate.

Abuse of Laxatives. When not used in a proper way, certain laxatives can worsen the problem. If we rely too much on the (wrong) laxatives, the muscles can become dependent on laxatives to constrict, perfectly fitting a saying “if you don’t use it, you lose it”. There is also a risk to disrupt the function of colon nerve cells. It’s a risk only for certain laxative formulations. Most newer formulations of laxatives should not cause these problems. Always use laxatives as recommended in order to prevent creating additional problems. 

How to fix heartburn? 

Heartburn is associated with burning sensation in the middle of the chest and is a common symptom of reflux. 

The good news is that acid reflux can often be soothed and managed by dietary and lifestyle interventions, especially when it has not progressed to the esophageal inflammation and tissue erosion. 

So, before jumping into the anti-acids and over-the-counter drugs (H2 blockers, aginate drugs, or proton pomp inhibitors), explore your diet and lifestyle. Reflux medications do have side effects and typically do not solve the core problem. 

What can you do? Think of eating smaller meals regularly, chewing well, chewing a gum, avoiding trigger foods, relaxing, quitting smoking, losing weight, avoiding tight clothing, avoiding unnecessary medications and exercising wisely. Also, worth trying chamomile, ginger, fennel or licorice tea, or cabbage juice to alleviate acid reflux symptoms.  

If your symptoms do not subside after using the self-help tools, seek medical help to properly evaluate the underlying cause. Long-term acid reflux can lead to complications such as esophagitis, Barrett’s esophagus, manifested as esophageal scarring and constriction leading to swallowing disorders.

Fix for better blood sugar 

An interplay of reactions happens in order to regulate our blood sugar levels, including our hormones, our gut environment and our gut microbiota. It’s complex and not entirely understood but we know enough to take appropriate actions. 

I could write an assay on how to support your gut health, your gut microbiome and your blood sugar. But, without making it too complicated and overwhelming, let’s focus on how we can promote a healthy gut while promoting a steady blood sugar. 

It’s quite simple. Studies clearly show that dietary fibers can improve blood sugar control and insulin sensitivity, as well as nourish the gut microbiome. They possess anti-obesogenic effects. The foods your gut microbiome loves are the foods that are typically good for a balanced blood sugar. If you want your beneficial gut microbes to thrive and to support your metabolism, you need to take care of them. If you treat them well, they will make good things for you. 

Let’s keep it simple and let’s focus on the 4 Ps.  

4 Ps for a heathy gut and blood sugar

The 4 Ps stands for: proportions, prebiotic rich foods, probiotic rich foods, and polyphenol rich foods. The traditional Mediterranean diet would be the closest to the 4 Ps principle. 

Keep the right Proportions

Prepare balanced meals by combining, by volume: 40-60 % of non-starchy vegetables (for fiber, phytonutrients and polyphenols), 20-25% of protein rich foods (eggs, nuts, seeds, tofu, chicken, meat, fish, legumes), 10-25% of foods rich in resistant starches (potatoes, sweet potatoes, peas, yams, plantain, lentils, chickpeas, beans, buckwheat, oats, barley), 10-25% of foods rich in healthy fats (quality plant oils, raw nuts and seeds), herbs and spices. 

Have Prebiotic rich foods

They serve as food (dietary fiber) for beneficial microbes. Prebiotics are non-living, non-digestible by human ingredients (carbohydrates) that feed trillions of microbial mouths in your gut and helping them to bloom. They are microbiome superfoods that naturally occur in plant foods (vegetables, fruits, grains) such as chicory root, Jerusalem artichoke, onion, leek, garlic, raw oats, banana, broccoli, carrots, or fruit skin. Dietary fiber aids digestion, bowel movement and assists the removal of toxins from the body. 

Have Probiotic rich foods

They contain beneficial microbes such as bacteria or yeast. They are present in certain foods containing live cultures such as yoghurt, kefir, aged cheese, kombucha, kimichi, sauerkraut, and miso. Probiotic rich foods may support digestion and immunity. 

Have Polyphenol rich foods

Polyphenols are plants’ powerful nutrients that to become active undergo diverse intestinal transformations thanks to the action of human digestive enzymes and microbial metabolism. They include flavonoids, tannins, chlorogenic acids, anthocyanidins. They have antiviral, antibacterial, and antiparasitic properties. Vegetables, fruits, herbs are rich in polyphenols such as onions, apples, grapefruits, plums, broccoli, citrus fruits, tomatoes, green thee, cocoa, bananas, berries, chickpeas, beans, soy, parsley, thyme, celery, walnuts, grapes, flaxseed, apricots, coffee seeds, and peaches.  

Having a diet rich in prebiotic foods, probiotic foods and polyphenols at the right proportions, is a wonderful way to support your gut microbiome, your gut health, as well as to promote a steady blood sugar, and as a bonus to support your cardiovascular health.  

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

Gut issues are a warning sign and when left unmanaged, they pose a risk of chronic health problems. 

If you are following health related news, you probably have seen blogs stating that all gut issues and often all health issues are caused by a “Leaky Gut”. Is that true?

To my opinion, it’s NOT. A Leaky gut may play a role but not always and there are many other factors at play which are often overlooked. Let me explain. 

Proper gut health assessment

For a proper gut health assessment, you need to think of a digestive system as a sort of manufacturing plant where many sequential steps are taking place in order to deliver a final product, hopefully a well-formed poop. Each step along the way plays an important role, therefore when focusing exclusively on a leaky gut as a cause and supplementing with probiotics as a fix, you might miss other important digestive pieces. 

If you see the digestion process as a sequence of events, you can imagine that whenever one step goes wrong - it affects what happens next, as a result affecting the quality of the end product, your poop. 

The gut functions in a top-to-bottom sequence. Issues can take place anywhere along this sequence and if you overlook any one of them, you most likely won’t have good results with conquering your gut issues by applying a standard gut healing protocol. For instance, you will have limited results when you fix your gut with probiotics and herbals while you have low stomach acid or a sluggish gallbladder.

Many different things can cause gastrointestinal challenges so you want to investigate which ones might be affecting you. It will help you to develop a customized plan to address your problem in a smart and strategic way. 

Few common gut issues include:

• not chewing foods well enough,
• having suboptimal levels of gastric acid,
• having a poor bile flow,
• not making enough digestive enzymes,
• having a gut dysbiosis,
• suffering from a too slow or too quick intestinal transit. 

So, if you are struggling with digestive issues, do not exclusively focus on a leaky gut – keep a bigger picture. 

5 common signs of an unhealthy gut 

These are symptoms, not diseases. Nevertheless, they might sometimes be associated with a disease. 

1. Abdominal bloating 

For many of my clients, it is one of the top complaints. It is a feeling of fullness, swelling, tightness, or hardness often described as a “feeling of being pregnant”. It may also be associated with pain, flatulence, abdominal distension, nausea, burping, belching, or gurgles. 

Causes of abdominal bloating

The cause can be as simple as eating and drinking too fast and too much. We tend to swallow air when eating fast and our digestive system can take-in only a certain amount of food at the time. Overconsumption of starchy foods such as grain products, seeds and nuts can promote bloating as well. A common bloating bomb is having a large pizza with a large dose of coke. Abdominal bloating can also be driven by low gastric acid levels, dyspepsia (indigestion), impaired pancreatic function or bile production, constipation, food allergies, food intolerances, celiac disease, gallstones, SIBO, gut microbiome dysbiosis, Helicobacter pylori infection, parasitic infections, Inflammatory Bowel Disease (IBD), use of medications that influences digestion, hormonal changes, reproductive track issues, or abdominal water retention. People with IBS and SIBO often experience bloating.  

2. Diarrhea

Diarrhea is defined as loose and watery bowel movements and a too fast bowel transit. Then, feces do not stay in the colon long enough for water to be re-absorbed into the body. Diarrhea can be associated with cramps, nausea and vomiting. 

Diarrhea is described as acute when it lasts less than four weeks, as in viral gastroenteritis. It is considered chronic when it lasts four weeks or longer. Everyone experiences diarrhea once in a while, for a couple of days. It’s usually not serious and the problem resolves on its own. 

Causes of diarrhea

Typically, acute diarrhea is a sign that your body wants to get rid of something, could be microbes, parasites, foods or toxins, for example such as during a food poisoning. Then, the toilet is your best friend. It’s an intelligent way of reducing the infectious and unwanted agents. It’s self-limiting and typically will resolve in a couple of days. 

Chronic diarrhea however, might be the result of food allergies, food intolerances (lactose, fructose, histamine), celiac disease, persistent bacterial & parasitic & viral or fungal infection, Small Intestinal Bacterial or Fungal Overgrowth (SIBO and SIFO), Inflammatory Bowel Disease (IBD), IBS, diverticular disease, gallbladder issues, certain foods and sugar substitutes (sorbitol, mannitol, xylitol), alcohol abuse, malabsorption, overactive thyroid, excessive secretion of fluids by the intestine, or the use of certain medications and supplements (magnesium citrate, vitamin C). Stress is a big factor as well. When you have chronic diarrhea, you are at risk of not digesting the foods well and not absorbing all nutrients well, and you may end up with nutritional deficiencies. 

3. Constipation 

Constipation refers to bowel movements that are less frequent and often associated with dry and hard stools which are difficult or painful to pass. The Rome IV criteria for constipation states that a diagnosis of functional constipation is made when at least two of the following criteria are met for the last 3 months with symptom onset at least 6 months prior to diagnosis:

• straining on >25% of defecations;
• lumpy or hard stools on >25% of defecations;
• sensation of incomplete evacuation on >25% of defecations;
• sensation of anorectal obstruction/blockage on >25% of defecations;
• manual maneuvers on >25% of defecations;
• less than 3 defecations per week.

Constipation creates a problem in the large intestine, the colon. The colon’s role is to reabsorb nutrients and water back into our system and to eliminate what we don’t need. Adequate hydration and fiber are the colon’s best friends and essential for its health. Without adequate dietary fiber, the colonic cells (colonocytes) have a difficult time to do their job and to preserve the colon integrity. In addition, your colon is home for gut microbes. The microbes are processing and metabolizing your food and other intestinal content to make various products. The healthier foods (fiber and polyphenols’ rich) your gut microbes receive, the healthier products they will make, including short chain fatty acids (SCFAs) such as butyric acid. The SCFAs are a primary fuel for the colonic cells and are required to nourish the cells and to regenerate them. If the stool is not eliminated in a timely manner, more and harder stool accumulates which adds to discomfort when stool finally passes.  

Causes of constipation

Constipation typically can be a result of the changes in diet or routine (travelling), lack of exercise, low intake of fiber and water (liquids). Fiber absorbs water and causes stools to be larger, softer, and easier to pass. Sometimes, it is caused by a gut dysbiosis or by the use of medications (opioids, iron supplements, antacids that contain aluminum, sedatives, antidepressants, bismuth salts, diuretics, calcium-channel blockers), or by an underactive thyroid, or by neurodegeneration. Interestingly, one of the first symptoms of Parkinson is constipation. Constipation affects women (possible thyroid connection) twice as often as men and is more prevalent as we age (possible neurodegeneration, lack of fiber and less physical activity). Constipation can also occur when you routinely neglect the urge to defecate, your reflex to defecate may be dampened, and accumulated stool may harden as a result, becoming even more difficult to pass. 

4. Heartburn 

Heartburn is a symptom of burning sensation in the middle of the chest and is a common symptom of reflux, a very common gastrointestinal complaint. Reflux or acid reflux, officially called gastroesophageal reflux disease (GERD) is the medical condition, in which stomach content (acid, pepsin) flows back up to the esophagus (the food pipe). 

Reflux of gastric contents into the esophagus is normal physiology, therefore incidents of reflux often go unnoticed. However, when reflux occurs frequently and excessively, it can lead to esophageal mucosal injury and inflammation and persistent symptoms associated with acid reflux. The reflux pain and discomfort can radiate from the lower end of the rib cage to the root of the neck and can be accompanied by the stinging and sour sensation in the throat. Other symptoms of reflux may include hoarseness, cough, and asthma as well as pharyngitis, sinusitis, pulmonary fibrosis, recurrent otitis media, and sleep apnea. Some individuals will also experience bloating, burping, difficulty swallowing, hiccups, or nausea.

When reflux symptoms are severe, chronic and affect the quality of life, a doctor may refer you for a diagnostic testing such as upper GI endoscopy, monitoring Ph, transnasal esophagoscopy or the impedance testing. The results of a medical exam can be helpful in assessing the severity and a possible cause of reflux, and into classifying the heartburn you experience into one of the following categories:

• functional heartburn, featured by an absence of reflux or excessive sensitivity to acid,
• reflux hypersensitivity, characterized by the normal levels of refluxed gastric acid which induces heartburn symptoms,
• non-erosive reflux, characterized by an abnormal amount of acid reflux with no inflammation in the esophageal lining,
• erosive esophagitis, characterized by the inflamed esophageal lining with eroded spots resulting in ulcers. 

Causes of heartburn

Often, when the lower esophageal sphincter (LES) weakens and relaxes too much, gastric fluids surge up into the esophagus, sometimes causing a painful burning sensation. Poor contraction of esophagus and stomach muscles can also promote reflux. 

Common reflux triggers include being overweight, being pregnant, smoking cigarettes, having a hiatal hernia, overtraining, overeating, wearing tight-fitting clothes, lying down, bending over, certain medications and supplements (antibiotics, muscle relaxers, blood pressure drugs, ibuprofen, hormones, potassium and iron supplements), Helicobacter pylori gastric infection, low magnesium levels, chronic cough, stress, old age, or sensitivities and allergies to foods.  

Certain foods and drinks can also contribute to reflux by influencing the function of the LES or gastric acid production. For example, many people experience reflux/heartburn complains after alcohol, coffee, caffeine-containing products, cocoa, cola drinks, onions, garlic, citrus fruits, tomato products, high-fat and fried foods. 

5. Poor blood sugar control (hypoglycemia or hyperglycemia) 

You might be surprised to learn that there is a connection between the gut microbes, gut health and blood sugar regulation, according to the latest research. Blood sugar control is a complex symphony of interactions on many levels; genetic, biochemical, hormonal and metabolic level. We know that hormones such as insulin, glucagon and cortisol regulate our blood sugar levels but as scientist continue to study our gut microbiome, they constantly discover new things. We know now that thousands of the metabolites manufactured by gut microbes interact with our body cells and modulate our physiology.

Changes in the gut microbiome (gut dysbiosis) were shown to be associated with poorer blood sugar control and with metabolic disorders such as insulin resistance, diabetes, obesity, and metabolic syndrome. The preliminary findings and the logic behind it, is that changes in the intestinal ecosystem can drive inflammation, alter intestinal permeability, modulate metabolism of bile acids and short-chain fatty acids; and that microbial metabolites act synergistically on metabolic regulation systems possibly contributing to insulin resistance. 

People susceptible to obesity are thought to have a gut microbiota that endorses more effective storage and extraction of energy from the consumed diet when compared to the microbial community of non-obese people. Interestingly, gut microbes produce certain metabolites that may affect satiety and insulin resistance.

Studies on the effect of probiotics and prebiotics on blood sugar control and insulin resistance demonstrated that prebiotics and probiotics may have potential to improve glucose metabolism. 

Causes of poor blood sugar control

Poor blood sugar control is mainly driven by a poor diet and poor lifestyle. Diets rich in sugar and processed foods will typically drive blood sugar imbalances, will alter the gut microbiome and impair digestion. The use of medications, antibiotics, chronic stress, poor sleep, sedentary lifestyle and genetics influence both, our blood sugar and our gut microbiome.  

Stay tuned to learn, in my next blog, the ways how to fix these common digestive complaints. 

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

ANTIBIOTIC – antibiotics, or antibacterials, are a type of antimicrobial used to target bacteria, and are often used in medical treatment of bacterial infections. They can either kill or inhibit the growth of bacteria.

DYSBIOSIS – also called dysbacteriosis, this refers to microbial imbalance on or inside the body. Dysbiosis is most commonly reported as a condition in the digestive tract.

FERMENTATION – a chemical process that converts sugar and carbohydrates into acids, gases, and/or alcohol. It occurs in yeast and bacteria, but also in oxygen-starved muscle cells, as in the case of lactic acid fermentation. Humans use fermentation to produce food and beverages.

GUT MICROBIOTA – microorganisms residing in the gastrointestinal tract (GI tract).

GASTROINTESTINAL TRACT/DIGESTIVE SYSTEM – an organ system responsible for consuming and digesting foodstuffs, absorbing nutrients, and expelling waste.

INTESTINAL BARRIER (gut barrier) – is essential in human health and constitutes a tight barrier that controls what gets absorbed into the bloodstream. It is a semi-permeable barrier that allows the uptake of essential nutrients and immune sensing, while being restrictive against pathogenic molecules and bacteria, this filtering structure is essential function of the gastrointestinal tract. The central component of the barrier is formed by intestinal epithelial cells, which physically separate the intestinal lumen and the body. In addition, various molecules are secreted into the intestinal lumen to reinforce the barrier function and a variety of immune cells below the epithelial layer provides additional protection. 

INTESTINAL PERMEABILITY - is defined as the system describing the control of material passing from inside the gastrointestinal tract through the epithelial cells lining the gut wall, into the rest of the body. The intestine normally exhibits some permeability, which allows nutrients to pass through the gut, while also maintaining a barrier function to keep potentially harmful substances (such as antigens) from leaving the intestine and migrating to the body more widely. A crucial function of the intestinal epithelium is the maintenance of a proper barrier function, allowing the permeability of nutrients, water and ions, but limits entry of pathogens and bacterial toxins. 

INCREASED INTESTINAL PERMEABILITY aka LEAKY GUT – refers to a compromised intestinal barrier, meaning that the gut lining might have a sort of “cracks or holes”. Physiologically, our intestinal barrier is permeable but it’s problematic when the permeability is increased allowing translocation of partially digested food, toxins, and bugs to the tissues beneath the gut barrier. The expression “leaky gut” is getting a lot of attention in medical blogs and social media; however, many doctors will be unfamiliar with this term. This undesired translocation may trigger immune system, promote inflammation and lead to changes in the gut microbes that could lead to problems within the digestive tract and beyond. The current research shows that abnormalities in the intestinal barrier, intestinal bacteria and inflammation may play a role in the development of several common chronic diseases.

POSTBIOTIC - also known as metabiotics, biogenics, or metabolites - are products or byproducts made by live bacteria, or released after bacterial lysis. Studies demonstrate that postbiotics may play a role in general health and well-being, providing physiological benefits to the host. An example of a postbiotic is butyric acid. It’s a Short Chain Fatty Acid made by intestinal bacteria and by probiotic bacteria. 

PROBIOTIC – live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The term derives from the Latin preposition pro (“for”) and the Greek adjective βιωτικός (biotic), the latter deriving from the noun βίος (bios, “life”).

PREBIOTIC – generally refers to compounds (food ingredients) that induce the growth and/or activity of commensal microorganisms (eg bacteria and fungi) that contribute to the wellbeing of their host. A prebiotic is a selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon the host’s health.

SYMBIOSIS – interaction between two or more different biological species.

SYNBIOTYK - A mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host. Simply, Probiotic(s) + prebiotic(s) working to achieve one or more health benefits. 

MICROBE – an organism that is microscopic.

MICROORGANISM – a microscopic living organism, single- or multiple-celled. Microorganisms include bacteria, archaea, protozoa and some fungi and algae. Viruses are also sometimes classified as microorganisms.

MICROBIOTA – sometimes called microflora; a community of symbiotic, commensal and pathogenic microorganisms inhabiting either the surface of the body or its different cavities: the skin, mouth, ears, vagina and gastrointestinal tract, among others.

MICROBIOME – the collective genomes of the microorganisms that reside in an environmental niche, such as a gut microbiome referring to microbial genomes found in the gut.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 

IMMUNITY

You may have some questions now.

Why do some of us get sick more often than the others? What makes some people more susceptible to get sick? Is it possible to, by supporting your immune system, become almost resistant to colds, flu and other infections? And if you do catch something, can you bounce back to feeling well within 1-2 days?

There are many factors that influence the condition of our immune system, some of them are genetically determined and some are determined by our environment, lifestyle, diet (the so-called epigenetics). So by and large, we can take actions to support our immunity.

Lifestyle factors that compromise our immune system in adulthood include poor diet (resulting in a suboptimal nutritional status), chronic stress (physical and psychological), sleep disturbances, alcohol overuse, cigarette smoke, pollution, prolonged and excessive exercise.

As I am writing this blog, we are facing a coronavirus COVID-19 pandemic. Catching a coronavirus may manifest from mild to severe symptoms (severe especially in elderly and those with health issues). What determines how you experience an infection is the virulence (pathogenicity) of a given virus, bacteria and the efficiency of your immune system.

“Compromised immune function increases the risk of infection”

The immune system evolved as a defense mechanism against infectious disease. The immune system is a collection of various cells and molecules present in our bloodstream, tissues and organs.  They defend our body against foreign bodies (antigens), such as bacteria, viruses and cancerous cells. There are many molecules involved in an immune response, such as lymphocytes, antibodies, dendritic cells, mast cells, macrophages, NK cells.

 It’s important to realize that to support your immune system and to have long-term results, it’s not something you do overnight, it’s a process. The more you do to positively stimulate your immunity (like eating healthy foods and having restorative sleep) and the less you do to undermine it (like eating junk foods, excess sugar, or having poor sleep), the stronger your immune system will be. In addition to building immune resilience, you can also improve, and even reverse, many health issues.

Below I have put together essential and powerful tips to make your immune system resilient. It’s all about having a good foundation. There is NO shortcut or a miracle pill and the reality is that the safest, most robust interventions include lifestyle interventions. It's worth the daily investments in your diet and lifestyle.

WHAT CAN YOU DO TO INCREASE IMMUNITY IN THE HEALTHY WAY?

Get quality sleep. Sleep is one of the best immune superpowers. Sleep deficit promotes release of pro-inflammatory cytokines (more inflammation) and can lead to chronic, systemic low-grade inflammation. Studies show that sleep deprived people (common among parents of young children) are more prone to catch a flu virus, and when sick they have more symptoms and longer recovery than people who sleep well and enough. During sleep you make a hormone, a powerful anti-oxidant, melatonin. Preliminary findings indicate that melatonin could be helpful in the management of COVID-19 infections. Also, no surprise why we need more sleep when we are sick, it helps us to mobilize our immune defences. Tip: invest in a relaxing evening routine (taking Epsom salt bath, reading a book) to promote quality sleep, avoid alcohol and caffeine in the afternoon. 

Nourish your body and feed your good gut microbes.  Healthy immune system components need good and regular nourishment. Scientists have long recognized that people who live in poverty and are malnourished are more vulnerable to infectious diseases. Healthy foods provide us with nutrients and help our beneficial gut microbes (microbiota) thrive, on the contrary junk foods and sugary foods deprive us from nutrients and result in compromised microbiota. Gut microbes teach our immune system to generate appropriate immune response and competes with pathogens for nutrients. Gut health is essential to immune health and how we respond to viruses and other pathogens. Therefore, the quality (not quantity) of foods you eat is essential. Research indicates that brightly colored vegetables and fruits boost immunity better than most supplements. Tip: have a diversity of healthy foods, strive for colors and quality. Eat high amounts of vegetables and fruits, have healthy fats and adequate protein. Avoid sugar, alcohol and processed foods.

Minimize stress. Scientists are actively studying the relationship between stress and immune function and there is still a lot to learn as stress is perceptive and difficult to define. But what we know now is that short-term stress can actually boost your immunity and is adaptive, however chronic stress is maladaptive, it weakens our immune system and can result in Th2 dominance (Th2 cells are helper T cells producing various interleukins) resulting in an immunological shift, imbalance. When we’re stressed, the immune system’s ability to fight off antigens is reduced. That is why we are more susceptible to infections. For example, prolonged stress and elevated cortisol levels can suppress the effectiveness of the immune system (lowers lymphocytes). Luckily, humans have the capability to modify what they perceive as stressful and how they respond to it. It’s all in our hands, whether we manage stress or stress manages us. Tip: some successful stress management strategies include meditation, mindfulness, psychotherapy, physical activities, social connection, breathing, hobbies, humor, keeping a perspective in life. Do what works for you.

Stay hydrated. Proper hydration helps us to feel better, to function better and it’s key to our overall health. Water is our building block, solvent, lubricant, medium for biochemical reactions, transport medium, thermo-regulator, and shock absorber. Water facilitates countless number of processes in our body so if we have too little of it, these processes will be impaired, impaired at the cellular level. If you are chronically dehydrated, at some point you may start experiencing certain symptoms like constipation, headaches, or dryness. Your optimal water intake is affected by physical activity, exercise, metabolism, diet, health status, humidity and ambient temperature. If you sport and sweat you obviously need to drink more water. Tip: the average recommendation for adult females is about 2,5 liter daily, for adult males about 3-3,5 liter daily.

Exercise moderately. Regular physical activity of moderate intensity is one of the pillars of healthy living. It improves cardiovascular health, helps control body weight, and protects against a variety of diseases. Just like a healthy diet, exercise can contribute to general good health and therefore to a healthy immune system. Exercise, by promoting good circulation, can allow the cells and immune system molecules to move through the body freely and do their job efficiently, and therefore be helpful in reducing inflammation, maintaining the proper immune response, enhancing immunosurveillance, and reducing psychological stress.

Be positive. Your mindset influences not only how you perceive the world but also how you feel and how your immune system is working. Positive thinking creates positive results and more optimistic individuals are less likely to suffer from chronic diseases and stress burden. Also, being surrounded by loving and positive people helps us to stay positive. Tip: by telling yourself “I am strong”, “I am healthy”, “I am resilient”, “I have a supercharged immune system” you are telling yourself how you should feel. It literally can make you feel better. And it’s not about curing a disease by positive thinking but about creating health promoting thoughts in contrast to disease promoting thought (“I am weak”, “I am sick”). You can “program” yourself to a certain degree. Your mind believes what you are saying, whether it’s good or bad. So let’s keep it positive.

NUTRIENTS TO THE IMMUNE RESCUE

Micronutrient (vitamins, minerals) deficiencies can impair immune function. Therefore, malnourished individuals are more prone to infections and may have a more challenging time to recover. Micronutrients with most vital immune support include vitamins C and D and zinc. Also, vitamin A, B12, B6, E, folate, selenium, iron, and copper are essential to ensure the proper integrity of immune barriers and proper function of immune cells. These micronutrients are involved at every stage, via various mechanisms, of the immune response. Noteworthy, foods contain many nutrients we can never get in supplements, yet foods alone will not always meet all of our needs for micronutrients. Thus, sometimes micronutrient supplementation is beneficial to support immune function and/or reduce the risk of infection.

A word of caution about supplementation, more supplements or higher dosages do not necessairly create better results, on the contrary - over dosing can even create unwanted results! It is about having enough of what our body needs. Micronutrients can challenge your immune system when you have too little and too much. They are also not helpful if they are in the wrong chemical form or in poor proportions. For example, there is a tendency to take very high amounts of vitamin D3 without any assessment of a baseline vitamin D levels. I discourage taking mega doses of any individual vitamin or mineral, unless recommended by a health care professional.

 You may consider taking daily:

• A high-quality Multi-Vitamin & Mineral Supplement
• A high-quality omega-3 supplement (DHA, EPA), especially for individuals with a low intake of fatty fish

In a period of an increased infection risk and/or lower immunity:

• Zinc - 15-45 mg daily (zinc glycinate, zinc methionine, zinc gluconate, zinc citrate or zinc sulfate), best divided in 3-4 doses taken through the day. If you supplement with zinc daily for a longer period of time, take copper supplement as well. Aim to get 1-3 milligrams of copper per day. Aim for 15-to-1 zinc to copper ratio to provide 1 milligram of copper per 15 mg of zinc.
• Vitamin D: 1,000 – 5,000 IU daily (in case of a deficiency the dosage might be adjusted). Of note, sunshine is where most of our vitamin D comes from. Resonable sun exposure can elevate your vitamin D levels without a need of supplementation. 
• Vitamin A: 3,000 - 10,000 IU daily (in case of a deficiency the dosage might be adjusted)
• Vitamin C (with bioflavonoids): 500 - 3,000 mg daily
• Elderberry extract: 500 - 2,000 mg daily
• Echinacea extract: 500 - 2,000 mg daily

I do not recommend supplementation with high doses of individual vitamins and minerals for a longer period of time. 

Other immunomodulating compounds: Astragalus, medicianal mushrooms (like Reishi, Turkey Tail), antioxidants (like glutathione, resveratrol, flavonoids, vitamin E, selenium, melatonin, quercetin)

HOW TO SURVIVE THE CORONAVIRUS CRISIS

In addition to what’s mentioned above, there are few measures specific for the COVID-19 situation, such as:

#1 Avoid exposure. The key is prevention. One of the best strategies is to isolate to prevent contracting a virus. People can be contagious days before they have any symptoms at all. If you have any possible options for staying away from all others, please do so. Avoid touching your eyes, nose, and mouth.

#2 Realize it’s temporal. There is panic and stress around coronavirus situation, but it’s important to realize that it will pass. You need to use your mind to stay calm and remind yourself that it’s a temporal situation.

#3 Wash your hands well and regularly, disinfect and clean surfaces.

#4 Cover your mouth when coughing.

#3 Include following herbs, extracts and foods in your diet for protection: oregano, turmeric, ginger, citrus peel, tickberry leaves, orange peel, garlic (stabilized allicin), onion, green tea, wild berries, pomegranates, seaweeds, mushrooms, cat's claw tea, lemon balm tea, elderberry, and grapefruit seed extract.

#5 Sore throats: Try salt water gargles, sage tea gargles, hot teas and lozenges containing slippery elm, lozenges with zinc for fighting infection and soothing irritated sore throats.

#6 Respiratory congestion & congested sinuses. Nasal irrigation using a neti pot (with saline solution) can be very helpful, as well as nasal sprays (with saline solution, xylitol) and sinus drainage massage. Saline solution (water + salt) is easy to make or can be purchased. You can also use a humidifier, vaporizers, or steam inhalers, or spend time in steamy baths or showers. Vaporizers and inhalers can also be used with decongestants or essential oils such as eucalyptus, menthol, peppermint, or frankincense.

#4 Be careful with anti-inflammatory medications like Ibuprofen and Aspirin. It's unclear at the moment but there was a suspicion that they may raise the risk of COVID-19 complications.

#6 Be careful with high doses of vitamin D3 and vitamin A. Vitamins A and D are very important to ensure a proper function of our immune system. However, there is a hypothesis that over-supplementing with these vitamins may potentially make us more vulnerable to COVID-19 infection. Why? Because the coronavirus uses the receptor ACE2 (angiotensin-converting enzyme 2), mainly in the respiratory tract, to get inside our cells. And these two vitamins are helping us to make ACE2 and therefore it’s thought that possibly the more ACE2, the higher risk of virus invasion.

We are still learning about the impact and the best management of COVID-19, therefore the recommendations can change overtime as new research emerges.

Last but not least, if you are feeling unwell, watch out for the typical symptoms associated with the COVID-19 infection. Most of those who contract COVID-19 will have less or more severe symptoms. While having no symptoms is possible, if you have COVID-19 you are likely to experience: fever, cough, impaired breathing, fatigue and a small population of patients may have gastrointestinal complaints like diarrhea.

If want to feel better and don’t know where to start, begin by healing your gut as the saying goes “When in doubt, begin in the gut”.

Healing tips for an unhappy gut  

When your gut is out of balance and digestive system is weak, it is often the best to go back to basics by eating simple and restorative foods to accelerate healing. Below I provide some basic tips to consider when dealing with an unhappy gut:

• Have (warm) cooked/steamed/baked foods, they are easier to digest than raw and cold foods
• Eat frequently and in small amounts, it’s easier on your digestion than big portions at once
• Have proteins as they are needed to heal, include bone broths, vegetable broths, mushroom broths, soups and stews, well-cooked pastured meats, bone marrow, organic eggs, optionally high quality dairy (sheep, goat, coconut) and protein powder (green pea, hemp, whey)
• Have healthy fats to nourish and soothe your immune system, consider coconut oil, butter, ghee, olive oil, hemp seed, avocados, flax seed, coconut milk and coconut water. If you tolerate nuts and seeds you may eat them in small amounts, preferably soaked at first
• Have various (cooked) vegetables – at least half of what’s on your plate ought to be vegetables. Cabbage-family foods are high in glutamine, a healing nutrient that helps repair the gut
• Have preferably non-gluten containing grains such as quinoa, amaranth, buckwheat, millet and rice. Soaked in water for few hours before cooking, it makes them easier to digest
• Have gentle fruits, such as ripe or cooked fruits
• Have enough liquids such as water, water with lemon, water with raw apple cider vinegar, mint tea, fennel tea, ginger tea, green tea, rooibos tea, broths (bone broths are rich in glutamine), or some fresh vegetable juice (carrot, ginger, beet, kale, parsley, cabbage or sauerkraut)
• Have herbs and spices such as salt, peper, basil, oregano, dill, fennel, cumin, coriander, cinnamon, nutmeg. Try to avoid hot spices such as cayenne and chili
• Supplementation with licorice (in a form of deglycyrrhizinated licorice DGL), glutamine, or quercetin can quench inflammation and help gut healing
• Get unstressed – stress is a very common contributor to digestive complains
• If you feel like you overreact to almost all foods, go low on lectins. Check the shopping list of Dr. Gundry for foods low/high in lectins. Lectins can aggravate inflammation

If above strategies do not help or you think you need a more targeted approach, seek some professional help.

Common causes of digestive issues:

• Chronic stress
• Poor diet and low dietary fiber intake
• Infections
• Low stomach hydrochloric acid
• Medications, prescribed and over the counter
• Alcohol, drugs and cigarette smoking
• Genetics
• Lack of exercise
• Environmental toxins, irritants, heavy metals

“P-foods” for good gut health

Your gut likes real foods but here I want to focus specifically on three gut healthful P’s: prebiotics, probiotics and polyphenols.

3 x P rich foods for heathy gut and for healthy you:

#1 Prebiotic rich foods = serve as food (dietary fiber) for beneficial microbes. Prebiotics are non-living, non-digestible by human ingredients (carbohydrates) that feed trillions of microbial mouths in your gut and helping them to bloom. They are microbiome superfoods that naturally occur in plant foods (vegetables, fruits, grains) such as chicory root, Jerusalem artichoke, onion, leek, garlic, raw oats, banana, broccoli, carrots, or fruit skin. Dietary fiber aids digestion, bowel movement and assists the removal of toxins from the body.

#2 Probiotic rich foods = contain beneficial microbes such as bacteria or yeast. They are present in certain foods containing live cultures such as yoghurt, kefir, aged cheese, kombucha, kimichi, sauerkraut, and miso. Probiotic rich foods may support digestion and immunity.

#3 Polyphenol rich foods = polyphenols are plants’ powerful nutrients that to become active undergo diverse intestinal transformations thanks to the action of human digestive enzymes and microbial metabolism. They include flavonoids, tannins, chlorogenic acids, anthocyanidins. They have antiviral, antibacterial, and anti-parasitic properties. Vegetables, fruits, herbs are rich in polyphenols: onion, apples, grapefruit, plums, broccoli, citrus fruits, tomatoes, green thee, cocoa, banana, berries, chickpeas, beans, soy, parsley, thyme, celery, walnuts, grapes, flaxseed, apricots, coffee seeds, and peaches.

If you want to know more how to create a healthy plate for you, for your gut and your gut microbes, check my blog on “How to create your healthy plate”. Keep in mind that everyone is different and some foods that are great for one person will not necessarily be healthful for the other person.

Healthy Diet promotes Healthy Gut - Healthy Gut promotes Heathy You!

The wisdom of Hippocrates (460-370 BC) with regards to the importance of gut health finds its place today. Hippocrates has stated ages ago that “All Diseases Begin in the Gut”. Recent scientific and clinical findings support his statement. If you want to invest in your wellbeing one of the elements you want to give a special attention to is your gut heath. I am here to take the gut health under the loop and to have a gut talk.

Why is healthy digestion essential for optimal health? 

Healthy gut is one of the prerequisites of staying healthy. Digestive health promotes overall health as digestive system communicates with your immune system, it runs your metabolism, it chops up the food to usable nutrients, and communicates with other cells in your body. By nourishing your gut you nourish every cell of our body. In a perfect world, the foods you eat are properly digested, their digestion products are absorbed, assimilated and used as a fuel, building blocks and materials for various biochemical reactions within our body. Digestive system brings nutrients to your body. When these nutrients are deficient or do not get where they are needed, you feel tired, have concentration problems and over time you develop more symptoms. Conditions not obviously associated with gut such as skin conditions (eczema, psoriasis, acne) are actually often linked to dysfunctional gut. The take-home-message: thrive to have a properly functioning digestive system.

Two brains in one body

Our digestive system is often called the “second brain”, it’s connected with our brain via the vagus nerve forming the enteric nervous system (ENS) and the communication system – the so called gut-brain axis. Importantly, most of your neurotransmitters such as serotonin and dopamine is manufactured in the gut and not in the brain. If these neurotransmitters are out of balance you may experience mood swings or mood disorder. Another factor that makes your gut so vital is that about 70-75% of your immune cells reside in the gut. So the first thing to do if you want to boost your immunity, you need to take care of your gut. Think of a link between your gut– brain– immune system.

The forgotten organ: gut microbiota

You may have not realized that about 500-1000 microbial species (bacteria, yeast, protozoa, and viruses) live in your gut, weighting up to 1,5-2 kg. This gastrointestinal community of microorganisms is called gut microbiota (microflora). It comprises of commensal (coexisting, acquired during and after birth, from breastmilk and from environment) and transitional (just passing through, contracted through food and drinks) microorganisms. They can be beneficial, opportunistic (potentially harmful) or pathogenic (harmful). Your body has much more microbial cells than your own human cells. Your gut microbiome (genomes of the gut microbiome) contains about 150 times more genes than your human genome. Our gut microbes coevolved with us, playing an essential role in various processes within our body, such as food digestion, immunity or neuro-psychological functions. The condition of our gut ecosystem has a significant effect on our health. Beneficial microbes help to keep “bad” microbes in balance as a results to keep a balance between inflammation and healing. For example, an imbalance (dysbiosis) of microorganisms (either in number or type) inhabiting your gut can affect digestion and even contribute to the pathogenesis of some diseases including asthma, eczema, obesity, or rheumatoid arthritis. The take-home message: thrive to have a balanced gut microbiota.

Quality matters more than quantity

Imagine building or repairing your house using poor quality materials, will it last long and in good condition? Probably not because of poor foundation, the same counts for your health. The same counts for your body, the quality of materials (foods and drinks) you consume every day is very important. Your body recognizes real foods and gets confused with highly processed foods. Too much and too frequent consumption of processed foods will cause the “fire” (inflammation, dysbiosis and more) in the gut and as a result it may affect other parts of your body - including brain. Food is your best medicine so thrive to consume real foods and avoid processed foods.  Real foods contain information (proteins, fats, carbohydrates, vitamins, minerals and phytonutrients, water) that our bodies utilize to run and optimize countless number of processes. A handful of candies can’t be compared with a handful of wild blackberries, the first one has no nutritional value and undermines our health whereas the second one is laden with nutrients and promotes our health. Highly processed foods disrupt our biology, the flow of information and are devastating to our health. Remember that foods best for you come as mother nature designed them: naked and not packed, not labeled and not processed. For drinking, water should be your number one drink. If you are craving sweets, please read my blog on “combating your sweet tooth”. Also, if you want to learn more about sneaky sugars in our wester diet, have a look at the piece I wrote on “sugar essentials” for SugarSkills, which is a sugar awareness initiative. The take-home message: nourish your body by eating real foods.

Healthy gut: good digestion + balanced microbiota + intake of real foods + stress management

If want to feel better and don’t know where to start, begin by healing your gut as the saying goes “When in doubt, begin in the gut”. 

If your gut is unhappy, try tips provided here.