You Are What You Eat – Revisited

“Patients often chuckle when I tell them I am a recovering vegetarian. As a child I was pretty squeamish about things like chicken drumsticks, spare ribs and other anatomically identifiable foods. In my teens I decided the only rational way to handle my qualms was to be a vegetarian.

Decades later, and somewhat overweight, I decided to go back to being a picky eater instead of a strict vegetarian. Thus I increased the protein content of my diet and lost fifteen pounds. Reading Barry Sears (“The Zone”) and Atkins helped me understand what had happened to me.”

This is the beginning of a post I wrote exactly ten years ago. Today the notion that we are what we eat is even truer than it was back then.

In that post I describe our jet black German Shepherd puppy, raised on organic meat. I am pleased to report that he is just as magnificent today, graying just a little bit, like his “Pappa”.

But the idea that our food determines who we are goes much deeper than the quality of our nutrition. Today we know so much more about how the bacteria in our bodies, particularly our intestinal flora, our biome, determines our mood, appetite and many other aspects of our identity.

When food makes us obese, our excess fat in itself can cause disease, writes Manzel:

“White adipose tissue (WAT) is not an inert tissue devoted solely to energy storage but is now regarded an “endocrine organ” releasing a plethora of pro-inflammatory mediators such as TNF-α, IL-6, leptin, resistin, and C-reactive protein. These “adipokines” account for a chronic low-grade systemic inflammation in obese subjects. Of note, these chronic inflammatory signals can have a profound impact on CD4+ T cell populations.”

National Geographic published a succinct article in 2016, which includes the following:

“The modern rise in obesity, allergies, asthma, rheumatoid arthritis, Type I diabetes, multiple sclerosis, irritable bowel syndrome, cirrhosis of the liver, cardiovascular disease, and anxiety attacks – perhaps even autism – may be related to the bacterial populations in our guts.

The root of all evil here may be a leaky epithelium. The epithelium, the all-important lining of the digestive tract, ordinarily acts as a barrier between the teeming bacterial world of the gut and the rest of the body. Resident bacteria ordinarily keep epithelial cells healthy by providing them with short-chain fatty acids and other nutritive factors. In the absence of the appropriate nurturing bacteria, however, the starved epithelium breaks down, allowing bacteria and toxic bacterial byproducts to enter the bloodstream. This sends a signal to the immune system, alerting it to the presence of invaders, which can lead to persistent inflammation and eventually, a host of chronic diseases.”

Even out appetite, for too much food, or the wrong kind of food, appears to be influenced by bacteria. There is now increasing evidence that not only dietary preferences but also eating disorders are linked to gut bacteria: Prevotella thrive on carbohydrates and Bacteroides prefer protein and animal fat.

One article I came across spells out something I have noticed about the association between bowel and psychiatric symptoms: 40-60% of patients with functional bowel symptoms also have psychiatric symptoms and, looking at it the other way, 50% of psychiatric patients have irritable bowel syndrome. And SSRIs like Prozac (fluoxetine) are now first line drugs for IBS.

What we call the gut-brain axis isn’t just a chemical/hormonal and neurotransmitter communication between our intestines and our brain; our gut bacteria also have their voice in this chatter and homeostasis. They outnumber our own cells and they contain 1000 times as much DNA, so they might even dominate the “conversation”. Most of that DNA is influenced by, and also influences, what we eat. So the old saying is proving itself to be very, very true, indeed.

These are two great scientific articles on this topic:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490581/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554020/

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