The Microbiome Solution: A Radical New Way to Heal Your Body from the Inside Out - Softcover

Chutkan MD, Robynne

Softcover

ISBN 10: 039957350X ISBN 13: 9780399573507

Publisher: Avery, 2016

Synopsis

Live Dirty, Eat Clean—because every serious disease or chronic ailment begins in our gut. The author of Gutbliss and one of today’s preeminent gastroenterologists distills the latest research on the microbiome into a practical program for boosting overall health.
 
The microbiome—the collective name for the trillions of bacteria that live in our digestive tract—is today’s hottest medical news topic. Dr. Robynne Chutkan explains how the standard Western diet and our super-sanitized lifestyle are starving our microbes, depleting the “good bugs” that are crucial for keeping us healthy, and encouraging overgrowth of exactly the wrong types of bacteria.
          
But, as Dr. Chutkan explains, there are effective lifestyle and diet changes we can make to reverse this damage. Dr. Chutkan has helped thousands of patients suffering from a disordered microbiome with her comprehensive Live Dirty, Eat Clean Plan, designed to remove damaging medications and foods, replace important bacteria that have been lost, and restore health. The Microbiome Solution offers: a microbiome overview, nourishing recipes, questions for your doctor, preventative and recovery health tips, and the next frontier for a severely troubled microbiome—the stool transplant.
 
This is the first book to provide a practical, effective plan for replenishing and optimizing the vital ecosystem in our gut. Start living dirty and eating clean today to ward off disease and begin the path toward lifelong, vibrant health.

About this title

About the Author

Robynne Chutkan, M.D., is one of the most recognizable gastroenterologists working in the United States today. The author of Gutbliss, Dr. Chutkan has a B.S. from Yale and an M.D. from Columbia, and is a faculty member at Georgetown University Hospital. An avid snowboarder, marathon runner, and Vinyasa yoga practitioner, she is dedicated to helping her patients live not just longer but better lives.

Excerpt. © Reprinted by permission. All rights reserved.

Acknowledgments

Introduction:
Live Dirty, Eat Clean

MY HUSBAND ISN’T completely on board with my plan to sell our house in the city, move to a farm, raise animals, and grow our own food. But since much of what’s available in the supermarket is full of chemicals and devoid of any real nutrients, taking control of what we eat and making sure it comes from nature, not a factory, strikes me as a good idea. I’m fortunate to live in Washington, D.C., where farmers’ markets and community supported agriculture (CSA) shares are plentiful, so moving to an actual farm may seem a little extreme. My real motivation is that I want my daughter to grow up dirty, literally—as in easy on the soap and shampoo, heavy on the mucky animal chores. I shared her saga of antibiotic misadventure in my first book, Gutbliss. Since then, I’ve seen hundreds of patients with stories similar to hers, and I’ve become even more convinced that damage to the microbiome—the trillions of organisms that call our digestive tract home—is at the root of many of our current health problems. Figuring out how to undo that damage and “rewild” ourselves has become a focus of my medical practice and a personal journey in our household. Living a little dirtier and eating a little cleaner is definitely part of the fix.

Unwilding Ourselves

Our ancestors had a symbiotic relationship with their microbes that evolved over millions of years and served them well. They were benevolent hosts to a dense jungle of microscopic creatures, including worms and other parasites that actually contributed to their health. Large predators and the absence of food were their main threats, not the hundreds of diseases that afflict us today. The irony is that as we’ve “unwilded” our bodies and our environment in an effort to become healthier, we’ve actually become a lot sicker in some important ways.

Urbanization and modern medicine have undoubtedly improved our lives, but they’ve also introduced practices—overuse of antibiotics, chlorination of the water supply, processed foods full of chemicals and hormones, microbe-depleting pesticides, increasing rates of Cesarean sections—that have ravaged our microbiome, diminishing the total number of organisms as well as the diversity of species. The result is an increase in a wide range of modern plagues, including asthma, allergies, autoimmune diseases, diabetes, obesity, cancer, irritable bowel syndrome, anxiety, and heart disease. The rise of these diseases is inextricably intertwined with the full-on assault on our microbiome resulting from our super-sanitized lifestyle.

A decade ago, who knew that every antibiotic dispensed during cold and flu season was potentially bringing us one step closer to a diagnosis of Crohn’s disease, or making us fatter? None of us doing the prescribing realized that we might be paving the way to real illness in our well-meaning attempts to cure the sniffles. The prevailing wisdom was—and to some extent still is—that germs are bad and we should get rid of them, and antibiotics are good and we should use them. And use them we have: the average American child will receive more than a dozen courses of antibiotics before reaching college, primarily for minor illnesses that require no treatment at all. Despite the tremendous amount of research in the last few years connecting the dots, many physicians and their patients remain in the dark, blaming each manifestation of microbial discord on bad luck or bad genes, never questioning or understanding the root cause.

Less Is Often More

My own understanding came only after my daughter was treated with antibiotics at birth and throughout infancy, setting off a series of events that, a decade later, continue to affect her health. I had been trained at world-class institutions and practiced gastroenterology at a leading teaching hospital, but, like most physicians, I had no idea that the antibiotics I thought were so helpful were actually creating illness by decimating her microbiome at a time when it was most vulnerable, making her more susceptible to infection and inflammation. I wish I had known then what I know now and what I continue to learn every day: that illness is often the result of a decreased, not increased, bacterial load, and that less is sometimes more when it comes to medical intervention.

Rehab for Your Microbiome

Every day in my gastroenterology practice I see patients with the telltale signs of a disordered microbiome: bloating, leaky gut, irritable bowel, gluten intolerance, Crohn’s disease, ulcerative colitis, eczema, thyroid disorders, weight problems, fatigue, and brain fog. It’s a veritable epidemic of “missing microbes,” as infectious disease specialist Martin Blaser, MD, describes it. The symptoms vary, but the history doesn’t: overzealous use of antibiotics, often accompanied by a highly processed Western diet low in indigestible plant fiber—the preferred food of gut bacteria.

Repopulating the microbiome can be a challenging process, but the good news is that most people do get better. Your microbes are constantly changing and evolving, and even if they’ve been severely damaged by medications, infection, or diet, paying attention to what you put in and on your body can yield huge improvements. The microbiome you have today isn’t the one you were born with, nor is it the one you’ll have next year or even next week. It’s highly dynamic, constantly changing and adjusting in response to your internal and external environment.

In medical school, I was taught how to eradicate people’s germs. A quarter-century later, I’m teaching my patients how to restore theirs: which foods to eat, how to care for their bodies and their homes without stripping away their microbes, what questions to ask when their doctor recommends an antibiotic, and whether a probiotic or even a stool transplant might be of benefit. These, I believe, are the new and essential survival skills for thriving in our super-clean era. You’ll find them all in the Live Dirty, Eat Clean Plan at the end of this book.

When Dirty Children Grow into Clean Adults—My Rewilding Journey

I spent my early childhood in the tropics, eating food from my grandfather’s farm grown in rich soil fertilized by a herd of goats (which we sometimes also ate) instead of chemicals. We lived in the hilly suburbs and roamed around outside with our dog after school, exploring gullies, picking mangoes and oranges from the fruit trees in our backyard, and acquiring the occasional case of pinworm as a result of our barefoot explorations. In our household there was lots of attention paid to schoolwork and athletics, but shoes, showers, and shampoos were more or less optional. My father was an orthopedic surgeon whose great fear was that his children would grow up to be hypochondriacs, so his medical advice for whatever ailed us—from the flu to a sprained ankle—was always the same: go lie down and you’ll feel better in the morning. We were vaccinated for the big stuff (polio and smallpox) but didn’t sweat the small stuff (whooping cough and chicken pox). My daughter had more visits to the doctor before she was in preschool than I’ve had in my entire lifetime.

So, despite my dirty childhood filled with organic, homegrown food, protective parasites, lots of time outdoors, and limited contact with an overzealous medical system, how did I end up in adulthood with not one but three manifestations of microbial discord: eczema, rosacea, and yeast overgrowth? It took a while. I managed to weather potent microbial disruptors like the antibiotics prescribed in college for acne and twenty years of birth control pills (we’ll talk about this more in Chapter 5) with no ill effects. But as life got more complicated, unrelenting stress and the cookies, cakes, and candy I consumed to combat it were my ultimate undoing. A Western diet high in sugar and fat promotes growth of the wrong types of bacteria in your gut, and a lifestyle that leaves literally no time to go outside and smell the roses can be the straw that breaks the camel’s back, particularly if you have additional risk factors, as I did, such as significant antibiotic use.

Disease Begins in Your Microbiome

My firsthand experience with how poor nutrition and stress can unmask the effects of a damaged microbiome and lead to a multitude of symptoms is representative of what most of the patients I see in my office have experienced: a decline in overall well-being characterized by seemingly unrelated conditions that appear out of nowhere, leaving them scratching their head and wondering what’s going on.

Microbial disruptors are everywhere—in the food we eat, the water we drink, the products we use, and the medications we take—and the clinical manifestations of a disrupted microbiome are varied and show up in people of all ages and stages. Chances are there’s someone in your family with asthma, allergies, eczema, thyroiditis, diabetes, arthritis, or any of the many disorders that we’re now discovering have the same root cause. A damaged microbiome isn’t the only reason people develop these conditions, but it’s often a major contributor that interacts with genetic and environmental factors to create a perfect storm of disease. That’s why it’s more important than ever to understand the complex and critical role bacteria play in our health, so that if and when yours is compromised, you can connect the dots and start to heal yourself.

The solutions you’ll find in this book are based on clinical trials in our own patient population at the Digestive Center for Women, data from other scientific studies, published papers, trial and error, anecdote, patient testimonials about what’s worked for them, and careful observations accrued over almost two decades of taking care of people with all kinds of bacterial imbalance—from serious autoimmune illnesses such as Crohn’s disease and ulcerative colitis to complaints of gas and bloating. They’re also based on my own journey of exploration and healing necessitated by my health challenges.

The new paradigm of bacteria as friend rather than foe is at the heart of a revolution in health care that’s forcing us to reexamine how we live, as well as our medical practices, with new microscopic eyes, and to consider how modern life and our everyday choices affect the life of our microbes—and how our microbes in turn affect us. What has become very clear is that our individual and collective health depends on it. My sincere hope is that this book will provide you with the microbiome solution that will help you reclaim your health and vitality and set you on the path to a dirtier and disease-free life.

See you on the farm!

part 1

CHAPTER 1

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OUR MICROBES ARE intimately involved in every aspect of our health—from ensuring our digestive well-being to influencing our likelihood of being obese and our risk of developing cancer or diabetes. They even play a role in our brain chemistry and mental health, affecting our moods, our emotions, and our personalities. We are, it seems, single individuals comprised of multiple living, breathing, moving parts. The more we learn about this fascinating microscopic community, the clearer it becomes that our fate is inextricably tied to theirs, making it essential that we learn more about where our microbes come from, what they do, and why we literally can’t live without them.

Meet Your Microbiome

The microbiome refers to all of the organisms that live in or on your body: all of the bacteria, viruses, fungi, protozoa, and helminths (worms, for those of us who have them), as well as all of their genes. A staggering hundred trillion microbes that include thousands of different species inhabit your nooks and crannies—with more than a billion bacteria in just one drop of fluid in your colon alone.

Your unique microbial footprint develops over your lifetime, and it reflects everything about you: your parents’ health, how and where you were born, what you’ve eaten (including whether your first sips were breast milk or formula), where you’ve lived, your occupation, personal hygiene, past infections, exposure to chemicals and toxins, medications, hormone levels, and even your emotions (stress can have a profound effect on the microbiome). The end result is a microbial mix so distinctive from person to person that yours is a more accurate identifier of you than your own DNA.

We’ve known about the microbiome since the 1600s, when Antoni van Leeuwenhoek first looked at his own dental plaque under the microscope and described “little living animalcules, very prettily a-moving.” But it’s taken us a few centuries to figure out that these fellow travelers might actually be helping rather than hindering us, with a specific purpose that’s very much aligned with our own survival. The overwhelming majority of our microbes aren’t germs that cause disease. Quite the contrary—they’re an essential part of our ecosystem and play a vital role in keeping us healthy.

How do we get from germ-free fetus to living, breathing petri dish, colonized with trillions of bacteria? Let’s start at the cradle and work our way toward the grave, to find out exactly how our microbiome evolves and the crucial role it plays at every stage in our development.

Pregnancy

Long before we enter the world, our mother’s microbiome starts to prepare for our arrival. One of the most dramatic changes happens in her vagina. During pregnancy, cells in the vaginal lining ramp up production of a carbohydrate called glycogen, sending glycogen-loving Lactobacillus bacteria into a feeding frenzy and increasing their numbers. Lactobacilli convert lactose and other sugars to lactic acid, creating an acidic, unfriendly environment that helps to protect the growing fetus from potential invaders.

Bacteria don’t just protect us from undesirable germs that can enter via the vagina; they also nurture us. In the third trimester of pregnancy, Proteobacteria and Actinobacteria species increase in number and cause a corresponding rise in the mother’s blood sugar and weight gain in her breasts, with the specific goal of ensuring adequate growth and breast milk for the baby. Transplanting gut bacteria from late-trimester pregnant women into nonpregnant mice produces identical changes in the mice—confirming that the transformation is indeed mediated by gut bacteria, not hormones.

In addition to our founding species of bacteria, we also receive protective antibodies from our mother through the placenta. Armed with these antibodies and our own few but plucky microbial soldiers, we’re ready to make our entrance into the world. But exactly how we enter isn’t just a matter of convenience; it has significant microbial repercussions that continue to affect our health well into adulthood.

Birth

During a normal delivery, the baby’s head turns to face the mother’s rectum as it crowns and exits the birth canal. This turning brings the baby’s nose and mouth into direct contact with her vaginal and rectal contents. What better way to get inoculated with a good dose of bacteria than to come face-to-tush with the source? A study published in Proceedings of the National Acad...

Edition details

• Publisher: Avery
• Publication date: 2016
• ISBN 10: 039957350X
• ISBN 13: 9780399573507
• Binding: Paperback
• Language: English
• Number of pages: 304