Leaky Gut Syndrome: Causes and Symptoms

In recent years, most of us have become familiar with this new(ish) term: Leaky Gut Syndrome. Sounds delightful, right? However, most people don't actually have a solid idea of what this is referring to, so allow me to explain...

Leaky Gut Syndrome is simply a nickname for the real problem at hand which is quite common and centers around impaired digestion: increased intestinal permeability. Sounds equally as lovely, I know. Having increased intestinal permeability means that for whatever reason (and there are many factors at play here) the lining of our intestinal walls have become damaged and are allowing particles to pass through that should not. A healthy intestinal wall will only allow properly digested matter (proteins, fats, and starches) to enter the bloodstream, while at the same time keeping out foreign bacteria, undigested molecules, and any particles that should pass through without being absorbed. The walls of our intestines are lined with millions of villi and microvilli, which are microscopic "fingers" of sorts....also known as the brush border of our gut, in place to filter out the bad and allow the good (nutrients) to pass through. However, due to an array of factors with our modern day diet and lifestyle, this system is commonly impaired to varying degrees.

Below is a list adapted from Elizabeth Lipski, Ph.D, in her book Digestive Wellness, of conditions and symptoms commonly associated with leaky gut syndrome:

• Acne
• Autism
• Celiac disease
• Chronic fatigue
• Crohn's disease
• Eczema, hives, and skin rashes
• Food allergies/sensitivies
• Inflamed joints or arthritis
• Intestinal infections and IBS
• Asthma
• Abdominal pain, bloating, gas, diarrhea and/or constipation
• Poor exercise tolerance
• Anxiety and mood swings
• Poor immunity
• Poor memory and fuzzy thinking (aka: brain fog)
• Depression
• Impaired liver function

And there are many more! It is important to keep in mind that the gut and brain are intricately connected, which is why we often see more mental/emotional/psychological symptoms like some of the ones listed above when dealing with leaky gut.

Now, lets take a look at the causes of leaky gut syndrome:

CHRONIC STRESS

I have talked a lot in previous blog posts about the detrimental effects elevated cortisol levels can have on our bodies, and this is a big one. According to Lipski, "prolonged stress changes the immune system's ability to respond quickly and affects our ability to heal." When our body is constantly getting the message to be in that fight-or-flight mode, we produce less of our immune boosting hormones (like DHEA), and also slows digestion because digestion is obviously down on the list from running from a tiger (or having a work deadline, as the case may be). I know it may seem impossible sometimes, but it really is crucial to prioritize relaxation throughout our weeks, even if it is just 10 minutes in the morning and at night of deep, belly breathing.

POOR FOOD CHOICES AND ALCOHOL

Naturally, consistently putting processed, refined, and inflammatory foods into our bodies has a profound effect on our digestive well-being. Eating poor quality foods decreases our amount of good bacteria (probiotics) and increases the bad. Also, not getting enough fiber (and I don't mean from a fiber supplement or powder, I mean the real thing) slows digestion and causes toxins to accumulate and irritate the gut lining. Any processed, refined foods (think white flour, sugar, cereals, commercial milk, food products with ingredients we can't pronounce) cause severe inflammation if eaten regularly. Alcohol is a kind of anti-nutrient, as it takes nutrients to metabolize but provides us with none in return. It particularly can zap our B vitamin stores and strains the liver.

ENVIRONMENTAL TOXINS AND MEDICATIONS

Two huge factors that lead to leaky gut. Environmental toxins are all around us in the form of household products, hygiene and cosmetic products, air and water pollution, and many more. These toxins lead to impaired immune function, which in turn affects digestive function (much of our immune system is located in the gut). This manifests in the inability to absorb key vitamins and minerals, and (of course) inflammation. It all leads back to inflammation! Medications is one of the worst offenders of gut integrity, and are sadly quite overprescribed/overused in the western medical model. NSAIDS (nonsteroidal anti-inflammatory drugs) like advil, ibprofin, aspirin, and prescription drugs have a huge impact on the brush borders that I mentioned earlier (the villi that line our intestinal wall). This in turn allows those undigested particles to enter the bloodstream, potentially leading to the array of conditions/symptoms listed above, as well as ulcers.

The best option if you think you may suffer from leaky gut syndrome is to work with a nutrition professional, as depending on the severity, there are many different things to consider in the healing process. As always, feel free to contact me with further questions, and here's to our health and wellness!

Coconut Flour Muffins: Quick and Easy Breakfast!

Following up my recent post on how to make eating a whole foods diet more feasible for us who feel like we're always running out the door (especially in the morning), I've found this to be an excellent breakfast. These muffins are a wonderful recipe from a fellow Nutrition Consultant, Mary Vance (maryvancenc.com). All you need to do is find about 20 minutes sometime during the week to prepare these. I then store them in the fridge and re-heat them in the toaster oven in the morning, and have one with two eggs. You will then have started off your day with a nice healthy serving of fat and protein. Also, try spreading them with almond butter or tahini!

I know, I am obsessed with coconut, but remember that coconut flour is full of fiber and protein, and can be purchased at Whole Foods, your local co-op, or online at tropicaltraditions.com. And these muffins are far superior to other, gluten and sugar containing muffins that will spike your blood sugar and set you on the wrong foot for the day to come. Enjoy!

COCONUT FLOUR MUFFINS

1/4 cup + 1 tbsp coconut flour
3 eggs
2 tbsp melted coconut oil or butter
1/4 cup whole coconut milk (melted if needed)
1/4 tsp baking powder
cinnamon to taste
pinch of sea salt

Optional:

Add blueberries, honey to taste, cardamon, or vanilla.

Pre-heat oven to 400 degrees. Mix all ingredients together well (coconut flour can be a little chunky so make sure to really mix). Pour into greased or lined muffin tin (if you don't have a muffin tin, you can try making these as "cookies" as well), and bake for about 15 minutes.

Veggie Pancake Recipe

It is always a challenge for me to include enough veggies at breakfast, as I grew up eating sweet, dessert-like breakfasts, and now that I realize how devastating this is to my energy throughout the day, have realized the need to find (quality) protein and fat rich breakfasts that will sustain my blood sugar, set me off on the right foot, and are quick enough to make early in the morning. Here is one of my recent favorites, and it can be modified/experimented with....get creative! Also, if you're pressed for time in the morning, try grating the veggies the night before.

Ingredients:

1-2 cups vegetables of your choosing, I like to include a combo of: zucchini, summer squash, sweet potato, carrots

1 tablespoon coconut flour

1 egg

Spices of your choosing, I like: salt, pepper, and a touch of cinnamon

Directions:

Simply mix all together, cook stovetop in coconut oil, and serve topped with 1-2 eggs, sunnyside up or over easy!

Modifications:

For a sweeter pancake, stick to sweet potatoes for a sort of modified "latke." Then add cinnamon, cardamom, and a touch of sea salt. I've also added grated or finely chopped kale before

Tips to Make Eating a Whole Foods Diet Easy!

One thing I hear all the time from clients, friends, and family, is that switching to a more whole foods-based diet is hard because, first and foremost, it is more time consuming. I can't disagree with this! It will undeniably take you a bit longer to chop up vegetables in the morning than it will to go next door and buy a burrito. BUT....as is the case with so many aspects of life, it's all about creating new habits. Studies have shown that this habit making/breaking period is generally about 3 weeks, so be prepared for the first 3 weeks to be a bit more difficult, but have faith that your health, energy, mind and body will pay you back tenfold. Here are some suggestions of how to better incorporate this kind of diet from a time management perspective, as well as some simple, quick meal suggestions:

• Over the weekend (or whatever day you have off), make a grocery list and do your grocery shopping for the week. Don't make this trip on an empty stomach, because you are way more likely to stray from the list at hand and buy foods that will tempt you later on in the week. 
• Menu plan! If you are a recipe person, make a detailed menu plan for the week before shopping. If not, make a more rough plan, buy the types of foods you want to eat, and wing it. Just make sure you have enough food for the week so you can prepare your meals.
• Cook once, eat 2, 3, 4 times. Take time one day of the week (or more) to make some staples. For example, sometimes I will roast a chicken, or cook a pound or two of ground beef with yummy spices (takes 10 minutes), and then I have these quality protein sources to add to salads, lettuce wraps, eggs in the morning, etc. Chop vegetables ahead of time and keep them in the fridge. Or, make whole meals and eat leftovers.
• When you are at the grocery store, stick to the perimeter. Avoid packaged foods as much as possible, and if you must buy something with an ingredient list, make sure you recognize all of the ingredients! If you can't pronounce it, probably not a good choice.
• If you know you will snack throughout the day, keep healthy snack foods at your work, home, etc. This could be raw nuts/seeds, chopped vegetables with nut (not peanut) butter, whole fruit (no fruit juice!). If you get stuck, see if there is a store nearby that sells Lara Bars, the one commercially made bar that is, actually, healthy (has just 3 ingredients or less, made of nuts and dried fruit).
• Hard or soft boil eggs ahead of time. These make a great snack or can be added to salad.
• Make a salad dressing to use for the week. One of my favorites is a simple vinaigrette: chop garlic, crush with a bit of sea salt, add olive oil and vinegar and shake well. 
• Remember not to let yourself get really hungry by forgetting to eat or skipping meals. Eating every 3-4 hours will guarantee that you don't get to the point of being ravenous at night and reaching for anything in sight.
• Practice getting up from 10 minutes earlier to assemble food for the day. It is worth it.

Simple Meal Suggestions:

• Big salads with protein. This is probably the easiest to throw together, include any leafy greens and other veggies you have in the fridge, add a protein source, maybe some raw nuts/seeds, avocado, hard boiled eggs, anything! 
• Make a lettuce wrap. Kale and collard greens work great for this, too. Try ground lamb (or any meat) with avocado, onion, and cilantro. Or ground beef seasoned with cumin, topped with raw sauerkraut and spicy mustard. Or a BLT lettuce wrap with bacon, tomato, and onion. Get creative!
• In the morning try a smoothie (see my previously posted breakfast smoothie recipe). If you like eggs in the morning but don't have time to cook them, have 2-3 hard boiled eggs with a handful of raw nuts/seeds to go. 
• For a snack or part of a meal, or if you are craving sugar/refined carbs, bring a roasted sweet potato topped with some coconut oil or butter, grass-fed butter, shredded coconut, or nut butter. I guarantee this will satisfy your sweet tooth!
• If you are going to eat out, opt for baked, broiled and grilled options. Choose a salad with protein, skip the bread basket, ask for oil and vinegar vs. pre-made dressings, and if the portion is huge, bring half to go.

Remember, building routines and habits centered around a whole foods based diet might take a little getting used to, but with time, the idea of opting for non-nourishing and energy-blasting meals/snacks will slowly but surely become a distant memory...

Letter From an Angry Tufts Nutrition Researcher...

I received this letter recently from someone I used to know, who is now studying and researching the economics of food at Tufts University (a very noble, yet very different field of study). Her message is very angry and accusatory, yet I think (sadly) indicative of how a more mainstream nutrition "professional" might see the work practiced by a more holistic nutrition model. I wanted to share not only her letter, but my response, so all of my blog followers can have a better understanding of what I do! I posted it here on my blog, so see the link if interested!


Hey Rachel-

I don't know if you have your RD, but if you don't, I just wanted to say that I think it is totally inappropriate for you to be giving dietary advice! I hope your clients know that you aren't an RD (are you? correct me if I'm wrong). I am NOT an RD, which is why I NEVER give dietary advice, and, if someone asks me, "well, you're doing your PhD in nutrition, don't you know enough to give me dietary advice?" I respond, "no, I don't, I'm a researcher, I am NOT clinically trained, I haven't taken the exam, and my specialty is in the economics of food, so here is the phone number of a good RD that I know."

Probably you should do the same, especially because it seems that you are recommending only what is "trendy" in the world of "alternative nutrition," things that haven't necessarily been established in the literature yet.... I hope your clients know that you're not qualified! It bothers me when people give advice when they aren't certified or appropriately trained, because they think they're just "going against the system," which is apparently cool and hip and makes you not have to get the proper credentials.

Look, if you really want to change the system (and I understand that there are important things to change, and things that could be improved), just get the RD, and work in policy or research! Change it from the inside...otherwise, you're just whining! The patients/clients who really need people like you (educated in health/nutrition), are mostly poor, and can't afford your fees unless you work in a clinical setting, which you can't do if you don't have an RD! Unless you do pro-bono for malnourished, poor clients, don't pretend that you are "making a difference" in any consequential way.

Anyway, feel free to un-friend me....(maybe I should un-friend you, my message might provoke some kind of vindictive backlash, I suppose??)....I'll understand if you do, this is obviously a very bitchy, arrogant, butting-in-to-your-life-when-I-don't-know-you-anymore message. Unfortunately, I couldn't help it. I'm quite an arrogant person, and fine with it! Have a nice life! Try not to give anyone heart disease.


MY RESPONSE:

Don't fear a vindictive backlash, while I do think your message was a bit ignorant (and undoubtedly arrogant, as you pointed out), I think you are the one getting more worked up here than I am! However, I would like to address a few things.

First of all, I'm not sure if in between your rants you were able to check out my website to see what I actually do, but just in case you don't know, I do have a 2 year certification from Bauman College of Holistic Nutrition...I am not simply blogging about the "trendy" new fad diets out there. And let me tell you a bit about what got me to this point, since you're right, you don't know me at all.

Post Guatemala, I worked in social services with various non-profits for several years, both in domestic violence shelters and as a case manager for a child abuse prevention program, where I did home visits with my clients. Seeing the kinds of foods they were putting into their bodies, and the diseases that were created by lifetimes and generations worth of non-nourishing foods, along with some personal health issues, led me to consider getting my doctorate in Naturopathic medicine. After a few pre-reqs, I realized this was financially not feasible, and ended up finding Bauman College of Holistic Nutrition, since nutrition was/is my main area of interest.

My long term goal is to open a wellness center which provides, first and foremost, community education in poor/uneducated communities, and sliding scale fees (which if you saw on my website, I do now as well). So yes, I feel good about the difference I am working towards making, and I think it will be/is consequential.

As far as our ideas about food and diet go, we simply just don't agree, and that's ok. I do give dietary suggestions. I would never tell my clients who were thinking of visiting an RD not to, by any means, and I'm sure there are many good ones out there. But the RD's I've met in my practice have a very different approach than I take, which is more a USDA food pyramid based model (for example, fat is just a tiny little triangle, and canola oil is recommended, an oil that is oxidized before it even hits the shelves). Here is one of the various studies I have read, a 2010 meta-analysis on saturated fat and heart disease risk:

http://www.ncbi.nlm.nih.gov/pubmed/20071648

This is showing that there is very little statistical evidence for the occurrences of saturated fats and heart disease. Furthermore, the study does not specify the kinds of fats they were using...there is a world of difference between conventional (non-grassfed, commercial) butter, and raw, organic coconut oil, for example. Please also check out this following article by Mary Enig, PhD, an expert in lipid biochemistry and author of Know Your Fats, and Eat Fat, Lose Fat.

http://westonaprice.org/know-your-fats/526-skinny-on-fats

So do I think I'm "going against the system?" Perhaps sometimes I do when I am confronted by attitudes such as yours, but mainly what I focus on in my day to day practice is helping my clients who have (in most cases) tried a more conventional diet model (lower fat, higher carbs, for example), and have experienced ongoing health problems (ranging from something less serious like heart-burn to more serious degenerative disease). When they come to a Holistic Nutritionist, they generally realize that changes need to be made that are, many times, outside the scope of the RD's they have seen previously.

So thanks for your input, but I feel pretty good about the knowledge I have acquired, how much more there always is to learn, and the practice I am growing to help people, regardless of their economic status.

Rachel Fiske, NE, CPT-NASM
madronawellness.org

Quality NOT Quantity: What Counts When Considering Weight Loss

QUALITY, NOT QUANTITY

WHY EXERCISING MORE AND EATING LESS DOESN’T WORK FOR WEIGHT LOSS!

We have all been consistently told that in order to lose weight, we must simply eat less and exercise more, the basic law of thermodynamics. We now know that not only will this not promote weight loss, but will actually often lead to weight gain or weight loss resistance. Most importantly, it is the types of foods we eat that is key, as they influence our metabolic and hormonal responses, leading to true change, or (in many cases) lack thereof. 

What about the law of thermodynamics?

There is certainly truth to this principle: if we are taking in more energy (calories) than we are burning, we will not effectively lose weight. However, this law does not touch on the quality of energy we take in, and it’s effects on our metabolism and hormones. The primary hormone we are talking about is insulin, which is our fat storage hormone, and is produced in the pancreas as a response to ingesting carbohydrates. Many individuals find that once they change the kinds of foods they are eating, without adjusting their caloric intake (in many cases, increasing it), they begin to see fat loss.

I burn so many calories from doing cardio, so why am I not losing the weight?

Again, this really comes down to our body’s hormonal responses to exercise. When we cardiovascularly overtrain, our body produces excess cortisol (the stress hormone), which inhibits our ability to lose weight, and makes us gain weight around our mid-section. Strive for somewhere between 1-2 hours/week, and focus more strength training and diet. See what happens. Incorporating weight/resistance training into your exercise program will build lean muscle, which raises metabolism (and no ladies, you will not bulk up, I promise), as well as preventing future injury.

So what types of foods should I eat?

The key here is having a diet focused on real, whole foods. As Michael Pollan notes, if your great grandparents wouldn’t recognize it as food, probably not a good choice. If weight loss is the goal, strive for meals based more on quality fats and proteins rather than carbohydrates. Primary sources of carbs should be leafy and crunchy vegetables, rather than starchy. Remember, dietary fat does not equal body fat; however, refined carbs, sugar, and alcohol absolutely do.

http://www.jtsstrength.com/articles/2011/05/16/females-fat-loss-and-performance/

undergroundwellness.com

The Paleo Solution, Robb Wolf

Always remember, there may be other players contributing to weight loss resistance, including sleep, stress, toxicity, and other factors, as well. Contact me with further questions!