Dr Dingle's Blog / digestion
The most important aspect of dysbiosis is that a loss of total microbial diversity which represents the first link in the chain of events leading to the development of local and body wide inflammation. Multiple human conditions have been associated with dysbiosis, including autoimmune and auto inflammatory disorders, such as allergies, cardio vascular, metabolic disorders (diabetes, obesity and non-alcoholic fatty liver disease), various cancers and inflammatory bowel disease such as Crohn's and ulcerative colitis (UC), celiac disease, and neurological disorders including autism.
Once inflammation starts it appears that these opportunistic microorganisms are able to exploit the inflamed environment and expand their numbers to become an even bigger problem.
There appear to be three types of dysbiosis that more often than not, occur together to create the problem. These include (i) loss of beneficial microbial organisms perhaps through the use of antibiotics, (ii) expansion of pathobionts or potentially harmful microorganisms as a result of too much processed foods and (iii) loss of overall microbial diversity. It is likely that dysbiosis encompasses all three of these manifestations at the same time to influence disease.
The challenge is that the Dysbiotic microbial ecosystem can become resilient over time and may become hard to alter. In one study while dieting rapidly reversed the metabolic problems associated with a high fat diet, the dysbiosis in mice after a 4-week high fat diet persisted up to 21 weeks after returning to normal chow diet. It did however change after 21 weeks.
 Milani et al., 2016.
 Chow et al., 2011.
 Baumler and Sperandio, 2016.
 Del Chierico et al., 2012.
 Konig et al., 2016.
 Spees et al., 2013.
 Petersen and Round, 2014.
 Thaiss et al., 2016.
Sleep and weight
Obesity in another disorder linked with insomnia. Research shows that diets that are higher in saturated fats are more susceptible to chronic diseases and disorders which includes insomnia (Novak et al. 1995). This is an alarming fact as 20% of the population of the United States of American are overweight or obese (Patterson et al. 2004).
Many studies, including one spanning twenty years, have tested the hypothesis that sleep and obesity are linked and the majority of results show positive correlations (Gangwisch et al. 2005). Further studies, with over 500,000 total participants via meta‑analysis have supported obesity and insomnia in adults and children (Cappuccio et al. 2008). The trends of increasing BMI and reduced sleep hours appear to go hand in hand, along with sleeping troubles related to Sleep Apnoea often seen in obese patients.
This link between Obesity and the symptoms of its associated diseases demonstrates a common trend towards diminishing an individual’s peak performance. Obesity and many of the health conditions which result from it increase the lower productivity levels associated with lower mental and cognitive functioning.
Obesity is also a serious factor in poor sleep habits. In a number of studies obesity was associated with "reduced sleeping hours " (Ko et al (2007). Obesity, particularly abdominal and upper body obesity, is the most significant risk factor for Obstructive Sleep Apnea (OSA). Patients with sleep apnea often experience daytime sleepiness and difficulty concentrating (Teran-Santos et al, 1999). Studies have also shown a strong association between sleep apnea and the risk of traffic accidents (Terán-Santos et al (1999). In fact, subjects suffering from sleep apnea were at a higher risk than those who had consumed alcohol to be involved in a traffic accident. This has major implications, particularly for overweight and obese workers using any form of equipment of driving vehicles.
This lack in sleep will then leave the employee going to the work already feeling tired, irritable and stressed, therefore making it difficult to concentrate, and highly increasing the chances of being injured or making a mistake which may put fellow workmates in danger (Lynch, 2005) It is situations like this, where the worker comes to work already feeling tired, that the employee is putting his safety and other's safety at risk.
Shift workers are known to be a high-risk group for obesity. In the current study population, rotating-shift workers showed a higher distribution of the highest body mass index compared with daytime workers
In a study of the brains of 24 participants after both a good and a bad night’s sleep. after disturbed sleep, there was increased activity in the depths of the brain, areas which are generally associated with rewards and automatic behaviour. It seems a lack of sleep robs people of their self-control and so their good intentions are quickly forgotten.
What we have discovered is that high-level brain regions required for complex judgments and decisions become blunted by a lack of sleep, while more primal brain structures that control motivation and desire are amplified.”
In other words: lack of sleep robs people of their self-control and so their good intentions are quickly forgotten.
On top of this, the researchers found that after being deprived of sleep, participants displayed greater craving for high-calorie junk food. The more sleep-deprived they were, the greater the cravings. A stufy of 13,284 teenagers found that those who slept poorly also made poor decisions about food. Similarly, a Swedish study found that at a buffet, tired people were more likely to load up their plates.
The link has even been made from poor sleep through to food shopping. A Swedish study found that men who were sleep-deprived bought, on average, 9% more calories than those who’d had a good night’s sleep. These results were likely the result of the poor decision-making. It had been thought that the tendency to eat more after poor sleep was related to the so-called ‘hunger hormone’ ghrelin. But the latest studies suggest that it’s simple self-control that is most important in causing the sleep-deprived to over-indulge.
The benefits of sleep include:
Being physically and mentally alert;
Having more energy;
Making fewer mistakes (including causing accidents);
Feeling psychologically and emotionally recovered;
and to experience:
Improved cognitive function;
Higher stress tolerance and resilience;
Normal body balance;
Reduced risk of CVD, diabetes and cancer;
Living longer; and
during sleep the mind is cataloguing our memories and deciding what to keep and what to throw away it is making memories stronger. It also seems to be reorganizing and restructuring memories.
It’s not possible to learn something new when you sleep, like a foreign language, but you can reinforce something you already know.One study found that students learned to play a series of musical notes better after listening to them during a 90-minute nap. The research shows that memory is strengthened for something you’ve already learned. Rather than learning something new in your sleep.
A review of studies on sleep found that we tend to hold on to the most emotional parts of our memories.
Getting enough sleep is associated with energy, joy, optimistic thinking and coping with negative emotions.
Stages of Sleep
4 to 8
Transition between sleep and wakefulness
Eyes begin to roll and close
Consists of mostly theta waves with some brief periods of alpha waves (similar to waves of wakefulness)
Stage lasts 5-10 mins
8 to 15
Brain wave peaks become higher
Spontaneous periods of muscle tone mixed with periods of muscle relaxation
Heart rate and temperature decrease
Stage last 5-10 mins
2 to 4
Deep Sleep or Delta sleep
Very slow brain waves
0.5 to 2
The last of deep sleep before REM begins.
Consist mostly of Delta waves
Beta waves have a high frequency and occur when the brain is active when asleep and awake.
Frequent bursts of rapid eye movement (REM) and muscle twitches.
Increase in heart and breathing rate
Vivid dreaming occurs here.
When a person falls asleep and wakes up is largely determined by their circadian rhythm, a day-night cycle of about 24 hours. Circadian rhythms greatly influence the timing, amount and quality of sleep (Lockley et al. 1997).
Literally hundreds of circadian rhythms have been identified in mammals (Campbell 1993). Among the numerous systems and functions mediated by the circadian timing system are, hormonal output, core body temperature and metabolism. The circadian clock is believed to sit in the suprachiasmatic nucleus (SCN) located in the hypothalamus of the brain. It was thought that processes now linked with circadian timing e.g. sleep wake cycles, were due solely to environmental cues, for example solar activity, it is now recognised however that these biological rhythms are regulated by factors inherent to the organism (Campbell 1993). A circadian rhythm displays a 24 hour cycle of wakefulness and sleep synchronised with the world’s night/day clock (Mansuy et al, 2003). Everyone’s cycle will vary depending on behavioural and psychological factors (Mansuy et al, 2003). The most typical pattern will be low alertness in the mornings as we wake, to highly alert mid afternoon (Swain et al, 2007).
The natural circadian rhythm in the body, which maintains a regular sleep-wake cycle, makes important contributions to physiological processes and psychological health. The normal rhythm is reset daily by the influence of bright light in the morning. Shift-workers, who may work at night and sleep in the daytime, and blind people may have difficulty maintaining a normal sleep-wake cycle because the natural environmental cues are miss-timed (Morris 1999). Studies show that shift work is one the greatest influencing factor causing an alteration in an individual’s cycle along with sleeping disorders (Baulk, 2008). Altering the circadian cycle can lead to periods of decreased alertness leaving people extremely vulnerable to accidents and injuries (Andersen et al, 2009).
Our sleep patterns appear to be polyphasic. In one experiment, subjects were exposed to 14 hours of darkness; then they remained in a state of quiet rest for about two hours before falling asleep. They then slept for four hours, awakened from a dream, spent another two-hour period in quiet rest, and then fell asleep again for four hours more. The subjects awoke at 6 a.m. each morning from their dream sleep and then spent two hours in quiet rest before arising at 8 a.m. These subjects followed their own natural rhythms, sleeping for eight hours with blocks of time at quiet rest (Wehr, S.E, 1996). This polyphasic sleep appears to be a pattern in many mammals. We experience hypnagogic imagery – a state described as dreaming, drowsy, floating, wandering – every night just before we fall asleep. Every night before we go to sleep we spend a few minutes in a state of relaxed wakefulness characterised by drifting thoughts and alpha brainwaves.
Another interesting method for lessening the impact of sleep deprivation was through a study that found there were certain hours better to sleep through the night. A new Stanford University study on the science of sleep deprivation suggests that early morning sleep is more restful than a middle‑of‑the‑night nap. In a study of two groups of men they found that early‑morning sleepers scored higher on wakefulness tests and on measures of sleep efficiency. (Stratton, 2003) Although this study shows that there may some advantages to when you get your sleep it is more an avoidance of the problem rather than a solution.
We are also influenced not just by sleep but also our perceptions of its quality. If we think we’ve had a wonderful sleep last night, we feel and perform better, even if our sleep was actually the same as usual. In this study researchers randomly told some people they’d had better sleep than others after they were hooked up to some placebo brain sensors). When they were given a cognitive test the next day, those who’d been told they slept the best also did the best in the test.
Part 3 and more coming
The reason I call it the blood pressure smoothie is all of the ingredients have been multiple shown in scientific studies to reduce blood pressure. By no way is this meant to replace advice from you GP but you can share it with them and see if they are interested in preventing the problem rather than just treating it with pharmaceuticals. Remember also that I am not a GP I am just the guy who does all the research which is why I have a PhD.
4 ingredients in order of importance
Almonds (soaked for at least 8 hours)
Filtered re-mineralised ionized water.
(equal amounts of each ingredient excerpt a more water)
Extras for taste and minerals
Start by grinding the linseed and the almond in the smoothie maker.
Add the beetroot and the filtered water to make up to the constituency you need.
If you want to make it a bit sweeter add some ripe banana, dates or coconut water (and coconut meat if you have the whole coconut) as they are rich in Potassium (and other minerals) which is essential for muscle relaxation and tastes great. But wait till the banana is ripe for the best taste. You can also cold green tea instead of water to add to the antioxidant mix.
The properties that make this smoothie such a potent blood pressure mix is all of the ingredients have excellent antioxidant properties, rich in minerals and other nutrients liked with lowering blood pressure in scientific studies.
High blood pressure or hypertension is having a blood pressure reading of above of around 90mm Hg on 140mm Hg. Hypertension itself is not a disease but a condition or as an indicator of ‘increased risk’ of cardiovascular disease. Patients who are hypertensive have an increased risk of heart attack and stroke due to the direct correlation between the two. Hypertension also contributes significantly to the increased risk of kidney failure and other chronic illness.
In healthy people the cells of blood vessels produce the substance called nitric oxide (NO) which instructs smooth muscles surrounding arteries to relax. If they cant relax they stay rigid and you end up with high blood pressure. The NO is produced in a single layer of cells that line the inside of the arteries called the endothelium. If this tissue is damaged in the case of too much pressure, oxidation or through other means it stops producing NO and blood pressure rises.
Many of the beneficial actions of nutrition on lowering blood pressure results both directly and indirectly through improving endothelial tissue and NO production and release from this tissue. Two major pathways to increase NO are increase the rates of nitrates in the diet, the building block for NO, and L-Arginine which stimulate the enzyme to manufacture NO. Endothelial-derived NO also inhibits platelet adhesion, activation, secretion, and aggregation and promotes platelet disaggregation so you are less likely to have a stroke. A third mechanism that is absolutely critical is to protect and repair the endothelium, remember it is only one cell thick and very susceptible to damage. Vitamin C and antioxidants are essential for this part.
Diets high in dietary nitrate such as beetroot are associated with reduced blood pressure increased exercise performance as a result of vasodilation (expansion) of the blood vessels and a decreased incidence in cardiovascular disease. 100-200mg of beetroot per day has been shown to produce immediate effects of lowering blood pressure by around 15 mm of Hg. Beetroot is also rich in vitamins, phytochemicals and contains large amounts of iron and folic acid Mg, Na and Ca. Apart from the nitrates the major bioactive molecules in beet are polyphenols, flavonoids, betalains, therapeutic enzymes, ascorbic acid, and dehydroascorbic acid (DHAA). So they not only provide the ingredients for NO production but also help in repair and protection of the endothelium.
Almonds have one of the highest sources of L-Arginine (most nuts have lots of L-Arginine so you can substitute the almonds if you want) which stimulates NO synthesis. Studies of almonds have shown reductions of 5-6 mm of blood pressure. It is important to soak the almonds as they (all nuts and seeds) have enzyme-inhibiting factors in them which stop them from germinating until they have enough water. These enzyme inhibitors also stop the absorption of some nutrients, particularly minerals. When you soak the nuts many of the nutrients also become more available for digestion.
Flaxseed is rich in Omega 3 fatty acids, L Arginine (about 20% less than almonds), lignans, antioxidants and fiber that together probably provide benefits to patients with cardiovascular disease. Studies on consuming 30g of flaxseed have been shown to reduce blood pressure by up to 15 mm Hg.
A study of 20 volunteers, eight males and twelve females, who were given Bifidobacterium and Lactobacillus strains, either 30 min before breakfast (pre-prandial administration), or 30 min after breakfast (post-prandial administration) found no difference in the levels measured in the stools. Different theories have suggested the higher acidity in the empty stomach or the mixing in with the food might influence the amount of viable bacteria that populate the colon. While only a small number the study suggest take them any time.
The study also found probiotic supplement levels up to 1 month after the end of probiotic oral intake in both groups. It also reported a significant decrease in Firmicutes abundance which has been associated with weight gain and diabetes. The abundance of a particular stain Akkermansia muciniphila was increased compared to samples collected at the beginning of the experiment. This is important as it is the bacteria that increases with the diabetic drug metformin and is associated with breaking down the mucus build-up in the gut and stimulating energy production in the cells (the mitochondria). Yes that is how the drug metformin works. If they inject it directly into the blood it has no benefit at all. Yes the worlds most effective drug is just a prebiotic.
In this study the probiotic supplement showed the ability to modulate the gut microbiota composition, leading to a significant reduction of potentially harmful bacteria and an increase of beneficial ones. The two bacterial strains seemed able to exert a beneficial effect on the bacterial ecology of the gastrointestinal tract, as many significant positive changes in gut microbiota composition have been highlighted.
In the last years, their numerous beneficial properties and positive impact on human health have deeply been described. Nowadays, hundreds of different bacterial strains are available in the global probiotic market and consequently, the choice of the most suitable probiotic product becomes very difficult and fragmented. Lactobacilli and Bifidobacteria are the main microorganisms used as probiotics; indeed, numerous species belonging to these genera have been reported as safe and effective in improving the host’s health. Several studies showed that the combination of specific bacterial strains belonging to Lactobacillus and Bifidobacterium species can act in optimal synergy for restoring the intestinal balance.
The thought of eating nothing but raw food, seems somewhat alien in the modern world, where the methods are cooking food are widely varied. But, until the discovery of fire, and the ability to recreate fire was developed around 1.8 million years ago, our human ancestors consumed massive amounts of raw food. It has been estimated that throughout 99% of human evolution, we consumed nothing but raw foods – something that is hard to imagine.
Humans are the only species (if you don't count our domesticated animals) that do not eat a 100% raw food diet, with many populations, eating a diet consisting almost entirely of cooked and processed foods. Undomesticated and wild animals live on a completely raw food diet, and suffer few of the serious degenerative conditions that we humans do.
The paleo-diet (i.e. the Hunter-Gatherer Diet), has received a lot of attention in the media recently, for it's proposed health benefits. But we humans are much more, in evolutionary terms, than the early cave (paleo) man. It is on the right track, but less than 5% of the evolutionary history of man, has been as bipedal hominids, walking tall on two legs. We have been using tools to grind, prepare and cook food, for less than 1% of our evolutionary history. We are in fact well and truly pre-paleo-raw food eaters if you look at our history. Additionally, it has only really been the last 1000 years that we humans have been processing our food, something that has really taken off in the last 100 years and even worse in the last 50 years with modern junk foods and take-aways.
Humans are unlike any other primates. If you spent the day watching any one of the great apes, our closest evolutionary cousins, you would see that they spend the majority of their time eating raw fruits, vegetables and leaves. Chewing each mouthful for minutes. Gorillas and orangutans are almost entirely herbivorous (plant-eating), while chimpanzees eat mostly plant foods including, fruits, seeds, nuts, leaves and flowers, they will also eat insects and even more rarely they hunted larger animals (around 2% of their diet). All of their food is raw. Now I am not recommending you go out and eat your meat raw, but there is a lot of merit in increasing the raw component in your food.
If you look at the evolutionary history of humans, and the dietary habits of our closest relatives, the great apes, it seems that we have a digestive system that has evolved to ingest and breakdown raw foods. So why don't we eat them more?
Health benefits of raw
At both a personal and scientific level I have no doubt about the health benefits of increasing the raw component in your food. There is growing scientific evidence that a higher consumption of raw, plant-based foods is beneficial to human health. Increased consumption of raw foods can lead to a reduction in allergies and strengthening of the immune system. As a result, the risk of cancer and other chronic diseases is reduced. Other health benefits such as a lower Body Mass Index (BMl), lower blood pressure, and beneficial levels of lipids, lipoproteins, glucose, insulin, HDL cholesterol, LDL cholesterol and triglycerides can also be attributed to raw food consumption. Raw diets lead to a decrease in obesity and cardiovascular disease through less consumption of processed carbohydrates and sugars. All of the people I have encouraged to consume more raw food, usually through having a vegetable smoothie have all lost weight and reported more energy. An increase in raw vegetable protein also decreases bone loss and the risk of bone fractures.
In a study of blood pressure for 2,195 participants, intakes of both total raw and total cooked vegetables were inversely related to BP. However, the study found raw vegetables had a stronger effect on blood pressure than cooked vegetables. In a study that followed 32 individuals on diets containing at least 40% uncooked foods (vegetables, seeds, nuts, fruits, and certified raw milk) for six months; intakes were significantly associated with lower blood pressure of participants but increased to previous levels when switched from high raw food diets back to cooked diets (without altering caloric or Na intake). You might recall the raw blood pressure smoothie I wrote about last year. Just by having a raw vegetable smoothie peoples blood pressure dropped by as much as 50 mmHg. Such large drops in blood pressure are unheard of in medicine. A recent cohort study of 20,000 men and women in the Netherlands, using food frequency questionnaire data on seven raw vegetables and 13 cooked vegetables, reported that raw vegetable intake was significantly inversely associated with ischemic stroke and raw fruit and vegetable consumption was also inversely related to coronary heart disease.
Studies of patients suffering fibromyalgia showed a marked improvement in their condition after following a raw food diet. Improvements included better sleep and digestion, along with less pain, fatigue, anxiety and depression. The reversal of chronic metabolic acidosis, as well as improvements in people suffering from diabetes, can be achieved through a raw diet.
A raw food diet also results in numerous mental benefits. Eating raw foods leads to better sleep and hormone regulation. One report found that patients who were suffering from anxiety, depression and eating disorders showed significant improvement in their condition after beginning a raw food diet.
Overall raw food has the potential to have a major positive impact on our health and out lives and the benefits are derived not just from the additional nutrients and improved digestion but also from exposure to a lower level of cooking based toxins.
Pre-digestion by food enzymes occurs in every creature on earth, the only exception is humans on a cooked enzyme-deficient diet. When we eat raw foods, physical contact, heat and moisture in the mouth activate the enzymes in the food. Once active, these enzymes digest a significant portion of what we ingest.
The stomach has two distinctive sections – the upper Fundus and the lower Pylorus. The bolus of food remains in the upper part, the fundus for up to one hour where pre-digestion of raw foods takes place. All raw foods come with their own digestive enzymes, thus saving the pancreas from supplying all the enzymes needed for digestion. You don’t want to waste too much of our “Life Force”. Cooked foods, which have no enzymes as the break down around 48oC, must wait in the Fundus and can only rely on enzymes from the pancreas, which means a lot more work for our body, and the feeling of fatigue after eating a big cooked meal.
There are two zones of protein digestion in the stomach one has a pH of 1-2.5 at which, the enzyme pepsin is most active. The other zone with a pH of 3.3-4 at which, the enzymes naturally occurring in raw foods are still active. The amount of digestion in both zones is approximately equal. For example, raw meat has its own supply of cathepsin so if you eat raw meat like all other carnivorous or omnivorous animal, up to 50% of the digestion occurs before it even comes in contact with the pepsin from the gut. The same happens with plant based proteins. Digestion can continue without the use of our body's own digestive enzymes when the pH changes in the intestines allowing the foods natural digestive enzymes to become active again.
Enzymes are essential for the digestive process and when food is cooked the naturally occurring enzymes are destroyed, meaning that the digestive system has to work so much harder to digest food. Additionally, digestive enzymes help to cleanse our colon – foods that are not digested properly are stored in our colon and digestive problems can begin. Undigested protein putrefies, carbohydrates ferment, and fats turn rancid in our colon. Unpleasant isn't it?
The most obvious symptoms of enzyme deficiency are easily identified, particularly after meals, which can include:
Bloating, gas and cramping.
Constipation and poor elimination.
Cooking food can have a negative effect on digestion, by both destroying enzymes and other nutrients that aid in the digestive process such that heat and processing, reduces the amount of co-factors and co-enzymes, which are essential for efficient digestion. Co-factors are inorganic micro nutrients, which includes, zinc, iron and copper, which are important for the function of many digestive enzymes. Co-enzymes are organic molecules, such as vitamins, that also assist in digestion.
Digestive Enzymes cleanse our colon. Foods that are not digested properly are stored in our colon and digestive problems can begin. Undigested protein putrefies, carbohydrates ferment, and fats turn rancid in our colon. The enzymes from live raw foods prevent this from happening. Excess enzymes from these foods can also be absorbed into the blood and assist with numerous health conditions, including attacking cancer and viruses.
Poor or inefficient digestion can cause a number of health conditions, ranging from arthritis to Alzheimer's, to cardiovascular disease to cancer, as well as, diseases of the digestive system. An estimated 40% of Australians have lower gut disorders and one in five Australians is known to suffer from irritable bowel syndrome, and the number is on the rise. Other conditions of the digestive system include: colitis, Crohn's disease, leaky gut, gluten intolerance, bloating, acid re-flux, heartburn, constipation, diarrhea and food allergies. Other health problems that can develop as a result of poor digestion include: fatigue, yeast overgrowth, acne, depression, obesity, high blood pressure, circulatory problems, chronic inflammation and auto-immune disorders.
Enzymes are literally the life force and it is well established the higher the supply of enzymes you have in your body, the slower you will age and the more resistant you are against degenerative diseases. In general the duration of life varies inversely with our enzyme activity and the older we get, the weaker our enzyme activity becomes - this is not just an indication of lost enzyme potential, but a reduction in the enzyme potential of the whole body, both digestive and metabolic enzymes.
If you take you health seriously I suggest start with a raw plant based smoothie each day. You might be surprised at not only how good it is for you but also how quickly you can make it.