Dr Ese Stacey, Sport and Exercise Medicine Doctor, explains what ‘health’ is and how we can make sure we maintain good gut health to stay generally healthy.

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The traditional model of how to tackle ill health takes a disease or condition or symptom and tries to find a treatment for it. For example, if you have a headache you take a headache pill. If you have diabetes you take medication to lower your blood sugar. If you have high cholesterol you take medication to lower your cholesterol. If you have high blood pressure you take medication to lower the blood pressure. I could continue but I think you get the picture.

In general, this medication may be a short-lived affair for something like a headache, but for chronic disease, this will mean life-long treatment. Conventional medicine often means that we ‘manage’ the condition with daily medication. But how about if we take a different approach to understanding disease, or ‘dis-ease’?

When we’re young our bodies are able to cope with almost everything we throw at it. Colds are easily dispensed with. If we get injured, we quickly recover. As we get older, we find that a cold may last a few days longer and the injuries take longer to heal. Why is this? Just old age? Well, what is old age? What is ‘ageing’ and why do we suddenly start to get the diseases of old age such as arthritis, diabetes and high blood pressure? Why can’t we lose those extra pounds in weight and why do we ache and feel tired in the mornings?

This article will answer some of these questions as I explain ‘health’.

How does gut health fit in?

Your gut and its microbes are the body’s first line of defense. We exist in a complex two-way relationship with our gut microbes, or microbiota, to give them the correct term.

Microbiota help us to digest food, provide valuable nutrients and play and important role in helping to maintain a strong immune system. In fact, the gut is an immune organ, rather like the spleen.

Good gut health is dependent on a positive balance between ‘good’ and ‘bad’ microbes. When this balance is lost, immune function suffers and we are then prone to inflammation. This inflammation is not usually noticed by the individual. It is a silent type of inflammation.

However the body will use of valuable nutrients and energy in trying to keep this low-grade inflammation in check. In fact, it is chronic low grade inflammation that has been shown to be the trigger for most chronic diseases.

This low-grade inflammation can switch on and off in your genes. So, for example, we know that just because you carry the genes for a particular condition, you will not necessarily get that condition. We know that ‘bad’ genes can be switched on and off. This is called epigenetics.

This means that gut function and the balance of microbiota in your gut can determine the levels of low-grade inflammation, which in turn can affect your genetics. Gut health, therefore, is important for almost all health conditions.

In order to maintain good gut health, you need to consume ‘good’ microbes in the forms of either probiotics or fermented food. Fermented foods need to be eaten regularly with each meal. For some people pasteurised milk of all types will injure the gut lining and hence will have a harmful effect on gut microbes.

Fermented foods:

• Sauerkraut
• Kimchi
• Kefir
• Kombucha
• Olives in brine
• Live yoghurts
• Fermented cheeses

How do sugars fit in?

There are hidden sugars in many of our modern-day foods. It is my opinion that sugars are the single most important food associated with ill health. Sugars feed ‘bad’ microbes. ‘Bad’ microbes promote inflammation and inflammation leads to disease.

Which sugars should you cut out to avoid this outcome? Well, the inflammation-causing foods that come up regularly in my consultations with patients are cereals, (including oats), and sweet fruit and/or fruit juice. People tend to not like to hear this as they consider these 2 food groups to be healthy, and indeed you may get away with eating these foods if you have a healthy gut microbiota balance.

However, if you don’t have a healthy gut microbiota balance, (a condition called gut dysbiosis or ‘leaky gut’), eating sugars as mentioned will be detrimental for your health. It’s a good idea to view your gut microbe family like trees. The ‘good’ microbes represent one tree and the ‘bad’ microbes represent another tree. Both trees can eat sugars. If you start off with a very big ‘good’ tree and a small ‘bad’ tree and you feed your gut with sugar, the ‘good’ tree will grow more than the ‘bad’ tree. So, no problem there. However, if you start off with gut dysbiosis i.e. a very big ‘bad’ tree and a small ‘good’ tree and you feed your gut sugar, it’s the ‘bad’ tree that’s going to grow the most. There are also other reasons why cereals and sweet fruit may not be good your health, and I will come to this a bit later on.

Fats

Your gut and your gut microbiota are your first line of defence. Anything that breeches your gut lining will then have access to the cells in your body. Your cells are where the action happens. The cell membrane represents another barrier to harmful substances but also needs to be healthy to allow passage of nutrients. The mitochondria exists inside the cell and is the engine of the cell. It is responsible for producing energy or adenosine triphosphate (ATP). If you wake up feeling fatigued in the morning, chances are that your mitochondria aren’t working so well.

The cell membrane is made up of fats. In order to maintain the integrity of the membrane, you need to consume ‘good’ fats.

Polyunsaturated and monounsaturated fatty acids are ‘good’, such as:

• Fish oil
• Flax seeds/flax seed oil
• Avocados and avocado oils
• Olive oil (virgin olive oil in cans, not bottles)

Saturated fats, contrary to popular belief, are required for optimal health. Oils such as virgin coconut oil for cooking, raw red palm oil and organic grass-fed beef dripping contains valuable saturated fats that have been shown to be especially beneficial for health.

Cholesterol is required to transport the above fats and other nutrients around the body and is especially important for neural health. Cholesterol is part of the wrapping around nerve sheaths. Eggs and liver are a rich source of cholesterol. Eggs should be from chickens that have roamed outside and can peck (eat worms).

Cholesterol is an antioxidant, which means that it works to combat inflammation. This means that if your cholesterol is raised it may mean that it represents the body’s way of trying to deal with inflammation in the body. Of course, not all fats are good for us. Fats to avoid occur in processed foods such as shop bought pre-packaged foods/sandwiches.

Normal cells and bone cells will not function without fats and fat-soluble vitamins (A, D, E and K). Fat soluble vitamins cannot be adequately absorbed from salads and vegetables if these are not eaten together with good fats.

How does immunity work?

We often think of immunity as related to fighting off infections. This is correct, but only part of the story. The immune cells are the cells that are also responsible for dealing with inflammation and for helping our cells to regenerate.

Your immune cells are rather like scavengers that look for trouble around your body and deal with it to keep you fresh. Prolonged injury or infection can occur if the inflammation associated with it is not dealt with well by your immune cells. Cancer happens when there is a failure to regenerate adequately new cells adequately. Your immune cells would normally pick up on abnormal regeneration and deal with these rogue cells. Poorly functioning immune cells may come as a result of a lack of adequate nutrients or a sustained effort to combat low grade chronic inflammation.

Fermented foods, good fats and oils, and prebiotic foods such as cruciforous vegetables, mushrooms, beans and spices are examples of foods that would enhance immune cell function.

When you engage in exhaustive exercise and experience stressful events on a daily basis, your gut microbes and nutrients are challenged, so it is important that highly nutritious food is consumed. In addition, supplements may be required that boost immune cell function.

How does detoxification fit in?

It is important that the body has a way to eliminate toxic waste. This is a normal part of body metabolism.

Regular exercise within your level of functioning will help detoxification through breathing and sweating.

The optimum number of bowel opening episodes should be 2-3 per day of soft, reasonably large stools. If this isn’t happening, an increase in the amount of cruciferous vegetables and fermented vegetables is advisable. If stools are loose, this could represent a need for a more diverse population of gut microbes.

Eating peppers and spices and drinking purified (and preferable structured) water will assist urine detoxification. Saunas (particularly infrared) and footspas will free up toxic substances that rest in adipose tissue and these substances are then excreted through sweating or urination.

Working in a polluted city could be responsible for increased amounts of toxins in your system, including diesel particulates and heavy metals.

Detoxification mechanisms:

• Breathing
• Sweating
• Urination
• Defecation

I mentioned earlier that cereals and sweet fruit can contribute to our inflammatory burden for other reasons that just sugar content. It is my opinion that cereals and sweet fruit, together with nuts and milk may be subject to toxins from environmental pollutants such as pesticides. In some circumstances fungal toxins found on grain and stored dry goods may also contribute to the toxic burden.

Under normal circumstances the levels of these toxins would be extremely low. However, it is useful to view health in terms of a balance between inflammation-causing and inflammation-combating factors. All the little factors that cause inflammation, such as sugars and environmental toxins must be weighed up against inflammation-combating factors such as prebiotic and probiotic foods.

If the body receives an insult such as a highly stressful event such as an operation, emotional stress from work/partnership breakup etc, the stress will tip the body into inflammation. If the inflammation-combating factors are not strong and the background levels of inflammation-causing factors are high, the body may find it difficult to find its equilibrium again. The net inflammation will then tip you into ill health. The genes will determine the type of ill health you get because, as mentioned above, the inflammation acts as an epigenetic switch.

How does electromagnetic pollution or electrosmog affect gut health?

Electrosmog comes from electromagnetic radiation from such things as wifi, computer screens, electric cabling, fridges and lights etc. Electrosmog has a destabilising effect on cells and kills gut microbes. It also interacts with any heavy metals that may have built up in the body.

Electrosmog is therefore an inflammation-causing factor, and will magnify the negative effects of the elements we discussed above. Your mobile phone is the most likely cause of electromagnetic stress. Think of turning of the wifi router in your home at night or put your phone on ‘airplane’ mode if you tend to use it as an alarm clock. Do not carry your mobile phone in your pockets as electromagnetic frequency may have an effect on cells that are highly active such as breasts and the prostate gland. You can now purchase electromagnetic shields for phone and equipment. Remember that wearable technology may use wifi.

Does emotional stress play a part in maintaining good gut health?

A gut-brain axis exists. Anything that affects emotional function will have an effect on the gut (microbial) function and vice versa.

Paying attention to your emotional wellbeing will have a positive effect on gut function and therefore on your background levels of inflammation. Poor gut function will also have a detrimental effect on how we perceive stress, as well as how well we sleep and concentrate. I often find that attention to gut microbial function has a positive effect on stress perception and is often one of the first things to change when a good gut solution is found. Taking probiotics or eating probiotic food is expected therefore to have a positive effect on your mood. The exact dosing and type may need some adjustment.

What tests do I need to make a diagnosis?

Tests can be expensive. Although they are not always required, they can help to formulate a plan for how to strategize a return to health.

Standard blood tests include a full blood count looking or anaemia, kidney and liver function are normally the first set of tests required. Markers of inflammation can be assessed by looking at the ESR, CRP. Interestingly the cholesterol, triglycride and uric acid levels will also give some useful information about background levels of inflammation.

Vitamin D3 is low in almost everyone except in those taking supplements. This is thought to be because of poor exposure to sunlight; however, that is not the full story and a look at the ratio between vitamin D3 and vitamin 1, 25 Vitamin D (the activate form vitamin D) can also provide important information about the degree of background levels of inflammation.

When the vitamin D3 is very low the parathyroid hormone (PTH) will be raised. When the PTH is raised and the vitamin D3 is low, this constitutes a condition called secondary osteomalacia. This is not that uncommon in my clinics and can be associated with increased pain in the joints. Supplementation with the correct dose of vitamin D3 and diet modification is often helpful.

The urine OAT test to look at urine metabolites. This test will give a good overall picture of gut and nutrient status. It is available from http://www.biolab.co.uk/index.php/cmsid__bi-olab_test/Organic_Acids_Profile–

Urine toxicology tests will give an idea of toxins from metals and non-metals and toxins such as fungal mycotxins.

If the immune system has been compromised for some time it can be beneficial to analyse the complexity of infections that you may be harbouring. AONM comprehensive lyme and co-infections test is useful for this purpose and if available from https://aonm.org/arminlabs-price-list-and-order-forms/

To make an appointment to see Dr Ese Stacey please visit the website
www.brightonsportsmedicine.co.uk

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