Monday, April 16, 2012

A Gut Feeling

~Hugo Rodier, MD

Since graduating from Medical School in 1984 and more so after becoming a member of the MA’s Environmental/Public Health committee over 10 years ago I have studied Energy issues documented in Medical and Physics journals. It has become clear to me and many of my colleagues that not only societal but health issues revolve around the concept of ENERGY.[1] The physicist David Deutsch even predicted that doctors would make significant breakthroughs in treating patients by applying Physics’ concepts in their practices.[2] Some authors have even compared our society’s use of energy to our own somatic cells.[3] Erwin Schrodinger, one of the founders of Quantum Physics defined life as the ability to metabolize Energy and Information.[4]. Last February, the journal Scientific American highlighted this concept on its cover issue.

Having dedicated my professional life to nutrition, and seeing a significant number of my patients overcome health problems that are relevant to all medical specialists, I have come to believe that how we process Energy and Information at the cellular level (the mitochondria and metabolism) is the key to maintaining health. To optimize this function we must eat whole, plant based foods, eschew toxic agents in our environment (food included,[5]) and have a healthy gut.[6] These simple themes are highlighted in our medical literature with increasing frequency.[7]

In my opinion the March 16th issue of the Journal Cell contains a most compelling summary. Since “evidence” is the guiding light in our profession, let me step out of the way and quote the abstracts of 3 outstanding articles:

1. The Impact of the Gut Microbiota on Human Health: An Integrative View.[8] The human gut harbors diverse microbes that play a fundamental role in the well-being of their host. The constituents of the microbiota—bacteria, viruses, and eukaryotes—have been shown to interact with one another and with the host immune system in ways that influence the development of disease. We review these interactions and suggest that a holistic approach to studying the microbiota that goes beyond characterization of community composition and encompasses dynamic interactions between all components of the microbiota and host tissue over time will be crucial for building predictive models for diagnosis and treatment of diseases linked to imbalances in our microbiota.”

2. Cellular Metabolism and Disease: What Do Metabolic Outliers Teach Us?[9] An understanding of metabolic pathways based solely on biochemistry textbooks would underestimate the pervasive role of metabolism in essentially every aspect of biology. It is evident from recent work that many human diseases involve abnormal metabolic states—often genetically programmed—that perturb normal physiology and lead to severe tissue dysfunction. Understanding these metabolic outliers is now a crucial frontier in disease-oriented research. This Review discusses the broad impact of metabolism in cellular function and how modern concepts of metabolism can inform our understanding of common diseases like cancer and also considers the prospects of developing new metabolic approaches to disease treatment.”

3. Mitochondria: In Sickness and in Health.[10] Mitochondria perform diverse yet interconnected functions, producing ATP and many biosynthetic intermediates while also contributing to cellular stress responses such as autophagy and apoptosis. Mitochondria form a dynamic, interconnected network that is intimately integrated with other cellular compartments. In addition, mitochondrial functions extend beyond the boundaries of the cell and influence an organism's physiology by regulating communication between cells and tissues. It is therefore not surprising that mitochondrial dysfunction has emerged as a key factor in a myriad of diseases, including neurodegenerative and metabolic disorders.”

In short, a healthy gut flora, a result of a plant based diet high in fiber and low in additives and refinement,[11] is of paramount importance to our metabolism, which ultimately takes place in the mitochondria.[12] By optimizing our patients’ nutrition and gut health we may resolve, not just mitigate 80% of the health problems we see in our clinics, according to doctors like Walter Willet. Dr. Willet’s Public Health approach has been amply documented in the Journal of the American Medical Association and his own publications.[13] But, as the saying goes, “the proof of the pudding is in the eating:” I have also observed an 80% cure rate in my practice when patients buy into these simple concepts.

Doctors routinely measure chemicals in the body to get health information, such as cholesterol and triglycerides. METABOLOMICS, however, involves measuring hundreds or thousands of chemical processes, such as the breakdown of nutrients from diet, going on in the body at the same time, which could yield a lot of information. [METABOLOMICS] can also account for environmental factors, such as how well a patient is absorbing medications. Since METABOLISM-energy generation and breakdown-gets disrupted in many diseases, figuring out how these metabolic pathways change could potentially yield better ways of diagnosing or treating a wide range of diseases.”[14]

Keeping our gut flora or microbiome healthy[15] also influences the expression of our genome,[16] which “may play a role in regulating one’s risk of obesity, asthma and allergies. Now some re­searchers are wondering if the microbiome may have a part in an even more crucial process: mate selection and, ultimately, evolution.”[17] In fact, our metagenome, or the genetic makeup of all species harbored in the gut flora, outnumber our somatic cells’ genes 1:150. We will soon have our “other genome” mapped out,[18] with repercussions that will reverberate across all specialties.

As shown by Dr. Metchnikoff’s 1908 Nobel Prize winning research, “ The tens of trillions of bacteria aren't just hitchhikers; they interact intimately with the immune system, and are so integral to our health that some scientists have deemed them the “forgotten organ”.[19]In fact, the microbiome “educates” the immune system we learned about in Medical School:

Understanding the nature of that relationship could improve understanding of inflammatory mechanisms in autoimmune disorders such as lupus, rheumatoid arthritis and multiple sclerosis, in which immune cells attack and eventually destroy healthy tissue.”[20]

The main manifestation of a disrupted immune system is Inflammation, a close process to Oxidation.[21] Dr. Virchow, over 150 years ago stated that practically all diseases are inflammatory/oxidative conditions, a concept that we have applied in our practices for the last 15 years or so.[22] Just like any engine, our cells follow thermodynamic principles; the process of metabolizing energy and information produces inflammation, hence, the word “Meta-Inflammation” has been coined.[23] By optimizing the “fuel” (food) we consume and the fitness of the “engine,” (our gut’s microbiome,) ultimately the mitochondria, which is also quite susceptible to inflammation and oxidation, will have a good chance to provide the energy each of our 50 trillion cells need to do their respective jobs.

The health problems we may thus address may surprise the most hardened skeptics of the role of nutrition in medicine. The following problems, in addition to the ones alluded above, have been documented to improve:

depression,[24] chronic fatigue,[25] irritable bowel syndrome, fibromyalgia,[26]diabetes, ulcerative colitis, Crohn's disease,[27] arthritis, central nervous system inflammation[28] and even cardiovascular problems.[29]

But, perhaps the most crucial issue we may address with this approach is the epidemic of obesity[30] that is maiming our patients:

The guts of obese mice and people harbor an array of microbes different from that of their lean counterparts… Manipulating gut bacteria might keep weight down in people. Another researcher who was struck by how successful farmers are at increasing the growth rates of livestock by adding low doses of antibiotics to their feed began to wonder whether antibiotic use, particularly in children,might affect the long-term establishment of a balanced microbial community in the human gut, eliminating bacteria there that could help ward off obesity.”[31]

Remember, “The proof of the pudding is in the eating.”[32]

[1]Reinventing Fire,” Amory Lovins, Rocky Mountain Institute; Chelsea Green Publishing, 2011

[2]The Fabric of Reality,” David Deutsch; Penguin Books, 1997

[3]Biology of Belief,” Bruce Lipton, page 35; Elite Books, 2005

[4]What is Life,” Erwin Schrodinger; Cambridge University Press, 1944

[5]An Environmental Link to Obesity,” J. Environ Health Perspect 2012;120:a62

[6]Microbiota: a factor in energy regulation,” J. Nutrition Review 2006;64:47

[7]Integrative Health Newsletter: a monthly review of 100 medical journals,”

[8] J. Cell 2012;148:1258

[9] J. Cell 2012;148:1132

[10] J. Cell 2012;148:1145

[11]The Guts of Dietary Habits,” J. Science 2011;334:45 & “Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes,”J. Science 2011;334:105-108

[12]The hybrid science of diet, microbes, and metabolic health,” Am J Clin Nutr 2011;94:11

[13] Book “Eat, Drink and Be Healthy,” Dr. Walter Willet, Harvard Press, 2002

[14] Wall Street Journal, July 19th2011

[15]Microbiome: That healthy gut feeling,” Journal Nature 2011;480:S88–S89

[16]Has the Microbiota Played a Critical Role in the Evolution of the Adaptive Immune System?” J. Science 2010;330:1768

[17]Gut Microbes May Drive Evolution: The bacteria that live quietly in our bodies may have a hand in shaping evolution,” February 23, 2012

[18] Cover issue Journal Nature March 2010

[19]Microbiome: Gut reaction,” J. Nature 2011;479:S5

[20]Peripheral education of the immune system by colonic commensal microbiota,” J. Nature 2011;478; 250 & “Keeping Bacteria at a Distance,” J. Science 14 October 2011;334:182

[21] J. Clinical Chemistry 2007;53:456

[22] Cover Issue J. Scientific American May 2002

[23] 8th Academic Board Members Meeting of the International Chair on Cardiovascular Risk; Boston, October 2009

[24]The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression,” J. Neuro Endocrinol Lett. 2008;29(1):117-124

[25]Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria,” J. Neuro Endocrinol Lett 2008;29(6):902-910

[26]Small intestinal bacterial overgrowth,” JAMA 2004;292:852

[27] Metagenomics and Personalized Medicine,” J. Cell 2011;147:44

[28]The Gut's Clostridium Cocktail,” J. Science 21 January 2011: 289

[29]Cardiovascular disease: The diet–microbe morbid union,” Journal Nature 2011;472:40

[30]The Microbiome and Obesity: is obesity linked to our gut flora?” J. Current Gastroenterology Reports 2009;11:307

[31]Girth and the Gut (Bacteria),” J. Science 2011: 32-33

[32] For an expanded article Email me at