Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Saturday, May 15, 2010

Healthcare: DNA Testing vs. Diet and Exercise

Contributions of genetic alleles to disease are useful for understanding, but not in predicting disease.  Diet and lifestyle are the major determinants of disease and not genes for most common diseases.
OTC Genetic Screening Kits
A recent headline touted the availability of a kit at Walgreens to screen for “predisposition” to a hundred common diseases.  A few months earlier, scientists admitted that after lengthy examination of a dozen major diseases, the genetic contribution was negligible.  It may now be possible to cheaply (less than $25,000) determine the sequence of the entire genome of an individual or even more cheaply test for the presence of particular genetic alleles, but that information is useless compared to diet for predicting if the person will actually get the disease.  The screening kits were pulled before they reached the shelves.
Gut Flora Dominates Gut Genotype
I think that the reason why an individual’s genes don’t dominate health issues, is because the composition of meals dominates the development of the gut flora community and it is the interaction between the gut and its bacteria that dominates health.  The genes of the individual are just not that important in determining disease.
You Are What You Ate  
For each individual, the meals eaten over the last years have cultivated the existing gut flora, composed of hundreds of different species of bacteria with unique metabolic capabilities to digest unusual meal molecules and modulate the immune system.  Molecular communication between gut and the bacteria in intimate contact determine food intolerance, allergies, autoimmunity and many other disease processes.  Healthy eating produces a healthy gut flora and bad meal decisions can lead to unhealthy gut flora and the modern litany of  inflammatory ailments.  Some genes may mitigate or magnify the development of unhealthy gut flora, but it is difficult to be healthy with compromised gut flora.
Antibiotic Disruption of Gut Flora Trumps Good Genes
It doesn’t matter if there are great genes to help avoid disease, if the function of those genes is compromised by gut dysbiosis, a lack of functional gut flora.  Many antibiotic treatments, e.g. for acne, act by attacking the gut flora that support a specific portion of the immune system.  Deletion of this function causes cosmetic improvement, e.g. relief of  skin inflammation, but at the expense of producing a dysfunctional immune system that may lead to other diseases.  Presence or absence of healthy genes can be made irrelevant, if the gut flora is dysfunctional.


Tanya said...

What a timely post...I received a newsletter with an article "Rats on Junk Food Pass Cancer Down the Generations" and said to myself...I have to show this to Dr Ayers! Junk food=fatty diet in the study, by the way. Please debunk this! said...

Fascinating! I guess I need to quit feeding so many artificial chemicals to my gut bacteria.

Anonymous said...

Dr Ayers. You have previously mentioned Olive Oil as the only vegetable oil worth consuming. Any thoughts on sesame oil? The Chinese have consumed oil for many years, and are known for their longevity.

I have heard sesame oil referenced as anti inflammatory and high in antioxidants. Is it net harmful because of its high omega 6 content?

Cristian said...

Why Is Breast Milk Best? It's All in the Genes

Cheese -- Acting as 'Carrier' for Probiotic Bacteria -- Found to Improve Immune Response of Elderly

Dr. Art Ayers said...

I think that the articles cited show long term impact of diet and they show some epigenetic effects of diet, i.e. semi-permanent alteration of gene activity by DNA modifications.

This doesn't change my perspective on the preeminent importance of diet. After all, it was diet that reset the gene expression. The multigenerational studies also fail to account for the transmission of gut flora across generations. Children inherit unusual patterns of gut bacteria found in their parents. Also eating patterns are inherited.

From my perspective, your next meal has a much bigger impact on your disease future, than what your parents ate. Changing your diet/gut flora, changes your destiny.

Thanks for the interesting article.

Dr. Art Ayers said...

I think that the significance of artificial chemicals is exaggerated. The major components of our diet are far more important.

I think people worry about the contaminants in their water bottles, but are killing themselves with vegetable oils, starch and fructose.

Dr. Art Ayers said...

I occasionally add some sesame oil for the flavor. It is loaded with omega-6 oils, which can contribute to inflammation, so I don't want to eat very much.

The major points on fatty acids are:
1) Get most of your calories from saturated fats.
2) Small amounts of omega-6 fatty acids, found in vegetable oils, are needed for health.
3) Large amounts of vegetable oils, e.g. using for frying, are inflammatory.
4) Omega-3 fish oils (long chain, not short chain from flax) are anti-inflammatory.
5) Omega-3 oils can balance omega-6 oils, as long as the omega-6 oils are not a major part of the diet.
6) There is typically enough omega-6 oil in meats and vegetables, so that vegetable oils (except olive oil) should be eliminated from the kitchen.
7) Saturated fats are safer/healthier than omega-6 polyunstaturated oils.

I hope that makes it more clear. Thanks for the question.

Dr. Art Ayers said...

The prebiotic impact of breastmilk and the resulting Bifidobacter monoculture in the nursing baby is a favorite topic. The article you cite shows that gut development is significantly altered along with the gut flora by formula. One wiff of the diapers would tell the researchers that formula is a poor approximation of breastmilk.

They mention necrotizing colitis as a consequence of formula use. Hospital cases of this severe disease can be eliminated by use of human milk from milk banks. Pediatricians are very slow in reading the biomedical literature and many babies die unnecessarily.

Wow, who would have thought that feeding elderly people probiotics would rejuvenate their immune systems?

Thanks for the headsups on the articles.

Anonymous said...


I have read recently that the chinese and other Asian countries have historically used lard, tallow, etc for the bulk of their cooking and use very small amounts of the likes of sesame oil for flavour.

It would seem however that these countries have not been immune to the 'saturated fat is bad' rubbish and have trended toward increasing amounts of omega 6 and increasing amounts of inflammatory conditions as a result.

Anonymous said...

Dr. Ayers,
You've mentioned before that chronic constipation is a result of poor gut flora, but what would you say to someone who has chronic diahrrea or loose/runny stool?

Anonymous said...

I have recently been prescribed antibiotics for adult acne so your last paragraph really caught my eye. I have not taken them yet. Do you have any advice? Will cooling inflammation also clear my acne? Or, is there something else involved? I think it is odd because acne was never an issue with me until I hit 30. By this time I had been cutting refined carbs and sugar from my diet and had started to eat real fat. What else can I do?

Jeremy said...

Dr. Ayers,

Stumbled across this blog recently and I really enjoy it (although some of the science is beyond my pay scale). I really appreciate your perspective.

My comment doesn't necessarily have much to do with your latest post, but I had read this article today and thought of your blog, so I thought I'd throw it out there in case you had any thoughts:

It seems like they got the inflammatory foods - asthma connection down, but the article's authors came to the wrong conclusion from the correct data: It's not fat itself that's inflammatory, it's the SORT of fats they were eating in the study. Possible?

Anna said...

Off topic, but I just clicked on your hit map. It's fascinating to see where your blog hits originate. Congratulations on reaching so many far-flung people.

I know breast-feeding is a favorite topic of yours, and the discussion of gut flora has reminded me of something that always puzzled me.

When my son (now almost 12 yo) was an infant he was exclusively breastfed for about 7 mos before starting some solid foods. During the exclusively breastmilk months, he developed a pattern of going a very long time between bowel movements - often a week, sometimes even 10-12 days. Even with this timing, the BMs were sweet-smelling and easy to clean up compared to what I have observed with formula fed infants. I was unconcerned about the infrequent timing, as I understood this to be not unusual with breastfed-only babies (my mother reported the same was thing when I was a baby). Also, my son was healthy and exhibited no signs of discomfort or difficulty passing the stool. The pediatrician was also unconcerned (bowel habits were always asked about at well-baby check-ups so it wasn't that I reported it out of concern). My understanding, reiterated by the pediatrician, was that breastmilk was so completely and easily digested and well-absorbed, there was little waste left. It was great for keeping our diaper consumption low, btw. However, at the same time I was friends with other mothers with breast-fed infants (in fact, they breastfed much longer than I did), who did not experience this ery infrequent bowel movement pattern at all - their babies often dirtied gobs of diapers, sometimes many in a day.

However, in recent years, I have become aware that bowel movements are isn't mostly undigested/unabsorbed food (one hopes) but also of shed gut bacteria and shed waste materials from the body. So now I'm wonder why even exclusively breast-fed infants have such widely varying bowel movement habits. Is it mostly a gut flora thing? Any thoughts?

Anonymous said...

I needed to come update!!!

after probably over a month or so with kefir, sauerkraurt, pickles, goat yogurt, cider vinegar, cultured butter(may be others i cant remember)

I CAN EAT CHEESE!!!!!!! i digested smooth sailing raw goat feta and cheddar :) happy girl. so much easier to rack in my calories with cheese

thank you SO MUCH for the help

Lucy Wilburn said...

Do you know if steroid nasal sprays have an impact on gut bacteria? I take beclometasone for 2 weeks before I fly to keep my eustachian tube from being blocked due to inflammation-or thats what the ENT says? I fly about 3-4x a year, but am now nervous about what this medication does to me. That would be two months a year on this med! I have popped my eardrum 2x while flying. Thanks for your reply! I have learned so much from your site and am slowing trying to change over to an anti-inflammatory diet!

Cristian said...

"The University of Leeds biologists have identified a previously-unknown ion channel in human blood vessels that can limit the production of inflammatory cytokines - proteins that drive the early stages of heart disease."

Anonymous said...

Dr Ayers,

I was wondering if you had an opinion on something. I’ve mentioned before having hidradenitis suppurativa, but very mild and it generally stays in remission as long as I avoid grains and stay low carb. I was fortunate that when it developed I also started having digestive problems which I linked to gluten. Over time I’ve also connected fructose to it as well. Not a whole lot is known about it, although there’s a strong possibility that it’s an AI disorder. It has a high co-morbid rate with crohn’s disease, is often linked with other AI disorders, PCOS and insulin resistance. A support group that I’m a member of did a survey looking for commonalities, in which 118 people responded. I went through the responses and found 44 instances of PCOS or related problems, 41 instances of type-2/IR/prediabetes, 25 instances of thyroid problems, 78 digestive disorders, 50 arthritic, 97 depression or other mental disorder (although this is understandable due to the nature of the disease and limited treatment options), 32 AI disorders and about 20 other diseases or disorders.

With the numbers and types of disorders found in the group, does it look like a symptom of gut malfunction and inflammation to you as well?

Dr. Art Ayers said...

I think that diarrhea comes from irritation/inflammation of the gut, e.g. IBD, disruption of the gut flora by introducing novel food or bacteria, or perhaps paradoxically dehydration.

The Anti-Inflammatory Diet that I recommend should eventually fix the problem. Pectin and inulin, as well as lactulose should be particularly helpful.

Thanks for the question.

Dr. Art Ayers said...

Acne is a symptom of chronic inflammation and can be addressed with all of the components of the Anti-Inflammatory Diet.

Get your serum vit.D checked and supplement until a recheck gives a value over 70 ng/ml. Get some limited sunshine. Eliminate vegetable oils and start using butter/coconut oil. Supplement with fish oil and increase until the acne is gone.

Make sure that your gut flora is in good shape and particularly avoid antibiotics.

I hope this helps. Let me know either way.

Dr. Art Ayers said...

That is a rather typical paper in which they change three or more components of the diet and attribute result to just one part. A burger and fries is a high carb diet with a lot of omega-6 fatty acids. It is obviously the antithesis of the anti-inflammatory diet that I recommend.

I think that a broiled steak with a bunch of green veggies would have been better than the yogurt, unless the yogurt was normal fat with live bacteria.

Thanks for the article and comments.

Dr. Art Ayers said...

Hi Anna,
What could be better than discussing baby poop?

I think that your conclusion is correct. If the breast milk is fully digested, then there is only a maintenance growth of Bifidobacter and fewer soiled diapers.

I think that whether or not the baby has bountiful bowels is dependent of meal frequency/volume and nursing style. Milk production is highly adaptable and many approaches work well. A single bottle of formula will, however, permanently change the baby's gut flora. Most hospital care workers are unaware of this obvious issue and casually use formula to help new mothers "rest." Of course the mother is not resting with the sick baby at home. Necrotizing colitis results from using formula rather than banked mothers milk.

Thanks for the comments.

Dr. Art Ayers said...

Great results. I am glad that you can enjoy cheese and it was all because of your hard work to make yourself healthy.

It is always nice to here good news.

Dr. Art Ayers said...

It seems to me that your eustacian tubes are plugging because of inflammation in the surrounding tissue. It seems obvious to try to reduce the inflammation, because it will contribute to other problems.

Regardless of the source of the inflammation, ear infection, food allergy, etc. the answer is the same for all: eliminate food-based inflammation and improve your gut flora health to restore proper function of your immune system. Just follow the suggestions for the Anti-Inflammation Diet. (Don't forget to check your serum vit.D.)

Thanks for the questions.

Dr. Art Ayers said...

I always look forward to your new finds.

It is interesting that cholesterol metabolism is involved in shutting down inflammation. That is probably a red herring, a may just reflect that the signaling involves membrane lipid rafts that are sensitive to cholesterol levels.

I noted that cyclodextrins can also be used to deplete membrane cholesterol. You should look at my article on cyclodextrins, a la Febreze. These molecules are very cool.

Thanks for the stimulating article.

Dr. Art Ayers said...

I think that you are right. It looks like an autoimmune disease to me. Linking it to gluten intolerance brings in inflammation, immunological intolerance and the gut. If I had HS, I would use the Anti-inflammatory Diet as a first line of attack. It would also address all of the other co-morbidities.

It seems important to also focus on gut flora health.

Thanks for your queries.

Tanya said...

Re: adult onset acne...if you are a woman, I'd say your progesterone levels are starting to drop and so your natural anti-inflamm. is dropping too...just a thought.

Anonymous said...

Thank you Dr. Ayers. I was fairly certain this was what was going on, but was hoping for confirmation.

Re:adult onset acne... Like Tanya said, can be linked to hormonal changes. And hormonal changes can be caused by fructose, specifically PCOS, insulin resistance. I think a mistake that a lot of people make when eliminating sugar is replacing it with honey or agave (I did it myself at first). A lot of "healthier" options are sweetened with honey, agave or fruit juice, all incredibly high in fructose. And eating fruit, touted as being healthy, can add a lot of fructose to your diet, depending on which ones you're eating. Along with the anti inflammatory diet Dr Ayers recommends reducing the fructose in your diet should also make a big difference.

Dr. Art Ayers said...

I try to understand the molecular interactions of diseases by comparing the machinery of different diseases. That necessitates simplification. I tried to stay outside of cells and concentrate on heparin-mediated interaction, but then got drawn into NFkB and other transcription factors, such as the vit.D receptor.

I have tried to place thyroid and steroid hormones on the periphery, but there are many inflammatory processes, e.g. pregnancy, that are orchestrated by estrogens. In fact, most women can enjoy very unhealthy diets and be protected to some extent by their anti-inflammatory hormones. The problem is that they cannot continue their inflammatory practices as their protective hormones wain.

Thanks for your input.

Lucy Wilburn said...

Thanks for your reply Dr. Ayers! I will work on the anti-inflammatory diet! Am taking D3 supplements and will buy some glucosamine and pro& prebiotics! Lucy

Dr. Art Ayers said...

I just want to harp on the vit.D. Most people supplement, but do not raise their serum vit.D to the optimal level of >70ng/ml. Test, supplement, retest.

Anna said...

Dr. Ayers,

You crack me up! Baby poop fun indeed.

"I think that whether or not the baby has bountiful bowels is dependent of meal frequency/volume and nursing style."

Hmmm, that's an interesting thought. Of my friends with infants back then, I was the only one who had a baby who slept through the night most of the time (beginning at 7 weeks). I tried keeping him the same room but I couldn't get quality sleep from his noisy sleep sounds. I had to move him to his room, and a week later he began to sleep very long stretches - at one point as much as 10-11-even 12 hours, plus a good afternoon nap. My son was like clockwork with his feeding schedule during the day; I didn't even need a watch to know what time it was - every 2.4 hours he became hungry except for during the 4 hour afternoon nap. I didn't impose this, it just sort of worked out that way. He was very happy so much of the time and mainly fussed when hungry, so there was little need to nurse for comfort. That first year or so was truly the easiest year we've had with our son - my husband and I were nearly always well-rested and relaxed, even when I had to wake up at 4am to pump a bit of milk to avoid leaking - those mammary glands worked all day and didn't like to stop for the night shift ;-).

My other friends' babies (the really poopy ones) usually slept with their moms quite a bit of the time; tended to sleep lightly and not for long stretches; fussed a lot more (esp 5-8 am and pm) and nursed a lot more for comfort than my son (he had his thumb I guess). I got a lot of knitting and reading done while friends were tending to their babies.

I hadn't considered the nursing habits, but it makes a lot of sense in this context. Thanks for the reply.

The preteen stuff we're dealing with now feels like a "balloon payment" for all the easy fun we had when he was a baby...;-).

Unknown said...

Hi there Dr Ayers,
I enjoy finding "well argumented" opinions in blogs in the missinformation of the Internet. So good to find this blog.
I was wondering if I could use some of the points of your main speech in my blog, which is is spanish so people from Spain who don't speak english can benefit from your knowledge. Of course I would cite your blog as my source.

Thank you for your time

crapartist said...

Dr Ayers,

Do you have any more to say about coconut oil? It's supposed to be one of the best anti-fungals/immune super powers around (esp for beating candida). Do you think olive is superior?

Danner said...

This is going to be a long post, so all who dare, go get some coffee :)

Male, 22 years old, 5 feet 9 inches, 135 lbs.

Medical history:
I was diagnosed acne vulgaris by my dermatologist in 2006. I have taken antibiotics (tetracycline) from 2006 to 2007 with some on and offs. In 2009 I've been on three cycles (3 months each) of Doxycycline. I didn't have a single pimple within two weeks of first starting them but immediately after I stopped, all acne came back in even a larger amount. The second treatment was a little bit worse since I had acne even during the cycle but again after the ending of the cycle, all got worse. The third time the antibiotics didn't effect the condition.

I was eating large amounts (pound to two pounds) of whole grains and ground beef at the time.

In February I decided to switch my diet. I stopped eating grains, dairy, using plant oils, ...

The condition of my acne got better but I still have a few (5-10) whiteheads left. This condition has been more or less stable for a month.


My acne gets worse when I ingest the following
- coconut milk
- milk
- cheese
- sour cream
- creamed coconut (more than three ounces)
- Greek yoghurt (I eat 1 pound of it and the next morning woke up covered in whiteheads)
- processed meat (like hotdogs)

Even mascarpone or heavy cream seem to break me out.

I took probiotics for 14 days and things got a bit better but still acne remained.

Basically I have no idea what to do. I suspect that I have somehow destroyed my gut flora (I "hear" things in my stomach after ingesting the above mentioned food) with antibiotics but I have no idea if I can even fix the damage. I have problems with dairy although I've been eating it all my life so I don't how if I'm intolerant.

Anyway any idea would be really helpful since I'm pretty sick of walking around doctors and alternative medicine since the first want to give me topical creams and antibiotics and the second ones either want a 600$ for 5 visits or they said that they can't figure out what is wrong with me. Are probiotics the solution ? If so, could you recommend a brand since my pick didn't do much ? Any tests I should do ?

Thank you for your time and wisdom :)


I usually eat two meals per day, one in the morning (7,8 AM) and one in the afternoon (2,3 PM). I have a 24 hour (from

breakfast to breakfast usually) fast once a week.

My breakfast consist of:

1 pound of frozen spinach (defrosted during the night and microwaved for 5 minutes)

2 ounces of onion
1 ounce of butter
3 ounces of mushrooms
4 ounces of squids
2 ounces of jerusalem artichokes
3 ounces of endive salat

1 spoon of coconut oil
1 spoon of palm oil

2 spoons of home made yoghurt (probiotics+raw milk)

I just throw it all in a pan with butter and later add the spinach :)

For lunch I usually eat
4 eggs
3 ounces of pumpkins
2 ounces of eggplant
1 ounce of butter
3 ounces of endive salat

1/2 pound meat (turkey, pork)
4 ounce of cauliflower
4 ounces of broccoli
1 ounce of brussels sprouts/1 ounce of eggplant
3 ounces of endive salat

I also eat two big plates of vegetable soup about four times a week.
I use onions, carrots, broccoli, cauliflower, leek and a three big spoons of sour cream.

Sometimes I also eat some canned tuna in water but rarely.

I get up at 6,7 AM with no alarm and go to bed at 9,10 PM. I sleep in a pretty dark room.

I have regular constipation and usually have to "push" the stool out. On the Bristol Chart ( mostly Type 1 or Type 2.

I don't use any topical medicine for acne. I just wash my face with water in the morning and during the shower in the evening.

Unknown said...

Part 2 (4096 characters at most :O)

In the morning with a spoon of macadamia oil during a meal:
- 2g of Omega 3 (min. 180 mg EPA, min, 120 mg DHA)
- 5000 UI of Vitamin D3 (as cholecalciferol - from Lanolin) in MCT ;

- 1 capsule of Vitamin K2 (as menaquinone-7 -100 mcg ; as menaquinone-4 1300 mcg) ;


In the late (4,5 PM) afternoon on an empty stomach:
- 50 mg Zinc (from zinc gluconate dihydrate, zinc picolinate)

Before bed:
- 2/3 capsule of Calcium Complete (250 mg of Calcium and 125 mg of Magnesium per capsule)

I've been taking
Omega 3 - months
Vitamin D - 1 month
Vitamin K2 - Month and a half
Zinc - 10 days
Calcium & Magnesium - One week

Tyler F said...

Dr Ayers,
Your reference to acne and prescribed antibiotics touched a number of us out here.

For the past two months I've been taking 200 mg a day of Doxycycline Hyclate for acne. I've stopped as of a couple of days ago after reading your post.

What kind of detrimental effect to my gut flora do you think I've incurred?

To echo others, thanks so much for your work and service.

David L said...

Dr Ayres, question for you. I recently took penicillin for strep throat. 4-5 days later I started waking after 6 hours sleep with sharp abdominal pain. The pain dissapears 30 minutes after getting up. It has persisted for two weeks now, but gradually gotten better. I find sleeping upright helps. There are no prior medical problems and I excercise regularly. If I damaged my gut bacteria, how long would I expect to return to normal? My diet is varied, but I believe the pain is worse after eating more dairy. Thee is no pain whatsoever during the day.

Thanks alot,

David L

Anonymous said...


I have a skin condition sometimes referred to as "acne inversa". I keep it in remission with diet. What's been working for me is very little grain although I do eat whole buckwheat. No gluten, plenty of fresh veg, especially leafy, olive oil and raw cheeses. I found a source of raw sheep's milk so I'm going to order some and try that. I noticed that your diet has a lot of foods that can cause intestinal upset if your gut flora is out of balance. I think you could use more variety as well. I would add raw, leafy, dark lettuces, fresh tomato and herbs. Drizzle any of that with olive oil, lemon juice if you want. I've been eating fresh tomatoes with crumbled raw goat cheese, basil and olive oil as a side dish or snack lately. And although I wouldn't recommend adding too many fruits, due to the high fructose content, fresh blueberries in small amounts are good. I snack on olives, nuts (although not peanuts), small amounts of yoghurt and any of the above I mentioned.

And what are you drinking? It's important to drink enough water. Tea is good as well, although I don't know about the different types because I don't like tea. And I take turmeric supplements as well.

These are just a few suggestions that seem to work for me.

Anonymous said...

Hi Dr. Ayers! Love your blog and I have been incorporating your suggestions into my diet.

I asked my doctor to measure my Vitamin D during my bloodwork, and I'm not sure how to interpret the results. Can you help me?

This is what the lab report said:
Tests: (10) Vit D/1/25 Hydroxy (16493E)


CALCITRIOL (1,25 DI-OH VIT D) 97.7 PG/ML (with a reference range of 10.0-75.0, so I am high)

Does this mean I should cut back my supplementation? Or do I need a different test, and if so is there some place you could recommend?

Thank you!

Unknown said...

"I noticed that your diet has a lot of foods that can cause intestinal upset if your gut flora is out of balance"

Which food would that be rainarana ? I drink only water and sometimes lemonade.

Also do you have any recommendations for sorting out the gut flora ?

lightcan said...

regarding the supps IMO the omega 3 is not enough and you just started the others. Also, you need testing for vit D status.
Constipation points towards damage to the gut flora (I'm referring to Dr. Ayers's ideas) so probiotics might help.
I can totally understand your situation as I still have acne (on and off) after almost 2 years low carb, no wheat, no veg oil and similar supplements. I am taking the fourth set of probiotics since January with FOS and inulin, calcium ascorbate in the morning a la Monastyrsky or 400 mg of Mg citrate for constipation (to avoid the compaction). I even have acne where I never had it before, on the side of my nose near the corner of my eye. I couldn't link it to anything in my diet as I don't consume big quantities of cheese, try to eat goats and sheep, never milk, sometimes live yoghurt and more often heavy cream.
I think I have some form of hormonal problem as I am a woman in my early 40s.
You might be luckier than me if you keep at the anti-inflammatory diet. Give it time.

Anonymous said...

Hey Keyser,

If you look at this list of foods for fructose malabsorption you will see that you are consuming many of the forbidden foods under vegetables. Now, that said, I have problems with fructose malabsorption myself but I don’t agree with just eliminating them and that’s that, as tends to be the recommended advice. Because my gut flora is out of balance, adding foods that stimulate them (or specific populations) can result in various symptoms. What Dr. Ayers recommended, and I’ve been doing, is eating a variety of foods, saturated fats (grass and naturally fed meats), avoiding processed foods, vegetable oils and excess sugar, no starches, a little bit of complex carbs, (berries, buckwheat, the occasional very small apple), raw dairy products (I like sheep and goat cheese especially) and fresh herbs. I’m fortunate enough to have room for a small garden so I’ve got a lot of lettuces and herbs that I can pick directly from there. I don’t wash them too thoroughly, just enough to get rid of the mud and grit as you want the natural bacteria from the plants. I haven’t really added much inulin yet but will start easing that in over the next couple of weeks.

It will be uncomfortable for a while. It’s been about a month now and my guts are settling down and my bowels seem to be working just fine. I was retaining a lot of water, bloating and having weird breakouts, under my arms, over my ears, etc . . . I found that taking activated charcoal helps with the gut symptoms and drinking fennel tea for water retention.

@Lightcan – I’m 43/F as well. I’ve found that supplemental probiotics and inulin are too much for me. There is definitely a hormonal link to acne and fructose/fructans in large quantities can be problematic. I prefer a dietary approach as I can control the amount that I eat much more easily. I see it a bit as a see-saw; harder to balance if you add large weights to either side than if you increment slowly. When I do eventually get things worked out I don’t plan on going back to eating much fruit or grains as the sugars do affect your metabolism which can be especially hard on women.

Anna said...


Your doctor ordered the wrong Vit D test. This isn't uncommon, but it underscores how little most doctors know about Vit D testing (that's improving, albeit slowly).

The 1,25 (OH)D test merely measures the "active" form of Vit D circulating in your blood, which is like viewing only the cash flow in a checking account to assess wealth. The active form is kept fairly constant by making withdrawals as needed from the "storage form of Vit D (primarily stored in the fat cells).

The proper test to order to check Vit D status is the 25 (OH)D (hydroxy) test. That test is like reviewing savings, investments, and other assets to assess wealth, not simply the cash flow in a checking account.


BTW, except in the state of NY (where the PTB seem to think that citizens can't be trusted with their own health), it is possible in most states to order your own lab tests (however, you may not be able to get your insurance to pay for it).

You can also participate in an international Vit D study and do finger prick blood spot test kit by mail for low cost via (conducted by University of California faculty).

Anna said...

I forgot to mention Blood draws possible nearly everywhere, including the numerous LabCorp sites.

Anonymous said...

Thank you so much for your help on my Vitamin D bloodtest question. Your analogy is fabulous and makes perfect sense!

I will just pay for the correct test.

I've got to tell you that since beginning Vitamin D supplementation, my mood has improved tremendously and consistently. It is really noticeable to me, and since I'm always experimenting with foods and supplements, I'm pretty sure it isn't the placebo effect because nothing else has caused me to be more cheery like this.

Dr. Art Ayers said...

Go ahead and cite my ideas and use summaries of my articles. Let me know about your writing by sending me a comment on your articles.

Dr. Art Ayers said...

I think that coconut and olive oils are used differently based on their composition. I think that both are useful, because they are relatively low in omega-6 fatty acids and higher in saturated and monounsaturated fatty acids. Coconut oil is more stable for cooking and olive oil is great for sprinkling on everything to add nutritious calories.

So, I like both.

Thanks for your comments/questions.

Dr. Art Ayers said...

I have been away and other thoughtful readers have already made most of the best comments. Overall, I think that your diet has been great, but it is impossible to have a normal, supportive gut flora and take antibiotics simultaneously.

As others have pointed out, rebuilding your gut flora takes persistence. In the mean time, you can expect some food intolerance. e.g. dairy, as a reflection of missing bacterial species. Start with probiotics and perhaps try lactulose in addition to the veggies with pectin and inulin, that you are already eating. As others have noted, I think the process can be helped along by not overly washing local organic veggies.

I would treat fructose intolerance/malabsorbance as separate from fructose containing polysaccharides. I think that several different sets of bacteria are involved. Fructose, sucrose and inulin are all processed differently, although fructose and sucrose can end up having the same impact on the liver. I would doubt that inulin sugars reach the liver.

Persist. I think that you are heading in the right direction, but the antibiotic use set you back.

Thanks for the detailed comments/questions.

Dr. Art Ayers said...

In most cases, taking antibiotics will disrupt gut flora and persistent use of antibiotics can eliminate large groups of bacteria that are needed for normal digestion and function of the immune system.

Food intolerance is an indication of lost bacterial diversity. Persistently eating a variety of vegetables will increase gut bacterial diversity. I think that it is also a disadvantage to use antimicrobial soaps and overemphasize washing of vegetables, since that eliminates the normal source of bacteria needed for health.

So, using antibiotics can ruin your gut flora, but persistent eating habits can return normal function.

Thanks for your comments/questions.

Tyler F said...

Dr. Ayers,
Thank you for your response.

In searching for information on Doxycycline I came across this article. Salts of tetracyclines

I was encouraged by this paragraph (13th paragraph under Background of Invention)
"Doxycycline is not metabolised in humans (Saivin 1988). It is mainly excreted in faeces and approximately 20% can be recovered in urine. The doxycycline excreted in faeces is probably bound in a way that makes it inactive, as the intestinal flora is not affected by doxycycline treatment (Cunha 1982)."

Could this be true regarding flora not being affected by doxycycline? Your post addressed to me said "in most cases". Could this be an instance of a situation outside of most cases?

The PubMet site for the Cunha 1982 article is

torunafter said...

Dr. Ayers,
I stumbled across this youtube video where I go uses his his vermicomposting bin as a source for getting bacteria (he easts a worm in the video).
Could this be a good source for good bacteria? For most people it's hard to find unwashed organic local veggies, so if you had your on vermicomposting bin in your backyard, you could compost all your food scraps and snack on some bacteria (worms), kill two birds with one stone!

torunafter said...

...Also, here's a link to a message board where Scott Wheeler, meat-eater in the video, describes more about his eating rotten meat and composting worms as a 'probiotic'.
(link found from youtube video above)
Very interesting. Could this be a good avenue for getting more bacteria? Should be loaded with microbes, after all the next step would be using the compost for gardening.

Anna said...


Glad my comment was helpful.

The two supplements I most notice marked benefits from are Vit D3 and magnesium; when I don't take them for a while I really miss them. I don't usually notice specific benefits from other supplements and vitamins that I can trace so specifically. It took high enough doses of Vit D & magnesium to see results, though.

Vit D definitely enhances my perception of well-being and mood, esp in winter, as well as improves endurance, strength, and balance (I esp notice this with our infrequent ski trips).

Magnesium keeps nighttime leg calf cramps at bay, as well as improves my overall sleeping patterns, plus is an excellent mild "regularity" agent.

Anonymous said...

I am new here, what suggestions do you have to treat h pylori other than anti biotics. I seem to have a chronic case of this.

Monika said...

Dear Dr.Ayers,

as someone who suffers from rosacea, I was wondering what you would advise to get tested in your blood(any deficiencies ..etc) ?

Thanks in advance


Unknown said...

First, thank you all for your comments. I really appreciate it :) And no problem about the timing, I was also busy with school lately so my replies might come in a little bit late.

lightcan: Yes :D That feeling that you've been good but still things don't change, will it ever, etc ... And the worst, like you pointed out, is getting new acne in new places while eating a whole lot better. Makes no sense :)

rainarana: Luckly I also have a garden with fresh muddy salad :D Guess I'll save a buck on two on water :)

Are you taking inulin as a supplement ? If so, what dosage ?

Dr. Art: I understand that being on antibiotics for almost three years has had some consequences and it would be unrealistic for me to expect a quick recovery.

I find that dairy use usually does not cause new acne but instead it heavely increases the amount of sebum although if I've been eating "bad" I also have acne occur within the nose.

From the lactose point of view I presume I'll have to restrict milk consumption but I can keep ghee and heavy cream perhaps even cheese.

I don't know if the antibiotics use also could cause dairy allergy since in that case casein and whey are not my friends ergo everything besides ghee and heavy cream (even that maybe :O) must go.

I'm getting the following supplements:

- Now Foods Gr8-Dophilus Probiotic Bacteria (8 Strains & 4 Billion Potency)
- Inulin (I was deciding either buying inulin or oligofructose but the latter seems to be sweet and I would like to break that addiction so inulin it was). Any insights on dosage ?

Also would glutamine be benificial in my situation ?

Be well and thank you,


Dr. Art Ayers said...

Tyler F,
Doxycycline is a potent antibiotic that will certainly disrupt normal gut flora. Whether or not it eradicates most of the bacteria is dependent on their sensitivity to that particular antibiotic. My impression is that antibiotics used to treat acne work by disrupting gut flora to reduce normal immune function and stop facial inflammation. The action of the antibiotic is not on facial bacteria, since those aren't the main problem anyway.

I hope that by changing your diet and building up your gut flora you can eliminate the acne.

Let me know how you do.

Dr. Art Ayers said...

I think that all of your conclusions about vermiculture and compost are probably correct and may provide a great answer to the need for additional gut bacteria.

I am just hesitant to recommend the use of these sources of bacteria on the off chance that someone will encounter a pathogen or have a compromised immune system and not be able to handle undomesticated bacteria.

Clearly, safe approaches for the restoration of healthy gut flora should be a medical priority, but there is no money to be made by simple answers that help millions of people improve their health.

Thanks for the input.

Dr. Art Ayers said...

I think that curing H. pylori is controversial. Some studies have shown that Hp actually improves immune function.

I think that the problem may come with Hp and some diets that result in Hp contributing in to ulcers and ultimately gastric cancer.

The current evidence says that the majority of people in the world are infected with Hp and some of these get Hp resulted diseases. Most don't show any symptoms and may benefit from infection.

I think that the traditional control of Hp is by herbs, spices and traditional whole foods. I suspect that problems with Hp result from refined foods, e.g. starch and sugar.

How do you know that you have an Hp infection? Do you already have some symptoms?

Dr. Art Ayers said...

I think that glutamine is usually a good idea as a supplement for people who have some symptoms of gut irritation. Glutamine is a nutrient used by the intestines and help the intestinal epithelial cells to heal.

Dr. Art Ayers said...

You should read the rest of my articles on rosacea (use the search function, upper left.)

Rosacea is a complex group of diseases that have many different developmental stages. The simpler forms can be treated with vit.D and an anti-inflammatory diet. The more complex forms involve dysfunctional gut flora, dysbiosis and frequently constipation. Those cases require a reconstitution of the gut flora. Many cases also involve other sources of inflammation, such as gum disease.

With this as a general background, I guess you could start with serum vit. D [25 (OH)D (hydroxy)], and a measure of general inflammation, hs-CRP. I don't think that most of these tests will tell you other than that you have obvious deficiencies or that you have inflammation, which the rosacea symptoms already indicate. The serum vit.D could be useful in following your progress to normalizing your serum vit.D to >80 ng/ml.

Maybe other readers can provide other suggestions.
Let me know how you progress.

Anonymous said...

2 quick questions if you have time....

i have probiotic capsules. they are in a casing. i have read about people opening them and adding them to liquids. would it work if i opened one and added it to coconut milk? would i still get the benefits?

also, when is the best time of the day to take probiotics, nonfood ones i mean?

are the benefits of kombucha way overated?? sounds from reading like some superfood but wanted an opinion

and lastly, i eat full fat FAGE like it is going out of style, and it seems to help tremendously with the weight i need to gain. is there a connection to dairy and weight gain? it seems the more dairy i have regardless of caloires the better i gain weight as opposed to something like chuck steaks and oxtails

Dr. Art Ayers said...

Hi Malpaz,
I think that the capsules for probiotics may help them reach the intestines. I wouldn't recommend opening them up.

I love the full fat Greek yogurts (especially with honey.) Unfortunately, the fructose in honey is probably not healthy, and as you indicated dairy is one of the most common ways that people mess up weightloss diets.

Dairy is optimized for weight gain for calves, and I have noticed that I will quickly gain a pound if I eat as much yogurt as I would like. It may be that dairy promotes probiotic gut flora that stimulate weight gain.

Thanks for your comments.

Aaron said...

I know I keep asking about this -- but do we know 100% that cal/mag supplements are going to fuel biofilms?

Most people I know who take the above 2 supplements seem to do just fine, most show benefits.

Dr. Art Ayers said...

I think that it is obvious that divalent cations such as calcium and magnesium will stabilize acidic polysaccharides like those present in biofilms.

But, biofilms are a natural and perhaps essential form of bacterial growth on surfaces of the gut. The point is that biofilms in general can be destabilized by chelators of the divalent cations. This would be useful for a one shot cleanse of problem bacteria and then develop a healthy gut flora.

Most of the treatments of gut flora that I recommend would be to replace and then help a healthy biofilm develop over time. The biofilm destabilizers are not for continuous use.

Thanks for your questions.

Dr. Art Ayers said...

I didn't answer all of your questions previously.

I don't know the answer to when probiotics would be most effective. Most of the probiotic species of bacteria grow near the junction of small and large intestines, where there is low oxygen, but not anaerobic as in the rest of the colon. I would imagine that rapid transit through the stomach and access to nutrients in the small intestines would be important.

Kombucha, I would expect, to be like many other plant products, i.e. it would provide both phytochemicals and fiber polysaccharides that interact with gut flora and the gut. I don't think that clinical studies show dramatic effects. As with all plant materials, moderation in use is probably the best advice.

Anonymous said...


I understand being busy with things, I'm under a mountain of work at the moment. Do you get much exercise? When my stress is high (currently) and my exercise level is low my symptoms tend to be a lot worse. Last month I took a five day holiday, spent time with friends, goofed off, and I felt great. As soon as I got home felt bad again. I don't fully understand the mind/gut relationship but it is there.

About inulin/fos, I found this page which pretty much sums up my experience with it. I've never taken supplements but used a gluten free flour once that contained it. I had such a violent reaction that I considered going to the ER until I figured out what happened. My advise, if you already have gut problems, is to go slow and carefully introduce natural sources such as tomatoes, leeks, garlic and onions, while at the same time slowly adding probiotics. And muddy greens, of course.

Dr. Art Ayers said...

Muddy greens indeed. Is that your phrase. I want to use it.

[The site that you reference talks about supplementing digestion with plant enzymes. I don't get that and put it in the same category as adding enzymes to soil. Enzymes are usually ineffective extracellularly unless used in massive amounts. That is why only the fungi or bacteria producing an enzyme tends to benefit. Human digestion by gut enzymes focuses only on a couple of enzymes that produce big fragments from molecular polymers, proteins/polysaccharides. Enzymes would not be efficient enough for complete digestion down to amino acids or sugars.]

Thanks for your input.

Steve said...

Dr Ayers,

What would be the best and safest approach to disrupting the gut flora/biofilms in order to 'start again' and repopulate it with a range of probiotic sources as discussed already.
I have been working with a patient with obvious long term gut flora disruption, long term diarrhea, malabsorption etc. that is not responding to gut healing protocols such as glutamine, gut herbs (slippery elm..) probiotics form commercial sources, eats onions, leafy greens, tomato.
Her diet is already grain/dairy/vege oil free, paleo style.
It first started after minor surgery 9 months ago for a uterine 'scrape' for fibroids, after a messy C-section scar 4 years ago.

Greatly appreciate the time put into getting this valuable info out to everyone who cares about theirs or others health.

Dr. Art Ayers said...

I think that most people should try to build up their gut flora before they try to strip away biofilms and start over, simply because they need a source of complex gut flora to start again, i.e. 150 different species of bacteria are needed for a healthy gut.

I think that your patients problem is a lack of bacteria and bowel irritation/inflammation. She is probably vit.D deficient, so test serum, supplement, retest to >70 ng/ml. Diet should be low carb, most calories from saturated fats. Plenty of veggies to supply plant fiber polysaccharides, pectin/inulin. Probiotics fed by dairy products and test to see if lactulose helps with the bowel irritation and enhances normal stool formation. Encourage her to use local veggies and not to overwash them, because she needs a source of new bacteria.

She should be aware that developing a new functional gut flora will require some bowel discomfort and persistence in continuing to eat diverse veggies even if they don't agree with her initially.

I think that it is good for her to avoid grains and starch/sugar/fructose, etc., but I think that she might benefit from dairy and its support for probiotic bacteria.

Fish oil might help, after she has increased her saturated fat intake.

You can use the search function (upper left) to look up my articles on stripping biofilms, but I would only recommend that approach after some gut flora has developed.

Let me know how this works.

Martin E said...

I found something called the GAPS diet the other day. GAPS is an acronym for Gut And Psychology Syndrome. When I read about it I came to think of your diet recommendations.

Jamison said...

Sorry Doc, this isn't quite applicable to your current article but I'd really like to hear your thoughts

While exploring my medical curriculum on degenerative neurological disorders, I stumbled across a thought, and my third parent Google did not have a good answer.

We all know there's a strong correlation between chronic illness and depression, and it makes sense. If I was sick all the time I wouldn't feel to happy myself. However, I'm curious about the connection of depression and our immune system in regards to auto-immune disease.

Although I have read it can exacerbate specific types of inflammation, to my knowledge, idiopathic major depression has been shown to cause impairment of your bodies immune function.

Its safe to assume that inflammation is essential in protecting our bodies in the case of external harm, but as you put so flawlessly its also true that it is the foundation for many a cancer and degenerative/autoimmune diseases.

So in the case of auto-immune disease, one of the core principals of treatment varies between suppression of all or some parts of your immune system. So here comes my though: It sounds to me like depression could function as a part our brains efforts to return to homeostasis, by inhibiting an over-active or out-of-control immune system.

In this way of thinking, something subjective like idiopathic depression could be treated as the reciprocal to something objective like a fever. (Which we know to be beneficial in most cases, but also maladaptive if it gets out of hand.)

I guess this also leads to questioning if anti-depressant treatments might be unintentionally silencing a first-response-alert from your brain? (That'd be one way to explain why rates of some auto-immune disease are increasing in the US very loosely along with anti-depressant use)

Whoops! I'm going way off track... Lets paraphrase.

-Could depression be a innate (autonomic..?) response to help regulate your immune system?

(As opposed to being a conscious result of a diseases negative/painful sensory symptoms. The chicken or the egg ect ect.)

Is this a relatively novel thought or am I completely reinventing the wheel?

-Jamison Daline, Nursing Student

Dr. Art Ayers said...

I think that it is always a good starting point to assume that a bodily response makes sense from an evolutionarily adaptive perspective.

Depression causes an increase in inflammatory cytokines and inflammatory increases in cytokines causes depression. One of the reasons that anti-depressants have been found to be ineffective for mild depression (caused by chronic inflammation?) is that the anti-depressants don't alter the ongoing inflammation. Whereas anti-inflammatory agents, such as NSAIDS are effective in treating some forms of depression.

Depression as a treatment for auto-immunity? I think that the auto-immunity is causing depression via its inflammatory component. I doubt that depression dampens inflammation and I don't think that it improves immunological tolerance. I also don't think that depression improves the health of gut flora that are probably the basis for the defects in the gut-associated immune system that are causing the autoimmunity.

I encourage you to continue to try to make evolutionary sense of physiology, but in this case, I don't see the adaptive advantage of depression in response to an autoimmune disease.

Thanks for your thoughts.

Dr. Art Ayers said...

It is certainly not surprising that the diet that I recommend has components that have been found empirically to benefit body and mind. I just try to make sense of the biomedical literature. Unfortunately many of the recommendations of the medical community are not consistent with science or biomedical research. Many of the current medical recommendations are silly and unhealthy, unfortunately they support a very healthy pharmaceutical industry.

The GAPS concept and diet is based on a mix of common sense, medical observations and a few older misconceptions. There are only a few places that I disagree, but much of that is over details. I agree with much of the broad sweep of diet, gut flora and health.

Anonymous said...

Dr. Ayers

This is all very facinating. I've been googling information on the vagus nerve. I see you reference it quite a bit and talk about vagus maneuvers. Is there a post where you write specifically about them. I've been having spasms just below my sternum, I know it's stress, and headaches which look like they're related to the vagus nerve. While I've been doing what I can to alleviate the stress, some of it just can't be avoided just yet. Exercise and lifestyle/diet changes help, but would vagus maneuvers be helpful for specific symptoms?

As for the depression-gut angle, too much fructose makes me particularly weepy and emotional. When I eliminated gluten I changed into an almost completely different person. I thought it was the inflammtion affecting the seratonin in my gut which affected my mood. Could it be the other way around? Or simultaneous?

Anonymous said...

Dr. Ayers,
I have some questions on fructose and Fructose Malabsorption (not Fructose Intolerance).

It seems I have a lot of problems with fructose, problems I have always ascribed to IBS.

Half a banana gives me terrible gas, flatulence and loose stools.

Probably I'm not alone in that, 30-40% of the population of Central Europe suffers from it, with about half of the affected individuals exhibiting symptoms.

30-40% of the population of Central Europe? To me this is an huge number...

The problem also concerns Fructans, so onions and similar are forbidden in this situation (the same for bread and wheat products).

Another interesting point is the tryptophan/serotonin/melatonin connection.

Fructose binds to tryptophan rendering it inabsorbable.

So... no tryptophan, low serotonin (depression), low melatonin (insomnia).

Please have a look here:

Uhm... maybe FOS/Inulin is not a good idea with this condition.

Don't know about adding other probiotics into the mix.
Probably not a good idea too.

What's your opinion on this?

Does an apple a day still keep the doctor away?


Dr. Art Ayers said...

Vagus nerve stimulation can be very effective in reducing stress and associated inflammation. I discussed that:

and Nigel provided some appropriate links in his comments.

Let me know if those Vagal stimulation exercises help you.

Dr. Art Ayers said...

I think that the data on fructose malabsorption are weak. I think that it is all a matter of gut flora and is similar to lactose intolerance.

I think that the binding of tryptophan and fructose is interesting, but is not involved in fructose malabsorption. The binding of these two molecules could not possibly be strong enough to cause major neurological consequences. Action of fructose on protein/receptor active sites containing tryptophan is a different matter and is very interesting.

It also seems silly to me to relate dietary fructose with dietary fructans. It is like considering glucose and cellulose as the same. I think that they are metabolized by two different sets of bacteria and should be considered independently.

I think that all of the problems of digestion of fructose and fructans can be eliminated by appropriate inclusion of these carbs in diets and gradually changing gut flora. Without these adjustments there can be dramatic symptoms transmitted through gut/gut flora interactions.

I need to write something about dietary carbs affecting the gut, e.g. human milk oligosaccharides.

Anonymous said...

Hi Dr. Ayers and thanks for your answer.

I'm sorry, but there’s something I couldn’t understand in your reply.

I’ve always thought bacteria doesn’t help with fructose digestion because the problem is not the absence of certain kind of bacteria digesting fructose, but the PRESENCE of bacteria fermenting undigested material in the colon (for example fructose).

I knew that fructose is not metabolized by bacteria unless it reachs the colon undigested.

So why do you say the problem is lack of bacteria or enzymes for proper fructose digestion (like lactose)?

I have the same problem of this guy.

When I eat half a ripe banana (40 grams.) in my two protein shakes I have problems (very loose stools, bloating, flatulence).
My protein contains no lactose and are sweetened by stevia.

I have rid myself of this banana, a couple of tomatoes and a little piece of rye bread I ate in the morning with butter, and loose stools suddenly disappear turning into rabbit stools (sorry for these details...).

I have done blood tests for celiachia and I’m negative, so the problem probably isn’t this piece of rye bread.


Dr. Art Ayers said...

What you are describing is dysbiosis or lack of colon bacteria. The diarrhea and rabbit pellets that you describe is constipation, the absence of sufficient bacteria to produce a normal, hydrated stool. Diarrhea is not the opposite of consipation, but rather irritation of the bowel that sloughs off the outer layers of the intestines and dumps in serum to flush out the irritant. Some laxatives work by causing this type of irritation and flushing.

Bowel discomfort in response to food results from an imbalance in the gut bacterial community (>100 different species) so that the products of a minor group of species are not consumed by missing species and the products irritate the intestines.

Recent studies confirm that less than 20% of food allergies are actually immune responses. Most food "allergies" and intolerances, including lactose and fructose, are due to a lack of appropriate gut flora.

Fructose can be absorbed by the small intestines and or by bacteria at the end of the small intestines. Fructans, such as inulin, will not be absorbed. Fructose that reaches the large intestines can be used as food by numerous species of gut bacteria. If all of the appropriate bacteria are present, it doesn't matter how much fructose is eaten, there will be no discomfort. If the gut flora has been wiped out by antibiotics or eating a diet of processed foods with very few different sugars and polysaccharides, then eating other sugars, such as fructose, will result in the sugar just passing through into the stool, or being converted into products that irritate the bowel.

Bowel discomfort after eating fructose is not a result of fructose just reaching the colon, but fructose reaching the colon and not being fully digested by gut bacteria. The presence of a simplified, inadequate gut flora is confirmed by constipation.

Constipation as an indication of a simplified gut flora also points to an increased risk of allergies and autoimmune diseases, because the gut-associated immune system requires diverse gut bacteria to function and produce immune tolerance.

Please check my other numerous articles on related subjects. You needed to build up your gut flora to be healthy and just avoiding triggering foods is more of a problem than an answer.

Persist in asking questions if this still isn't clear. Let me know how you do.

Anonymous said...

Thank you Dr. Ayers, I appreciate a lot your help, you’re a very special person.

Basically I’m on a low carb, I wouldn’t like to irritate my gut ingesting a lot of fiber or damage my liver with large amounts of fructose.

I don’t eat starch, apart from that slice of rye bread, which however isn’t a good idea.
Gluten doesn’t seem a good idea to me, even for non-celiacs.

Consequently I aim for a low-carb diet where the bulk of my calories comes from fat (cream, cheese, butter, lard or extra-virgin olive oil which I produce for my needs in Central Italy).

My diet is almost 2000 calories, 60% of the calories comes from fat, 30% from protein, 10% from carbs.

As do weightlifting (Slow Burn) twice a week I eat two protein shakes/day (25 grams of protein, an egg, 50 grams of cream and 3 grams of leucine).

Getting 40/50 grams of carbs a day without fruit or starch is a very hard job.

I had an idea: half a ripe banana (simple sugars instead of starch) in each protein shake.

But the consequences are those I’ve told you in my previous message: rotten gut.

I’ve always eaten tomatoes without apparent consequences, ripe bananas must have something special in upsetting my bowel. Yet tomatoes contain fructose too.


Dr. Art Ayers said...

I didn't want to give the false impression that fiber is irritating or that fructans, such as inulin are digested to fuctose that reaches the liver. I think that both of these ideas are false.

Most of the plant cell wall and storage polysaccharides, e.g. pectin and inulin, are completely degraded to short chain fatty acids that are partially used to feed the colon. Bacteria in the gut do all of the digesting and if those bacteria are missing, the fiber will pass on through. Fiber feeds gut flora and the result is the bacteria that make up the bulk of normal stools. Note that fructans are converted to fatty acids, not free fructose, so inulin does not result in fructose that could reach the liver.

Green leafy vegetables are needed for a healthy gut flora and immune system. They are not irritating unless the gut flora is compromised.

Good luck.

Anonymous said...

Dr. Ayers,
The impression that fiber is irritant or sort of dangerous doesn’t come from you, but from Dr. Michael Eades, Peter from Hyperlipid, Dr. Barry Groves and Konstantin Monastyrsky.

Dr. Jan Kwasniewski states in his book “Optimal Nutrition”:
“I consider fiber to be, rightly, an ingredient that is indigestible and therefore inedible by humans and unnecessary in our diet”.

Cassandra said...

Dr. Ayers -- you may have already seen this info regarding studies about the role bacteria in the digestive tract may play in obesity, but just in case, here is the link:

Dr. Art Ayers said...

I am familiar with all of your sources and in most cases the health problems discussed are associated with bran from grain. I have tried, apparently unsuccessfully, to indicate that grain-based foods are to be avoided and the fiber that I am advocating are polysaccharides that are degraded in the colon by a healthy gut flora. Examples are veggies containing pectin and inulin. Most of this fiber would be called soluble fiber.

The fiber that I am recommending is polysaccharides that cannot be digested by human enzymes, but which is digestible by adapted colon gut flora. That does not include bran.

Adaptation is important, because the fiber-digesting bacteria will not be present unless the fiber is routinely eaten. That is why those who restrict their diets have bowel discomfort when they eat new foods, e.g. those who eat only meat and then eat Jerusalem artichokes. More than 100 different species of bacteria and the veggies needed to support that diversity are required for a healthy gut flora.

Note also that my goal is to encourage a fully functional gut flora that avoids constipation and permits the development of a competent immune system. I speculate that a diet lacking adequately diverse vegetable-based polysaccharides will not develop a healthy gut-based immune system. That deficiency would be expected to lead to enhanced allergies and autoimmune disease.

Thus, I recommend a diet with most calories from saturated fats consisting of meat/fish/eggs/dairy plus diverse veggies/herbs/spices.

I think that the diet that I recommend is consistent with what most of your sources would suggest. That is what Konstantin Monastyrsky recommends to repair constipation. I have merely made the point that adapting the gut flora to diverse soluble fiber is important for health of the immune system.

I hope that this clarifies my position on dietary fiber.

Thank you for making your points. I appreciate your help.

Dr. Art Ayers said...

Thanks for the headsup on the recent presentation of data that shows that obese people have bacteria that are better adapted to converting the particular polysaccharides/fiber that they eat into short chain fatty acids that are converted into fat.

It would appear that people who eat more diverse sources of fiber (or don't eat a high carb diet) do not convert the extra vegetable material as efficiently into fat.

Thanks for the comment.

Jamison said...

Hello Doctor, its me again. A couple hours before the time of this posting a big black spider fell on my head. Hence why I'm still awake.

Anyway, I've got more questions/eccentric ideas to pester you with. I'm reviewing for my final exam which includes all the major endocrine disorders, most notably Diabetes. And then I got off track. Heh.

I've taken some interest with Fructose. Which is to say I've taken offense with it. As you know, chronic spiking of our blood glucose levels seem to dispose us to Insulin resistance, obesity, ect ect.

And now we know that Fructose is even worse than its partner glucose for insulin resistance and fat storage(oddly despite its low glycemic index compared to glucose). From what I understand this is partly related how its absorbed and to the fact that its only metabolized into glycogen in the liver ect ect.

(Despite the effects of fructose, I guess I'm not exclusively concerned with High fructose corn syrup 45/55, when contrasted with Sucrose which as you know is 50/50.)

Basically too much simple glucose is bad, but too much glucose and fructose is even worse.

I would say we should abolish sucrose along with HFCS, but that leaves us with pure glucose as a sweetener, which isn't as sweet as fructose and it'd be skipping hydrolysis just like it does when present in HFCS, raising its GI.

But what about completely replacing sucrose with a more friendly disaccharide? Apples and pears naturally have more fructose, yet sucrose is somehow our "gold standard" for what constitutes "table sugar." And as a gold standard, its doing a really crappy job.

My first thought was "Eureka! Maltose!" Nothing but safely bonded glucose, owing my knowledge to fathers hobby of home brewed beer. But I looked up maltose and found that for reasons beyond my comprehension its worse on your blood sugar that glucose! Which then led me to another isomer, Trehalose.

Although this 2xglucose disaccharide depends on different enzymes to hydrolyze than maltose/sucrose, it appears to me like a good replacement for sucrose/fructose in the context of the anti-inflammatory diet.

I should note that it does lack the sweetness of sucrose. I believe this could be balanced by finding its right mix with inert glycosides like rebaudioside A from the stevia plant.

In this way, the trehalose would function as component with a low glycemic index, and then I would also suggest the addition of maltose to act as the glucose component with a high index.

Here's the idea: Find the ideal mix of trehalose/maltose/stevioside/reb-A to create the closest possible doppelganger to sucrose's sweetness/behavior, without the deadly cost of fructose metabolism.

(But not used to excess of course, adhering to the original A.I. diet's concept for restricted simple carbohydrates.)

And if it were possible, the best option from that point would be to formulate another mix to reduce the total glucose(maltose/trehalose) to as little as possible, with only enough present to keep your metabolism afloat from mild keto-acidosis.

Do I sound crazy yet? I think so. Anyway, please let me know what your thoughts are.

Best regards,
-Jamison Daline

Dr. Art Ayers said...

Some responses:

Insulin resistance results from superoxide production in response to intracellular glucose overload -- it protects cells.

Frutose is metabolized in the liver and causes the same damage as ethanol.

I don't think that the ratio of glucose to fructose matters and is only approx. equal to make HFCS look like sucrose, so it can be claimed that it is the same as sucrose. That is true, they are equally unhealthy.

Candidates for safer carb sweeteners could be maltose, trehalose or even lactose, but I think the point is that they are unnecessary. The carb sweeteners are predominately craved, because we have too much carb in our diets and we use too much insulin. The net result is plummeting blood sugar and carb lust. Take out the grains, starch and sugar, replace them with saturated fat and the craving for carbs disappears. Most people adjust in less than a month without carbs. We just have the wrong food and food advertising.

Thanks for the thoughts.

crapartist said...

Dr. Ayers,

I can't understand why my rosacea gets worse when i follow the anti-inflammation diet, yet when i cut out salmon, turkey, chicken (all organic freshwater of course) and eat rice protein powder and some rice cakes, about 80% vegetables (no sugar, dairy, wheat, gluten ever)-- my skin calms down. thought it was the "die off" reaction (also eat coconut oil and break out) but after months--just seems something else is going on. take high quality probiotics (used antibiotics for 8 months only) along with Vit D, C, etc. had perfect skin for 33 years before the rosacea hit. stellar immune system/health too. I just don't get it. and the doctors have been useless at best. now seeing a naturopth, getting tests. any ideas why?

Dr. Art Ayers said...

You are describing the symptoms of what I call the paradoxical form of rosacea, that seems to respond to anti-inflammatory treatments with unexpected inflammation.

I am currently leaning toward explaining some of these cases as a response to yeast infections, intestinal candidiasis, following antibiotic treatment. The yeast thrives under conditions that suppress inflammation, since local inflammation is effective in controlling yeast. Yeast also utilizes high carb diets.

I would expect that you also suffer from constipation, as a result of your reduced gut flora.

Let me know if this makes sense.

Unknown said...

rainarana: I don't get much exercise, just walking I guess.

I want to try high intensity training but I'm afraid on it's effect on IGF-1 and the potencial effect of that on acne.

Dr. Art Ayers: I have started taking inulin and the above mentioned probiotics so I guess the process of rebuilding has started.

Are there any timelines for this. I was thinking that a month of inulin/probiotics should produce some visible results whether it be in skin condition or deconstipation/stool type ?

Dr. Art Ayers said...

It sounds like you have a good start.

I think that results may vary depending on your starting point. Starting from dysbiosis, as indicated by constipation, then much of the gut flora or at least colon anaerobes may be absent. The microaerobic types near the junction of the small and large intestine may still be present, but these, I think are the most important for normal function of the immune system. Since immune system disfunction is a likely culprit in your health issues, then probiotics and lactic acid fermentation would seem to be another good initial focus.

As you indicate, vegetable rich in inulin and pectin would be a good way to support the rest of your gut flora.

Let me know of your successes and problems as you go ahead.

Anonymous said...

Hey Keyser,

I've been sick for the last week, a cold in combination with allergies, the end result being bronchitis. Fun. I don't really know too much about high intensity exercise, but I walk (with the exception of this past week) quite a bit, most days between 30-90 minutes, and it works really well for stress, is good for digestion and helps my concentration as well.

As for constipation, mine has improved tremendously eating raw cheeses, drinking raw sheep's milk and eating yoghurt, although I had to cut back on the yoghurt as I like it a little too much . . . And lots of greens as well. It took about two weeks to see a big difference, at first bordering on diarrhea and particularly smelly, then after about a month better consistency and more volume. I've been reintroducing some veg that had given me a problem in the past, asparagus, zucchini, etc . . . and eating very small apples once or twice a week. Guts are a bit displeased but nothing like before so I'm sticking it out at the moment.

Anonymous said...

Hello Art...Saw this article Good Read.

Dr. Art Ayers said...

Thanks for the minireview on control of the development of gut proinflammatory T helper 17 (Th17) cells by gut bacteria. I wrote about another paper on the subject (see IL-17 in the index.) The review discusses the origins of the research on earlier studies of germ-free mice that were observed to have immunological defects, until their gut flora was restored. The defect included a deficiency in the production of IL-17.

Keyser said...

rainarana: I hope you are doing better. I understand that spring and summer can be quite difficult for people with allergies. But hey as long you can, at least for a second, think about it as "fun", you're good ;)

I used to walk daily, just to clear my mind and stretch but I have become a little bit lazy lately ;). I think I'll take your advice and restart my forest route, just for the kicks.

Constipation has gotten better. I blame probiotics and well probiotics, hehe.

Dr. Art: Could there be a possibility that inulin is somehow connected to acne outbursts ? I started taking it and after three days my face kind of light up, new acne all over the place.

I've done a few experiments and I'm almost certain that the degree of acne and the amount of diary products are somehow related.

Another funny thing that I've noticed is that every time when I eat a lot of dairy products I have gas. A lot of it. If I don't eat dairy thought, I'm gasless. Any thoughts ? Can that be a sign of lactose/casein intolerance/allergy ?

I'm at day one of a 30 (I hope) day dairyless period, which should clear the acne/diary connection once and for all.

All be well,


Dr. Art Ayers said...

It seems that you have established a connection between acne outbreaks and eating inulin or dairy. The dairy is also associated with gas/bloating.

This suggests that as expected your gut flora will require some adapting. The milk intolerance is the easiest to solve, since it is just a matter of putting up with small amounts of yogurt to feed your probiotics. One indication that the probiotics are working is a reduction in symptoms with dairy products.

If you have intestinal yeast, which is common after taking antibiotics, then whey may not be easy to take, because it attacks yeast. I suspect that intestinal yeast, candidiasis, may be the basis for why people respond paradoxically to a lot of inflammatory nutritional supplements. How do you respond to fish oil. What about your serum vit.D?

Your intolerance of inulin should be expected until you develop the gut flora to digest it. You will need to persist and go gradually.

Unfortunately, I have never found that avoiding triggering foods solves any intolerance/gut flora problem. It merely contributes to a crippled gut flora, that becomes progressively more simple and less functional. So, just avoiding dairy will probably have no permanent impact on your acne.

Thanks for the update and questions.

Anonymous said...

Hey Keyser, yes feeling better, although busy, busy, trying to get it together to move back to the states.

To add to what Dr. Ayers said, when I first started changing my gut flora I would have outbreaks of acne, weird rashes, etc . . . There were a couple of points where I questioned the wisdom of what I was doing, but persisted, and am doing remarkably better now. It took about six weeks of (sometimes not too) careful adding of probiotic dairy-yoghurt, raw milk and cheeses, before the reactions stopped. From my experience the outbreaks aren’t necessarily a reaction to the inulin or probiotics, per se, but rather a symptom of bacteria dying off. I found that taking activated charcoal helped manage this until the reactions subsided. In the beginning I focused on adding probiotics/raw dairy, so not to overwhelm my system. After that I added more inulin and cruciferous veg and am expanding on that. This, in addition to eliminating vegetable oils, adding more saturated fats and eating grass/naturally fed meat and eggs has made a big difference. To illustrate, last week I decided to treat myself to some gluten free ice cream cones. Big mistake. Burning pain in my ankles, wrists and knees was back. And another odd thing, I have tattoos, and when my diet is off I get swelling and itching, mostly in the newest one. But after about two days back on track it was gone. Even more remarkable, this is the first month ever that I don’t have cramps. At all. Previously I would need large quantities of pain killers, but no, none. I also got my blood work back, finally, and am deficient 59 nmol/l, so I’ve been supplementing D as well as taking omega 3. So yes, it absolutely does work, but you have to work through the discomfort for awhile.

Anonymous said...

Dr Art, this one's for you!

Going mainstream:,0,1586624.story

Dr. Art Ayers said...

Hi Rainarana,
You are certainly getting some benefits for your hard work on improving your health! You are definitely a success story.

It takes a lot of strength, more than most people have, to makes the changes that you have. In many cases, you have had to tolerate a lot of discomfort and trust yourself. It is good that you are getting some rewards now.

Congrats and thanks for your continuing input to help others.

Dr. Art Ayers said...

Thanks for the LA Times article. Gut flora seem to be finally news worthy. It is interesting that the goals are now to develop expensive proprietary strains of bacteria to be administered by MDs to help people overcome their maladies. The other alternative would be free diet advice and changing unhealthy national diet recommendations.

Keyser said...

Dr :)

I'm presume I'm doing OK with fish oil. I don't recall any symptoms associated with it, although the dose is take is quite small, about 540gm of EPA and 360 mg of DHA. Any special signs I should be aware of ?

I'm planning of taking a vit D test in 14 days or so but I supplement with 5000 UI for now.

Actually, the day before the inulin breakout occured, I just upped my dose of inulin going from 8g to 15g so it might just be that the dosage was simply above my threshold and therefore acne appeared. I shall restarted taking inulin about 5g/day and increasing it graduatelly 2g per week.

Yeah you have a good point. Avoidance doesn't mean that something is OK, 'cause you still have to run from it.

Avoiding excess diary reduces my acne but only to a limit so I presume you are correct that the impact may only be recognizable in day to day basis but overall I would still be "broken", diary or no diary.

Can I start with drinking Kefir or does it have to be (Greek) yoghurt ? I presume both are OK since they are "alive" but just to be sure :) Also what should be the starting dosage? I realize that this vastly varies from invidual to invidual but just a rough estimation would be great. I'm thinking something along the lines of 100g or so.

As rainana mentioned Activated charcoal I'm wondering could it help and more importantly can it hurt me in any way ? Excessive usage over long period or something. I got fucked over with antibiotics, so I got to ask :)

rainana: A real world traveler, hehe. Where you currently at ?

I'm wondering, about your six week plan, what were the dosage of various dairy products that you consumed and how did you scale them overtime ?

I know this might sounds weird but it would be really helpful to have some sort of orientation what were your starting amounts and how did they change over time :)

Activated charcoal you say ? Interestingly one day during my dairy craze, eating everything from cheese, cottage cheese and milk, I took some active charcoal and I haven't got any symptoms which usually occured with excessive dairy consumption. Did you took it daily or ? For how long ?

And just to be clear homemade icecream >>>>>>>> googolplex of cones :D

I'm so glad that things are getting better for you. Be emazing, be joy :)

Thank you both for you help, you can't imagine how much this means to me.


Dr. Art Ayers said...

If you can tolerate a small amount of fish oil, then you should be able to increase your dose (in the absence of vegetable oil in your diet, and adequate saturated fats for absorption) until you suppress the inflammation that produces acne breakouts with various foods. This would be useful to help your gut flora adapt to new foods.

I don't think that it matters which fermented dairy products that you use to adapt to dairy. The more variety in probiotics the better. I would think that even 25 g would be useful as a start, if it produced no acne symptoms.

Activated charcoal is supposed to work by trapping small organic molecules in the matrix of carbon. I have no idea why it would help to reduce inflammation when eating dairy. The charcoal should just pass on out and it should not act like antibiotics. It will probably alter gut flora, but I would not know what to predict.

It is a pleasure to provide help and hearing that my info and ideas can be of benefit is very rewarding. Let us know what works.

Anonymous said...

Hey Keyser, I’ve gotten the most help from blogs and message boards so I’m more than happy to return the favor.

I’m in the Netherlands, been here ten years, but am really homesick and miss a lot of things I don’t have access to here. I’m moving to Nashville which has a fantastic local food scene which I’m really excited about.

I don’t really do “dosages” and everyone would be different I imagine, depending on which gut bugs you were dealing with and your size. What I did was to start with a small amount, a tablespoon or two of yoghurt for instance, check my reaction then increase the amount slowly until I reacted. I love yoghurt and cheese so it didn’t take long before I reacted, unfortunately, then would have to scale back again. Also, I try not to eat too much at once, a few spoonfuls of yoghurt over blueberries with breakfast, a little bit of cheese with lunch, a small glass of raw milk with dinner, and so on. And wanting some kind of orientation doesn’t sound weird at all, it is confusing and there’s a lot of conflicting information out there. I’ve actually been trying to put together a list of things that work for me for a fructose malabsorption group I read, as I don’t think FM is a permanent situation, it’s just that fixing it can be difficult and take a long time so people get frustrated. That plus fixing gut flora is a rather new idea that most doctors have no idea about so they just tell you not to eat the foods that bother you.

As for the activated charcoal, I gleaned that idea from reading about herxheimer reactions in people who have lyme disease. Charcoal absorbs toxins and when bacteria dies you get toxins. Seems to help, although whether that’s what’s happening or it’s just a placebo, I don’t know. Interestingly, I’ve read about it in veterinary journals, specifically when horses overload on carbs and end up with laminitis. Why human doctors haven’t figured out the gut/carb connection is beyond me.

The bottle I bought says I can take up to 27 tablets a day for a few days in a row. I don’t take nearly that much, and generally only for a few days in a row, usually with or soon after eating something that bothers me. Warning though, if you haven’t noticed it yet, it will turn your feces black.

Anonymous said...

Bentonite clay may be another alternative for intestinal cleansing and absorbing toxins. Sounds like it can be used longer term and possibly has a greater affinity for heavy metals than activated charcoal, while still absorbing bacteria, toxins and other pathogens.

One site to read about these are at:

Or check out the Intestinal Forumla #2 at: (3/4 or more down the page)

Curious what Dr. Ayers thinks of these approaches for cleaning up the gut as one embarks on a journey of rebuilding a healthy intestinal environment.

Dr. Art Ayers said...

I enjoy your attitude toward dietary change.

The observation on horse laminitis is very informative. I like the links between high carbs/colic and inflammation/leaky gut and LPS/endotoxin release and connective tissue disease/laminitis. The inflammation and connective tissue/glycosylaminoglycan disruption is one that is very common, e.g. heparan sulfate loss from kidneys leading to proteinuria in preeclampsia.

Thanks for the entertaining input.

Dr. Art Ayers said...

Clays have very chemically active surfaces and may destabilize biofilms by adsorbing ions.

I have no idea what toxins are, except for the bacterial proteins, polysaccharides and lipids that have specific receptors on human cells. I would not expect most of these to have particular affinities for activated charcoal or clay. Besides, I wouldn't expect bacterial components that leach off the bacteria and bind to charcoal or clay, to have an impact on gut cells. I would expect most of the impact from bacteria in biofilms or attached to the intestines, not out where the charcoal or clay particles stay.

So, what is it that is moving from the bacteria to the charcoal/clay, it could be signal molecules from the bacteria, which are involved in biofilm formation/quorum sensing. Perhaps the charcoal is disrupting quorum sensing and thereby changing biofilms.

I remain puzzled.

Keyser said...


I have been "over supplementing" with various dairy products (cheese, ricotta, mascarpone, heavy cream, yoghurt, kefir) over the last 14 days and despite the new appearance of acne, their form is much less severe in terms of quantity.

I still believe that part of my acne is connected with large quantities of dairy and truth be told when you eat 1/2 pound of mascarpone, pound of ricotta and 1/2 of cheese and of course a cup or two (250-500ml) of cream, skin issues can be a viable option :) But like I said before, if I would have eaten this much dairy a month ago I would be full of acne but last week only about five-seven whiteheads occurred.

For this month I was thinking about a new experiment, which will be lower in dairy and higher in fish oil.

10 caps of fish oil (180 EPA/120 DHA)
25 g of kefir
25 g of yoghurt
25 g of cheese (probably not needed, maybe just for variety)
5g of inulin

I would up the dairy content for each product for 25 g every week (25-50-75-100) and 1 gram increase in inulin.
Any comments on that ?

I believe I will stay with 10 caps of fish oil for atleast 14 days.

Anyway again I really really appreciate your insights so if you're ever in Central Europe let me know :)

rainarana: A year back I would smother you with various druggie question about the drug scene in Netherlands but hey, we paleo now :D

The biggest problem I face is the psychological aspect. It starts with a spoon of yoghurt and I'm like "OK, just one more" and after I have six I start thinking "Well you have eaten six, better finish it all and go low tomorrow". Of course tomorrow never comes, hehe. At least not in a "Really just ONE spoon" type of way :)

I've hit a wall with doctors. "I will go away", "Here take some pills", "New research show that food is not connected with acne", ... The last one actually made me wonder why even bother.

I guess it all boils down to being Columbus and exploring our bodies, food by food.

Your story gives me strength to proceed and reinforces hope that things will work out.

The only association that I have with Nashville is country, so, ride on cowboy, ride on ? ;)

The man with the worst response time EVAH ;)


Dr. Art Ayers said...

I think that your dairy diet would max out the gut flora in the upper GI and starve out the rest. I think that your more moderate dairy consumption with diverse veggies should be better for a more balanced gut flora and therefore a more balanced immune system.

It sounds like you are on the right track. Let me know about the outcome of the rest of your experiments.

Keyser said...


I shall stick with kefir/yoghurt only then.

I have found an interesting observation in the last days. I have been taking 5g of inulin and after two days, the amount of sebum and the number of have increased for a factor of 1,5-2.

I shall lower it to 3g and report again.

Am I having inulin intolerance ?

Dr. Art Ayers said...

It may just be that processed inulin is pushing your gut flora too far too fast. I think that less would be better and leeks might be preferable to straight inulin.

It is interesting that your body still reacts to food intolerance (poor gut flora adaptation) by acne symptoms. I still wonder about the signal from gut to face that is triggering the acne. Is it LPS from the gut? or inflammatory cytokines?

I think that by pursuing all aspects of the anti-inflammatory diet and building a healthy gut flora, the acne response should be eliminated.

Keep me posted.

Dr. Art Ayers said...

What about your serum vit.D level?

Keyser said...

Hello again Doc :)

Hm, any explanations why processed inulin would effect me differently ? I'll turn to leeks, onions and jerusalem artichokes. Since j. arthicokes have about 18g of inulin (per 100g of plant) even an amount of 30g should produce acne. We'll see.

I have no idea what "inflmmatory cytokines" or LPS would be :D

My Vit D level was somewhere around 60 ng/ml, since I was taking 10000 IU for two months or so. Are they any other tests that should give a clearer picture on my condition ?

Be well and thank you,


Dr. Art Ayers said...

Your response to inulin is puzzling. It suggests that acne in your case is mediated by bacteria/fungi in your gut that can metabolize inulin. The answer would be to eat the maximum amount of inulin that you can without contributing to acne with the goal of a acquiring other gut flora that provide a better adaptation to the inulin.

It should also be possible to eliminate the environment in the skin that provides a response to the inulin in the gut. If the skin is responding with inflammation, then it should be possible to block the prostaglandin side of the inflammation, just by increasing the ratio of omega-3 to 6 fatty acids in the diet. Increasing fish oil, under these circumstances should eventually eliminate the inflammation component.

A significant part of the acne response is the offloading of white blood cells from blood circulation at hair follicles in response to inflammation signals displayed on the surface of blood capillaries. This is the source of pus. I have to think more about how to block pus accumulation in response to inulin. ?

I hope this answers some of your questions.

Keyser said...

Doctor :)

OK, I shall continue with inulin although in smaller doses and preferably in the form of various vegetables (onions, leeks).

I think I have found part of the problem with Omega's. For the last two months or so I was eating bacon five or six times a week and when I yesterday put that in some nutrition software with USDA database I found out that bacon has about 16 g of Omega6 per 100g, which totally broke down my Omega 3:6 ration, since Omega 3 intake was about 2/3g therefore making a 1:10 ratio. So no bacon for me.

I'm wondering thought. How much fish oil is still safe ? Robb Wolf and Charles Poliquin advocate up to 30 g per day which seems like an overkill ?

Will report back with any new finds.

Be well,


Anonymous said...

i've suffered with crohn's disease for years and have the opposite problem of most people-I would actually like to gain weight. I have not had any surgeries, but due to an inflamed small intestine, I am likely not absorping food like I should. do you think there would be any benefit to the Eades diet with regards to weight gain? thanks in advance, doc.

Dr. Art Ayers said...

I think that a major problem in Crohn's is the simplification of the gut flora -- half of the species are gone. This means that the immunological problems of the disease are reinforced by the absence of the gut bacteria needed to fix the immune system.

Both the gut and the gut flora need to be fixed in Crohn's. The Eades' Cure destabilizes the gut flora, but I don't think that for someone with Crohn's, that would be helpful. It would depend on how the Crohnnie responded to the other parts of the anti-inflammatory diet: vit.D3, fish oil, low carb/high fat, veggies, etc. Also, what is the response to attempts to alter gut flora: probiotics, pectin/inulin/soluble fiber? What are the existing food intolerances? What is the prior antibiotic exposure?

It is a little too complex to be predictable.

Thanks for the question.

Daniel Feenstra said...

great post, funny how everything returns back to the basics. Problem is so few people apply the basics, and hence end up sick and diseased.

Anonymous said...

hi i am not sure if you still check this post, but if you do, I have several questions. Thanks so much for all your time and effort!!

1. how do you feel about lectins and their role in gut health?

2. do you think drinking well water would help more bacteria get into my system?

3. why do you tell people to eat spices?

4. If eating a raw veggie like a carrot is what gives you bacteria that eats carrots, how do you get bacteria that eats grains and meat if you don't eat those raw?


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