Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
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Thursday, March 1, 2012

Dr. Oz, Constipation, Soluble Fiber, Food Intolerance

The medical industry doesn't seem to understand the basics about the interaction of gut flora with food and the immune system.

I respect Dr. Mehmet Oz for creating a media personality to communicate medical information for public consumption and I know that there are many constraints placed on his freedom to discuss his personal and professional insights on health. That said, it seems to me that the public Dr. Oz, the voice of mainstream medicine and to some extent the food industry, fails to understand some essential features of the transformation of food to poop.

Dr. Oz has described on his television series, the impact of major disease on diagnostic changes in the color and appearance of poop, but he doesn't seem to understand that poop is mostly bacteria that have grown in the gut. The major implication of the predominance of gut bacteria in poop is seen in constipation. The pounds of bacteria in the colon provide the bulk and hydration of the poop, and when the bacteria are not abundant, the result is compacted, undigestible dietary fiber, which is the hard poop of constipation. That is why antibiotics, which have the major effect of killing gut bacteria, result in constipation. Chronic use of antibiotics, or frequently even a single use, can produce prolonged constipation.

The impression that I get from listening to Dr. Oz discuss soluble fiber, is that these food polysaccharides pass through the small intestines and then contribute to the texture/hydration of poop. This would be the case, if there were not bacteria in the gut, because the only polysaccharides/carbohydrates digested by human enzymes in the gut are starch and sucrose. Plants (and animals) produce hundreds of other types of polysaccharides that can only be digested by bacterial (and fungal) enzymes. All of the types of polysaccharides, abundantly present in fruits and vegetables, that can be digested by gut bacteria are called soluble fiber. (Undigestible fiber, such as grain fiber, is of no benefit.) Soluble fiber is the main source of food for gut bacteria and is also converted into the short chain fatty acids, e.g. acetic acid, that are the major nutrients for the human cells that line the colon. Thus, soluble fiber, such as the inulin in leeks or the pectin in apples, is essential for healthy poop and intestines.

Dr. Oz advises eating dairy and fermented foods with their live bacteria to supplement gut flora and to compensate for antibiotic treatments. This suggests that providing just a few different species of fermenting bacteria, probiotics, can produce a healthy community of gut bacteria. Unfortunately, each human gut requires hundreds of different species of bacteria that are not present in common dairy products, such as yogurt. The hundreds of different types of bacteria needed for a healthy gut are normally acquired from other people and animals, and from uncooked, raw vegetables. Cooking and excessive sanitation eliminates the exchange and acquisition of healthy bacteria. Exposure to antibiotics can lead to a lasting deficiency of gut bacteria that is unrecognized by modern medicine.

Dr. Oz recommends that people who have trouble eating certain foods or have good intolerances, should avoid the problem foods. This suggests that the problem is somehow in the intolerant person, even though there are no genes for food intolerance and very few cases of food intolerance result from an immune reaction. Food intolerance is actually the inability of an individual's incomplete gut flora to digest certain types of food. Antibiotics, for example, can kill off species of bacteria that are needed to completely digest certain types of soluble fiber or other plant products, phytochemicals, so instead of producing the needed short chain fatty acids, other irritating molecules are produced and the digestive system is upset. Simple intolerances, such as lactose intolerance, can be remedied by just eating small amounts of yogurt containing fermenting bacteria, probiotics, that have the genes for enzymes that can digest lactose. In a couple of weeks, most people are permanently able to tolerate lactose. More complex intolerances may require more persistent pursuit of the missing bacterial species by eating many different types of raw vegetables with clinging soil bacteria. The medical community has failed to acknowledge the need to repair gut flora compromised by antibiotics and to provide simple guidelines for reacquiring missing gut bacteria.

Dr. Oz provides a great service by promoting some healthy ideas, but it would be even better if he helped the public to understand how the gut and gut flora produce healthy poop.