Correct your nutrition and supplement to heal your gut

The importance of a varied diet of whole foods (not processed) in maintaining the diversity and health of the microbiome has been established.Arranga, T., Viadro, C. I. and Underwood, L. (2013). Bugs, Bowels, and Behavior. New York: Skyhorse Publishing.

• Choose foods rich in probiotics–good bacteria which aid digestion, promote gut diversity and nourish the gut microbiome
• Probiotics can also be taken in supplement form. See below for more details.Greenblatt, J. (2011). The Breakthrough Depression Solution. North Branch, MN: Sunrise River Press, pp. 76-80.

• Choose foods rich in prebiotics such as chicory, garlic, artichoke, etc. as they help to feed the beneficial bacteria in our gut and lower gut inflammation

• Eat a clove of garlic every dayJunger, A. (2013). Clean Gut. New York: HarperCollins.
  • Helps feed good bacteria and helps eradicate bad bacteria

• Fermented and soil-based foods (organic) are full of probiotics, or good bacteria

Fermented foods are full of beneficial bacteria. Populating your gut with good bacteria can help to maintain the gut lining, avoid inflammation, and improve digestion as well as reduce the number of bad bacteria, fungi and parasites which can cause mental health problems.

Fermented foods contain probiotics which can help reduce anxiety.Scott, T. (June 2016). Anxiety Summit Opening: Benzos, Electroshock, Blueberries, Sauerkraut and the Vagus Nerve. [online] The Anxiety Summit, Season 4. Available at: http://season3.theanxietysummit.com/.

• The good bacteria from fermented food contribute to making GABA and serotonin, two neurotransmitters which help to enhance feelings of calmness and happinessScott, T. and Bock, S. (May 2015). Sauerkraut for Gut Healing and Reducing Anxiety. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
• Fermentation of fibre-rich components like soy germ, wheat germ, rice bran or bread have been shown to increase the levels of GABA within the brain, and are associated with a reduced risk of depression
• Sauerkraut
  • Sauerkraut contains lactic acid, which can function as a natural antibiotic which can destroy food-borne pathogens that may lead to gut problemsScott, T. and Bock, S. (May 2015). Sauerkraut for Gut Healing and Reducing Anxiety. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
  • Sauerkraut is also very high in vitamins – fermenting cabbage amplifies the vitamin C thousands of times, and the good bacteria will create vitamin K and B
• Kimchi (Korean pickle)
• Natto (fermented soybeans)
• Kombucha tea
• Kefir (water, milk or coconut water or milk)

  • There are different types of kefir grains — some to make water or coconut water-based kefir, some to make milk or coconut milk-based kefir

  • Milk kefir is rich in vitamins and stimulates a mucosal immune response, which helps to protect against microbial invasion in the gut

  • All kefir types improve digestionScott, T. and Bock, S. (May 2015). Sauerkraut for Gut Healing and Reducing Anxiety. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.

• Tempeh
• Live-cultured yogurt

Soil-based bacteria are important in helping us to break down and digest food, and can also kill dangerous micro-organisms.Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].

• A study on the Yanomami tribe in South America showed that they had particularly diverse gut bacteria
• They ate venison, fish, insects, plantains, casaba like fermented drink and vegetables out of the ground with dirt still on them, so they consumed soil-based probiotics on a regular basisScott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].
• Pesticides and chemical fertilisers destroy soil-based probiotics and other helpful microbiota so eating organically grown produce is essential

Bone broth is made from boiling chicken, fish, beef, lamb or pork bones, skin and cartilage for 4 to 24 hours with 2 tablespoons of apple cider vinegar and a pinch of sea salt to maximise protein, collagen, vitamin and mineral content.

• Bone broth can be very healing for the gut, as the collagen and protein released from the bones during the boiling process help rebuild and strengthen the epithelial cells in the gut lining, and reduce gut permeability
• The collagen and tissue repair amino acids which are specifically high in bone broth are
  • Glycine (especially helpful for supporting liver detoxification)
  • Proline, which is particularly beneficial for tissue repair and collagen production
  • L-glutamine – considered ‘food’ for the cells lining the gut wall, and protects the cells of the gut during times of damage (stress, toxins, etc.)Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].
• Bone broth is also high in magnesium and potassium which are necessary for cell repair
• Chicken broth contains more type II collagen which is good for gut, immune system, inflammation, and joints
• Beef broth contains more type I and type III collagen which are beneficial for skin, hair, nails and bones

Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].

Certain foods are particularly helpful to digestion:

• Herbs and spices, such as turmeric, cumin, fennel seeds, fenugreek, paprika, cayenne pepper, black pepper and ginger stimulate digestive processes
• Garlic and onions support the liver’s detoxification pathways and the balance of good and bad bacteria
• Apples, papaya, pears, pineapples, mangoes, blueberries contain digestive enzymes that support the production of pancreatic enzymes
• Avocados, rich in vitamin E, can help reduce inflammation in the small and large intestines
• Fennel, dandelion and mint leaves can have an anti-spasmodic effect
• Celery can reduce inflammation and increase digestive juices to help the breakdown of food
• Start every day with a large mug of hot water, grated ginger and the juice of half a lemon, as this helps stimulate stomach acid and can aid digestion
• Drinking a glass of room temperature or warm water with 1 or 2 tablespoons of apple cider vinegar 20 minutes before a meal can help stimulate digestion

Gut permeability is partially a result of inflammation in the body, often caused by stress or poor diet. To read more about gut permeability click here. 

• Studies show that reductions of up to 38% in blood Lipopolysaccharide (LPS) levels (a key component of leaky gut) occur when following a traditional diet of unprocessed, whole foods for one monthScott, T. and Selhub, E. (May 2015). How to Heal Anxiety with Nature and the Body, not just the Mind. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
• Kharrazian recommends following a life-long, anti-inflammatory diet
  • Eliminating grains, legumes, dairy, caffeine, and chocolate
  • Eliminating all processed fats and focussing on natural, unprocessed dairy, egg and vegetable fats
  • Focussing on a diet of whole foods with predominantly vegetables (vegetable fibre helps our colons to repair and heal)Scott, T. and Osborne, P. (May 2015). Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/. such as fermented foods, meat, low GI fruit (apricots, plums, apples, peaches, cherries, berries), coconut oil, coconut butter, coconut milk, coconut cream, herbal teas, olives and olive oil, turmeric and curcumin (which have a protective effect against LPS and cytokine-induced toxicity)

• Saturated fats such as butter, coconut oil, ghee, and animal fat can help to improve the integrity of the gut lining and heal or avoid leaky gut
• Omega 3 polyunsaturated fatty acids, found in seeds, green leafy vegetables and oily fish have a positive effect on the gut microbiota and inflammation levelsRobertson, R. C., Seira Oriach, C., Murphy, K., Moloney, G. M., Cryan, J. F., Dinan, T. G., Ross, P. R. and Stanton, C. (2017). Omega-3 polyunsaturated fatty acids critically regulate behaviour and gut microbiota development in adolescence and adulthood. [online] Brain, behavior, and immunity, 59, pp.21-37. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27423492 [accessed 6 Dec. 2017]
• Eat good quantities of short-chain fatty acids found in vegetable foods
  • These are byproducts of bacterial fermentation of vegetable fibreScott, T. and Osborne, P. (May 2015). Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.

• Try to eat regularly, slowly, and in a stress-free environment, respecting your body’s natural biorhythms. Chew your food carefully
• Avoid fad diets, and strive to achieve a balanced dietPallardy, P. (2006). Gut Instinct. London: Rodale.

The two biggest foods that are known to contribute to leaky gut are gluten and diary.Dr Peter Osborne ‘Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders

• Gluten
  • Gluten can negatively impact the lining of the gut, creating leaky gut or intestinal permeability
    • Leaky gut makes our gut vulnerable to bacterial infection, viruses and parasitesDr Peter Osborne ‘Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders
  • Certain bacteria which are affected by gluten can cross communicate with the brain, impacting mental healthDr Peter Osborne ‘Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders
  • Gluten is notorious for disrupting B12 absorption, which can cause B12 deficiency (pernicious anemia)
  • The most common side effect of B12 deficiency beyond fatigue is anxietyDr Peter Osborne ‘Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders ‘Anxiety, Depression and the Vegetarian Diet’, Lierre Keith
• It’s not always the gluten causing leaky gut and inflammation, but the glyphosates (pesticides) used on gluten-containing grains such as wheat, which are now being identified as major contributors to gut dysbiosis and leaky gut
• Dairy
  • Cow’s milk is the third most common food to cause anaphylaxis comprising 10-19% of food-induced anaphylaxis cases presenting in emergency roomshttps://www.allergyuk.org/assets/000/001/369/Stats_for_Website_original.pdf?1505209830. Accessed 19 Jan 2021.
  • It has long been assumed that the common cause of dairy intolerance is due to lactose and an insufficient lactose enzyme activity. However, studies have evidenced in recent years that some of those presenting with dairy intolerance show no evidence of lactose malabsorption. Instead, it is now considered that the primary cause of gastrointestinal issues from dairy is due to bovine beta-casomorphin-7 (BCM-7), derived from A1 beta-casein.Pal, Sebely et al. “Milk Intolerance, Beta-Casein And Lactose”. Nutrients, vol 7, no. 9, 2015, pp. 7285-7297. MDPI AG, doi:10.3390/nu7095339. Accessed 19 Jan 2021.
  • Within cows’ milk are two main types of protein – whey and casein. Over 80% of the total protein in milk is in the form of casein.
  • The A1 variant of beta-casein releases the bioactive peptide beta-casomorphin once digested. Casomorphins are the reason why some people claim to be ‘addicted’ to dairy; especially cheese which has a higher level of casein than milk. The reason for this addictive quality is that casomorphins target the opiate receptors in the brain.Boutrou, Rachel et al. “Sequential Release Of Milk Protein–Derived Bioactive Peptides In The Jejunum In Healthy Humans”. The American Journal Of Clinical Nutrition, vol 97, no. 6, 2013, pp. 1314-1323. Oxford University Press (OUP), doi:10.3945/ajcn.112.055202. Accessed 19 Jan 2021.
  • Casomorphins are considered a noncytotoxic, direct histamine releaser in humans. Histamine is involved in our inflammatory responses to the presence of allergens.Kurek, M. et al. “A Naturally Occurring Opioid Peptide From Cow’S Milk, Beta-Casomorphine-7, Is A Direct Histamine Releaser In Man”. International Archives Of Allergy And Immunology, vol 97, no. 2, 1992, pp. 115-120. S. Karger AG, doi:10.1159/000236106. Accessed 19 Jan 2021.
  • Inflammation in the gut significantly contributes to the development of leaky-gut which occurs when the cells comprising of the gut-lining develop fissures or holes allowing partially digested food, bacteria and toxins to permeate through to the surrounding tissueMarcelo Campos, MD. “Leaky Gut: What Is It, And What Does It Mean For You? – Harvard Health Blog”. Harvard Health Blog, 2021, https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451.
  • A casein intolerance or allergy can cause:
    • Hives and skin rashes
    • Breathing problems and wheezing
    • Abdomen pain, bloating, diarrhoea, constipation and vomiting
    • Food malabsorption
    • Mental health issues such as depression, anxiety, poor concentration and attentionCrichton, Georgina E et al. “Dairy intake and cognitive health in middle-aged South Australians.” Asia Pacific journal of clinical nutrition vol. 19,2 (2010): 161-71.
    • Intestinal permeability

These foods can be inflammatory in certain people, especially in those with leaky gut. For more on avoiding inflammatory foods for gut health, click here.

• All sugars and artificial sweeteners, including honey, agave, maple syrup, coconut sugar etc.
• High GI fruits: watermelon, mango, pineapple, raisins, grapes, canned fruits, dates, dried fruits etc.
• Nightshades such as tomatoes, potatoes, peppers, eggplant, chili and goji berries
• All grains, especially wheat but for some also including quinoa, buckwheat, barley
• Dairy (milk, butter, cheese), with the exception of ghee (clarified butter) which is well tolerated by most people, including those with dairy intolerance
• Eggs or foods that contain eggs (mayonnaise)
• Soy (milk, sauce, tofu, etc.)
• Alcohol
• Some nuts, beans, peanut butter etc.
• Coffee can be a gastric irritant, so is best avoided if you have a gut problem, at least for the first six monthsScott, T. and Osborne, P. (May 2015). Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
• Processed food
• Canned food
• Processed fats such as canola oil, rapeseed oil, peanut oil, soya oil, margarine, corn oil, sunflower oil

There are certain supplements which can help support and heal the gut lining, as well as reduce inflammation. Work with your health practitioner to devise a supplement plan adapted to your needs.

• L-glutamine
  • L-glutamine is an amino acid used by the cells in our intestines for rebuilding and gut repair
  • Supplementing with L-glutamine can help rebuild the gut lining, as well as aid with detoxification
  • Glutamine is also a precursor to the antioxidant glutathione (PH 59), as well as GABA, the calming and focus neurotransmitter
  • Glutamine is a source of fuel for the small intestineScott, T. and Osborne, P. (May 2015). Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
    
  • The form called L-alanylglutamine is more absorbable than L-glutamine
  • The best form of glutamine is the one you get from bone broth – good for leaky gut and immune response
  • Can get alanylglutamine supplements, order bone broth protein powder or make bone broth, though this can be time-consumingScott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].
• Deglycyrrhizinated licorice
• Aloe leaf extract
  • aloe and deglycerolized licorice help line the gut and give it a layer of protection, which helps leaky gut, however, does not heal itScott, T. and Osborne, P. (May 2015). Grainflammation – How Grain Consumption Contributes to Anxiety and Mood Disorders. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
• Tillandsia
• Marshmallow extract
• MSM
• Gamma oryzanol
• Slippery elm bark powder or capsules
• German Chamomile
• Marigold flower extract
• EFAs
• Probiotics

• Digestive enzymes
  • If you lack the correct balance of digestive enzymes, your body may not be able to absorb and use the nutrients you consume, even if you eat a perfectly balanced diet
  • Take high quality digestive enzymes which can help with digestion and absorption of nutrients and with the symptoms of leaky gut (eg: constipation, diarrhoea, bloating, etc.)
• Betaine HCL
  • Betaine HCL helps to boost hydrochloric acid levels
  • Hydrochloric acid is necessary for the digestion and absorption of nutrients, to optimise neurotransmitter levels, and also for improved immunity and reduced inflammation
  • Hydrochloric acid diminishes with age, chronic stress, poor diet and nutritional deficiencies
  • Supplementing can be helpful
  • You can also optimise your hydrochloric acid levels by:
    • Relaxing at mealtimes
    • Avoiding cold drinks
    • Eating fermented foods with your meal
    • Making sure you are getting enough zinc
    • Eating whole foods and avoiding processed foods
    • Using good quality salt with your meals
    • Chewing thoroughlyWays to Increase Stomach Acid Production. [online] Branch Basics. Available at: https://branchbasics.com/ways-to-increase-stomach-acid-production/ [accessed 6 Dec. 2017].

Diagnosing if you have low levels of hydrochloric acid can be done by mixing 1/4 teaspoon of baking soda in 150ml of water and drinking it first thing in the morning before eating or drinking anything else. If it takes you longer than 5 minutes to start belching, you may be low in stomach acid and supplementation could be useful

• Digestive enzymes
• Certain vitamins and minerals are particularly helpful for digestion
  • B3 – Niacin
    • Helps maintain healthy nervous and digestive systemsGreenblatt, J. (2011). The Breakthrough Depression Solution. North Branch, MN: Sunrise River Press, p.175.
  • Zinc
    • Helps stomach acid production

Herbal anti-microbials can be very powerful, and should only be used under the supervision of a health care practitioner.

• Undecylenic acid
• Caprylic acid
• Uva ursi
• Cat’s claw
• Pau d’arco

• Berberine
• Goldenseal
• Oregano (emulsified is less irritating to the gut)
• Allicin (the antibacterial ingredient in garlic)
• Neem
• Clove

Die-off is common with herbal antibiotics (more than with pharmaceutical antibiotics) because herbal antibiotics can kill many other substances, including fungi

• When bacteria die, they break into pieces and release toxins, which can then trigger the immune system, leading to “die-off”
• This can create inflammation, the common symptoms of which include the feeling that you’re coming down with something, and fatigue

• Berberine
• Yerba mansa
• Oregano extract
• Mastic gum
• Deglycerized licorice extract
• Grapefruit seed extract

Work with a herbalist to customise an anti-parasite protocol.

• Wormwood extract
• Olive leaf extract
• Garlic extract
• Black walnut extract

Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].

Licorice is an adaptogenic herb used in Chinese medicine. Adaptogens help the body adapt to and withstand stress

• Licorice root is beneficial with leaky gut that is accompanied by emotional stress
• Licorice root can help the body balance out cortisol levelsStudy published in the Journal of Molecular and Cellular Endocrinology
• Deglycyrrhizinated licorice (DGL licorice) is better if one is concerned about their blood pressure

Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].

• Certain essential oils such as frankincense are used in Ayurvedic medicine as anti-inflammatory agents for the gut

Scott, T. and Axe, J. (June 2016). Anxiety: The Stressed and Toxic Gut. [online] The Anxiety Summit, Season 4. Available at: http://season4.theanxietysummit.com/ [accessed 6 Dec. 2017].

Taking probiotic supplements can help restore a healthier balance of gut bacteria, which in turn can improve mental health (see gut dysbiosis for more on the importance of healthy bacteria for mental health). Numerous studies show the positive effects of probiotics on mental health.Campbell-McBride, N. (2010). Gut and Psychology Syndrome. Cambridge, U.K: Medinform Pub.

Supplementing with probiotics has been shown to reduce inflammation and improve levels of neurotransmitters. There are many different strains of probiotics, however only some of them are well researched. The ones below have research behind them, however there are many others not listed here which may also be excellent.

• A combination of gamma-linolenic acid and probiotics has been shown to reduce inflammationScott, T. and Selhub, E. (May 2015). How to Heal Anxiety with Nature and the Body, not just the Mind. [online] The Anxiety Summit, Season 3. Available at: http://season3.theanxietysummit.com/.
• Administration of probiotics has been shown to affect tryptophan levels, which in turn increases serotonin levelScheri, G., Fard, S., Schietroma, I., Mastrangelo, A., Pinacchio, C., Giustini, N., Serafino, S., De Girolamo, G., Cavallari, E., Statzu, M., Laghi, L., Vullo, A., Ceccarelli, G., Vullo, V. and d’Ettorre, G. (2017). Modulation of Tryptophan/Serotonin Pathway by Probiotic Supplementation in Human Immunodeficiency Virus–Positive Patients: Preliminary Results of a New Study Approach. (2017). International Journal of Tryptophan Research, 10. Available at : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457170/ [accessed 6 Dec. 2017].
• Administering Lactobacillus Helveticus ROO52 and Bifidobacterium longum RO175 has been shown to support mood and relaxationPerlmutter, D. and Colman, C. (2004). The Better Brain Book. New York: Riverhead Books.; Perlmutter, D. and Loberg, K. (2015). Brain Maker. London: Yellow Kite.

There are many types of bacteria considered to be probiotic, some of which are known to be particularly helpful for certain types of mental health concerns. However as the research into the different effects of probiotics is still limited, it is best to take a broad spectrum of probiotics.

• 10-60 billion units per dayAmen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 99.
• The broadest spectrum possible
• High quality probiotics
  • It has been shown that many supermarket probiotics do not contain a strong enough quality or concentration of bacteria to help treat mental health issues.

Bacteria which are considered to be probiotic include the following:

Lactobacilli

• This family includes L Acidophilus,  L Casei, L Rhamnosus, L Brevis etc.
• Seen on probiotic yogurt labels
• Naturally present in the body
• Lactobacilli are crucial to your immune system, and prevent harmful bacteria, virus and fungi from developing in the gut

Bifidobacteria

• The commonly known members of this large family include B. Bifidum, B. Brevis, B. Infantum, B. Lactis, B. Longum etc.
• Responsible for the production of amino acids, which are the building blocks of proteins and essential for neurotransmitter production
• Actively synthesize various vitamins-including vitamin K, and B group vitamins which are important in absorption of calcium, iron and vitamin DCampbell-McBride, N. (2010). Gut and Psychology Syndrome. Cambridge, U.K: Medinform Pub.

Ecoli

This bacteria has received media attention due to its association with food poisoning outbreaks and it can cause serious infections.

However, E Coli strains perform useful functions within the body such as

• Digesting lactose
• Boosting the immune system and producing antibiotic-like substances
• Producing vitamins, in particular B and K