The problems with eating yoghurt for IBS or digestive health.

If you are dealing with IBS, or constipation and diarrhea, and you’re eating yoghurt and fiber, you may be doing more harm than good.

Here are 4 problems to this approach:

  1. Dosage – the amount of probiotics in a common products, like yoghurt, are too low to be beneficial. You need at least 10 billion colony forming units (CFUs), and even better, strains that have been researched to withstand stomach acids.

Even with medical grade probiotic products that may contain up to several hundred millions CFUs, it may still be a drop in the bucket comparing to the total number of bacteria you have. Humans have trillions (a million of a million) probiotic cells. While introducing researched probiotic strains in a supplement form may be beneficial, it usually is not the end-all be-all with health problems like IBS.

  1. Probiotic products typically assume that you have normal levels of stomach acid and intestinal movements. Many people, especially those who have digestive problems, do not have normal levels of stomach acid. In addition, medications that reduce stomach acids such as Nexium and even Tums are one of the most commonly prescribed medications in the United States and patients discontinuing these medications may not return to normal stomach acid levels. Lastly, chronic stress, bad nutrition, and poor eating hygiene often lead to reduced stomach acids and intestinal movements. If this is the case, the introduced probiotics may colonize in the small bowel instead of the large bowel, leading to small intestine bacterial overgrowth, which is believed to be the root cause of many health problems.
  1. Most yoghurt products market themselves for the benefits of probiotics, but not only do they usually not contain enough bacteria to make a difference, the problems actually include:
  • Antibiotics may be mixed into the feed of the cows that make the milk and this comes out in the milk.
  • Added sugar or artificial sweeteners that can be harmful.
  • Artificial flavors and additives that can irritate the gut further.
  • Residual lactose, as commercial yoghurts are fermented only for a short period of time. The remaining lactose can lead to bloating, flatulence, and more digestive problems.
  1. Lactic acid bacteria isn’t the only thing that is beneficial. In fact, they can cause trouble like very severe diarrhea for some people. For these people with preexisting gut bacteria imbalances, introducing lactic acid bacteria may not be a good idea.  content3

 

  1. Other factors like mental/emotional stress and chemical exposures can mess up your gut bacteria and digestive system, no matter how many probiotics you take. This may be why you still have IBS.

Want to learn more:

 

 

Overall health vs cardiovascular health? Is low cholesterol really healthy?

My mom loves seafood and it rubbed off on all of her kids. As we drooled over the 12 oz. lobster tails and octopuses at the specialty market, she passed on those things saying, “These have high cholesterol.”

She is fairly educated and definitely not stupid, but I find it interesting that the cholesterol propaganda has caused her to think that cholesterol is absolute poison and that all high cholesterol foods should be avoided. Unfortunately, lots of yummy and nutritious foods are usually high in cholesterol.

It is intuitive to think that eating high cholesterol foods will raise blood cholesterol levels. That is simply not true because the body produces most of the cholesterol depending on the needs. If we eat more cholesterol, it produces less. We need cholesterol to stabilize the membranes of every single cell in our bodies, as well as to make hormones and vitamin D. Stress and inflammation increase the needs for cholesterol, and that may raise cholesterol levels. Humans with genetic defects that prevent them from making cholesterol, either die shortly after birth or exhibit mental retardation and developmental abnormalities.

I myself have experienced having very low cholesterol. A few years back, I was mega-dosing a plant sterol supplement to control my allergies and eczema, but I wasn’t aware that plant sterols are potent cholesterol reducers as well as immune stimulants. At the same time, I was going through a lot of stress in graduate school, working out 12 hours a week and dieting to lean out. My total cholesterol level was borderline hypocholesterolemia (low enough to need intervention) at 4.1 mm/dL or 158.3 mg/L. Although the number may not be out of range, it was definitely too low to be healthy for me. Alas, my doctor told me that my bloodwork looked perfect.

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My perfect bloodwork while I was a complete mess.

Generally, stress and inflammation may increase cholesterol because there is greater needs to produce the stress hormones cortisol, among other things. However, because my cholesterol was artificially lowered, my body wasn’t able to produce enough cortisol and sex hormones; I experienced what many people call “stage 3 adrenal fatigue.” The adrenal crash, together with the immune stimulating effect of the plant sterol and my stress levels, caused the biggest eczema and allergy flare-up I had ever had. My upper body was nearly covered in eczema. I became allergic to things I had not been allergic to my entire life. Also, my cycles were prolonged to up to 50 days in between. I was also very depressed and had very little energy, possibly because of low sex hormones, vitamin D, cortisol, and everything else that was made of cholesterol. I’ve since stopped the culprit supplement, and gobbled up some butter, my cycles have normalized, I cleared up the eczema completely (mostly with nutrition) and the depression is gone.

I’m absolutely not saying that no one on the planet needs to lower their cholesterol. We need to be reminded that all diseases, including cardiovascular diseases (CVDs), are multi-factorial. It usually takes more than one factor to cause heart disease or stroke. The total cholesterol number alone is not indicative of heart disease risk, unless it is more than 330 mg/L. Generally, factor that put people at higher CVD risk include smoking or oxidative stress, being overweight, diabetes or insulin resistance, hypertension, lack of physical activity and unhealthy diet. If you are curious, try the Framingham Risk Assessment Tool to estimate your 10-year risk of developing CVDs.

High-Cholesterol-Symptoms-1

The general model of how CVDs occur is that there is an insult to the arterial wall, such as a tear and then the body attempts to repair the tear by depositing oxidized cholesterol, fat, calcium and blood clot. As with any tissue repair process, this involves inflammation. People with more inflammation levels have faster plague buildup than those who don’t. The initial insult to the arterial walls happen because of oxidative stress and blood pressure. Also, oxidized fat and cholesterol get deposited in the plagues. While there is no direct scientific evidence that high cholesterol on its own cause diseases in humans, reducing cholesterol in people with previous heart attacks reduce the risks of subsequent heart attacks given that they also have high cholesterol.

In addition, there are subclasses of LDL (the generally called “bad” cholesterol) which are not commonly tested for in standard bloodwork.  Small, dense LDLs with oxidized fats and cholesterol are much more likely to cause CVDs than larger, more buoyant LDL particles. It seems like diets higher in refined carbohydrate, rather than dietary saturated fats or cholesterol, increase bad LDLs.

With all of that said, the way to manage your cardiovascular risk is not by avoiding high cholesterol foods. If you are reading this, I assume that you are in shape and eat a healthy diet. Here’s my take on how I usually help my clients manage their CVD risks if that is their concern.

  1. Eat a low glycemic impact diet
  2. Cut back on fructose
  3. Reduce inflammation with a fish oil supplement. In some cases I may recommend additional antioxidants such as curcumin. Also, maybe I would put them on an elimination diet or run a gut pathogen screen to reduce inflammation.
  4. Eliminate all sources of refined high-omega-6 oils (i.e. vegetable oils), especially ones that has been heated. Focus on monounsaturated fats such as olive oil, avocado oils and macadamia nut oils.
  5. Manage stress
  6. (If the doctor clears) exercise
  7. Supplements like plant sterols (in moderate dose), niacin and vitamin C may help reduce cholesterol.

For many athletic people, rather than cardiovascular concerns, the converse is true that they need to maintain healthy cholesterol levels while keeping oxidative stress in check. Therefore, if they have symptoms of hormone imbalances, I generally recommend adding fattier cuts of meats from healthy sources to their diets. Since exercise increases oxidative stress, athletic people could benefit from diets higher in antioxidants, and perhaps supplementation.

In case you are wondering about the blood numbers to look for, check out Dr. Spencer Nadolsky’s blog post.

Also, if you have any questions, feel free to ask in the comments below.

 

Functional medicine and holistic health – quackery or science?

Many people think holistic health is all quackery. But, in fact, that couldn’t be further from the truth! The reason I became a holistic health practitioner was because I started doing my own research as a skeptical scientist for my own health.

From my journey, here are 3 things that I find amazing about functional medicine, which agrees with common knowledge in biological sciences.

  1. Everything is important. Nothing is not important.

Every time a biologist observes something in nature, we know that Mother Nature creates that for a reason. Perhaps evolution selects for the best. Then, we proceed to try to dissect the reasons and to understand how something happens.

This applies to every field in biology, and it is a beautiful thing. The DNA molecule, for example, is perfectly crafted for its function. Every detail, every angle, had good reasons. There are reasons why the plants in a forest are spaced apart the way they are, and why the smaller plants exist in their shades. Numerous examples exists that Mother Nature always has her reasons for creating something.

Yet this common knowledge had been lost in the translation from research to clinical applications. When Mother Nature creates pain, depression, cancer, fatigue, and many other health problems, there are underlying causes. We as a culture have been conditioned for instant gratification, to expect that a pill would take all the problems away rather than to seek to understand Mother Nature’s reasons (the mechanisms) and resolve the root causes. Although much of medicine is based in science, from discovery to clinical trials, the practice of suppressing symptoms and ignoring the root causes are far from scientific because it is a big departure from common knowledge.

  1. Everything is connected.

Systems biology is a new field in where engineers use engineering methodologies to explain biology. These engineers often look at things that they work on in a circuit-like manner, by drawing diagrams and then creating mathematical models in order to understand the system. System biologists typically find that the connectivity or interactions between components are important to the overall function of the organism. Also, biological systems are more powerful than the sum of its parts, which is why synthetic biologists still can’t yet create the simplest cell from chemicals alone.

Scientists are still discovering these connections every day. Because biology is complex, we will never completely understand how everything is connected. Years ago we didn’t know our gut bacteria is connected to so many aspects of our health – mental health, metabolic health, nutritional status, skin health, hormonal status – just to name a few. We used to think that it is okay to just kill these bacteria, because they didn’t matter, but now we do and many are repairing the damages to their health from overuse of antibiotics. With this general trend that “things are connected,” it is usually safe to assume that changing one thing in a system will have ripple effects on other component of the systems.

With this in mind, it is counterintuitive to care for different body systems as separate units because everything in our body is connected. Since gut integrity affects the brain and skin functions, it may no longer make sense to separately visit a gasteroenterologist, a neurologist, and a dermatologist.

This is also why whole foods are much more powerful than the individual nutrients they contain. There are connections inside of those natural foods, such as antioxidant levels that synergize with vitamin C in fruits, giving us more benefits than the same dose of vitamin C alone. Omega-3 obtained by eating fish is also more bioavailable than by supplementation. Whole food natural nutrition is better and more powerful than synthetic (fortified or supplement) nutrition, and long term supplementation of single nutrients is not optimal.

  1. Biological systems are robust.
Image from Nature Reviews Genetics 5, 826-837 (November 2004).

Image from Nature Reviews Genetics 5, 826-837 (November 2004).

System biologists also find that biological systems can take on a lot of insults before they break down. Without this robustness, any species can and will go extinct. We get stronger against the insult, unless we have too many of those that our bodies break down.

For example, in order to keep warm, humans naturally store more fat as we approach winter. We also have the ability to generate heat inside of our body to keep warm, which is why we feel warmer in the spring than in the fall at the same temperature. When we do a resistance-training exercise, after our bodies recover from it, it will feel much easier to do the same lift. This is called hormesis.

Those small insults or stressors trigger us to grow, become stronger, and become more resilient. However, we have a limit to how much we can handle and adapt positively to these insults. Too many of them at a time, or if one of them become too big, will break down our health. Generally, symptoms are a sign that the system is breaking down or is lagging in its adaptive capability. Also, if you are constantly feeling run-down, it usually means that multiple different stressors have been attacking you from all directions for a long time. This is often why a pill, a crash diet, or one single quick-fix action is usually not the best cure for chronic health problems.

Many of us, however, can feel significant benefits from removing a few or even one of these insults. For example, just by making sure that I sleep well before midnight, I lose weight and my skin improves. Many of my friends experience significantly less PMS symptoms when they stop eating conventionally raised meats.

Functional medicine didn’t emerge as a pseudoscientific quackery because functional medicine explanation of human physiology is based on solid science.

Arguably, many “natural” treatments haven’t been tested through large double-blind placebo-controlled trials, which is considered gold standard for testing medical treatments. The fact that something hasn’t been through a clinical trial doesn’t mean that a treatment is ineffective, or unsafe. Often, when a treatment option is not patentable, there is less incentive for funding to do the clinical trials. Also, for some natural treatments, it is simply impossible to design perfect placebo-controlled studies. For example, there is no fake sugar pill for a whole foods diet. Prescribing medical treatments has always been based on risk vs. benefits analysis because most pharmaceutical interventions or surgeries come with risks of danger. However, with less invasive, lower risks treatment options, often the benefit of trying a natural option prior to resorting to conventional options may far outweigh the risks. For example, many people with autoimmune diseases have better success managing their diseases with diet and lifestyle changes than with medications.

However, this doesn’t mean that all functional medicine practitioners are created equal, nor that the (mostly unregulated) natural health industry are not tainted by pseudoscientific claims. It is wise to always be challenging what you learn, seek to be informed, and exercise good judgments for your own health.

blind spots people have that guarantee they fail new years resolution #3 & 4

3. Relying on exercise to lose weight

Most fitness coaches that consistently deliver result will say that diet is 80% and exercise is 20%. Fitness models may need to live on bland and regimented cardboard diets comprising of chicken breasts and broccolis. However, for the general population, very often switching from processed foods to whole foods and relying on appetite cues often produce great results, as long as the hormonal environment is fairly optimized.

Exercise alone rarely significantly change body composition in the long run (with some exceptions, of course), because the human body is very good at adapting the metabolic rate and appetite to match the calories burned. Those of us who struggle with weight loss also tend to reward ourselves with high calorie foods.

Sitting is the new smoking. It’s now clear that exercising for 1 hour a day may not mitigate the harm of being sedentary for the other 23 hour of the day. Therefore, for weight loss and general health, it may be more beneficial to move regularly and/or do short bursts of intense exercises throughout the day than to visit the gym for a long exercise session.

The fitness guru and my mentor Ben Greenfield says that exercise is not necessary to lose weight, but movement is.  So, whereever you are in your fitness journey, make it a point to stand up, walk around, stretch and do burpees every hour or so. Even better, get a standing desk or a treadmill desk.

4. Measurements fail

When new year resolvers attempt to lose weight, they only use the scale as their sole progress measurement. It’s called “weight loss” for a reason.

Your weight is simply a measure of gravity on your body. It doesn’t imply what your body is comprises of – fat, muscles, bones, water, and many more things. In fact, I’ve ran into many women who are up to 20 lbs lighter than me, who look larger than me.

Being fixated on weight can also cause backward progress. People who do a lot of long steady state cardio exercise and restrict calories to extreme ends or go on crash diets often lose weight that comprise mostly of water and muscles. It can even cause them to gain fat. Since most people have weight fluctuations, they will get more skinny fat over time. Being skinny fat means that they have more body fat and less muscle mass, which is worse for their metabolic and overall health.

The best thing to measure is body composition – how much lean mass you have and how much fat you have. It is indeed possible that you weight will stay the same once you do things that help with muscle retention, such as resistance training and eating sufficient amount of proteins. Heck, you may even gain weight but get smaller. Muscles are denser, and they store glycogen, which attract water.

None of the ways to measure body fat is perfect, unless you have access to some expensive lab equipments. So, when I work with my clients, I use at least 3 – 4 different ways to assess progress. These include weight, girth measurements, caliper skinfold measurements, Tanita scale (a Bioimpedence machine), and pictures. If someone is obese, it may be possible to drop a lot of weight, especially when they just start a new diet and exercise program. However, for leaner people, it gets more difficult to tell from measurements over time, but it is highly likely that pictures will show significant changes in muscle definition.

One of my client's caliper and weight measurements over 5 months. Her weight barely changed, but she lost 10% body fat.

One of my client’s caliper and weight measurements over 4 months. Her weight barely changed, but she lost almost 9% body fat and gained more than 10 lbs of lean mass.