Gut Health

11th December 2017

 

This is going to be Part 1 of a 2-part blog which will go into some depth about my own healing philosophy. “How did you get to where you are now?” is a question that I have been asked quite a lot in the last few months – both directly and indirectly. These two articles break down the complex philosophy I have about the importance of various elements of healthcare – and what truly was important to me during this journey (coming next week)…

But for now, let me start at the beginning… with every nutritionist’s favourite topic… FOOD! Be warned – these are both going to be lengthy articles. So grab a beverage of your choosing and settle in…

 

Reviewing the Year – Paleo In The UK

 

This year I worked intensively to launch the Paleo In The UK website. I wanted to build this resource because there is a lack of reliable, balanced, scientific information out there which covers the topic of ancestral health and nutrition for a UK audience.

 

Actually, I can be more bold than that – there’s a complete lack of balanced and measured dietary advice out there. When it comes to nutrition, it seems that many people seem to forsake pragmatic and rational and go instead for sensational and extreme – perhaps because it gets more clicks, likes, followers etc. etc.

My goal with Paleo In The UK was to bring some calm common sense to the message of a genetically and biologically appropriate, nutrient-dense diet.

 

The language of Paleo or Primal health is much more understood (and more widely used) in the US than in the UK. And yet within my work, the first step for many of my clients includes some sort of adoption of the basic frameworks of Paleo, Primal or AIP nutrition: reducing and removing inflammation from their lives, which is the primary focus of ancestrally appropriate nutrition. Eating the diet that is best suited to human biology is one of the best ways we know to minimise the damage (i.e. inflammation and gut permeability) that can arise after a lifetime of eating food that challenges and stresses the body. Working in Functional Medicine and with those who suffer from chronic illnesses in which inflammation plays a huge part, it is natural that this nutritional way of eating is a relatively common default (tweaked to suit each case).

When recommending a “Paleo” or “AIP” lifestyle I did not have excellent resources or guides to give people because, as with every nutritional approach, there is a lot of dogma and a host of rubbish that accompanies the grains of truth about what these diets are – and are not.

 

Additionally, the energy behind the way the Paleo or AIP approaches were recommended mostly endorsed or promoted fear of foods and lives based on restrictions, avoidance and labelling certain foods as ‘bad’. Playing on any moral, emotive and meritocratic ideology around foods (which suggests a value system around nutrition) is not something I am keen to do within my work. So I decided to create different resources.

 

If you’ve been on to the Paleo Area or the AIP Area on the Paleo In The UK site you will see there are 6 separate, free downloadable PDFs which summarise the principles, the ‘rules’ and recommendations of Paleo or AIP diet and lifestyles. I now use these to give to the clients to whom I want to recommend a nutrient-dense, low inflammatory diet and a lower-stress lifestyle.

 

The Nutritional Realm in 2017 – and the Place for Paleo

 

This year the world of nutrition has become more of a battle ground than ever before. The whole nutrition landscape has become very political and when discussing nutrition you are rarely just talking about health outcomes or mechanistic nutritional effects. Instead, the topic of food encompasses ethics, finances, big business vs. small businesses, pollution, planetary destruction and the concept of overpopulation and lack of resources. These are big subjects and they polarise opinion. They complicate the agenda of nutrition – which has the consequence of letting the health claims get lost amidst the bigger implications of food choices.

Against the backdrop of the politicisation of nutrition (not a new thing), the tenets of the Paleo and AIP are not borne out of ideological, financial or planetary concerns. At their purest they are based upon the principles of biochemistry and the nutrients that the human body needs to thrive, whilst eliminating the foods that are most challenging to human physiology. These diets are not concerned with planetary impact, but human impact. This is perhaps to their detriment because it lays them open to criticism from conservationists or environmentalists.

And yet, the Paleo and AIP templates are not attempts to recreate ancestral diets to the letter, ignoring the reality of the modern world. Instead, these approaches (applied correctly) incorporate the best understandings we have about minimising that which causes stress to the modern human body whilst also bearing in mind the welfare and the natural wellbeing of the animals and the plants we consume. This is much more about ways we can improve the food supply and the lives we live – incorporating mention of everything from anti nutrients to xenoestrogens, toxins to light pollution and even the chemistry of a negative mindset.

I started the Paleo In The UK site to bring a more scientific and balanced voice to what has come to represent a battle between carnivores and vegans. But also because I have witnessed the healing potential of eating the foods that are just overall healthier for us as humans.

 

In creating the Paleo In The UK site it was never my intention to endorse dietary restrictions or to promote that health is only accessible by following a ludicrously punitive diet. Because, quite simply, this is untrue.

The nutritional interventions that come in the package of Paleo and/or AIP are mere stepping stones towards healing. To my mind, and in my experience, they are in no way a “solution” – they are just one part of a picture. More than likely, they are not even the most important part.

Most of what these nutritionally specific diets do is to remove the noise of inflammation and the products in the modern, Western diet that overstimulate or tax the human nervous system and physiology. From here there is a clarity that comes and an ability to hear the distress signals from our own bodies.

But it is my belief that truly healing from anything requires more than just cutting out a host of foods from your diet.

 

The Biological Response To Stress

 

The noise of inflammation and the chemical confusion that I mentioned above is what happens when a human body goes into a place of stress and distress. The biological reality of this noise can be any one, or a number of, often ALL of, the following:

 

  • immunological dysregulation, i.e. too much inflammation, with too many cytokines and inflammatory markers floating around. This can also include a rise in auto-antibodies suggesting an autoimmune self-attack because of an immune system which has lost the differentiation between ‘self’ and ‘other’. The result is swelling, heat, and then other consequential impacts of inflammation which can be any of the bullet-points below …

 

  • neurological dysregulation, in which panic and alarm bell messages are being sent too readily. This causes odd physical sensations of tingling and fizzing – with heart palpitations and sensory issues and/or symptoms of mental panic or overstimulation (anxiety, preoccupations, obsessions, highly sensitised reflexes – to sounds, light etc.)

 

  • hormonal dysregulation – perhaps rises in cortisol and peaks of adrenaline or, instead, the constant underlying presence of these stimulating hormones and the subsequent suppression of other, more restful or nurturing ones. Left long enough this can result in complete ‘burnout’ of such systems, leaving the body fatigued and with a global suppression of all hormones

 

  • blood sugar dysregulation – peaks and troughs of energy availability and a change in the flux of nutrients across cell walls – which can have a knock-on effect on hormonal regulation for hunger, fullness, storage, burning fuel etc. etc.

 

  • barrier integrity dysregulation – certain barrier tissues may break down and/or become more permeable (hormones again play a role, as does immune function) the net effect of which is a decrease in function of the protective elements of human physiology contained within those barriers

 

  • emotional and mental dysregulation – everything from increased anger and rage to depressions, obsessions, fears, repression, isolation and/or decreased inhibitions. This can range in severity from minor conditions to serious, life-threatening mood and mental health disorders

 

And beyond these physical issues, compensatory behaviours can be set up to ‘cope’ with the dysregulation that is going on inside us. This can be anything from constantly seeking distractions or being utterly preoccupied with self-analysis or victim mentalities and self-resentment or an outward resentment of life itself. You can set up avoidance behaviour patterns, engage in self-deprecation or self-flagellation, beating yourself up with whatever tool you choose – from drink to drugs to overexercise to gambling and I see all of these responses within my practice.

The entire point of minimising nutritional assaults (which is all that Paleo or AIP diets aim to do) is to stop some of the dysregulation described above. This allows us to slow down the cascade of dysregulated hormones, immune markers and neurological messages. This is what I mean by minimising the noise. This, in turn, allows us to stop the coping strategies and deal better with life as a whole.

 

However, in a world where nutritional interventions are prized as hugely beneficial we often lose sight of the fact that all of the dysregulation described above can occur completely independently of any nutritional triggers.

Many things can cause the patterns of normal physiology to go awry as laid out above – and rarely, if ever, have I seen food be the sole agent responsible for such massive physiological dysregulation. What I am really saying is that food alone is not enough to cause the body to start behaving in such a traumatised way. And whilst we can utilise nutritional interventions and eliminations to assist with the calming of all of these noisy dysregulated systems… the magical effects of diets which eliminate nutritional stressors do not lie in the fact that those foods made you ill in the first place.

 

In very few cases does food create all of the problems. Of course, there are two exceptions. The first is in genuine food allergies, where the immune system has (for some reason – often genetic) a severe and dangerous reaction to a foodstuff. The other exception is, of course, Coeliac Disease, the autoimmune condition which occurs in response to the ingestion of a specific protein in wheat. These are the exceptions, however, and the few cases where a single food item is really all it takes. But remember this point – these are situations where one single food is at the root of dysregulation.

Beyond genuine allergy and genetically-determined coeliac disease we are looking at a host of food sensitivities wherein something in our bodies – whether that is our immune system, our microbiome or a combination of the two – reacts adversely to the ingestion of certain foods. In my clinic, this is rarely just a single item that the body has developed an intolerance to. Instead, our biology starts reacting negatively to a host of nutritional inputs.

 

Blaming food for this multi-reactive situation and constructing our lives around avoiding whatever we perceive to be our triggering foods is a fallacy. It’s a convenient one, I must admit. But it isn’t the whole truth of a complete health situation where food sensitivities are involved. In fact, quite often, finding health in these situations really isn’t about the food at all.

 

Every single one of the dysregulations mentioned above is instigated by stressors. Stress can come through eating foodstuffs which are biologically taxing, sure. But in my clinical and personal experience, the nutritional stressors are but one in a long line of stressors – some of which are physical, many of which are not. In fact, the nutrition might be the straw that breaks the camel’s back, and cutting out certain foods might be an easy route to begin minimising the total stress burden… but doing this can actually be a distraction. Getting lost in the dietary hoops we have to jump through to deal with our symptoms can mean that we fail to realise that the food was just the tip of an iceberg that has a host of other issues underneath it that must be dealt with.

 

True healing is actually very simple: it requires working out what the real stressors are for you. Instead of getting lost thinking that food is the problem, I believe it is fundamentally important to recognise that food (and food elimination) really is medicine – but if you need the medicine of an elimination diet then there is an underlying condition that you are trying to treat. Facing up to the real reasons behind dysregulated physiological responses is a tougher job. But, I believe, it is a necessary one.

 

I will reiterate that this does not mean that nutrition isn’t a perfect foundational tool to begin to reduce the total stress burden that each person faces. The nutrients we eat are the very things that are going to make our tissues, organs, chemical messages and neurotransmitters. Having adequate and appropriate nutrients is a fundamental bedrock of functioning well as a human. Removing foods which affect hormones, barrier integrity, blood sugar, the gut microbiome and the relative activations of the enteric, sympathetic and parasympathetic nervous system is a fantastic start to the re-regulation of internal physiology. Food is chemical after all, and it really can be a tool to alter our biological functioning.

But a tool is only appropriate to use in a situation where there is a job to be done. And if your body has stopped coping with food, as many of my clients’ have and as mine very definitely did for many years, it is mandatory that you look beyond the food to establish why your body is rejecting the nutrition and what has caused your systems to become so dysregulated in the first place that relatively benign foods can so drastically disturb your immune, hormonal, metabolic and digestive wellbeing. That is rarely, if ever, just to do with food.

The Situations When It Matters What You Eat

 

Now… those of you who follow my work will know that I’m not a fan of absolutes and extremes. So again, I’ll put some huge caveats in here. I am not saying that there are never genuine food sensitivities. I have some of those, as do some of my clients. Mainly, those sensitivities show up to gluten/dairy/eggs/nuts – the classic things. These responses are typically direct sickness or bowel effects, rashes, flushing and heat generated somewhere in the body and/or joint issues. Sometimes there are mood issues too, and this is something I am seeing more and more with commercial wheat/gluten. Also – these symptoms are those that occur when you are unaware that you’ve been accidentally exposed to the substance. i.e. they’re not placebo, because they occur when you consume that food unknowingly.

We also have to acknowledge that there can be more vague senses that you just don’t get on with certain foods. Perhaps this includes getting bloated, hanging onto weight around the middle and feeling just a little tired and rubbish after eating certain things. And yet, this will generally be to those foods that affect blood sugar overtly and/or alter hormonal balance (think the hormones and the insulinogenic properties of milk and/or the peaks and troughs following candy consumption or platefuls of pasta). Or the bloating etc. will be due to a gut biome situation. But even with all of the food reactions mentioned in these paragraphs, we’re already moving away from the problem being with the food itself… and we’re looking at the issues being with us – the bodies and the humans ingesting the foods.

Which brings me onto what I am increasingly seeing – and what I witness happening within my own community and my own life. For some individuals the dysregulation and symptoms as explained above, as well as with a host of other ‘reactivity’ issues, are occurring in response to all foods, every time that they eat, anything and everything. In my eyes when such reactivity is going on it is clear that there are deeper issues at play here.

 

When It Doesn’t Matter What You Eat

 

It is in these overreactive situations where I recognise that the food isn’t the issue at all. This is not me minimising or belittling each individual’s sense of reactivity to foods – the sensations are real, the reactions are true and no, this isn’t in anyone’s head. I am not even suggesting that these reactions are psychosomatic.

 

What I am saying is that for some individuals their body’s natural stress responses – to absolutely everything – are so heightened that they have reactions to every food (and chemical, toxin, situation etc.). The dysregulation in all of the systems laid out above makes them hyper-responsive to foods.

But in such cases, hard as it might be to accept, the foods aren’t the issue. Cutting out foods might reduce symptoms but it doesn’t address the actual problem.

Identifying the ‘why’ behind the body’s upregulated stress responses is of paramount importance in order to heal. And I reiterate… this ‘why’ is rarely, if ever, anything to do with any food specifically… Most often in my experience it’s nothing to do with food at all.

 

If a body has learned to react in this hyper-alert, stressed way it’s because at some level there is a high degree of threat and stress being pulsed through its physiology.

Looking back at Paleo and AIP, the data that informs these diets is mechanistic. This doesn’t make the data bad, it just makes this mechanistic view slightly reductionist. It isolates the impact of nutrition to the effects foods have on the gastrointestinal tissue and/or the immune system and/or hormones within certain conditions. It focuses solely on the food consumption and its direct effects. What it cannot show us is the networked response of the whole physiology in response to consuming foods. It also cannot show us all of the reasons why certain people react to certain foods and others don’t.

 

Basically, we can test in labs what happens when sensitive bodies consume adjuvant (immune triggering) or inflammatory foods … but if you stop at the point of following Paleo or AIP to remove those adjuvant or inflammatory foods you never really ascertain what made that body sensitive in the first place.

 

The more I have worked on myself (and I really do mean myself, but it also is being borne out in my clients) the more I realise that the real ‘bang for your buck’ when it comes to methods that can tip the balance within healthcare is actually to go deeper into the personal reasons behind heightened sensitivities. And no, I’m not suggesting that beyond the food you must look at sleep, meditation, appropriate exercise and socialisation (though these are the other pillars that make up health and the Paleo or AIP approaches).

Instead, I feel that the most important question to ask, always, is ‘why’ – but you really have to understand where you’re looking to find the answer. You’re not looking for ‘why can’t I eat cheese’, you’re looking for ‘why am I in a state of heightened stress so I’m reacting so negatively to sustenance?’.

The ‘why’ is not normally one thing, and it’s not about the food. It is likely to be multifaceted and complex, and multilayered if the situation has been continuing for a long time. But beyond the physical and the biochemical ‘reasons’, there is always the emotional, the psychological, the spiritual and the ‘self’ stuff. And all of them matter.

So next week, I am going to continue my journey in discussing what really matters when it comes to effecting healing from any form of chronic illness and nutritional sensitivities. Because whilst a lot of my professional year was spent building a resource entirely revolving around one tool within a healthcare journey (the food), the bulk of my personal year – and where my passion lies within healthcare – takes us beyond the food to the patterns and the wiring underneath our surface which triggers reactivity and negative responses to life and the world around us.

So in my next article, rather than continuing to talk in generalisations I will share about my situation. For those of you who know a bit about my history you will already know that so much of my dilemmas have revolved around the gastrointestinal issues that I faced. What you might not realise is that even then – with GI conditions being at the heart of my wellbeing – finding my own peace within my body was still not very much to do with the food…