Digestion (week 4) Flashcards
functional categories and frameworks
cofactors (vitamins and minerals)
mucus membrane support
tissue repair
digestive stimulus
replacements
immune modulators
glandular extracts
adaptogens
Cofactors (vitamins and minerals)
Provide the micronutrients required for catabolic and anabolic chemical reactions
Supply the required nutrients for form and function, including the activation, regulation, and building blocks (substrates) needed for enzymes to work
EX: Zinc is the mineral cofactor for carbonic anhydrase, the enzyme responsible for synthesizing HCL
mucus membrane support
Soothe tissues and bolster the protective mucus coating of the upper GI tract and intestines
EX: Demulcents – licorice root, aloe vera, slippery elm, etc.
Often used to soothe and restore mucous membranes before other approaches like increasing acidity
tissue repair
Increase the supply of readily available and easily absorbed nutrients that speed the processes of cell renewal and tissue repair
EX: L-Glutamine promotes enterocyte proliferation, regulates tight junction proteins, lowers inflammation, and protects enterocytes against
cell death during high oxidative stress
digestive stimulants
Elicit the body’s own digestive secretions:
EX: Digestive bitters
-Stimulate the secretion of hydrochloric acid
-Gentian root
EX: Choleretics
-Stimulate the release of bile
-ACV, turmeric, dandelion root, and dietary choline or lecithin, etc.
replacements
Direct addition of digestive or hormonal compounds either synthetically produced, animal-based, or plant-based
Our goal is always to support the body’s innate ability to produce its own hormones, enzymes, digestive juices, etc (endogenous), however, there are times when supplying an outside source (exogenous) can help overcome long-term imbalances, allow the body to reset and regain its own function, or compensate for a permanent loss of function
EX: Betaine HCL, ox bile, digestive enzymes
immune modulators
Directly inhibit, stimulate, or modulate the production of transcription factors on immune-related genes (influence gene expression), immune signaling compounds, and function of immune cells
EX: Nettles, quercetin: mast cell stabilizers, reduce histamine release
EX: Colostrum: produced by mammals after birth, contains immune factors like antibodies, exerts immune effects in the GI tract
microbiome modulators
Directly alter microbial populations via inoculation, prebiotics, or antimicrobials
Probiotics – inoculation with living microbes
* EX: Saccharomyces boulardii reduces Clostridium difficile infection. When S. boulardii is given to antibiotic-exposed mice or patients with diarrhea, normal microbiota is re-established more rapidly
-Helps re-establish healthy symbiosis between multiple populations of beneficial microbes
-Oregano oil - broad-spectrum antimicrobial activity
Glandular extracts
Not just organs – includes endocrine glands
Oral consumption is theorized to be effective based on three main categories:
-hormonal, enzymatic, and nutritive
Remains controversial in terms of hormone content, digestion of bioactive components, safety (non-standardized), etc.
Backed by biological rationale as well as traditional, anecdotal, and clinical evidence
-EX: Adrenal – low adrenal output or recovery from stress
-EX: Pancreas – serves as a glandular (endocrine) as well as a replacement because it contains pancreatic enzymes (exocrine)
adaptogens
over 50 plants have been reported to fit the criteria of being adaptogenic in their action.
increase the body’s ability to cope with internal and external stresses
stimulating effects after both single-time use and prolonged use, leading to increased working capacity and mental performance under stressful and fatigue inducing conditions without increasing oxygen consumption
normalize the functions of the body irrespective of nature of stressors
no negative side effects
Ex: red ginseng normalizes stress hormone levels and has been shown to reduce visceral hypersensitivty of IBS
The 5 R’s in restoring gut health
remove, replace, reinoculate, repair, rebalance
Remove:
In this step, you are looking to remove stressors and irritants. This can include things like foods that directly burden the north-to-south process in some way, microbial infections or overgrowths, or foods that someone may be allergic or intolerant to. Medications may also serve as an irritant, but you want to avoid recommending someone discontinue a prescription medication without oversight by a prescribing physician. So, in this step, we may think about elimination trials or testing to help identify food hypersensitivities or intolerances, or we may consider microbiome modulators like antimicrobials and antifungals to help remove the obstacles to optimal function. It is important to know that this “removal” may be short-term. We don’t want to let our thinking get too boxed in to “remove, remove, remove.”
Replace:
In this step, we want to focus on replacing key nutrients that may be missing from the diet. So, incorporating a nutrient-dense, properly prepared, whole- food diet is at the heart of this step. Also, ensuring that there is enough stomach acid, digestive enzymes, and bile being produced and secreted to ensure digestion and absorption. Adding bitters, HCl, vinegar, digestive enzymes, or bile support can be incredibly helpful to get someone back on track.
Reinoculate:
Here, we are working to fortify and diversify the beneficial populations of the gut microbiota. This is where we would use probiotic-rich food and drinks like sauerkraut, kombucha, kefir, kimchi, miso, etc. In some cases, probiotic supplements will be helpful. Additionally, ensure that the diet is rich in
enough prebiotic fiber and starches to serve as food for healthy bacteria to flourish. Foods rich in prebiotics include garlic, asparagus, onions, leafy greens, whole grains (quinoa, oats), apples, flaxseed, lentils, and jicama - if tolerated.
Repair:
Once we have removed obstacles, replaced nutrients or digestive aids, and started working on balancing the microbiome, it is time to work on repairing the integrity of intestinal walls. This involves adding essential key nutrients for tissue
repair like l-glutamine, gelatinous broths and/or collagen peptides, zinc, and vitamins A/C/D/E, etc.
Rebalance:
In this last step, I like to think about addressing the many lifestyle factors that also play a role in optimal health. This means encouraging a client to
realize the value of good hydration, stress management, daily movement, recreation
and creative self-expression, social connection, and of course, good quality sleeping- all of which will allow the nutritional work you are doing to be effective.
phytonutrients
phytochemicals
bioactive compounds found in plant foods - associated with many health benefits
~10,000 types
some top subtypes relevant to digestion: carotenoids, chlorophylls, curcumoids, organosulfur compounds, terpenes, and polyphenols
Carotenoids
re, orange, and yellow pigments
beta-carotene, lycopene, lutein, and zeaxanthin
potent antioxidants
beta-carotene can reduce LPS-induced intestinal inflammation and increase the expression of tight junction proteins (barrier function)
chlorophylls
green pigments needed for photosynthesis in plants
potent antioxidants
detoxification of heavy metals, environmental pollutants, and aflotoxin
anti-inflammatory properties and promote the healing of wounds and support tissue regeneration
act as internal deodorant
curcuminoids
includes curcumin
possess antioxxidant, anti-inflammatory, and potentially anticancer properties
reduced relapse rates and symptoms in patients with IBD (crohns disease and ulcerative colitis)
organosulfur compounds
sulfur containing phytonutrients in alliums (garlic, onion, shallot) and cruciferous vegetables (broccoli, cauliflower brussel sprouts)
include allicin and sulforaphane
antioxidant, anti inflammatory, and potential anti cancer effects
can be clinically useful in SIBO and have roles in detoxification and immune regulation
terpenes
large component of the essential oils
include limonene, linalool, and menthol
aroma and flavor
antioxidant, anti-inflammatory, and antimicrobial properties
EX: oregano’s antimicrobial properties from terpenes carvacrol and thymol
polyphenols
possess strong antioxidant and anti-inflammatory properties
exert beneficial effects on the intestinal microbiota
over 8,000 known types of polyphenols widely distributed in foods
ex: flavonoid (many subtypes including anothocyanins in berries and catechins in tea and cocoa beans)
ex: flavonols (quercetin)
polyphenols
secondary metabolites:
-not directly involved in the growth, development, or reproduction of the plant
-response to environmental stress
-protective properties conferred to humans when consumed
-can be toxic if consumed in excess
metabolism of polyphenols:
-microbes in the gut break down complex polyphenols into smaller metabolites that can be utilized by the body
-microbial metabolites contribute to the overall health benefits associated with polyphenols
polyphenols impact on digestive tract
Prebiotic:
-act as a food source for beneficial bacteria such as Bifidobacteria and Lactobacilli
Microbial diversity:
-associated with increased microbial diversity
-ex: polyphenols in cranberry, grape, pomegranate, and EGCG from green tea boost levels of Akkermansia muciniphila which helps to promote mucosal integrity and mitigate diabetes and obesity
intestinal barrier function:
-individuals who consumed a polyphenol rich diet exhibited reduced levels of zonulin (a marker of intestinal permeability), higher levels of short chain fatty acids such as butyrate, and reduced levels of pathogenic microbes
antimicrobial effects:
-inhibit the growth of harmful bacteria or pathogens
Herbs & Spices
used across time and cultures to promote healthy digestion
herbs: the leaves of a plant (fresh or dried)
spices: roots, stems, flowers, seeds, and berries
aid in the breakdown and absorption of nutrients
provide comfort and relief to digestive system
Herbs & spices
turmeric:
-reduces bloating, prevents ulcers, gastric infections
-reduces relapse/severity of IBS and IBD
-rich in curcumin
-increases microbial diversity in the gut
-fatty acids and black pepper increase absorption
cinnamon:
-increases appetite, eases gas, burping, bloating in IBD
-reduces H. pylori
-rich in antioxidants and polyphenols
-plays a role in blood glucose regulation
ginger:
-eases indigestion, reduce nausea
-naturally increases digestive juices
-increase peristalsis
-anti-microbial and anti-inflammatory
Cardamom:
-healing stomach ulcers
-reducing inflammation
peppermint:
-eases stomach discomfort and reflux
-can cause transient (temporary) relaxation of LES
slippery elm:
-prebiotic
-positively influences gut microbiota
-treats heartburn/relux
-increases mucous production and supports gut lining
Fennel:
-relieves bloating and gas
-increases appetite
caraway:
-eases stomach cramping and nausea
-dissipates gas
garlic:
-anti-microbial properties
-contains inulin, a powerful prebiotic
oregano:
-anti-microbial
-can be used to treat dysbiotic condition in the gut
helping clients incorporate herbs & spices
help clients get more familiar + better access
asking clients what they have, what are they open to trying?
buying in bulk
potted/planted herbs
new recipes for clients: curries, roasting blends, perstos, gremolata, chimichurri
probiotic rich foods
beneficial microbes
aids in digestion
nutrient breakdown and liberation
nutrient conversion
“fermentation is a health regimen, a gourmet art, a multicultural adventure, a form of activism, and a spiritual path, all rolled into one” -sandor katz
Fermentation types
differ based on types of organisms, substrates, and environments
Lacto-fermentation:
-more lactic acid producing bacteria
-requires low oxygen environment (anaerobic)
Ex: kimchi, sauerkraut, kvass
SCOBY: symbiotic colony of bacteria nad yeast
-more acetic acid producing yeast and bacteria
-form a cellulose-based biofilm
Ex: apple cider vinegar, kombucha
Kefir “grains”
-both lactic and acetic acid producing bacteria and yeast
-protein matrix called kefiran
Ex: dairy kefir, water kefir grains
Mycelium: mold and fungi
-Ex: tempeh, miso (koji)
Wild vs Cultured Ferments
Microorganisms:
-Wild = naturally occurring microorganisms present in the environment
Ex: lactobacillus bacteria on cabbage + salt and water
-Cultured = direct inoculation with specific strains of microbes
Ex: yogurt with starter culture
Control:
-Wild = less predictable and less control; flavor, aroma, and quality vary from batch to batch
-Cultured = more control, consistent results
Time and Speed:
-Wild = slower fermentation process
-Cultured = accelerate the fermentation process
Purchasing Fermented Foods
not all fermented foods are created equal
read ingredient labels:
-look for probiotics low in added sugar/flavorings
-organic, grass fed when possible
-DIY
Raw/Living vs Pasteurized
-look in refrigerated section of store
-metabiotics - still carry some benefits after fermentations have been cooked/killed
Categories of Prebiotics: Fructans
Fructans: includes inulin and fructooligosaccharides (FOS)
-Inulin:
-soluble fiber
-found in chicory root, jerusalem artichokes, onions, garlic, leeks
Criteria for Prebiotics
- resistant to gastric acidity and hydrolysis by mammalian enzymes and GI absorption
- Can be fermented by intestinal microflora
- selectively stimulates the growth and.or activity of intestinal bacteria associated with the health and wellbeing of the host
selective =
Categories of Prebiotics: Froctooligosaccharides (FOS)
-Froctooligosaccharides (FOS):
-a group of prebiotics composed of short chains of fructose
-bananas, onions, garlic, asparagus, wheat
Categories of Prebiotics: Galactooligosaccharides (GOD)
Galactooligosaccharides (GOD):
-made up of short chains of galactose
-legumes (beans, lentils), human breast milk, some dairy products
-commonly used as prebiotic in infant formulas
