Healthy Gut Healthy You

Book review: Healthy Gut Healthy You (Dr Michael Ruscio)

Healthy Gut Healthy You is the long-awaited book by Dr Michael Ruscio, an American functional medicine practitioner, researcher and podcaster. Dr Ruscio started off as a chiropractor and discovered functional medicine during his own healing journey. He focuses on treating the gut as the first step for improving a wide range health conditions, many of which don’t manifest as gastrointestinal discomfort.

In both his book and his podcast, Dr Ruscio offers a very sensible clinical approach. I think this is a product of working with real patients and noting what actually works. He avoids dogma and excessive testing, restrictions and treatment.

Healthy Gut Healthy You

The book has 5 parts: The Importance of Your Gut, Diet for Optimum Gut Health, Lifestyle and Environments for Optimum Gut Health, Tools for Healing Your Gut and The Great-in-8 Action Plan. It is written in a simple language for the non-scientific reader to understand. Each chapter of the book is followed by several pages of scientific references for those interested in cross-checking the sources. I think it’s a valuable resource for clinicians and people facing health issues. Having said that, there are parts of the protocol that are best implemented with the help of a clinician.

Gut basics

Part 1 sets up the stage for the rest of the book. It briefly describes the anatomy and function of the small and large intestine. Then it explains how derangement in the gut, such as bacterial overgrowth, can cause a wide array of health issues.

Another important topic covered in this section of the book is how to determine which scientific papers are worth considering. With the amount of scientific papers being published these days and the bad job that journalists do at communicating science, it is important to sharpen critical skills.

This part also covers the impact of early life bacterial exposure on health.

The importance of diet

The second section of the book deals with diet and its effects on our health and the health of our gut bacteria. Dr Ruscio emphasises the importance of focusing on reducing inflammation and balancing blood sugar first in order to create a healthy environment. Only then we can worry about feeding our gut bacteria (i.e. prebiotics).

This part of the book also covers Coeliac Disease and non-Coeliac gluten sensitivity. Other topics include appropriate amounts of carbohydrate for each individual and the issue with processed foods.

Fibre is another interesting topic in this section, as more is not always better. This is particularly the case for gut-related conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

Beyond food

Part 3 of the book highlights the importance of the environment and lifestyle on gut health. This includes topics such as vitamin D, sun exposure, time in nature, sleep and stress management.

Supplements, etc.

The next section of the book explores other treatments that can help with particular health conditions, including probiotics, digestive enzymes, etc.

Dr Ruscio has a very practical way of looking at probiotics. Rather than focusing on brands he divides probiotics into 3 categories depending on which types of microorganisms are present in them. This is based on the observation that a particular category might work better than others for a particular condition and/or for particular people. Using this approach, one can save time and money by trying different categories of probiotics rather than a many different brands within the same category.

This section also covers antibacterial treatments that can be used to remove parasites, for example, and the use of liquid supplements designed to provide complete nutrition while allowing the gut to heal.

Other topics in this section are prokinetics (which stimulate intestinal motility), fibre supplements, prebiotics and fecal transplants.

The plan

The final part of the book details Dr Ruscio’s protocol named The Great-in-8 Action Plan. As its name implies, it contains 8 steps but not everyone needs to follow all of them. Some people might experience significant improvement with just changing their diet, for example.

The protocol includes, as most sensible protocols, the elimination of suspect foods with later reintroduction of non-problematic foods. A note for the anti-paleo crowd: Dr Ruscio does recommend a paleo diet (either standard or the autoimmune version) or a low-FODMAP diet for the elimination step. I agree that eliminating grains, legumes and dairy can be an effective way of pressing the reset button. I like the fact that Dr Ruscio puts particular emphasis on the reintroduction step with the aim of eating the wider variety of foods possible.

More info

Head to Dr Ruscio’s website for more information about his book and his work. Also check out his podcast Dr Ruscio Radio.

longevity diet

Book review: The Longevity Diet (Prof Valter Longo)

The Longevity Diet is one of these few diet books worth reading. It was written by Prof Valter Longo, one of the leading scientists in the field of longevity. Prof Longo has been experimenting with fasting-mimicking protocols in order to extend life and vitality.

One of the coolest facts about Prof Longo I learned from his book is that he wanted to become a rock star and that’s why he travelled from his home town in Italy to the US. He was on his way through a jazz composition major when he decided to change gears and pursue an interest that had been dormant in his mind: to study the science of how to stay young.

Blue zones

The main motivation for Prof Longo was knowing that living a healthy life beyond a century is not only possible but relatively common in certain parts of the world, known as blue zones, which include Sardinia in Italy.

Prof Longo has also spent time studying a population in Ecuador who suffer from a disease called Laron syndrome, in which the growth hormone receptor is defective. Interestingly, these very short individuals have lower incidence of cancer diabetes, despite poor lifestyle habits.

Aim of the Longevity Diet

Prof Longo’s thesis stems from the fact that most diseases and ageing occur due to cellular/DNA damage. Science usually focuses on addressing the symptoms caused by this damage (a reactive approach). Conversely, the Longevity Diet aims to awaken the body’s mechanism that is meant to protect and repair itself from damage but has become dormant due to the advances in exogenous protection from damage (aka technology).

Benefits of the Longevity Diet

Multiple animal experiments and several human trials have been performed in order to explore the effects of this diet in health. Potential benefits include weight management, longevity, cancer, diabetes, cardiovascular disease, neurodegenerative diseases (such as Alzheimer’s), inflammatory and autoimmune diseases.

The longevity plan at a glance

Now, the bad news (just kidding!). This diet is a stricter, low protein, low calorie version of what we know as a Mediterranean diet. It includes lots of vegetables, whole grains, legumes, nuts and olive oil, but it limits animal protein to seafood a few times per week and dairy products, which are only permitted for adults over 65 years old who are losing weight or muscle mass.

The actual foods included in the diet should match what our ancestors used to eat.

The plan also include 5 days of a fasting-mimicking diet (very low calorie diet). The frequency and need for medical supervision vary depending on each individual’s health conditions, body composition, age, etc. Note that fasting-mimicking diets are not recommended for pregnant women, underweight people, high-charging athletes, etc.

The book also addresses the need of exercise, brain engagement and social interaction.

The daily diet

Below is a summary of the daily diet portion of the plan:

  1. Eat mostly vegan, plus a little low-mercury fish (two or three servings per week).
  2. Keep protein intake to 0.68 to 0.79 grams per kilogram of body weight (higher for people over 65 years old). Protein should maily come from legumes.
  3. Minimize saturated fats (with the exception of coconut oil) and sugar. Eat whole grains and high quantities of vegetables with generous amounts of olive oil and nuts.
  4. Supplement with a multivitamin every three days.
  5. Eat what your ancestors would have eaten.
  6. Have 2 meals and a snack per day if you need to lose weight, otherwise 3 meals and a snack.
  7. Eat all your meals within 12 hours.

Rationale

The diet is low in protein (and relatively low in calories) because proteins activate the growth hormone receptor (leading to increased insulin and insulin-like growth factor 1) and TOR-S6K. In addition, the diet is low in sugar because sugars activate PKA. The end result may be diabetes, cancer and accelerated ageing.

Following our ancestors’ diet (if they did eat a reasonably healthy diet) ensures our bodies are familiar with those particular foods and thus less likely to develop allergies or intolerances.

The fasting-mimicking portion of the protocol puts healthy cells in an antiageing state, promotes destruction and replacement of damaged cells and shifting the body’s fuel utilisation to abdominal/visceral fat. It is fasting-mimicking and not “real” fasting to provide enough energy for the immune system and other important functions.

The exercise

Below is the exercise part of the plan, which aligns well with the Australian guidelines:

  1. Walk fast for an hour every day, emphasise incidental exercise (e.g. stairs instead of escalators, walking instead of driving).
  2. Do moderate exercise for 2.5 to 5 hours a week.
  3. Do resistance training.
  4. Eat your largest protein meal (with 30+ grams of protein) after resistance training to maximise muscle gain.

The meal plan

The book comes with a 2-week meal plan with recipes for every meal and snack suggestions. Keep in mind the recipes are based on Italian traditional cuisine, which might not apply to you based on your ancestry. Also, you might need to adjust the recipes due to food allergies or intolerances.

More information

For more information on Prof Valter Longo’s work follow the links below:

Valter Longo Foundation
Prof Valter Longo on Facebook

To learn more about the book and/or buy it online, click here. All proceeds go toward funding more longevity research.

Gastrophysics

Book review: Gastrophysics (Charles Spence)

Gastrophysics: The New Science of Eating is a recently published book by British experimental psychologist Charles Spence. I had heard about his work in a few food podcasts I listen to, particularly his experiments with “sonic seasoning” – the effect that sound has on taste and texture perception.

The introduction was written by British celebrity chef Heston Blumenthal of The Fat Duck, with whom Spence has collaborated for a number of years. This fact certainly gives the author more credibility than the Ig Nobel Prize he won in 2008 for his sonic seasoning research on potato chips.

What is gastrophysics?

As described by the author in chapter one, gastrophysics is where gastronomy meets psychophysics (i.e. the scientific study of perception). As we know, we perceive things through our senses, and this is how the book starts.

The book

Chapters 1-5 cover the senses: taste, smell, sight, sound and touch. The author explains how our perception of food comes from multiple sensory cues, not just flavour. Things that affect our willingness to eat a particular food and our perception of it include colour, a food’s name, genetic predisposition to taste certain substances, scents, shapes, size of the serving vessel, sound of packaging, texture and weight of the cutlery, etc.

The rest of the book builds on how those sensory cues are affected or applied to particular situations. ‘The atmospheric meal’ explains how ambience affects our dining behaviour and experience. ‘Social dining’ explores the current trend of eating alone vs. with others, and how that can modify what and how much we eat. ‘Airline food’ explains why it is (or it seems to be) so bad and what can be done to make it less bad. ‘The meal remembered’ reminds us that experiences are more memorable than tastes.

‘The personalised meal’ is all about our preference for personalisation (the simplest example being seasoning our food on the table) and how this can be used by businesses to target consumers. ‘The experiential meal’ narrates different approaches of delivering multisensory experiences in fine dining establishments, including theatrical serving, storytelling, music, magic, opera, etc. ‘Digital dining’ questions the benefits of digital menus, digital plating (i.e. plating on tablets), 3D food printing, etc. ‘Back to the futurists’ contrasts the 1930s Italian futurists movement with today’s dining scape.

Book wrap-up

Even though the bulk of the book can be viewed as a marketing tool for restaurateurs, the author also gives recommendations that can be used in ordinary life, particularly if one is interested in eating healthier. Thus, Spence ends the book with the following recommendations for eating healthy, applying some of the lessons learned from research:

  1. Eat less
  2. Hide junk food
  3. For middle-aged and older adults: drink lots of water before meals to fill you up
  4. Eat in front of a mirror to decrease consumption of junk food, eat slowly and mindfully
  5. The more food sensations (i.e. the least processed the food), the better
  6. Eat from small plates
  7. Eat from heavy bowls without rims, held in your hands (to trick you into thinking there is more food)
  8. Use red plateware to trigger avoidance
  9. Eat using chopsticks or with your non-dominant hand or using small cutlery to make it more difficult to get food in your mouth
The Bad Food Bible

Book review: The Bad Food Bible

I first heard about this book in a food-related podcast (can’t remember which one). The full name of the book – The Bad Food Bible: How and Why to Eat Sinfully – was totally unappealing to me but somehow the book showed in my Audible list of suggestions and I decided to give it a listen.

The book was written by paediatrician Aaron Carroll. I have some bias against doctors who think they know more about nutrition than everyone else, especially knowing that they don’t get much nutrition education in uni. However, I decided to chill out and just listen to what he had to say.

Turns out that Carroll is not a regular doctor. He does not rely on textbook information that is taken as gospel even though is based on outdated or unreliable research.

In this respect, the most valuable takeaway of The Bad Food Bible for the lay reader/listener is that not all studies are created equal. The author explains in an approachable way how to critically appraise a research depending on the study design (e.g. randomised controlled trial > observational study), the study subjects (e.g. humans > mice), etc. I think this is important information that everyone should be aware of because of the way research gets portrayed (and sometimes misrepresented) in the media.

For the bulk of the book, Carroll talks the foods/ingredients that are generally considered as poison. These foods tend to be highly controversial and polarising. One of the reasons the author gives is the fact that there is research published for and against many foods. He cites the article Is everything we eat associated with cancer? A systematic cookbook review, in which the authors selected 50 ingredients from a cookbook and found that 40 of them were associated with cancer risk. The problem is that associations went in both directions, i.e. increased or decreased risk and that evidence was weak or non-statistically significant for most of the studies.

The author also mentions other sources of noise in research, including researcher bias, the placebo/

Cooked by Michael Pollan

Book review: Cooked by Michael Pollan

I finally listened to Michael Pollan‘s latest book, Cooked – A Natural History of Transformation. Pollan, a contributor writer for The New York Times, is one of the thought leaders of the real food movement. His previous books, which include The Omnivore’s Dilemma, In Defense Of Food and Food Rules, focus on the intersection of food, history, politics, society and health. I am a big fan of his writing, both in style and in content. Although I don’t necessarily agree with everything he stands for, I think the gist of his message is nothing but positive.

Cooked is divided in the four elements: fire, water, air and earth, which are not only essential to life in general but also specifically to food transformation. Part of the author’s research for the book involved travelling to multiple locations in order to find one or more experts in a particular way of cooking (or preparing) food, in order to learn how to do it by himself from scratch. As Pollan notes, current society spends more time obsessing about food and less time cooking than ever before. His message in this book is that cooking is a way of reconnecting with our human nature, expressing generosity, building community, improving our health and eventually influencing the direction of food production and politics.

This book, as the previous ones, is beautifully written. I think it should come with a warning: “this book will make you hungry”. Let me elaborate. Fire describes what is possibly the earliest technology that allowed us to maximise the nutrients that we could extract from food. Pollan, being American, explored this element using the example of barbecue. I spent the whole section not only craving, but looking for online menus and planning my next visit to a local American barbecue restaurant.

In the water section, the author narrates how he enlisted one of his former students, who has worked as a professional cook, to teach him how to cook. The lessons involved many “pot” dishes, such as braises, which link to the main topic of the section. Braising liquids, such as stock, wine, milk and plain old water, are discussed in this section, as well as the superiority of pot dishes as a means to nourish many mouths with less cost and more flavour.

Air is mainly about bread, one of the foods which structure is defined by the air produced by bacterial fermentation. Pollan embarks in the adventure of making his own sourdough starter and baking his own bread with the help of a professional baker. There was a time when I baked a loaf of bread every week (mainly for my husband) and, even though I used commercial yeast instead of a starter, I do agree it is a very satisfying thing to do from scratch.

The final section, earth, expands on the topic of fermentation. It includes cultured vegetables such as sauerkraut and kimchi, wine, mead, cheese and beer. As such, Pollan consulted with a few different experts, including a nun who makes artisanal cheeses and beer brewing experts. This section gave me cravings for cheese and beer, both of which were satisfied over the weekend :).

The book comes with four recipes, one for each transformation. These are involved recipes, don’t expect “ready in 15 minutes” weeknight dinner dishes. There is also a list of recommended books on cooking in general and also for each transformation.

Pollan makes clear that his prescription is not that everyone should be cooking all the time. Instead, he suggests we should aim to cook a few more times per week (and ideally eat with the rest of the family), and therefore eat out less and/or buy less ready-made meals. This is advice I can definitely get behind.