How to Increase Gut Bacterial Richness

We live in an “obesogenic environment,” with cheap junk food everywhere, thanks in part to subsidies going to the “‘food industrial complex,’ which manufactures obesogenic foods that foster addiction…The root causes…[may] make obesity difficult to escape,” but a lot of people do. If it were simply the external environment, why isn’t everyone obese?

“Some individuals seem to be more susceptible to the obesogenic environment…than others,” which suggests a genetic component, supported by studies of twins and adopted kids, but the genes that have been identified so far account for only 6 to 11 percent of the genetic variation in body mass index between individuals. Perhaps variation in our “other genome”—that is, all the different microbes that inhabit our body, known as the microbiome—may be playing a role. We have a hundred times more bacterial genes inside us than human genes.

As I discuss in my video Gut Microbiome: Strike It Rich with Whole Grains, a study found that people tend to fall into one of two groups: those who have lots of different types of bacteria in their gut (high “gut bacterial richness”) and those with relatively few types. Those with low bacterial richness had more overall body fat, insulin resistance, which is the cause of type 2 diabetes, high triglycerides, and higher levels of inflammatory markers, like C-reactive protein, compared to those with high bacterial richness. Not only did people with lower bacterial richness start out heavier, but the obese individuals with lower bacterial richness also gained more weight over time.

The question then becomes: Can a dietary intervention have any impact “A number of studies have associated increased microbial richness…with diets higher in fruits, vegetables, and fiber.”

Just giving fiber-type supplements doesn’t seem to boost richness, however, but the “compositional complexity” of a whole food, like whole grains, “could potentially support a wider scope of bacterial taxa,” types of bacteria, “thereby leading to an increase in diversity.” Human studies to investigate the effects of whole grains had been neglected, though…until now.

Subjects were given whole-grain barley, brown rice, or a mixture of both for a month, and all three caused an increase in bacterial community diversity. Therefore, it may take a broad range of substrates to increase bacterial diversity, and this can be achieved by eating whole plant foods.

Moreover, the alterations of gut bacteria in the study coincided with a drop in systemic inflammation in the body. We used to think that the way fiber in whole grains helped us was by gelling in our small intestine right off of our stomach, slowing the rate at which sugars were absorbed and blunting the spike in blood sugars one might get from refined carbs. We now know, however, that fiber is broken down in our colon by our friendly flora, which release all sorts of beneficial substances into our bloodstream that can have anti-inflammatory effects, as well. So, perhaps what’s happening in our large intestine helps explain the protective effects of whole grain foods against type 2 diabetes.

Interestingly, the combination of both barley and brown rice worked better than either grain alone, suggesting a synergistic effect. This may help explain “the discrepancy of the health effects of whole grains obtained in epidemiological [population-based] and interventional studies.”

Observational studies “strongly suggest” that those who consume three or more servings of whole grains a day tend to have a lower body mass index, less belly fat, and less tendency to gain weight, but recent clinical trials, where researchers randomized subjects to eat white bread rolls versus whole-wheat rolls, failed to provide evidence of a beneficial effect on body weight. Of course, whole grains are so superior nutritionally that they should continue to be encouraged. However, the “[i]nterventional trials might have failed to show [weight] benefits because they focused on a limited selection of whole grains, while in epidemiological trials [or the population studies], subjects are likely to consume a diverse set of whole grains which might have synergistic activities.”

Until recently, we knew very little about how powerfully our gut bacteria can affect our health. Catch up on the latest science with these related videos:

When it comes to rice, even white rice can be better than many choices, but brown rice is better and pigmented rice is probably the best. See my videos Kempner Rice Diet: Whipping Us Into Shape and Is It Worth Switching from White Rice to Brown? for more.

But what about the arsenic in rice? Learn more:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Best Diet for Depression

Depression affects more than 150 million people worldwide, making it a leading cause of losing healthy years of life as a result of disability. By 2020, depression may be second only to heart disease as the leading cause of healthy years of life lost. Why is depression so common? Well it’s said, “Nothing in Biology makes sense except in the light of evolution.” Why would we evolve to get depressed?

Depression presents a baffling evolutionary puzzle. Despite its negative effects, it remains common and heritable, meaning a large part of the risk is passed through our genes. Presumably, there must be some kind of adaptive benefit or it would have been naturally selected against. Could depression be an evolutionary strategy to provide a defense against infection? Infection has been the leading cause of mortality throughout human history, making it a critical force in natural selection. Indeed, because of infections, our average life expectancy before the industrial period was only 25 years, and it was not uncommon for half of our children to die without reaching adulthood.

When we become infected, there is a surge of inflammation as our body mounts a counter-attack. Our body responds by feeling lousy, sick, weak, tired, and slow. We don’t want to socialize. The only thing we do want to do is sleep. These symptoms are similar to the ones we experience during depression and are great for fighting infection. Slowing down not only helps us conserve energy to put up a good fight; it also reduces social contact so we don’t infect others. We see this protective phenomenon in other social animals, like honeybees and mole rats, who feel compelled to crawl off and die alone to reduce the risk of infecting the rest of their community. Humans have even evolved to think poop and decaying flesh don’t smell particularly good to keep us safe from infection.

To explore the relationship between inflammation and mental health, we have to look back to 1887, when this connection was first noted by Dr. Julius Wagner-Jauregg, the only psychiatrist to ever win the Nobel Prize. What evidence have we accumulated in the past century that inflammation causes depression? We know that people who are depressed have raised inflammatory markers, such as C-reactive protein and that inflammatory illnesses are associated with greater rates of major depression. Indeed, we find depression in even more benign inflammatory conditions such as asthma and allergies. This is important as it suggests that the mood symptoms may be directly tied to the inflammation and are not simply the result of “feeling bad about having a terrible disease.”

We also know that you can induce depression by inducing inflammation. For example, when we give interferon for certain cancers or chronic infection, up to 50 percent of people go on to suffer major depression. Even just giving a vaccine can cause enough inflammation to trigger depressive symptoms. Taken together, these studies “are strongly suggestive of inflammation being a causative factor of mood symptoms.”

Can an anti-inflammatory diet help prevent depression? We didn’t know until researchers followed the diets of about 43,000 women without depression for approximately 12 years. Those who ate a more inflammatory diet, characterized by more soda, refined grains and meat, became depressed. “This finding suggests that chronic inflammation may underlie the association between diet and depression.”

Normally, we think of omega-3s as anti-inflammatory, but researchers found fish to be pro-inflammatory, associated with increased C-reactive protein levels. This is consistent with recent findings that omega-3s don’t seem to help with either depression or inflammation. As I discuss in my video Anti-Inflammatory Diet for Depression, the most anti-inflammatory diet is a plant-based diet, which is capable of cutting C-reactive protein levels by an impressive 30 percent within two weeks, perhaps because of the anti-inflammatory properties of the antioxidants found in plants. I talked about this in my Anti-Inflammatory Antioxidants video, but never explained why antioxidants are anti-inflammatory.

When free radicals cause oxidative damage, it may cause an autoimmune response in the body by changing the chemical structures of otherwise ubiquitous molecules to generate new structures that the body attacks as foreign. For example, when LDL cholesterol gets oxidized, our body creates antibodies against it that attack it. Likewise, clinical depression can be accompanied by increased oxidative stress and the autoimmune inflammatory responses it creates. Free radicals may thus lead to autoimmune inflammation.

Where else does inflammation in our diet come from? Endotoxins. It’s worth reviewing my videos on the subject—The Leaky Gut Theory of Why Animal Products Cause Inflammation, Dead Meat Bacteria Endotoxemia, and The Exogenous Endotoxin Theory—to see how the endotoxins in animal products can cause a burst of inflammation within hours of consumption. What does this burst do to our mood? Within a few hours of injecting endotoxin, inflammation shoots up, increasing feelings of depression and social disconnection.

Although previous research has demonstrated that inflammatory activity contributes to depressive symptoms, only recently did research show the effect of experimentally induced inflammation on anhedonia, the lack of reaction to pleasurable stimuli. In the study, subjects were injected with endotoxin. Within hours of the endotoxin hitting their bloodstreams, they began feeling depressed and had significant activity reductions in the reward center of the brain. The subjects, for example, were less excited about winning money playing video games. But as I discuss in my Plant-Based Diets for Improved Mood and Productivity and Antioxidants and Depression videos, we may be able to treat or even prevent depression by eliminating animal products and eating antioxidant-rich diets.

If you’re as much of a sucker for evolutionary biology theory as I am, you can learn more about it by checking out my High Blood Pressure May Be a Choice, The Problem with the Paleo Diet Argument and Why Do We Age? videos. 

I have several videos on inflammation, including: 

And in Biblical Daniel Fast Put to the Test, I discuss a study that shows a dramatic decrease in inflammation within weeks on a plant-based diet.

For more information on the effect diet can have on mental health, check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Foods to Avoid to Help Prevent Diabetes

We’ve known that being overweight and obese are important risk factors for type 2 diabetes, but, until recently, not much attention has been paid to the role of specific foods. I discuss this issue in my video, Why Is Meat a Risk Factor for Diabetes?

A 2013 meta-analysis of all the cohorts looking at the connection between meat and diabetes found a significantly higher risk associated with total meat consumption––especially consumption of processed meat, particularly poultry. But why? There’s a whole list of potential culprits in meat: saturated fat, animal fat, trans fats naturally found in meat, cholesterol, or animal protein. It could be the heme iron found in meat, which can lead to free radicals and iron-induced oxidative stress that may lead to chronic inflammation and type 2 diabetes, or advanced glycation end (AGE) products, which promote oxidative stress and inflammation. Food analyses show that the highest levels of these so-called glycotoxins are found in meat—particularly roasted, fried, or broiled meat, though any foods from animal sources (and even high fat and protein plant foods such as nuts) exposed to high dry temperatures can be potent sources of these pro-oxidant chemicals.

In another study, researchers fed diabetics glycotoxin-packed foods, like chicken, fish, and eggs, and their inflammatory markers––tumor necrosis factor, C-reactive protein, and vascular adhesion molecules––shot up. “Thus, in diabetes, environmental (dietary) AGEs promote inflammatory mediators, leading to tissue injury.” The good news is that restriction of these kinds of foods may suppress these inflammatory effects. Appropriate measures to limit AGE intake, such as eliminating meat or using only steaming and boiling as methods for cooking it, “may greatly reduce the already heavy burden of these toxins in the diabetic patient.” These glycotoxins may be the missing link between the increased consumption of animal fat and meats and the development of type 2 diabetes.

Since the 2013 meta-analysis was published, another study came out in which approximately 17,000 people were followed for about a dozen years. Researchers found an 8% increased risk for every 50 grams of daily meat consumption. Just one quarter of a chicken breast’s worth of meat for the entire day may significantly increase the risk of diabetes. Yes, we know there are many possible culprits: the glycotoxins or trans fat in meat, saturated fat, or the heme iron (which could actually promote the formation of carcinogens called nitrosamines, though they could also just be produced in the cooking process itself). However, we did learn something new: There also appears to be a greater incidence of diabetes among those who handle meat for a living. Maybe there are some diabetes-causing zoonotic infectious agents––such as viruses––present in fresh cuts of meat, including poultry.

A “crucial factor underlying the diabetes epidemic” may be the overstimulation of the aging enzyme TOR pathway by excess food consumption––but not by the consumption of just any food: Animal proteins not only stimulate the cancer-promoting hormone insulin growth factor-1 but also provide high amounts of leucine, which stimulates TOR activation and appears to contribute to the burning out of the insulin-producing beta cells in the pancreas, contributing to type 2 diabetes. So, it’s not just the high fat and added sugars that are implicated; critical attention must be paid to the daily intake of animal proteins as well.

According to a study, “[i]n general, lower leucine levels are only reached by restriction of animal proteins.” To reach the leucine intake provided by dairy or meat, we’d have to eat 9 pounds of cabbage or 100 apples to take an extreme example. That just exemplifies the extreme differences in leucine amounts provided by a more standard diet in comparison with a more plant-based diet.

I reviewed the role endocrine-disrupting industrial pollutants in the food supply may play in a three-part video series: Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat. Clearly, the standard America diet and lifestyle contribute to the epidemic of diabetes and obesity, but the contribution of these industrial pollutants can no longer be ignored. We now have experimental evidence that exposure to industrial toxins alone induces weight gain and insulin resistance, and, therefore, may be an underappreciated cause of obesity and diabetes. Consider what’s happening to our infants: Obesity in a six-month-old is obviously not related to diet or lack of exercise. They’re now exposed to hundreds of chemicals from their moms, straight through the umbilical cord, some of which may be obesogenic (that is, obesity-generating).

The millions of pounds of chemicals and heavy metals released every year into our environment should make us all stop and think about how we live and the choices we make every day in the foods we eat. A 2014 review of the evidence on pollutants and diabetes noted that we can be exposed through toxic spills, but “most of the human exposure nowadays is from the ingestion of contaminated food as a result of bioaccumulation up the food chain. The main source (around 95%) of [persistent pollutant] intake is through dietary intake of animal fats.”

For more on the information mentioned here, see the following videos that take a closer look at these major topics:  

AGEs: Glycotoxins, Avoiding a Sugary Grave, and Reducing Glycotoxin Intake to Prevent Alzheimer’s.

TOR: Why Do We Age?, Caloric Restriction vs. Animal Protein Restriction, Prevent Cancer From Going on TOR, and Saving Lives By Treating Acne With Diet

Viruses: Infectobesity: Adenovirus 36 and Childhood Obesity

Poultry workers: Poultry Exposure and Neurological Disease, Poultry Exposure Tied to Liver and Pancreatic Cancer, and Eating Outside Our Kingdom

Industrial pollutants: Obesity-Causing Pollutants in Food, Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat

The link between meat and diabetes may also be due to a lack of sufficient protective components of plants in the diet, which is discussed in my videos How May Plants Protect Against Diabetes?, Plant-Based Diets for DiabetesPlant-Based Diets and Diabetes, and How Not to Die from Diabetes.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: