Blog

July 25

If we work at something long enough, despite how distant the horizon, there's an occasional breakthrough to celebrate. A month ago it felt a little bit like that when the American Heart Association released a "scientific statement" which critically reviewed one of the oldest, most obvious, and yet still wildly polarizing concepts in health care - that since food quality has the power to restore health, professionals (including physicians) should prescribe it like a medication. While this seems like common sense to many who agree with the fundamentals of the idea, not everyone does. Whether the lack of formal training health professionals receive in the area of nutritional science, or the claim that eating healthy is inconvenient or costly compared to the "ease" of medication or even questions related to effectiveness, getting to a point where "food is medicine" has been a slog. However, over the last 5 years, things have begun to shift, and the idea is gaining steam. A growing number of people are realizing that trading the convenience of cheap ingredients enhanced with ultra-processed flavor profiles now for a hefty quality of life cost in the future is not a good bet, and since the microbes in our gut (microbiome) play an oversized role, they are worth learning to take care of.

Making sense of exactly how the many-trillion microbes on board actually drive our health is no small task. However, an exponential growth of studies in this area has helped. Before 2010 for example there were hundreds and even thousands of references on the topic depending on how far you go back, but in the last 15 years there have been hundreds OF thousands...and more than a quarter million since 2020, bringing far more clarity to the picture; and with it, a few themes that have become reasonably well established:

(1) Healthy bacteria feed on fiber and fermented plants, so consuming a wide variety and volume daily helps grow the population of "good guys". On the other hand, bacteria implicated in disease prefer an industrialized diet, heavy in sugar and highly processed, so limiting these whenever possible can help keep their population in check.

 (2) It's not only food that matters - other lifestyle factors like physical activity, sleep, and stress management can also play an important role and often have a bidirectional relationship with the microbes - they both drive each other.

(3) Supplementing or replacing colonies in order to restore health is an interesting but still mostly experimental idea, so our best chance to reset things may be to restore our diet to one which mimics a pattern far more common before the industrialization of food...a theory which was tested in Canadian adults.

 Researchers recruited and randomly assigned 30 people to consume a diet which they called the NiMe Diet (short for non-industrialized microbiome restore), an eating pattern of times gone by for most of the world. Typical of "ancestral" diets, this one was primarily plant-based, contained no dairy or wheat, and was low in process, which means it was low in sugar (as measured by glycemic index) and high in fiber. From a macronutrient perspective, it was 60% carbohydrate, 15% protein, and 25% fat, and the menu featured foods like beans, sweet potato, rice, cucumber, and cabbage as well as foods which were known to feed the particular bacteria they were hoping to grow, such as Jerusalem artichokes, peas, and onions. 

Following the intervention, their deep-dive analysis of participants' health showed impressive changes in only 3 weeks. The findings, published earlier this year, showed that participants had a significant change in the makeup of their microbiome, including growth of a particular bacteria found in tribes that still eat this way, like those in rural Papua New Guinea. They also had meaningful clinical changes, including significant reductions in cholesterol, blood sugar, and body weight, which paralleled a significant drop in health risk.

It seems less likely that the "Father of Western Medicine" is the one who said it, but whoever gets the credit for "let food be thy medicine and medicine thy food"...the data says they're right. I hope your garden is growing as fast as my lawn and you're benefiting greatly from feeding those microbes.

Have a great weekend,
Mike E.