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The Brain-Gut Highway: A Two-Way Street
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The Brain-Gut Two-Way Highway
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This is Dr. Emeran Mayer. He has the rather niche dual specialty of being a gastroenterologist and a neurologist. He has published over 353 peer reviewed scientific articles, and he’s a professor in the Departments of Medicine, Physiology, and Psychiatry at UCLA. Much of his work has been pioneering medical research into gut-brain interactions.
We know the brain and gut are connected. What else does he want us to know?
First, that it is a two-way interaction. It’s about 90% “gut tells the brain things”, but it’s also 10% “brain tells the gut things”, and that 10% can make more like a 20% difference, if for example we look at the swing between “brain using that 10% communication to tell gut to do things worse” or “brain using that 10% communication to tell gut to do things better”, vs the midpoint null hypothesis of “what the gut would be doing with no direction from the brain”.
For example, if we are experiencing unmanaged chronic stress, that is going to tell our gut to do things that had an evolutionary advantage 20,000–200,000 years ago. Those things will not help us now. We do not need cortisol highs and adrenal dumping because we ate a piece of bread while stressed.
Read more (by Dr. Mayer): The Stress That Evolution Has Not Prepared Us For
With this in mind, if we want to look after our gut, then we can start before we even put anything in our mouths. Dr. Mayer recommends managing stress, anxiety, and depression from the head downwards as well as from the gut upwards.
Here’s what we at 10almonds have written previously on how to manage those things:
- No-Frills, Evidence-Based Mindfulness
- How To Set Anxiety Aside
- The Mental Health First-Aid You’ll Hopefully Never Need
Do eat for gut health! Yes, even if…
Unsurprisingly, Dr. Mayer advocates for a gut-friendly, anti-inflammatory diet. We’ve written about these things before:
…but there’s just one problem:
For some people, such as with IBS, Crohn’s, and colitis, the Mediterranean diet that we (10almonds and Dr. Mayer) generally advocate for, is inaccessible. If you (if you have those conditions) eat as we describe, a combination of the fiber in many vegetables and the FODMAPs* in many fruits, will give you a very bad time indeed.
*Fermentable Oligo-, Di-, Monosaccharides And Polyols
Dr. Mayer has the answer to this riddle, and he’s not just guessing; he and his team did science to it. In a study with hundreds of participants, he measured what happened with adherence (or not) to the Mediterranean diet (or modified Mediterranean diet) (or not), in participants with IBS (or not).
The results and conclusions from that study included:
❝Among IBS participants, a higher consumption of fruits, vegetables, sugar, and butter was associated with a greater severity of IBS symptoms. Multivariate analysis identified several Mediterranean Diet foods to be associated with increased IBS symptoms.
A higher adherence to symptom-modified Mediterranean Diet was associated with a lower abundance of potentially harmful Faecalitalea, Streptococcus, and Intestinibacter, and higher abundance of potentially beneficial Holdemanella from the Firmicutes phylum.
A standard Mediterranean Diet was not associated with IBS symptom severity, although certain Mediterranean Diet foods were associated with increased IBS symptoms. Our study suggests that standard Mediterranean Diet may not be suitable for all patients with IBS and likely needs to be personalized in those with increased symptoms.❞
In graphical form:
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And if you’d like to read more about this (along with more details on which specific foods to include or exclude to get these results), you can do so…
- The study itself (full article): The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome
- Dr. Mayer’s blog (lay explanation): The Benefits of a Modified Mediterranean Diet for Irritable Bowel Syndrome
Want to know more?
Dr. Mayer offers many resources, including a blog, books, recipes, podcasts, and even a YouTube channel:
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Walking can prevent low back pain, a new study shows
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly 70% of people who recover from an episode of low back pain will experience a new episode in the following year.
The recurrent nature of low back pain is a major contributor to the enormous burden low back pain places on individuals and the health-care system.
In our new study, published today in The Lancet, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.
PeopleImages.com – Yuri A/Shutterstock The WalkBack trial
We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).
Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.
The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.
Low back pain can be debilitating. Karolina Kaboompics/Pexels The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.
Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.
People in the control group received no preventative treatment or education. This reflects what typically occurs after people recover from an episode of low back pain and are discharged from care.
What the results showed
We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.
The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.
Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.
In our study, regular walking appeared to help with low back pain. PeopleImages.com – Yuri A/Shutterstock Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.
This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.
Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.
Walking has multiple benefits
We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all previous studies have focused on treating episodes of pain, not preventing future back pain.
A limited number of small studies have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.
On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.
Walking has a variety of advantages. Cast Of Thousands/Shutterstock Walking also delivers many other health benefits, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.
While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants reported that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.
Why is walking helpful for low back pain?
We don’t know exactly why walking is effective for preventing back pain, but possible reasons could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which block pain signals between your body and brain – essentially turning down the dial on pain.
It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, no studies have investigated this.
Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.
Tash Pocovi, Postdoctoral research fellow, Department of Health Sciences, Macquarie University; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Mark Hancock, Professor of Physiotherapy, Macquarie University; Petra Graham, Associate Professor, School of Mathematical and Physical Sciences, Macquarie University, and Simon French, Professor of Musculoskeletal Disorders, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How to Read a Book – by Mortimer J. Adler and Charles Van Doren
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Are you a cover-to-cover person, or a dip-in-and-out person?
Mortimer Adler and Charles van Doren have made a science out of getting the most from reading books.
They help you find what you’re looking for (Maybe you want to find a better understanding of PCOS… maybe you want to find the definition of “heuristics”… maybe you want to find a new business strategy… maybe you want to find a romantic escape… maybe you want to find a deeper appreciation of 19th century poetry, maybe you want to find… etc).
They then help you retain what you read, and make sure that you don’t miss a trick.
Whether you read books so often that optimizing this is of huge value for you, or so rarely that when you do, you want to make it count, this book could make a real difference to your reading experience forever after.
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With all this bird flu around, how safe are eggs, chicken or milk?
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Enzo Palombo, Swinburne University of Technology
Recent outbreaks of bird flu – in US dairy herds, poultry farms in Australia and elsewhere, and isolated cases in humans – have raised the issue of food safety.
So can the virus transfer from infected farm animals to contaminate milk, meat or eggs? How likely is this?
And what do we need to think about to minimise our risk when shopping for or preparing food?
AS Foodstudio/Shutterstock How safe is milk?
Bird flu (or avian influenza) is a bird disease caused by specific types of influenza virus. But the virus can also infect cows. In the US, for instance, to date more than 80 dairy herds in at least nine states have been infected with the H5N1 version of the virus.
Investigations are under way to confirm how this happened. But we do know infected birds can shed the virus in their saliva, nasal secretions and faeces. So bird flu can potentially contaminate animal-derived food products during processing and manufacturing.
Indeed, fragments of bird flu genetic material (RNA) were found in cow’s milk from the dairy herds associated with infected US farmers.
However, the spread of bird flu among cattle, and possibly to humans, is likely to have been caused through contact with contaminated milking equipment, not the milk itself.
The test used to detect the virus in milk – which uses similar PCR technology to lab-based COVID tests – is also highly sensitive. This means it can detect very low levels of the bird flu RNA. But the test does not distinguish between live or inactivated virus, just that the RNA is present. So from this test alone, we cannot tell if the virus found in milk is infectious (and capable of infecting humans).
It’s best to stick with pasteurised milk. Amnixia/Shutterstock Does that mean milk is safe to drink and won’t transmit bird flu? Yes and no.
In Australia, where bird flu has not been reported in dairy cattle, the answer is yes. It is safe to drink milk and milk products made from Australian milk.
In the US, the answer depends on whether the milk is pasteurised. We know pasteurisation is a common and reliable method of destroying concerning microbes, including influenza virus. Like most viruses, influenza virus (including bird flu virus) is inactivated by heat.
Although there is little direct research on whether pasteurisation inactivates H5N1 in milk, we can extrapolate from what we know about heat inactivation of H5N1 in chicken and eggs.
So we can be confident there is no risk of bird flu transmission via pasteurised milk or milk products.
However, it’s another matter for unpasteurised or “raw” US milk or milk products. A recent study showed mice fed raw milk contaminated with bird flu developed signs of illness. So to be on the safe side, it would be advisable to avoid raw milk products.
How about chicken?
Bird flu has caused sporadic outbreaks in wild birds and domestic poultry worldwide, including in Australia. In recent weeks, there have been three reported outbreaks in Victorian poultry farms (two with H7N3 bird flu, one with H7N9). There has been one reported outbreak in Western Australia (H9N2).
The strains of bird flu identified in the Victorian and Western Australia outbreaks can cause human infection, although these are rare and typically result from close contact with infected live birds or contaminated environments.
Therefore, the chance of bird flu transmission in chicken meat is remote.
Nonetheless, it is timely to remind people to handle chicken meat with caution as many dangerous pathogens, such as Salmonella and Campylobacter, can be found on chicken carcasses.
Always handle chicken meat carefully when shopping, transporting it home and storing it in the kitchen. For instance, make sure no meat juices cross-contaminate other items, consider using a cool bag when transporting meat, and refrigerate or freeze the meat within two hours.
Avoid washing your chicken before cooking to prevent the spread of disease-causing microbes around the kitchen.
Finally, cook chicken thoroughly as viruses (including bird flu) cannot survive cooking temperatures.
Are eggs safe?
The recent Australian outbreaks have occurred in egg-laying or mixed poultry flocks, so concerns have been raised about bird flu transmission via contaminated chicken eggs.
Can flu viruses contaminate chicken eggs and potentially spread bird flu? It appears so. A report from 2007 said it was feasible for influenza viruses to enter through the eggshell. This is because influenza virus particles are smaller (100 nanometres) than the pores in eggshells (at least 200 nm).
So viruses could enter eggs and be protected from cleaning procedures designed to remove microbes from the egg surface.
Therefore, like the advice about milk and meat, cooking eggs is best.
The US Food and Drug Administration recommends cooking poultry, eggs and other animal products to the proper temperature and preventing cross-contamination between raw and cooked food.
In a nutshell
If you consume pasteurised milk products and thoroughly cook your chicken and eggs, there is nothing to worry about as bird flu is inactivated by heat.
The real fear is that the virus will evolve into highly pathogenic versions that can be transmitted from human to human.
That scenario is much more frightening than any potential spread though food.
Enzo Palombo, Professor of Microbiology, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Related Posts
Track Your Blood Sugars For Better Personalized Health
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There Will Be Blood
Are you counting steps? Counting calories? Monitoring your sleep? Heart rate zones? These all have their merits:
- Steps: One More Resource Against Osteoporosis!
- Calories: Is Cutting Calories The Key To Healthy Long Life?
- Sleep: A Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
- Heart Rate Zones: Heart Rate Zones, Oxalates, & More
About calories: this writer (it’s me, hi) opines that intermittent fasting has the same benefits as caloric restriction, without the hassle of counting, and is therefore superior. I also personally find fasting psychologically more pleasant. However, our goal here is to be informative, not prescriptive, and some people may have reasons to prefer CR to IF!
Examples that come to mind include ease of adherence in the case of diabetes management, especially Type 1, or if one’s schedule (and/or one’s “medications that need to be taken with food” schedule) does not suit IF.
And now for the blood…
A rising trend in health enthusiasts presently is the use of Continuous Glucose Monitors (CGMs), which do exactly what is sounds like they do: they continually monitor glucose. Specifically, the amount of it in your blood.
Of course, these have been in use in diabetes management for years; the technology is not new, but the application of the technology is.
A good example of what benefits a non-diabetic person can gain from the use of a CGM is Jessie Inchauspé, the food scientist of “Glucose Revolution” and “The Glucose Goddess Method” fame.
By wearing a CGM, she was able to notice what things did and didn’t spike her blood sugars, and found that a lot of the things were not stuff that people knew/advised about!
For example, much of diabetes management (including avoiding diabetes in the first place) is based around paying attention to carbs and little else, but she found that it made a huge difference what she ate (or didn’t) with the carbs. By taking many notes over the course of her daily life, she was eventually able to isolate these patterns, showed her working-out in The Glucose Revolution (there’s a lot of science in that book), and distilled that information into bite-size (heh) advice such as:
10 Ways To Balance Blood Sugars
That’s great, but since people like Inchauspé have done the work, I don’t have to, right?
You indeed don’t have to! But you can still benefit from it. For example, fastidious as her work was, it’s a sample size of one. If you’re not a slim white 32-year-old French woman, there may be some factors that are different for you.
All this to say: glucose responses, much like nutrition in general, are not a one-size-fits-all affair.
With a CGM, you can start building up your own picture of what your responses to various foods are like, rather than merely what they “should” be like.
This, by the way, is also one of the main aims of personalized health company ZOE, which crowdsourced a lot of scientific data about personalized metabolic responses to standardized meals:
Not knowing these things can be dangerous
We don’t like to scaremonger here, but we do like to point out potential dangers, and in this case, blindly following standardized diet advice, if your physiology is not standard, can have harmful effects, see for example:
Diabetic-level glucose spikes seen in non-diabetic people
Where can I get a CGM?
We don’t sell them, and neither does Amazon, but you can check out some options here:
The 4 Best CGM Devices For Measuring Blood Sugar in 2024
…and if your doctor is not obliging with a prescription, note that the device that came out top in the above comparisons, will be available OTC soon:
The First OTC Continuous Glucose Monitor Will Be Available Summer 2024
Take care!
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A new emergency procedure for cardiac arrests aims to save more lives – here’s how it works
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As of January this year, Aotearoa New Zealand became just the second country (after Canada) to adopt a groundbreaking new procedure for patients experiencing cardiac arrest.
Known as “double sequential external defibrillation” (DSED), it will change initial emergency response strategies and potentially improve survival rates for some patients.
Surviving cardiac arrest hinges crucially on effective resuscitation. When the heart is working normally, electrical pulses travel through its muscular walls creating regular, co-ordinated contractions.
But if normal electrical rhythms are disrupted, heartbeats can become unco-ordinated and ineffective, or cease entirely, leading to cardiac arrest.
Defibrillation is a cornerstone resuscitation method. It gives the heart a powerful electric shock to terminate the abnormal electrical activity. This allows the heart to re-establish its regular rhythm.
Its success hinges on the underlying dysfunctional heart rhythm and the proper positioning of the defibrillation pads that deliver the shock. The new procedure will provide a second option when standard positioning is not effective.
Using two defibrillators
During standard defibrillation, one pad is placed on the right side of the chest just below the collarbone. A second pad is placed below the left armpit. Shocks are given every two minutes.
Early defibrillation can dramatically improve the likelihood of surviving a cardiac arrest. However, around 20% of patients whose cardiac arrest is caused by “ventricular fibrillation” or “pulseless ventricular tachycardia” do not respond to the standard defibrillation approach. Both conditions are characterised by abnormal activity in the heart ventricles.
DSED is a novel method that provides rapid sequential shocks to the heart using two defibrillators. The pads are attached in two different locations: one on the front and side of the chest, the other on the front and back.
A single operator activates the defibrillators in sequence, with one hand moving from the first to the second. According to a recent randomised trial in Canada, this approach could more than double the chances of survival for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard shocks.
The second shock is thought to improve the chances of eliminating persistent abnormal electrical activity. It delivers more total energy to the heart, travelling along a different pathway closer to the heart’s left ventricle.
Evidence of success
New Zealand ambulance data from 2020 to 2023 identified about 1,390 people who could potentially benefit from novel defibrillation methods. This group has a current survival rate of only 14%.
Recognising the potential for DSED to dramatically improve survival for these patients, the National Ambulance Sector Clinical Working Group updated the clinical procedures and guidelines for emergency medical services personnel.
The guidelines now specify that if ventricular fibrillation or pulseless ventricular tachycardia persist after two shocks with standard defibrillation, the DSED method should be administered. Two defibrillators need to be available, and staff must be trained in the new approach.
Though the existing evidence for DSED is compelling, until recently it was based on theory and a small number of potentially biased observational studies. The Canadian trial was the first to directly compare DSED to standard treatment.
From a total of 261 patients, 30.4% treated with this strategy survived, compared to 13.3% when standard resuscitation protocols were followed.
The design of the trial minimised the risk of other factors confounding results. It provides confidence that survival improvements were due to the defibrillation approach and not regional differences in resources and training.
The study also corroborates and builds on existing theoretical and clinical scientific evidence. As the trial was stopped early due to the COVID-19 pandemic, however, the researchers could recruit fewer than half of the numbers planned for the study.
Despite these and other limitations, the international group of experts that advises on best practice for resuscitation updated its recommendations in 2023 in response to the trial results. It suggested (with caution) that emergency medical services consider DSED for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard treatment.
Training and implementation
Although the evidence is still emerging, implementation of DSED by emergency services in New Zealand has implications beyond the care of patients nationally. It is also a key step in advancing knowledge about optimal resuscitation strategies globally.
There are always concerns when translating an intervention from a controlled research environment to the relative disorder of the real world. But the balance of evidence was carefully considered before making the decision to change procedures for a group of patients who have a low likelihood of survival with current treatment.
Before using DSED, emergency medical personnel undergo mandatory education, simulation and training. Implementation is closely monitored to determine its impact.
Hospitals and emergency departments have been informed of the protocol changes and been given opportunities to ask questions and give feedback. As part of the implementation, the St John ambulance service will perform case reviews in addition to wider monitoring to ensure patient safety is prioritised.
Ultimately, those involved are optimistic this change to cardiac arrest management in New Zealand will have a positive impact on survival for affected patients.
Vinuli Withanarachchie, PhD candidate, College of Health, Massey University; Bridget Dicker, Associate Professor of Paramedicine, Auckland University of Technology, and Sarah Maessen, Research Associate, Auckland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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It’s Not You, It’s Your Hormones – by Nicki Williams, DipION, mBANT, CNHC
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Nicki Williams’ basic principle is that we can manage our hormonal fluctuations, by managing our diet. Specifically, in three main ways:
- Intermittent fasting
- Anti-inflammatory diet
- Eating more protein and healthy fats
Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.
Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.
The style is very accessible and clear, and Williams walks us through the changes we may want to make, to avoid the changes we don’t want.
Bottom line: this book is aimed at peri-menopausal and post-menopausal women. It could also definitely help a lot of people with PCOS too, and, when it comes down it it, pretty much anyone with an endocrine system. It’s a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.
Click here to check out It’s Not You, It’s Your Hormones, and take control of yours!
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