The Brain-Gut Highway: A Two-Way Street
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The Brain-Gut Two-Way Highway
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:
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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Cure – by Dr. Jo Marchant
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The subtitle here, “a journey into the science of mind over body”, prompts an immediate question: is this book actually about science?
And yes, yes it is. It’s not about “positive energy” or “tapping into your divine essence” or anysuch. It’s about science, and scientific studies.
The author’s PhD is in genetics and medical microbiology, not metaphysics or something.
For those of us who read a lot of clinical studies about a lot of things (hi, regular researcher/writer here), we’re very used to placebo being used as a control in medical science.
“This drug performed no better than placebo” is generally considered a disappointing statement… But what if the placebo was already having a profound effect? Shouldn’t that be worthy of note too?
Dr. Marchant looks at more than just drugs, though, and also looks into the science (complete with EEGs and such) of hypnosis and virtual reality.
The writing style here is very accessible without skimping on science. This is to be expected; Dr. Marchant also has an MSc in science communication, and spent a time as senior editor of New Scientist magazine.
This isn’t a how-to book, but there are some practical takeaways too, specific things we can do to augment (or avoid sabotaging) any medications we take, for example.
Bottom line: placebo effect (and its evil twin, the nocebo effect) has a profound impact on all of us whether we want it or not, so we might as well learn about how it works and how to leverage it. This book gives a very good, hard science grounding.
Click here to check out “Cure” and get the most out of whatever you take (or do) for your health!
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Pistachios vs Pine Nuts – Which is Healthier?
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Our Verdict
When comparing pistachios to pine nuts, we picked the pistachios.
Why?
First looking at the macros, pistachios have nearly 2x the protein while pine nuts have nearly 2x the fat. The fats are healthy in moderation (mostly polyunsaturated, a fair portion of monounsaturated, and a little saturated), but we’re going to value the protein content higher. Also, pistachios have approximately 2x the carbs, and/but nearly 3x the fiber. All in all, we’ll call this section a moderate win for pistachios.
When it comes to vitamins, pistachios have more of vitamins A, B1, B5, B6, B9, and C, while pine nuts have more of vitamins B2, B3, E, K, and choline. All in all, pistachios are scraping a 6:5 win here, or we could call it a tie if we want to value pine nuts’ vitamins more (due to the difference in how many foods each vitamin is found in, and thus the likelihood of having a deficiency or not).
In the category of minerals, pistachios have more calcium, copper, potassium, and selenium, while pine nuts have more iron, magnesium, manganese, and zinc. This would be a tie if we just call it 4:4, but what’s worth noting is that while both of these nuts are a good source of most of the minerals mentioned, pine nuts aren’t a very good source of calcium or selenium, so we’re going to declare this section a very marginal win for pistachios.
Adding up the moderate win, the scraped win, and the barely scraped win, all adds up to a win for pistachios. However, as you might have noticed, both are great so do enjoy both if you can!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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The Food For Life Cookbook – by Dr. Tim Spector
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We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.
The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.
The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.
Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.
Click here to check out the Food For Life Cookbook, and get cooking for life!
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100 Hikes of a Lifetime – by Kate Siber
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This is published by National Geographic, so you can imagine the quality of the photos throughout.
Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.
It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.
Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.
Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.
Click here to check out 100 Hikes Of A Lifetime, and live it!
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Stolen Focus – by Johann Hari
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Having trouble concentrating for long periods? It’s not just a matter of getting older…
Johann Hari outlines twelve key ways in which our attention has not merely “wandered”, so much as it has been outright stolen.
By whom? For what purpose? Obvious culprits include social media and outrage-stoking news outlets, but the problem, as Hari illustrates, goes much deeper than that.
He talks about how we cannot truly multi-task, and can only switch beween tasks, at a cost. And yet, the modern world is not at all friendly to single-tasking!
Writer’s note: as I write this, I have active two screens, containing four windows, one of which has three tabs open. I am not multitasking; all those things pertain to the work I am doing right now. If I closed them between use, it’d only cost me more time and attention opening and closing them all the time. And yet, my working conditions are considered practically “hyperfocused” in this century!
- We learn about how the working world has changed, and the rise of physical and mental exhaustion that has come with it.
- We learn about the collapse of sustained reading, that started well before the modern Internet.
- We learn about factors such as dietary shifts that sap our energy too.
…and more. Twelve key things, remember.
But, it’s not all doom and gloom. There are things we can do to fight back. Some are personal changes; others are societal changes to push for.
The last part of the book is given over to, essentially, a manifesto (and how-to guide) for reclaiming our attention and thinking deeply again.
Bottom line: if you struggle with maintaining attention; this is a book for you. You might want to put your phone in a drawer while you read it, though
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How long does back pain last? And how can learning about pain increase the chance of recovery?
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Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.
Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.
If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:
- acute – those with back pain that started less than six weeks ago
- subacute – where it started between six and 12 weeks ago
- chronic – where it started between three months and one year ago.
We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.
Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.
More pain doesn’t mean a more serious injury
Most acute back pain episodes are not caused by serious injury or disease.
There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.
Your doctor or physio can rule out serious damage.
DG fotostock/ShutterstockEven very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.
The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.
The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.
Reduce your chance of lasting pain
Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:
- understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
- reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.
How to reduce your pain sensitivity and learn about pain
Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.
Some programs combine education with gradual increases in movement.
Halfpoint/ShutterstockThese programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.
But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.
When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.
Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.
But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.
Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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