Cathy Margolin LAc, DiplOM
Three years ago, I wrote an article for this newspaper entitled “New Chinese Medicine Tools to Replenish and Repair Our Gut”, where I discussed recent research and ideas on how practitioners of Eastern Asian medicine can identify themselves as experts in helping patients achieve a “healthy gut” and rightfully take their place as part of one of the largest movements in health care today: the “Healthy Gut Movement”.
In the three years since, a mountain of research has been published on our microbiome. This has inspired every variety of health practitioner to join the Healthy Gut Movement. Our foundation, as practitioners of traditional Chinese medicine (TCM), has been proven rock solid. Western science has just begun to understand what TCM has known for thousands of years: digestion is of utmost importance to a healthy body and healthy mind. A healthy gut is the root of a healthy body. We have been taught well by the classics and understand the importance of the spleen and stomach channels. How do we use the research that has emerged from the worldwide microbiome project to help us explain the importance of our spleen/stomach to our patients? Are you prepared to expand your client reach to a new population of patients that desperately need this information?
We know more about the one-celled organisms that live in and on us than at any other time in history. We know that they greatly affect our health. The increasingly large probiotic supplements sections at health food stores alone tells us that consumers are buying into the idea that a healthy gut is important. Yet acupuncturists have yet to emerge as experts in this field. What’s holding us back? Are we not having important conversations about diet with our patients because we don’t feel skilled enough in this area, or because we can’t bill enough for the time? Are we afraid to offer advice on supplements because we don’t understand pre- and pro-biotics, herbs and vitamins? Do we lack the time to read the research and study the details? I hope this article will shed a little more light on the subject and encourage you to dive deeper into this information with your patients.
Most of us understand by now that bacteria live in and on our skin, eyes, ears, nose, mouth, and of course our gut. Our lower colon is the most populated with the largest diversity of these microscopic cells. In fact, they out-number our human cells 10 to 1, which means we are more microbial than human. Dr. Stephen Barrie, an expert with 30 years of research experience in the field of the microbiome, recently said in an interview that “it is our individual microbiome that is responsible for ALL disease states today”. His mission is to make disease an option. In his words, “a healthy body relies on a healthy and diverse biome”. He continued on to say that this statement may shock the masses, but the evidence that proves it correct has already been amassed by many experts around the world. His ebook Microbiome: All Diseases Begin in the Gut – Short Guide to Fixing Your Gut is a great place to expand your knowledge. His words echo many of the greatest teachers in traditional Chinese medicine.
Whole schools of thought were developed in the 12th century that stressed the importance of “preserving stomach-qi” as the most important treatment method. Zhang Jie Bin, one of the four great masters from the Ming Dynasty and one of the most important doctors in the history of TCM, wrote: “the doctor who wants to nourish life has to tonify stomach and spleen”. According to Li Dong-Yuan, it is of paramount importance to protect the spleen/stomach if people want to stay healthy and to strengthen them once they become diseased no matter what other organs are affected; “if the root is sound the branch will prosper”.
Emerging science shows that our gut, our lower colon, is acting as our “second brain”. Many would say it is the first brain, because our gut bacteria produce hormones, neuro-transmitters, serotonin, amongst other chemicals that have yet to be identified. Our microbiome affects our daily thoughts, moods, actions, and even dictates food cravings. The secret to weight control is now attributed to the types of bacteria you foster. If you thought you ran the show, think again. The bugs within are more powerful than we know.
We can, however, exert influence on the bacteria within by controlling what goes in and on our body. There is good news: our gut microbiota are malleable. Our bodies are constantly trying to find homeostasis, whether through balancing blood sugar levels with food intake or hormone levels with outside stressors. Our microbiome wants the same type of balance. It’s not coincidental that TCM has taught us the importance of balance with our treatments. Our foundation has always emphasized that the primary goal is to bring balance to the body to achieve a healthy mental, physical, and emotional state. Although we may not think about “balancing” our microbiome, by balancing everything in the body we help the bacteria within us to achieve balance as well. This microbial balancing act is just another name for the treatments we perform. It’s time we explain it to patients in ways that are more relatable.
How do we keep the bugs balanced?
Worldwide microbiome research confirmed what many of us have always understood. If we nourish our spleen and stomach channels, our biome, we simultaneously nourish both our physical and mental well-being, so what do your bugs within like to eat and how can we keep them in balance? I recently spent a week listening to a group of experts at the Healthy Gut Summit. A few of their best words of advice to keep your microbiome balanced and healthy:
The Top Five Best Practices for a Balanced Biome
- Eat a variety of fermented foods—at least one every day.
- Eat foods high in polysaccharides every day.
- Eat at least 50 grams or more of fiber every day.
- Individualized diets are best, NO diet is right for everyone.
- Eat a diverse diet—seasonal foods are best. This rule is king.
These five best practices may seem common sense to some, but how many of us are doing these five things daily? When talking with your patients about these five best practices, let’s not forget our roots. Because everyone’s microbiome is different, the best way to treat individuals is the way TCM teaches us to diagnose and treat: individually. Balance the spleen/stomach channels according to each patient’s individual needs. A tonifying treatment, a sedating treatment, and qi moving treatment. You know best for your patients; you decide. The late, great, Giovanni said, “the stomach and spleen could be tonified at the end of each season, particularly at the end of winter, to regenerate the energy”.
Number one in the list of five best practices is fermented foods. In traditional cultures worldwide, fermented foods have played a part of every culture. This history lesson should not be overlooked. Fermented foods play a huge role in feeding our microbiome. Kimchi, sauerkraut, pickles, kombucha, miso, kefir, and other fermented foods provide a variety of healthy bacteria. A daily sampling of new live bacteria from fermented foods makes your gut community more adaptable and diversified.
Since diversity has been proven a key factor in a healthy gut ecosystem, there is no substitute for eating a variety of raw and fermented foods. A healthy brain also requires a healthy gut, so make smart decisions every day, and if you need some encouragement, track what you eat in an app. This is a great way to give yourself positive feedback, as you can review the past days of food intake easily and feel encouraged that the small changes will have a big impact over time. We can starve or nourish our gut bacteria in as little as two weeks and see measurable changes from stool tests.
Some of the most interesting research in the last few years shows that no diet is right for everyone, just like the same probiotic supplement cannot possibly be right for everybody. We all have individual sensitivities due to the colonies of bugs within. Some bodies are good at digesting sea foods and algae, others lack these bugs and cannot tolerate a diet rich in seafood. Research from just the last three years has shed light on the many diet programs and detoxing plans in books and online today.
Most of these fad programs have little to no effect on improving gut health for the masses. What works for one person does not work for all. What experts in the field do agree upon is that the best way to improve your microbiome is not an elimination diet or detox program, but rather a diet rich in polysaccharide foods, high-fiber foods (50-100 grams daily), and a diverse diet of seasonally harvested food; the more diversity of vegetables the better. Meat protein should be more like a condiment than a main course. Sugar should be completely eliminated for many reasons, including one you may not have considered: sugar is digested and absorbed in the small intestines. Most of your good gut bacteria live in the lower colon. A diet high in sugar leaves nothing for your gut bacteria to feed on, so they will eventually starve if all you eat is sugary foods. What’s worse, when your gut bacteria have nothing to eat, they feed on the mucous membrane fence that divides their living space from the space human colon cells inhabit. You’ve heard the saying “fences make for good neighbors”. When bacteria eat away at the fence, it creates inflammation. Starving your gut bacteria is a bad idea, but unfortunately, much of the processed food eaten today is doing exactly that. Take care of your bugs and they will take care of you. Nourish the spleen/stomach channels to nourish life.
I highly recommend the book The Good Gut by Drs. Justin & Erica Sonnenburg. Much of the information in this article is from the Sonnenburg research. I was lucky enough to meet Justin at conference a few years ago and he is not only brilliant but humble. He often mentions in his talks that his hope is that the research coming from their Stanford lab trickles down to everyone. Their book, written for exactly that purpose, is an easy read, a great overview of some of the latest science from the microbiome researchers, and a perfect introduction for patients to their gut health and the gut brain connection. The information will help you feel more knowledgeable about healing new patients as this gut health movement accelerates. It also has some fantastic recipes to create foods both you and your biome will love.
According to Dr. J. Sonnenburg, foods high in polysaccharides are powerhouses of nourishment for your microbiome. Sonnenburg says that “the safest way to increase your microbial biodiversity is to eat a variety of foods high in polysaccharides”. We are the lucky recipients of TCM herbal wisdom that understood that Astragalus (huang qi) and Reishi mushroom (ling zhi) are two amazing herbs with a high content of polysaccharides.
When you change and balance your microbiome, you change just about everything in your body. Whether you build it or destroy it, the reins are in your hands. This is one key piece of information from the last few years of microbiota research. Balance, like everything in TCM, is key. Rebalance your patient’s microbiome with herbs, foods, and acupuncture, and watch their health blossom all year long. Educating your patients about the integral role these organisms play in our bodies can vastly improve their healing outcomes. By understanding and building on this knowledge you will not only improve the health of your patients; you will also be educating patients on some of the greatest discoveries and advances in healthcare today. Your patients want and need this knowledge. It’s time TCM practitioners take a larger role in treating patients with compromised gut health—which is to say, pretty much everybody today.