I had the pleasure of going to the International Functional Medicine conference this year in Florida. The topic was ‘Solving the Puzzle of Autoimmunity: The Interplay of Gut, Genes and Environment’. All the top doctors that are treating autoimmune diseases successfully were at this conference and many were speaking. Dr. Fasano, MD gave the first lecture and it was fantastic. What follows are the notes I took that day.

There are over 100 autoimmune diseases now. 90% of chronic diseases are driven by the environment. Why is this and what is the root cause of this? The gut is a huge player in chronic disease as are allergens, toxins, infections, autogens. Autoimmune disease is highest in North America. We are not born with the destiny to develop chronic inflammatory diseases. We can change our destiny. Our genes, the environment, and increased gut permeability play a role. The immune response is involved; the microbiome is involved. Allergies can be turned on or off depending on the microbiome.

The cells play a role in immune homeostasis- epithelial cells, intestinal dc’s, B cells, T cells. The gut is a single layer of cells that interacts with our environment; the cells in the brush border have receptors that detect whether there are friends or enemies coming into the gut. These cells interact with our immune system and let the immune system know if we should be at war. The intestinal dc, B lymphocytes, immunoglobulins, secretory IgA shape the microbiota and function. T cells can create a lot of damage- can create chronic inflammation that goes to your joints, the brain, the thyroid, etc. If you have been exposed to the enemy before, you will have primed immune cells that are ready to go to war again.

When a situation of leaky gut is present, there is a loss of barrier function in the intestine. This can lead to inflammation/allergy and can initiate an immunoregulatory defect which can lead to proinflammatory allergic cytokines being released. This increased permeability can lead to a vicious circle of a breakdown in tolerance and create low grade inflammation.  1.Visc. hypersensitivity (IBS) 2. TH1 immune response chronic inflammation 3. TH2 response (food allergies)  4. TH17 immune response (autoimmunity).

The paracellular pathway-tight junctions which line the gut are not cement; rather they are dynamic levy bridges that are the dark horse implicated in a host of diseases ranging from acute injury to chronic inflammation. The zonulin gene is on chromosome 16 and is associated with diseases of the nervous system, cancer and autoimmune disease. Gluten causes zonulin release which opens up the tight junctions; causes an imbalance of the gut microbiome leading to dysbiosis which leads to bacterial overgrowth  which then triggers further zonulin release.

Good bacteria in our gut are our friends and support us. Taking antibiotics drops a bomb on our microbiome. We were so wrong. This ecosystem is symbiotic with us. Look at the popular journal titles -Scientific American -Your Inner Ecosystem; Nature -Fellow Travelers. Environmental factors, diet, stress, etc change our microbiome. Gut Dysbiosis- the first 1000 days of life are instrumental for our clinical destiny. This is why it is advantageous to have a vaginal birth- a baby born vaginally is exposed to the proper milieu when it travels through the birth canal…

I just read the Plant Paradox by Stephen Gundry and I highly recommend it. He talks about the presence of plant proteins in our diets called lectins that can cause inflammation and lead to chronic health issues and contribute to disease. These plant proteins that have evolved within plants were a strategy to ward off predators; basically make the person eating the plant either sick or triggering some sort of malaise so the person would think twice before eating that plant again. It makes sense to protect the plant kingdom as a whole that plants would have a substance to protect them in some way and these substances are lectins. With my history of having an autoimmune disease and being highly self aware of the foods that do trigger me, by looking at his list of lectin containing foods, I would agree that I might even do better than I already am by cutting out all lectin containing foods.

He claims success in treating all autoimmune conditions by eliminating lectins in the diet. Lectins contribute to molecular mimicry reactions (where similar amino acid structures in bodily tissues to lectins are attacked by the immune system when these proteins are ingested and not digested fully). The body tissues could include the myelin sheath (MS) or joints (RA) or any other tissue involved in autoimmune disease. Molecular mimicry reactions are thought to be the mechanism for autoimmune reactions in the body.

For a comprehensive list of lectin containing foods, please consult the book but I will mention some key lectins that must be eliminated. Lectin containing foods include gluten and dairy products (from A1 species) ;all grains but sorghum and millet are eliminated, nightshade vegetables (white potatoes, eggplant, tomatoes, bell peppers) are out. All nuts except macadamia, pistachio, walnuts and pecans must be taken out of the diet. (One thing I have included in my diet are organic peanuts because I have blood type A and they are highly recommended for blood type A. I also have not excluded organic soy milk for the same reason being that I am blood type A and soy is highly recommended for blood type A. I am also menopausal and do benefit from the phytoestrogens in my diet.)

The diet talks about the importance of resistant starch which helps to feed good microbes in your gut. Resistant starches include sweet potatoes, rutabagas, parsnips, plantain, celery root taro root, jicama, and radishes for starters. Fruits to include are green bananas, green mangoes, and papaya that is not yet ripe. These again have a beneficial effect on the gut. Other fruits like berries, lemons, limes and others can be included to a lesser degree. Hemp seeds or hemp milk, and coconut milk are beneficial dairy substitutes as are coconut yogurt.

This is yet another program that drastically cut back on the amount of carbohydrates in the diet. With the emphasis on protein in the form of wild seafood, shellfish, mussels, fatty fish that are low in mercury (wild salmon, wild sardines, wild herring, wild Alaskan halibut, see book for complete list). Grass fed meat and pastured poultry are included in the list of acceptable proteins. Protein amounts are reduced depending on the illness you are seeking treatment for. And there are options if you are Vegan and wanting to follow the program (think Hemp tofu!)

Emphasis on vegetables is prominent whether they be brassicas/cruciferous veggies, green leafy vegetables (spinach and the like). Start your day off with a green smoothie which is one thing I have recommended for years to patients! There is plenty of food that you can eat if you are following the Plant Paradox Program.

For a full list and a great read, pick up the plant paradox. Other conditions that he claims benefit from following the plant paradox program include neurological diseases such as Parkinson’s Disease, ALS and cancer. To discuss more in person, book an appointment with me at Parallel Wellness.

I watched the Broken Brain Series put on by Mark Hyman, MD a few weeks ago so I thought I would share a few things to help educate my patients about how best to assist their cognitive function. Starting with diet it is really key to avoid eating sugar and processed food, artificial sweeteners, refined carbohydrates, and a high glycemic diet in general. Our western diet is high in simple carbohydrates (flour and sugar) but it is terrible for brain function. Avoiding gluten is key to assist many neurological problems.  Reducing grain consumption in general is recommended (Grain Brain is a great book which goes into detail about this) and following more of a Paleolithic diet (organic, grass fed meats, wild seafood, organic free range poultry). Intermittent fasting regularly can help improve metabolic function at least 12 hours overnight if not 14 or 16 hours can help with clarity of mind. Following more of a ketogenic diet is particularly good for brain function because the brain is made up of fat. Eating healthy fat is key such as coconut fat, medium chain triglycerides, olive oil and avocados.

Eating high antioxidants in the form of organic fruits and vegetables supplies factors that reduce oxidative stress. Think blueberries, blackberries, black raspberries, turmeric, ginger, brassica family (broccoli cauliflower, kale turnips, radishes, etc.) onions, garlic, beets, mint, fresh rosemary and walnuts. Supplements that may prove useful include curcumin, EPA/DHA, gingko biloba, bacopa,  and methylated B vitamins.

Reducing toxins and looking at levels of heavy metals in the brain (mercury, aluminum, lead, cadmium, arsenicum, etc) as well as pesticide and chemical exposures can uncover causation and contributing factors for reduced brain function. Herbs that can help chelate out metals include fresh parsley, cilantro, and algae such as chlorella and spirulina. 

Consistent exercise is key as well. Exercise increases brain-derived neurotrophic factor which helps support optimal brain function. Walking daily for at least 45 minutes is good as is burst or high intensity exercise in spurts.  Regular meditation whether it be simple breathing exercises or mindfulness training has been shown to improve cognitive performance and consistently improves overall sense of well being.

Engaging the brain by learning new things (languages, taking new routes to work), puzzles, taking classes) can also help preserve and improve brain function.

Please consider purchasing the Broken Brain Series to learn more…