Nutrition and Mental Health

What you eat determines how you feel.  I'm sure you know this on a base level, if you've ever felt sleepy after a big meal, or scattered after a cup of coffee.  This is often readily apparent in children--feed a classroom of children cupcakes and try to get them to sit still afterwords.  The connections between nutrition and mental health go deeper than that.  There are a lot of factors at work here, and I'm going to try to break them down for you.

The Stress Response

The stress response is the body's natural reaction to danger.  You are out hunting/gathering in the woods and you see a tiger.  Your body prepares to fight or flee.  Both responses require the same physiological changes--a rush or energy to the muscles, increased heart rate, more oxygen to the lungs, dilated pupils (hyper-focused vision).  These changes are induced by the release of stress hormones from the adrenals.

In the brain, the emotional response is regulated by the amygdala.  You see a tiger, your eyes tell your amygdala ,"hey, it's a tiger."  Your amygdala recognizes that a tiger is dangerous and messages the hypothalamus, "OMG, IT'S A TIGER."  The hypothalamus is the first stop on what's known as the HPA axis, an endocrine channel that eventually results in the adrenals releasing the cortisol, epinephrine, norepinephrine, and the other stress hormones that let you get to safety.  

The stress response is important.  It's helpful that we can run away from tigers, and fend off wildebeests, and quickly find shelter during natural disasters.  Stress only becomes a problem if it is unrelenting.  The HPA axis is meant to turn on in response to danger, and turn off once the danger has passed.  It works like shooting a rubber band.  You can stretch a rubber band, and release it, sending it flying through the air.  The danger signal stretches the HPA axis, the corticosteroids send it flying.  If a rubber band is constantly stretched, it won't fly as efficiently.  Corticosteroids can become depleted, decreasing the efficiency of the stress response.  

We typically think of chronic stress as being based in emotion--a traumatic event, an overwhelming job, an unsupportive relationship--but chronic stress can be physical.  Minor viral infections, injury, and chronic inflammation will also trigger the stress response.  If you are back in the woods, hunting and gathering, and you break your toe, you have to be able to get to safety before a tiger shows up.  Your amygdala will trigger the release of the same cascade of hormones that can allow you to get to safety.

So, we know that chronic inflammation will trigger the stress response, but what triggers chronic inflammation?

Inflammation

Inflammation is the result of a functional immune system.  When the body is confronted with an injury or potential pathogen, it releases cytokines--proteins that warn the body of danger.  Cytokines call the immune system into action.  First through inflammation, later through the development of antibodies.  

The skin does a good job protecting the body from the outside world.  It exists to keep things out.  The digestive tract, on the other hand, is designed to let things in.  This intimacy with the outside world leaves the body vulnerable to all sorts of pathogens.  Subsequently, our immune system holds a strong presence in and around the mouth and gut, eliminating potential threats before things get out of hand.  

Gut-Barrier Function

Enterocytes, the cells lining the gut wall, are bound together with a series of junctions.  The junctions between the enterocytes regulate what gets in and what stays out.  If the enterocytes are injured, the barrier may become compromised, and unwelcome particles can enter the blood stream.  Remember that a functional immune system exists to fight unwelcome particles that enter the blood stream.  Our body only expects a small selection of molecules to be floating around in the blood, glucose, soluble vitamins, certain minerals, and select proteins.  If the gut barrier doesn't do it's job, particles that would be perfectly harmless contained in the gut are treated as if they were dangerous pathogens.

This is why leaky gut/intestinal permeability is a problem.  If larger proteins found in wheat, or dairy, or nuts get in the blood, the immune system will create antibodies to these proteins.  Later, when these proteins are ingested, the immune system reacts as if they are dangerous and responds in a resulting allergic reaction.

The same phenomenon may be an underlying cause of autoimmune disorders.  When cells die, they are removed by white blood cells.  They travel to the liver and are deposited into the digestive tract to be expelled.  If a dead cell enters the blood stream unexpectedly, the immune system will treat it as a pathogen, and produce antibodies.  The antibodies will seek and destroy the live cells in the body--creating an auto-immune response.

Even if gut barrier function is not diminished enough to trigger food allergies or auto-immune conditions, distressed enterocytes will trigger an immune response.  If the gut isn't happy, the body is inflamed.   Chronic inflammation will trigger the HPA axis, and trigger chronic stress.

So, how do we protect the enterocytes and improve gut-barrier function?

Gut Bacteria

The digestive tract is tube stretching through the center of the body.  The inside of your body is blood, bones, nerves, organs, and connective tissue.  The inside of the digestive tract is the outside of your body.  The cavern created by the walls of the digestive tract is a climate controlled chamber that receives a constant stream of nutrients and water; the perfect environment for the proliferation of bacteria, fungus, and other microorganisms.  An entire ecosystem exists within your intestines.  The number of bacteria in your gut outnumber the number of cells in your body 10 to 1.  Taken together, all of the beneficial microorganisms can weigh up to five pounds

The intestinal microflora has evolved alongside (inside!) us for millennia.  They keep the enterocytes healthy, they help us digest food, they produce essential hormones and neurotransmitters.  We cannot survive without them.  The gut lining is protected by a mucosal layer secreted by specialized enterocytes known as goblet cells.  The mucosal lining is divided into two layers.  The inner layer protects the enterocytes from irritation, the outer layer provides a habitat for the commensal bacteria.  If the internal microbial ecosystem is damaged, it leaves the enterocytes vulnerable to irritation and damage, leading to systematic inflammation.

How Stress Affects the Gut

A damaged gut can lead to a heightened stress response.  Likewise, chronic stress can damage the gut.  A 2014 study published in BMC Microbiology found that exposure to a 2 hour social stressor altered the integrity of the gut microbiota in mice.  This backed up findings from previous research--notably a 1999 study in the Journal of Developmental Psychology.  The researchers in this study stressed young rhesus monkeys by separating them from their mothers.  The researchers found that the stressed monkeys showed decreased levels of beneficial gut bacteria and increased stress-associated behavior.  

Furthermore, maternal stress can impact the microflora of their child later on.  A 2015 study published in the Journal of Endocrinology found that stressing pregnant mice would alter the vaginal microbiome of the mothers.  The current theory on microbiome development purports that the microbiome is seeded from the vaginal bacteria during the birth process.  If the vaginal bacteria is compromised, the gut bacteria of the offspring will also be compromised.  The study found that the offspring of the stressed mice had altered gut flora and the subsequent metabolic and behavioral changes associated with a damaged microbiome.  

So What Can be Done?

The good news is that healing the gut can help attenuate the stress response.  Gut healing is a complex process--an art, rather than a science, and involves four interconnected components:

  • Reduce Inflammation
  • Repopulate Gut Bacteria
  • Heal Gut Wall
  • Promote Healthy Digestion

Reduce Inflammation

The most important step in reducing inflammation is modifying the diet. Removing foods that trigger an inflammatory response is paramount.  Determining which foods are causing the problem is a little trickier.  Processed foods, fast-food, soda and alcohol should be eliminated immediately.  Blood tests checking for food sensitivities can be a good place to start, but they are not infallible.  An elimination diet can give a clearer picture of which foods are causing the problem.  In an elimination diet you remove all of the common inflammatory foods (wheat, corn, dairy, soy, eggs) from the diet, add them back in slowly, and check for a reaction.  

Anti-inflammatory supplements can also be tremendously helpful in reducing inflammation.  Curcumin, the active substance in turmeric, is a bright-yellow spice traditionally used in Ayurvedic medicine.  IT is a powerful anti-inflammatory and is usually well-tolerated.  It can be mixed into dishes or taken as a capsule.

Chaga is a large, woody, mushroom native to northern forests in Russia and Canada.  It has been shown to inhibit many of the cytokines that cause systematic inflammation.  Like turmeric, it is often well tolerated and has a host of other health-supportive benefits 

Repopulate Gut Bacteria

A probiotic is a substance ingested to support the health of intestinal microorganisms.  Probiotic supplements contain beneficial bacterial, in the genus Bacillus, Bifidobacterium Enterococcus, Lactobacillus, and/or Saccharomyces.  For a supplement to be considered a probiotic it must adhere to human cells, remain stable as it passes through digestive tract, be reliant to stomach acids and digestive hormones, be able to produce anti-microbial substances, and act against pathogenic bacteria.

Most commercially available supplements contain only one strain of probiotic bacteria.  Diversity in the gut flora is just as important as population.  Fermented foods often contain a larger variety of beneficial bacteria than supplements..  Fermented foods should be made in house, if possible.  Homemade yogurt, sauerkraut, kombucha, and kefir should be included.

Heal Gut Wall

Glutamine is an amino acid that serves as the primary energy source for intestinal cells.  It can stimulate the regeneration of and prevent damage to the mucosal lining of the intestine.  The body uses glutamine to heal from illness and injury and glutamine stores may remain replenished following an event.  Research in mice has shown that glutamine supplementation can decrease intestinal permeability and strengthen the integrity of the mucosal membrane.

Promote Healthy Digestion

Oftentimes, compromised gut health appears alongside a host of other digestive issues.  Various other supplements may be useful in treating digestive difficulties.  Digestive enzymes and hydrochloric acid supplements may be taken to improve nutrient absorption.  Triphala, an Ayurvedic herb has powerful antioxidant properties and may be taken to improve regular elimination.

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It is important to note that gut health is a complex process.  It is more akin to environmental restoration than healing a broken bone.  If you are interested in changing your gut to change your life, please contact me for a consultation.  Together we can customize a healing plan and monitor the process as it progresses.