It was 15 years ago at a conference that registered nurse and health consultant Liliana Fanariotis recalls a doctor proclaiming that there was an area of medicine that was relatively untouched, that would have the attention of researchers the world over in years to come. He was referring to the mind-gut connection, and it would seem he was right.
But it was in no way a revolutionary prophecy, after all, it was Hippocrates, the father of modern medicine (460-370BCE) who thousands of years ago declared that "All disease begins in the gut".
But it is only in recent times that neuroscientists have been referring to the gut as the 'second brain', found to have its own nervous system called the enteric nervous system, with over 100 million neurons that act as messengers telling the body what to do, and even how to feel, while protecting us from incoming pathogens and toxins.
There are said to be 100 trillion or so bacteria and other microbes in our intestines that make up the microbiome, which is a complete set of genes that is unique to each of us.
"The healthy microbiome and its population of microbes are so important to our body. They are our best friends and have evolved with us over millions of years. Sadly over the years, due often to our lifestyle choices we haven't been kind to these microbes, so we have decimated the population that live inside us," Liliana tells Neos Kosmos.
With over 50 years experience as a nurse, 25 of which have been spent working with families and in schools with a focus on nutrition, Liliana says the more she found out about the connection between the mind and gut, the more her experiences with patients made sense.
"Because I deal with families, I see how people's diets are; I see how it affects their mood and their skin and their weight. When I started nursing you never saw type 2 diabetes, very occasionally it was called 'adult onset'. Now even children have got type 2 diabetes. That's why I got very involved in that area," she explains, given that the 'Western' diet often has a low ratio of plant components, is high in animal fat and sugar, with additives such as emulsifiers and artificial sweeteners.
Just as the mind can have an effect on the stomach, releasing the stomach's digestive juices simply with the thought of eating, a troubled gut can also send signals to the mind.
But when this communication is negatively impacted due to factors that include poor diet, stress, and illness, it can result in digestive disorders and obesity, and mental health issues such as anxiety or depression.
This is because 95 per cent of the body's serotonin – happy chemicals – are found in the bowels and help to regulate mood. So an unbalanced gut can throw emotions out of wack.
It's no surprised to hear then, that studies have shown people with digestive-based problems such as IBS are significantly more likely to suffer from anxiety, depression, and mood disorders.
To better understand the connection between the two, UCLA professor and author of The Mind-Gut Connection, Dr Emeran Mayer is one of the researchers ahead of the game, having spent the past four decades studying how the mind and gut interact, puts it simply: "When you eat too much or have certain fatty foods, the changes in your gut can affect your mental state," he says.
"And when you feel 'butterflies' or a rumbling in your stomach when you're nervous, or knots in your stomach when you're angry, your mental state is affecting your gut."
"Therefore in order for the mind to be functioning properly, the whole body needs to be working properly - especially the gut," says Liliana.
Aside from diet, in her experience, Liliana says what is in part to blame is the medicinal approach. People often go to see their GPs and find themselves with a prescription in hand, and plenty of unanswered questions – a one size fits all approach that the nurse puts down to outdated training and the fact that many doctors are time poor with 10 minute restrictions for each patient. While she acknowledges that medication, and even antibiotics (aka enemies of the gut), can sometimes be necessary, there's no denying that while research is still in its infancy, the mind-gut is a key factor in our physical and mental well-being that is likely to have better lasting results.
To help improve gut and overall health, she suggests incorporating fresh fruits and vegetables, lean meats, oily fish and fermented foods into our diets such as yoghurt, kefir and sauerkraut to replace the good bacteria in the gut, especially for those on antibiotics. A positive model of eating is in fact the traditional Mediterranean diet, which is high in polyphenols, antioxidants, and anti-inflammatory molecules.
"The most important thing I saw in the last few years is that you can change your microbiome in your abdomen just by eating well, sleeping well, and relaxation," she says.
"I had a lot of friends who had digestive problems and I can see that by lifestyle and really changing diet, getting exercise, going out into the fresh air, getting good sleep - all those things - you can correct a lot just by the way you live, which I think is so powerful."
As Hippocrates once said, "Let food be thy medicine, and medicine be by food". Liliana suggests these practical ways to improve gut health and get good microbes into the system.
Foods that Nourish the Gut
- Olive oil: At least 2-4 tablespoons a day.
- Fish: Particularly oily fish such as sardines, salmon and mackerel. Aim for three times per week.
- Meat and poultry: Try and eat grass-fed. Limit to 500g per week.
- Organ meats: Liver, kidneys, tripe are excellent - if you like them, that is!
- Eggs: A great choice that you can eat every day.
- Butter: Fat is not to be feared and it is delicious.
- Vegetables: At least 5-7 serves a day. Choose vegetables that are brightly coloured as your gut loves the diversity i.e. carrot, eggplant, (red, yellow, green) peppers, broccoli, onions, spinach, garlic, leeks, bok choy, seaweed, etc.
- Fibre: Loved by the microbes, choose fibrous vegetables such as broccoli, cauliflower, zucchini, onion and sweet potato.
- Spices: Turmeric, cumin, curry powder, etc. Cinnamon and cocoa powder are also very gut-friendly
- Fruit: Only 1-2 pieces a day and preferably berries as they have the least sugar.
- Fermented foods: Probiotics are very beneficial. Go for full-fat Greek yoghurt, kefir, sauerkraut, kimchi, lassi, etc.
- Apple cider vinegar: Hippocrates also recommended this. It can be used as a salad dressing or consume a tablespoon in a glass of water.
- Dairy: Full-fat and only if you can tolerate it.
- Cheese: All cheese is good especially the smelly ones - full of healthy bacteria. Feta cheese is very good as it contains a type of bacteria called Lactobacillus Plantarum, which produces anti-inflammatory compounds.
- Wine: A glass of red wine with your evening meal is okay if you so choose.
- Dark chocolate: 85 per cent - but only as a treat!
What to Avoid
Sugar: Sugar has had a catastrophic effect on our health. The incident of obesity, Type 2 diabetes and Alzheimer's disease has never been so prevalent as it is now and research shows that it appears to be from excessive sugar consumption. Sugar contains no essential ingredient, causes tooth cavities, is addictive when mixed with fat, spikes blood sugar levels and puts you at risk of Type 2 diabetes. Being a diabetic cuts 10 years off your life, despite medication. Honey may have a few more minerals than sugar, but the body still treats it like sugar. Avoid fruit juices.
Artificial Sweeteners: As well as affecting your brain they can change your gut bacteria.
Processed Foods: It's not surprising that processed food is bad for you, but it is alarming at how bad it is for your microbiome. There is a lot of sugar and trans fats in most products, but also emulsifiers, which are a sort of detergent to extend the shelf life. Guts do not like this and it commonly leads to inflammation.
Seed Oils: Canola, vegetable oils, soya, and corn
Refined Carbohydrates: In particular anything flour based including bread, pastries, muesli bars, noodles, pasta and rice. If you find yourself in a position where it's hard to avoid these, especially when you are out, just order an entree size. Your gut will thank you because the body converts starches to sugar - see point one!
Antibiotics: When we are sick we can't avoid taking them, but even when it comes to colds, while they are annoying, they are usually viral, so antibiotics won't help anyway. Best not to take them at the first sniffle because they can change the gut microbiome for many months. If you can't avoid taking antibiotics, eat yoghurt and other fermented foods to feed the good bacteria.
Smoking: No benefits for your health or purse. Plus smoking has become anti-social.
Recommendations to assist with a healthy gut/mind:
Sleep: It is so important to get at least seven hours sleep every night. Turn off the TV, computer and phone for about an hour before you go to sleep. Relax and try and do some simple meditation. Avoiding eating late at night as you are forcing the gut to do heavy digestive work which won't improve your sleep quality. Also avoid alcohol before bed, which will will disturb your deep sleep cycle.
Stress: A useful tool to reduce stress is taking deep breaths, which is very easy and can be done anywhere. Try the yoga technique 4-7-8 breathing i.e. breathe in through the nose for the count of 4, hold for the count of 7 and then out through your mouth for the count of 8. Do this a few times a day.
Nature: Spend time in your backyard, or a park. While enjoying the fresh air you breathe in good bacteria that helps your gut.
Socialise: Spend time with family and friends; eat together, talk, launch and smile as much as you can.
Exercise: If joining a gym isn't an option, a half hour brisk walk five times a week will do the trick. If you sit a lot especially at work, get up for a couple of minutes every hour and move around - your joints and mind will thank you for it.
Liliana Fanariotis will be leading a talk on the mind-gut connect connection, interviewing ayurvedic lifestyle consultant Dylan Smith at Melbourne day spa Miss Fox on Monday 28 August.
by ANASTASIA TSIRTSAKIS published in Neos Kosmos