"Dr. Hyman, I've eliminated toxic foods, I exercise every day and overall I live a healthy lifestyle, yet I haven't been able to get anywhere near my goal weight," writes this week's house call. "What gives?"
I understand how frustrating this can become, especially when you feel like you've tried everything. You made a conscious decision to live a healthier lifestyle. You've cut out toxic triggers, ditched sugar and you're eating all the right types of foods. You're doing everything correctly, yet you can't lose weight.
Over the years, I've had many patients complain about this problem. They feel like they've exhausted every option, yet when we dig a bit deeper, we often find a hidden cause for their weight loss resistance.
One big obstacle becomes nutritional imbalances. After reviewing major nutritional research over the last 40 years and doing nutritional testing with more than 10,000 patients, I've concluded that Americans suffer from massive nutritional deficiencies.
Studies show these deficiencies are more widespread than you might imagine. More than 30 percent of American diets fall short of nutrients like magnesium, vitamin C, vitamin E and vitamin A. More than 80 percent of Americans have low Vitamin D levels. Nine out of 10 people are deficient in omega-3 fatty acids which, among other things, help cool inflammation and control blood sugar levels.
Simply put, Americans have been overfed and undernourished for a very long time. In fact, most obese children and adults are actually malnourished.
While that might sound contradictory, an abundance of calories does not necessarily deliver the right nutrients that your body needs. Actually, the very opposite is true: Overeating can create nutrient deficiencies. You can eat too many calories and too few nutrients. And guess what—you need vitamins and minerals to process all those empty calories. Low nutrients = poorly functioning metabolism.
How does this happen and why are we so undernourished? Simply put, food today is less nutritious. We don't eat enough whole, unprocessed, nutrient-dense foods. We do eat too much high fructose corn syrup, refined flours, refined vegetable oils, trans fats and overall fake junky processed foods.
These foods (and I use that term loosely) were not even in our diet as recent as 100 years ago. Our processed, inflammatory modern diet—which is relatively inexpensive and convenient because of government-subsidized crops like corn, soy and wheat—crowds out more nutrient-dense foods.
We evolved eating foods that were dramatically higher in vitamins, minerals and essential fats. We ate wild game, which contains higher levels of omega-3 fats and more nutrients than the factory-farmed animals we consume today.
Our hunter-gatherer ancestors also ate fresh fish and meat that grazed from pristine sources, whereas our factory farm-raised meats come loaded with hormones, antibiotics, pesticides, preservatives like nitrates and higher levels of inflammatory omega-6 fats.
Industrial farming practices also damage our soil, depleting important nutrients. As a result, vegetables and other plant foods harvested today have fewer nutrients than those picked from the ground just two generations ago.
Equally problematic, the average American today consumes an average of 152 pounds of sugar and 146 pounds of flour (which converts to sugar) every year Altogether, that's about a pound of sugar every day! These pharmacological doses cause serious harm to our metabolism and overall health.
At the same time, healthy fat in our diets has decreased during the past decades because of poor advice from so-called health experts and our government, The advice was based on flawed science and conflict-of-interest studies funded by big food companies (I've discussed this in-depth here).
Research also shows that since 1970, we have been eating an average of 500 additional calories a day, mostly from high fructose corn syrup and other carbohydrates. These nutrient-poor, calorie-dense, high-carbohydrate foods crowd out healthier choices while creating nutritional deficiencies like omega-3 fats,magnesium, zinc and vitamin D—negatively affecting our metabolism and our overall health.
That low-fiber, highly processed foods diet combined with other factors like environmental toxins results in leaky gut syndrome and numerous other gut problems, which further inhibits nutrient absorption.
When deficiencies become the underlying cause of weight loss resistance, I find nutrient-based treatment can often help reset my patients' metabolisms to balance out body chemistry. Getting the correct amount of nutrients can help you burn fat, balance blood sugar, stabilize hormones and build and maintain muscle mass.
To optimize nutrient levels and reach their weight goal, my patients often employ these eight strategies:
1. Heal your gut. Focus on eating whole, unprocessed foods such as vegetables, fruits, nuts and seeds that are rich in vitamins, minerals, antioxidants, anti-inflammatory compounds, fiber and essential fatty acids. These foundation foods also eliminate the many triggers of chronic illness. You are not only what you eat; you are what you absorb.
2. Prioritize eating plant-based fats. Get most of your healthy dietary fat from extra-virgin olive oil, coconut oil, nuts and seeds. Avoid refined vegetable oils like canola and soybean oils, as well as trans fats. You can get a powerful 21-day plan to easily incorporate healthy fats in my new book, Eat Fat, Get Thin.
3. Get sufficient protein. At least four to six ounces of lean protein at every meal stabilizes blood sugar and helps you lose weight. Good sources include small, cold-water fish that don't contain high levels of metals and other contaminants. Wild game such as elk and deer are other rich proteins sources that contain omega-3s and other healthy fats. Many grocery stores now sell healthier protein options including bison, grass-fed beef pastured chicken and barnyard eggs.
4. Use gut-healing nutrients. Glutamine and zinc are among the nutrients that help repair your gut lining. A broad-spectrum digestive enzyme before meals can also help absorb nutrients optimally. And a good probiotic helps rebuild the healthy bacteria essential for good gut health. You'll find these and other nutrients in my store.
5. Work with a functional medicine doctor. You may need to address deep-rooted issues like yeast overgrowth or small intestinal bacterial overgrowth. A Functional Medicine practitioner can help eliminate these and other issues that create weight loss resistance.
6. Manage stress levels. Chronic stress can deplete B vitamins and other nutrients like crazy. You can do deep-breathing exercises or meditation nearly anywhere. Get a massage, sweat in a sauna, take a stress-relieving bath with lavender and Epsom salt or sea salt, relax with friends, listen to soothing music or read a book. Simply do anything that creates calm and peace of mind. My UltraMind Solution program makes an excellent way to help ease your mind and relieve stress. Many patients also find my UltraCalm CD helps them manage stress.
7. Get adequate sleep. Proper sleep becomes essential for optimal nourishment. Sleep patterns affect how your body detoxifies, as well as how it repairs and heals itself. Poor sleep can increase inflammation that contributes to chronic illness. Check out my 8 simple hacks for a better night's sleep.
8. Exercise daily. Among its benefits, exercise is essential in order to sleep better, digest food better, balance blood sugar, relieve stress, rid your body of toxins and balance hormones. Just get moving, period. Find activities that you enjoy and do them daily. Even 30 minutes of walking each day does phenomenal things for your health.
For most patients, these strategies help optimize their nutrient status so they finally can lose weight and feel better. If you've utilized these strategies and still can't lose weight, I highly recommend testing for nutritional deficiencies and working with a Functional Medicine practitioner.
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
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