Rebalance Your Microbiome

review by Katherine Duff

, by Raphael Kellman, MD

Da Capo Press; 44 Farnsworth Street, 3rd Floor, Boston, MA 02210

©2014; $25.99; hardback; 344 pp.

The Microbiome Diet, by Raphael Kellman, MD, may be a new concept to some readers. Microbiome is a term used to define the pathogenic microorganisms that live in and on the human body, where they exist in symbiotic relationship with human cells. These pathogens, which are mostly bacteria, outnumber human cells by about 10 to 1. They are found in the mouth, vagina, skin, and, in the greatest amount, gastrointestinal tract. In an effort to better understand the role of these pathogens in human health, the National Institutes of Health launched a $150 million project called the Human Microbiome Project in 2007. Adhering to a policy of “rapid release,” the research generated under the project is released quickly and prior to publication, resulting in a wealth of information about this emerging area of study. Kellman, who has long focused on the role of the gastrointestinal tract on health and weight management, has been able to avail himself of the most current research for this book.

The microbiome, comprising “good” and “bad” bacteria, is critical to our very survival. We learn that our genes were not encoded for every task that the gut must execute for us to survive. We depend on the microbiome to accomplish tasks such as regulating the immune system, extracting nutrients, producing certain nutrients, and influencing the production of neurotransmitters. It is when the microbiome is out of balance that these tasks are not accomplished well and health problems occur. The those problems include weight gain or inability to lose weight, mental health; digestive issues, metabolic disorders, endocrine problems, and autoimmune illnesses.

A microbiome out of balance means that the bad bacteria overwhelm the good, and there could be parasites and fungi present as well. This imbalance can come about as a result of diet, antibiotic use, and stress. To rebalance, the author offers his plan of the “Four Rs.”

The first R is to Remove from the diet anything that interferes with intestinal health, such as foods that are highly reactive: dairy, soy, sugar, eggs, and gluten. Since leaky gut is a sign of a microbiome out of balance, these foods are to be avoided because they leak through the intestinal walls and create inflammation, which then leads to storing fat. Another example from the Remove list is to rid oneself of parasites. For this the author suggests using natural compounds such as berberine and wormwood.

The next R is Replace. Lack of hydrochloric acid in the stomach can result in incomplete digestion before food reaches the small intestine. This can lead to the possibility of food’s crossing the intestinal wall, which can then trigger more inflammation. Also, when this happens, critical nutrients such as vitamin B6, calcium, and iron cannot be absorbed. Another problem arises due to the fact that the small intestine does not get the signal to produce needed digestive enzymes. Kellman prescribes supplemental hydrochloric acid and digestive enzymes.

Food choices come into play in the third R – Reinoculate. Here we learn about the importance of diversity in the gut. Research has already shown that leaner, healthier people have greater diversity of species in their microbiome. We achieve our diversity through a lifestyle of eating different foods and mixing in different environments. To boost our diversity, Kellman looks to probiotics and prebiotics. He offers advice on selecting a good probiotic supplement and lists the fermented foods that will introduce their own living bacterial cultures.

Another form of inoculation is to encourage the good bacteria in the microbiome. This can be done with the prebiotic foods that are high in plant fiber, such as asparagus, carrots, and jicama, to name a few.

The last R is to Repair the gut wall and intestinal lining. In a microbiome that is off balance, the microvilli and the tight junctions found in the small intestine are not functioning properly. The tight junctions become loosened and can allow passage of food through the intestinal wall. The microvilli become atrophied and lose their ability to gather nutrients to be absorbed. The remedies include minerals and herbs, healthful fats, glutamine, and butyric acid.

The author has applied the “Four Rs” to a three-phase regimen. The first phase includes the meal plans for the first 21 days that will aid in healing the digestive tract. At its conclusion, the repair should be well under way. The microbiome is ever changing, and with a lifespan of 20 minutes for the microbes, even 24 hours can make a big difference.

The second phase of 4 weeks’ duration will reduce the inflammation that is causing fat storage and boost the metabolism into fat burning. At this point Kellman expects 90% compliance with the diet. The last phase is the plan for staying healthy for life that assumes a 70% adherence to the diet.

While this is certainly a diet book for losing weight, it is also a good primer on gastrointestinal health. We learn the importance of maintaining a balanced microbiome because, as it turns out, those pathogens are our gastrointestinal system. And rather than being “a blind tube,” as the author was taught in medical school, the gut is integral to the functioning of the brain and immune system. He states that 70% to 80% of the immune system is found in the gut and 95% of the body’s serotonin is located there to assist in digestion.

The National Institutes of Health proposes that if the effects of a changing microbiome on health can be demonstrated, the result will transform medicine. This book is on the cutting edge of that transformation.

Pearl: “Our metabolism, weight, and overall health depend on the balance of microbial life within our gastrointestinal tract.”