Wednesday, June 23, 2010

Glutamine: Reduces Inflammation and Improves Gut Health

L-glutamine is the most abundant amino acid in the human body.  Because we can make it endogenously, it is traditionally called a “non-essential amino acid”, but lately the literature seems to refer to it as a “conditionally essential amino acid” because we have learned that some people, particularly when we are under stress, require more glutamine than our bodies can produce.

Many animal studies and human clinical trials have shown that glutamine can reduce inflammation.  It seems to be especially effective at healing the mucosal lining of the intestine and restoring the hair-like villi which can be severely damage by an inflamed intestinal lining.  It is theorized that glutamine works by restoring the gut barrier and preventing the “leaky gut” syndrome which may result in chronic inflammation spreading throughout the body.

Glutamine is a very safe supplement at doses of <40 grams per day.  A normal therapeutic dose is 5-20 grams a day taken between meals in divided doses.  I generally take 5-10 grams at mid-morning and 5-10 grams at bedtime.  It is available as a capsule or powder.  At the required doses, a powder is probably more convenient and economical.  It is a fine white powder with a slightly sweet taste that is water soluble.  I mix it with water and drink it.

Glutamine is used medically to promote post surgery healing.  It is a popular sports supplement as it promotes the healing of overly stressed muscles and, taken at night on an empty stomach, can stimulate the normal pre-dawn release of human growth hormone.  Some claim that it helps with blood glucose management, but I have seen no research supporting this claim.  Presumably, reducing chronic inflammation should improve many conditions.

Tuesday, June 22, 2010

Making Super Yogurt – More Probiotics, Less Carb

Is yogurt a healthy diabetic food? Maybe not if you buy it at the supermarket. The tutti-fruity yogurt being marketed as a healthy treat can easily have more carb than a candy bar. Even the “plain” commercial yogurt has 11-13 grams of lactose (milk sugar) per cup. Commercial yogurt has too much carb for diabetics or people trying to lose weight, and all this carb is in the form of highly allergenic lactose which is not for people with autoimmune issues. I strongly encourage you to make your own yogurt that is healthy, low-carb, truly probiotic ... and much tastier!

Commercial yogurt is inferior in five ways:

Additives – Obviously, adding high fructose corn syrup can render any food unhealthy, but even the unsweetened plain yogurts have added carbs. Starches are sometimes used to make a thicker more pudding-like yogurt. Most commercial yogurts have added “milk solids” which increase the amount of lactose. Real yogurt is only made from milk, cream and live bacteria.
Little real probiotic organisms – Popular commercial yogurts usually just contain two yogurt strains that are not true probiotics. Although many yogurts are advertised as having live cultures, the number of live organisms is relatively low. Some commercial yogurts are pasteurized with zero live organisms.
Not fully fermented – Commercial yogurts use an abbreviated lower cost fermentation process (usually just 4-5 hours) that results in less probiotic organisms, more lactose and a less tart insipid taste. 
Not dripped – Most commercial yogurts are not dripped or strained. Only a few specialty Greek style yogurts use some straining. Dripping yogurt further reduces the lactose and makes it thicker.
Not fresh  Yogurt should be eaten within days of being made as most of the live organisms will die within a week even when properly stored in refrigerated conditions.  Yogurt sold in the supermarket is usually several weeks old.


1. I use an electric yogurt maker which has a one liter (1.06 quart) glass bowl. After sterilizing the bowl with boiling water to make sure there are no stray bacteria which may taint the fermentation process. I add about ½ cup (125ml) of heavy cream and then fill with whole milk. You can add more or less cream depending on how rich you want your yogurt.
2. Using a microwave oven and a food thermometer, warm the milk to about 85-95° C (180-200° F) to sterilize it. It should be warmer than 82° C (180° F) but no hotter than 93° C (200° F). A layer of scum will form on top which many people skim off believing it will give the finished product a better consistency. I prefer to stir it in so as to not lose any of the milk fat.  Set aside the bowl of hot milk covered by a clean towel until it cools to 108-112° F (42-44° C). 

2b. If you have access to UHT milk, it is safe to use an unopened carton of room temperature UHT milk poured directly into the sterilized bowl without further sterilizing the milk.  This saves  much time

3. Stir in a freeze dried probiotic yogurt starter. I strongly recommend an "ABC" probiotic starter.  What I refer to as "ABC" probiotic starters contain the two normal yogurt strains (L. bulgaricus and S. thermophillus) as well as the truly probiotic strains (A)  L. acidophillus, (B) some strain(s) of Bifidobacterium and (C) L. casei.  In China, there are many probiotic yogurt startes, but in the US, the dominant brand is the Yogourmet Casei Bifidos Acidophillus yogurt starter. These truly probiotic strains have the potential to colonize the gut with healthy gut flora and greatly improve one's health.
Freeze-Dried Yogurt Starter
4. Ferment the yogurt for a full 24 hours. Traditionally, yogurt is only fermented for 8-10 hours. This longer fermenting time will ferment away most of the lactose. The lactose is fermented into lactic acid which gives yogurt is tart tastes. This Super Yogurt is also super tart, a taste that I like, but others might need to get used to it. The longer fermentation also results in a higher probiotic bacteria count.

5. Drip the yogurt for 1-2 hours to make thick Greek style yogurt or 12-18 hours in the refrigerator to get yogurt cheese with the same consistency as cream cheese. Traditionally, yogurt is dripped through two layers of cheese cloth placed in a colander. I prefer to use two large reusable nylon coffee filters placed in similarly sized containers to catch the liquid that drips off. Throw away the liquid and enjoy the remaining delightfully thick yogurt. By dripping the yogurt, you also further reduce the lactose (carb) and reduce the lactic acid (less sour). Dripping yogurt reduces the volume about 25% for Greek style yogurt and 50-75% for yogurt cheese.

I have not measured the carbohydrate of this yogurt in the lab, but believe it is about 2-3 grams per cup compared to 8-13 grams of carb for plain commercial yogurt.  This 24 hour fermented Super Yogurt is estimated to have an average concentration of 3 billion cfu/ml of live organisms which works out to 750 billion probiotic micro-organisms per cup!

While common yogurt is a healthy food, only yogurt made with truly probiotic starters will greatly improve gut ecology and reduce chronic inflammation.  A fully fermented yogurt made with an "ABC" probiotic starter has the potential to colonize the gut with healthy gut flora.  No comparison with commercial yogurt.  

Monday, June 14, 2010

Xylitol: Healthy Like Sugar Isn’t

Xylitol is a sugar alcohol that is naturally occurring in the human body and is found in many plants.  It was originally made for birch but is mostly extracted from corn today.  Its taste, color and cooking properties are very similar to cane sugar … but that’s where the comparison ends.  In terms of health, xylitol is almost exactly the opposite of sugar and other fructose sources.

Xylitol is a prebiotic that is fermented in the gut creating short chain fatty acids (SCFA) which encourage the growth of good micro-organisms … but sugar and other fructose sources encourage the growth of harmful bacteria and yeasts seriously disturbing gut ecology.

Xylitol is anti-inflammatory … but sugar and other fructose sources are strongly pro-inflammatory.

Xylitol, in some studies, was shown to improve fasting blood glucose levels and post prandial blood glucose levels … but sugar and other fructose sources induce insulin resistance and worsen blood glucose levels.

As little as 7.5 grams of xylitol induced a satiety effect measured at about a 5-8% reduction in calories consumed in one study  … but sugar and other fructose sources impair leptin hormonal signaling resulting in increased hunger and weight gain.

Xylitol improves lipid profile resulting in lower triglycerides, higher HDL and lower LDL … but sugar and other fructose sources are turned directly into triglycerides in the liver and worsen the lipid profile.

Xylitol chewing gum is known to prevent tooth decay … but sugar and other fructose sources cause cavities.

Xylitol’s prebiotic function will improve immune function in general and xylitol gum is also known to prevent ear infections … but sugar and other fructose sources can impair immune function.

Xylitol prevents yeast infections … but sugar and other fructose sources encourage the overgrowth of Candida yeast in the intestine, urinary tract and vagina.

Xylitol helps heal an inflamed intestinal lining … but sugar and other fructose sources can destroy the delicate hair-like villi that line the intestine and contribute to a leaky gut.

Xylitol has 40% less calories than sugar and a much lower Glycemic Index.

Xylitol has a clean sweet taste … but sugar and other fructose sources have a sticky sickening sweet taste.

Is xylitol the perfect sugar substitute?  Well, maybe not perfect, but I believe it to be the best.  Xylitol’s main shortcoming is that some people develop diarrhea and flatulence when they eat too much.  Examined closely, this apparent shortcoming is revealing.  People who suffer ill effects from xylitol probably have unbalanced gut flora which are not able to digest it.  As people who have problems with xylitol gradually increase consumption, the community of micro-organisms in their gut adapts to be able to digest it.  In doing this, one’s gut flora greatly improves in other health promoting ways.

The great majority of people who are new to xylitol can eat up to 25 grams (1 ounce) with no ill effects.  In one study, participants were given a very large dose of 400 grams a day (almost a pound) of xylitol and more than half of the participants reported no ill effects.  The main ill effect reported was flatulence and a smaller number reported diarrhea.

While xylitol has been shown to be absolutely safe and generally healthy for both adults and children, the same cannot be said for all animals.  Xylitol is toxic to dogs.  This may be serious problem for people who share food with their pets.  You cannot give pets any food containing xylitol.

I do not have a dog in my 15th floor apartment, but even if I did, I would not feed it my food.  And, like the majority of people, I have no GI issues with xylitol.  I have always loved the fresh, natural taste of xylitol compared to some of the odd tasting artificial sweeteners, but I only recently came to understand the prebiotic effects of xylitol.  So, for me and most people, maybe xylitol really is the perfect sweetener.
Xylitol    100% Pure Xylitol   Xyli Pure Xylitol   
Where I live in China, xylitol is the most common sugar substitute and is used by almost all diabetics.  It costs about $4.00/lb.  I note that in the US, it can be purchased online at Swanson Health Products for about $5-9.00/lb.

If you have not tried it, I encourage you to experiment to see if it is for you.

Saturday, June 5, 2010

Heal Your Gut, Reduce Chronic Inflammation

This blog is about chronic inflammation which we are now finding can be improved by developing healthy gut flora. I write as a Type 2 Diabetic, but chronic inflammation is a factor in many chronic diseases.  I have found that addressing gut health dramatically helps children who suffer allergies, eczema and asthma.  For adults, it is a critical factor in obesity, heart disease, chronic fatigue, depression, fibromyalgia, lupus, arthritis, Celiac, Crohn's, IBS and many other disorders.

1. People with chronic disease (including T2s) generally have poor gut health. The mucosal lining of their small intestine is inflamed.

2. People with chronic disease (including obese people) have different gut flora than healthy people. The imbalance of the intestinal microbial community is clear and can be easily demonstrated. While we can see the differences in gut flora, our understanding of the hundreds of species and thousands of subspecies of the 10-100 trillion microbes in our gut is still very rudimentary at this point.  My blog explores emerging understanding.

3. People with an inflamed lining of their small intestine have an impaired gut barrier and the inflammation spreads.  We suffer chronic inflammation as measured by C-reactive protein and other markers of inflammation.

4. Chronic inflammation is associated with insulin resistance and obesity. Obesity is both a result of inflammation and insulin resistance and a cause of further inflammation and insulin resistance. Vicious cycle.

5. Incretins involved in insulin signaling are produced in the intestinal lining. In T2 diabetics, an inflamed gut leads to disturbed incretin signalling and a weak or nonexistent First Phase Insulin Response.

6. Other hormonal signaling is disturbed by chronic inflammation.  Beside insulin resistance, inflammation will impair the response to leptin (the hunger hormone) and result in increased obesity.

7. Five measures are known to improve the composition of the gut flora and reduce inflammation: 
-   (a) consuming more probiotic organisms.
-   (b) consuming more prebiotic soluble fiber that favors the growth of healthy bacteria.
-   (c) consuming more phytonutrients that discourage the growth of unhealthy bacteria and yeast.
-   (d) limiting the consumption of simple carbohydrates (especially fructose) which encourage the growth of unhealthy bacteria and yeast in the gut. 
-   (e) improving the body's omega-3 to omega-6 ratio by eating healthy fats and oils.

Rather than battling disease by killing and cutting, I am more interested in realizing health and wellness by achieving balance. I am pleased that many people are looking for gentler ways to achieve health through lifestyle changes and relying less on radical drugs and surgery.