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You are what you eat!

09.01.2019

Hippocrates proclaimed: "You are what you eat," explaining that: "All diseases come to us through the mouth with food" - Interview with Dr. Jolanta Julia Libura, a Board Certified Specialist in Internal Medicine.

"You are what you eat" – said HIPOKRATES long time ago suggesting the gut as the root of the disease. Each of us remembers this thought of the father of medicine, but many of us do not apply this obvious knowledge. Why is it so difficult to change our mind and our menu? Why are we still not paying enough attention to our eating habits? Healthy nutrition, a balanced diet, an active lifestyle and many other factors have a huge impact on our health. So what is the relationship between the content of our plate and the treatment or occurrence of chronic diseases? This and many other questions we decided to ask Dr. Libura, who is a specialist in Internal Medicine and Nutritional Medicine. You are welcome to join us to read!

- Doctor, what is the relationship between health and lifestyle? 

Many years ago Hippocrates advocated "Let food be our medicine." We believe in the healing power of pills and tablets, which of course we cannot avoid often in advanced stages of the disease. Meanwhile, more than 2/3 of diseases (including the largest plagues of the 21st century such as diabetes, obesity, allergies, coronary heart disease and cancer, etc.) depend on lifestyles, including mostly nutrition.

We often contribute significantly to the development of these diseases during our whole life. Ignorance, false premises, commercialism - they all fuel the lifestyle, trigger and shape habits and thus lead to the epidemic of civilization diseases of our century.

The quality of our health has a huge relationship with a lifestyle such as: diet, physical activity, rest time and the ability to cope with stress. There is so-called principle of the four pillars of health. They all contribute significantly to maintaining good health. Most often the patient comes to the doctor when the disease is already very advanced and its consequences are often difficult to reverse. What the doctor can still do - is to treat the symptoms with "pills". We treat the symptoms but not the root. Meanwhile, the best "pill" is prevention - that is, prevention before the disease enters the gate of our body. Functional and Preventive Medicine and especially its branch - Nutritional Medicine - are aimed at helping the patient to "take responsibility for the health in his own hands". The doctor uses his knowledge to effectively assess the current state of health, physiological needs of the patient or pre-existing risks or functional imbalances that has not yet caused, but may soon lead to the emergence of disease symptoms. After such initial examination that includes advanced blood tests, the doctor helps to choose the right diet or nutritional therapy with proper supplementation in accordance to the individual metabolic needs of the patient. This can prevent or support the treatment of existing diseases as well as delay aging. The patient makes his own decisions about how actively he will participate in this process and this will have an impact on his quality of life and mental and physical condition.

- Who would benefit the most from changing eating habits, at least changing thinking about food?

Changing dietary habits would in a way help everyone. Each of us is a kind of victim of the "food industry", so most of us would benefit from changing the menu and the so-called "optimization" of our diet as a form of disease prevention. Of course, people suffering from civilization diseases would benefit the most and most noticeably. A diet based on plants (mainly raw vegetables and fruits) has been known for centuries - as the so-called "Internal detox". Its value was described already in an ancient book such as the Bible, and is now popular as "Daniel's fasting" or fruit and vegetable diet. Its principles were investigated very well by dr Ewa Dąbrowska MD, PhD, who during her 30 years of practice proved how it can reverse the effects of many chronic diseases such as diabetes or coronary artery disease. It involves also so-called "External detox", which is based on the possible broadest elimination of processed food that is rich in chemicals, most of which are simply toxins for our body. Currently, the value of plant-based diet is recognized and promoted independently by many outstanding Health Care Professionals including doctors and cardiologists: Dr. John McDougall, Dr. Joel Fuhrman, Dr. Caldwell Esselstyn, Dr. Neal Barnard, who is the founder of the Physicians Committee for Responsible Medicine, etc. They all believe that the patient can take control of his health by changing his life style and this is one of the most important elements of therapy - considering that modern medicine often doesn't offer the treatment for the root of the disease.

- What should we eat and what should we take out from our plate?

Each age and physiological group has different metabolic needs. There are different metabolic and genetic profiles of patients, different nutritional and health requirements etc, etc. Nursing mothers, people in retirement age or young people at the peak of development will have different needs. Therefore, we must first determine patient’ health status, metabolic needs and the individual physiological context of the patient. In my office, I offer comprehensive health assessments and internal medicine consultations that can lead to early detection of serious medical problems long before even early symptoms arise. After initial evaluation and diagnosis, it is possible to determine the direction of nutritional therapy along with the necessary supplementation. This also includes the treatment with the necessary medication. I start the whole process by asking the patient to fill the online or paper "Health assessment questionnaire" that I can compare to “health confession” and includes questions about lifestyle, health history, eating habits, well-being and much more… This helps to determine what the individual triggering and facilitating factors are that contribute to the development of health problems. Then I see personally and interview the patient, perform the physical examination and order the extended blood tests that help me to see the health condition from inside out. Blood is perhaps the most important window through which we can gain a better idea of what's going on inside your body. Currently multiple clinical tests are offered including e.g Advanced Cardiovascular testing (most of them covered under common insurance plans) that help to uncover hidden risk for heart attack and stroke, other tests help to detect oxidative stress and pre-existing inflammation as well as cancer susceptibility status. The next step is to accurately and meticulously interpret the results, create an action plan including medication, a nutritional therapy program and balanced supplementation. As I mentioned earlier, this whole process is based on mutual support and cooperation between the doctor and the patient. The patient is not left alone at any phase of his health recovery process. The benefit is that most insurance companies cover additional medical appointments for patients requiring obesity treatment. We offer also supplemental services that include Body Composition analysis, creating individualized dietary programs etc that are meant to assist the patients. Additionally seminars and workshops in the field of "Culinary Medicine" are organized by my staff and supervised by dietitians working in the office.

- What do you think about a diet supporting the treatment of autoimmune diseases?

Today, it is believed that many autoimmune diseases start in the digestive tract. Processed foods rich in taste enhancers, artificial coloring agents and preservatives, the predominance of sugars and saturated fats in the diet that stimulate the development of inflammation and unhealthy bacteria in the intestine, stress - all this disturbs digestion and integrity of the mucosa lining of the intestines. It leads to absorption and passage of incompletely digested protein particles from the intestine lumen to the blood stream that stimulate inflammation and “irritate” the immune system to produce antibodies that can attack your own tissues. In addition, microbial fragments pass through the leaking intestinal wall. The toxins they produce should not normally cross the intestinal-blood barrier. It's just a simplified scheme. More and more clinical data suggest a link between diet and autoimmune diseases. There are many treatment protocols that can be implemented in existing disease entities in cooperation with the patient.

- Is there such a disease as a "leaky gut"?

The lining of the intestine is only one cell thick. The small intestine is the place where most nutrients are absorbed. The intestine is also part of the gastrointestinal tract where toxins, undigested food and bacteria that should not enter the bloodstream are retained. The integrity of this barrier is very important. The more damaged and permeable the lining of the intestine is, the weaker the protective barrier.

Allergies, weight loss problems, psoriasis, rheumatoid arthritis and even Hashimoto's or Leśniowski-Crohn's disease may be the result of leaky gut. The digestive tract has its own nervous tissue, called the intestinal nervous system, which senses and responds to the intestinal environment and thus regulates intestinal activity. While the intestinal nervous system can function independently, it also communicates with the central nervous system through a network known as the gut-brain axis. The two-way nature of this communication explains not only how stress can affect digestion but also how gastrointestinal diseases can affect the brain. The intestinal microbiome (probiotics) emerges as a key factor affecting communication along the entero-cerebral axis. Intestinal microbes themselves produce a number of neuroactive substances, help control intestinal barrier function, and modulate immune and inflammatory signaling. They affect and interfere with signaling along nerve pathways. It is thought that intestinal microbiological disorders are associated with autism spectrum disorders, ADHD, depression, anxiety neuroses, as well as Parkinson's disease, Alzheimer's disease and chronic pain.

- You mentioned the microbiome's balance. What is your opinion about probiotics?

Probiotics or selected bacterial cultures serve our health and improve digestive system function. The right microbiome affects not only our intestines but the whole body including the brain. According to scientific research, the wrong microbiome contributes, among others to depression or obesity. Probiotics are helpful bacteria that counteract the excessive growth of pathogenic intestinal bacteria and provide a broad spectrum of previously unknown health benefits. An unhealthy diet with a predominance of sugars and oxidized fats, taking antibiotics or a natural aging process - causes that the delicate balance between beneficial and bad bacteria is disturbed. An imbalance can wreak havoc on the whole body and leads to the development of the aforementioned "leaky gut syndrome", chronic inflammation and further chronic diseases such as the aforementioned autoimmune disorders, metabolic syndrome, diabetes, obesity, chronic fatigue syndrome and non-alcoholic fatty liver disease. While supplementation with good bacteria provides protection primarily against intestinal diseases - such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and colorectal cancer - scientists believe they also help prevent many diseases including aging.

The digestive tract is like a "chemical reactor" - unfortunately it is not made of corrosion resistant steel. Many complicated biochemical reactions take place here and various concentrations of bioactive chemical molecules are produced in high concentrations, including bio-transmitters, neurotrasmitors and other potent bioactive molecules with a colossal and underrated effect on all body cells.

Additionally, intestinal bacteria produce proteins that have a strong effect on peripheral receptors - which can be positive or negative. Long-term state of disturbed balance in favor of pathogenic bacteria called dysbiosis - activates many unfavorable metabolic, immunological and hormonal pathways in our body, which can stimulate the development of diseases in many areas of the body - not only those related to the intestine.