Super Gut Book Review & Commentary by Dana Carpender

What You Need to Know In his latest book, Super Gut, Dr. Davis explains how and why we have totally different gut flora than our hunter-gatherer ancestors or even our grandparents. Dr. Davis enumerates the staggering array of modern health problems attributable to gut dysbiosis. He then lays out a comprehensive but approachable path to reestablishing a healthy internal ecosystem.

Damn it, Bill Davis, you keep changing my worldview. 😉

I said regarding William Davis, MD’s groundbreaking book Wheat Belly that while I have learned a little something from most of the nutrition books I’ve read, Wheat Belly was so full of new information, stuff I’d never even dreamt of, that I was gob-smacked. My whole understanding of the virtues of a low carbohydrate diet, the addictiveness of carbohydrates, and the dangers of grain expanded exponentially. Just page after page of stuff that had never even occurred to me, much less been presented with scientific arguments and citations.

I’ve been reading Dr. Davis’s new book, Super Gut, and once again my view of health and nutrition is shifting dramatically. I’ve known for a long time that ninety percent of the cells in my body aren’t “me,” but rather all the interesting things that live in and on me, from gut bacteria to eyelash mites. This has never bothered me; I quite enjoy the idea of being a planet, even a universe, to all those tiny lives. I have for decades now avoided oral antibiotics unless absolutely necessary (see: Lyme disease). I have joked with my primary care physician that my, uh, lax housekeeping probably meant I have robust gut flora. I buy the yogurt with the broadest spectrum of bacteria. I thought I was reasonably hip to this stuff.

Hah. I knew nothing. Nothing.

The calls are coming from inside the house!

I figured that since I don’t have gut trouble, I didn’t have, well, gut trouble. Then I got a look at the list of health issues that are related to dysbiosis – having the wrong gut bacteria, and even worse, having them in the wrong places, like your small intestine instead of your colon. Fungus can get in on the fun, too.

Even worse, they can infiltrate your bloodstream and travel the highways of your circulatory system. The list of health problems related to dysbiosis is stunning – everything from irritable bowel, which seems logical, to fibromyalgia, to anxiety and/or depression. Osteoporosis. Arthritis. Insomnia. ADHD. Hypertension. Chronic headaches. Skin problems, like fungal breakouts – tinea and the like. Rosacea, which has recently been plaguing me – my skin is now worse than it was in my teens, and it is not fair to have to worry about wrinkles and zits at the same time.
In short, it reads like a list of modern health problems that medicine has hitherto treated but never actually cured. Turns out it’s because we are growing our own poisons.

How did we get here?

Dr. Davis explains how and why we have totally different gut flora than our hunter-gatherer ancestors, or even than our grandparents or great-grandparents, depending on how old you are. Why? It starts at birth. For most of human history, babies got their earliest microbiome on their passage through the birth canal. Then came Caesarean section, initially a life-saving procedure that has exploded in frequency – from five percent of births in the United States as recently as 1970 to nearly a quarter of all births now. (According to the National Institutes of Health it is as high as seventy percent of all births in some hospitals, and wouldn’t you like to hear the explanation for that?)

C-section means that the baby does not pick up helpful bacteria during labor and delivery. It’s common knowledge that breast feeding passes the mother’s antibodies to her child, but it also passes along helpful bacteria, starting a healthy microbiome. Breastfeeding is on the upswing again, but for decades it took a back seat to the “modern convenience” of formula. These two things alone mean that a vast segment of the population starts out lacking protective gut flora. (Please do not misunderstand. I know that breastfeeding is not always possible, and fed is best. But just as it has been important for formula to be designed to be as close to breast milk as possible, it is important to know that there is a need to compensate for the lack of those early, helpful bacteria.)

Even in children born vaginally and breastfed, the microbiome goes awry the first time they take antibiotics. I am not anti-antibiotics; they have been a genuine miracle. When I was diagnosed with Lyme disease, I was more than happy to take them; heck, I was eager. But the prescribing of antibiotics for viruses “just in case” – antibiotics do not affect viruses — is wiping out helpful gut bacteria, leaving plenty of real estate for bad bacteria.

What to do? or Dana uses the word ‘cleanse’.

The book digs down to which bacteria are helpful for which health problems versus which can cause those problems, and gives many recipes for making your own yogurts to address specific health issues, including yogurts to help beat back the bad bacteria that have set up housekeeping inside you so that you clear the way for the helpful bacteria to come. (I have l. reuteri yogurt in my refrigerator as I write this.) Dr. Davis then gives a clear and simple four-week plan for shifting from dysbiosis to a Super Gut.

I confess to being allergic to the hackneyed term “cleanse;” it is overused to the point of being nearly meaningless. In general, if you eat actual toxins your liver will package them up and ship them out. That’s your liver’s job. (Okay, one of your liver’s jobs. Your liver is the hardest-working organ in your body.) And a lot of so-called “cleanses,” like juice fasts, are actually harmful.

But Dr. Davis has convinced me that if colonic bacteria have invaded your small intestine – Small Intestinal Bacterial Overgrowth (SIBO) – or if fungus have established themselves—Small Intestinal Fungal Overgrowth (SIFO) – you need to clear them out before you can start establishing the helpful bacteria. He likens this to pulling the weeds and removing the stones and sticks before planting a garden and gives a few options of how to do this. One way is by consuming yogurt made from bacteria that actually produce antibiotics that fight the unfriendly organisms; I have those bacteria in my fridge awaiting my next yogurt-making. He also recommends specific spices, herbs, and essential oils for getting rid of the fungus, which are harder to kill. Then he lays out the plan to establish and nurture the good stuff, step by step.

Among the things I have learned from Super Gut

This is getting long, but here in no particular order is a far-from-exhaustive list of things I have learned from Super Gut:

• The right microbiome can improve insulin sensitivity and even cause weight loss.
• Our gut microbiome can dramatically alter mood. For example, l. reuteri, among many other virtues (like making you look and feel younger, and who doesn’t want that?), increases levels of the hormone oxytocin, making us feel greater fondness and empathy. I find myself wondering how much of the current at-each-others’-throats political climate is related to a lack of this one bacteria.
• Toxins released by the bad bacteria and fungus dying – keep in mind that they go through many generations in a day, so they are not only living but dying inside you constantly – cause a lot of those mood issues. Because of this, the early stages of killing off the unfriendly organisms can cause a spike in depression, anxiety, even anger. This is not a reason not to do it, of course, but it’s important to be aware that this may happen. If you can time the first week for a period of less stress (“Hah!” I hear you cry), it would be a good idea. But just knowing that those mood swings are to be expected can help.
• The importance of fermented foods, which were common in the human diet until refrigeration, complete with recipes for making them. I have already discovered I like kimchi!
• The dangers of Small Intestinal Bacterial Overgrowth (SIBO) and Small Intestinal Fungal Overgrowth (SIFO), and even the fact that how far up your small intestine the invading colonic bacteria have gotten can make a difference in their health impact – including causing gallstones. Fungus can also cause anxiety; if you or a loved one suffer from Generalized Anxiety Disorder you know how painful and even crippling it can be, and how resistant to medication. This alone would be sufficient reason to follow the Super Gut program.
• The importance of fiber even in a low carbohydrate diet. I have, I admit, been pretty catch-as-catch-can about fiber, figuring that since I wasn’t eating a diet of paste (pasta, pastry) and I was regular, I needn’t concern myself. Turns out that while we can’t digest fiber, our gut bacteria can. Once you get the right species and strains going, you’ll want to feed them – not cellulose, as found in grains (not recommended!), but soluble fiber, as found in vegetables and low-sugar fruits, chia and flax, psyllium husk, and even legumes. I may add a small quantity of beans back to my diet. This may mean that strict carnivory is not the best diet.

  (I know someone is thinking, “But what about the Inuit?” They did, indeed, eat a mostly carnivorous diet and were, by all reports, robustly healthy. I am not a biologist nor an anthropologist, but it occurs to me that the Inuit studied by White explorers in the late 19th and early 20th centuries would have been born vaginally and breastfed, setting up a beneficial microbiome from the start. They also ate plenty of aged – ie, fermented – meats and fish. They were getting probiotics from those, I’m sure. And they certainly would not have taken antibiotics, since they had yet to be discovered/invented when those early observations of their culture were made.)

• Because of the need for prebiotic fiber, Dr. Davis is against super-low-carb diets, though he has long been an advocate of carbohydrate restriction. He suggests no more than 15 grams of carb per meal – so 45 grams per day – from high fiber sources. Many people will still be in a mild ketosis at that level of intake.
• Why the fact that some beneficial foods pass through you without being absorbed is a good thing, because their main benefit is to the gut microbiome.
• Not so happily, for some reason not yet understood, the bacteria in the probiotics and yogurt we consume do not establish themselves permanently in our colons. Time to get in the yogurt habit. Currently I eat mine a few ways – with vanilla stevia and a little low carb strawberry jam, with English toffee stevia, a little natural peanut butter and a swirl of that same low carb jam, or with lemon drop stevia. I’ve also used it to make horseradish sauce for beef. I’ll make the sauce again, measuring this time, and send it to Dr. Davis to post; it will also be at CarbSmart, of course. And more recipes as I think of them! (As I was editing this article, I found a recipe I simply must decarb for a chocolate-orange mousse made from Greek yogurt.)
• The importance of intestinal mucus for preventing bacteria from leaking into the bloodstream. Having “got nutrition” long enough ago that I can remember old books touting the virtues of a “mucusless diet,” this made it clear to me why those books always struck me as pure quackery.
• Why NSAIDs – aspirin, ibuprofen, naproxen – are hard on your gut. I’d heard about them causing stomach damage, of course, and learned the hard way that they can also damage kidneys (I will never take naproxen again, but my kidneys rebounded nicely). I did not know they could damage intestinal mucus, thus increasing the risk of bacteria passing into the blood stream.
• A reason to eschew artificial sweeteners that makes sense to me – the same damage to intestinal mucus.
• That different strains of the same bacteria behave differently. In other words, one strain of l. reuteri may have a beneficial effect while another strain of l. reuteri does not. A weird analogy that occurred to me: As a Boomer, I grew up knowing the music of two Englishmen named David Jones. One was a Monkee and sang ’60s pop. The other changed his surname to Bowie, had a brilliant career, changed rock music dramatically and, despite his death, still has an outsized influence. He also had a modest but stunning acting career – take it from one who saw him play The Elephant Man live on stage. Two British musicians named David Jones, very different effect. Okay, it’s a reach, but it’s the best analogy I could come up with.

Now I want to know more!

I still have questions. It is clear, for instance, that depression, aka “melancholia,” has been with mankind for a very long time; it was one of the four classical “humors.” This suggests that there is more to it than just dysbiosis caused by modern influences. But with the World Health Organization reporting that depression is increasing worldwide, something is driving that increase. It would be interesting to know if people in societies where vaginal birth and breastfeeding are the rule, and antibiotics few, have lower rates of depression – except that there are so many confounding factors. How do you know the effect of, say, a traditional lifestyle in general? More familial and tribal involvement? Sun exposure? Levels of exercise? Traditional diet? I don’t know how such a study could be designed. But if improving gut flora can simply ease depression and anxiety it is worth pursuing.

Similarly with ADHD, which I have – one of the questions in the ADHD assessment I initially took was “Were you breast fed?” This indicates that the people studying and diagnosing ADHD are aware of some connection. But the answer was, “My mother tried, but I kept trying to sit up and look around,” so apparently, I was distractable from birth, long before I’d had antibiotics.

I’m convinced my dad also had ADHD – he was never diagnosed, but he had all the personality traits. And having been born at home in 1928, he had a vaginal birth and was breastfed. Penicillin was discovered that year; it’s unlikely he had it young. What little I know of my paternal grandfather – including a three-pack -a-day cigarette habit and a codeine addiction (cough syrup for that smoker’s hack, to the tune of a bottle a day) – suggests he had it, too. I am convinced that there’s a genetic basis to ADHD, but open to the possibility that gut dysbiosis either has an epigenetic effect triggering the ADHD gene, that dysbiosis can worsen ADHD, or that there is a form of dysbiosis that closely mimics ADHD, or any combination of the three. I am more than open to the possibility that some of my ADHD traits will soften with a Super Gut.

As you can tell, I am deeply impressed with Super Gut. There is one big difference, however, between this review of Super Gut and my reviews of Wheat Belly (I re-reviewed it when an enlarged and updated version came out) – I had already had an ugly enough experience with wheat that I had decided it was not for me. So, the book was telling me why wheat was not my friend, but I already knew it was not and had knocked it out of my diet (gave up low carb tortillas and bread). I knew I felt better without wheat, or grains in general.

Wheat Belly Book Reviews

• Dana’s First Review of Wheat Belly
• Dana’s Updated Review of the Updated Version of Wheat Belly at the Dr. Davis’ Wheat Belly Blog
• Amy Dungan’s Review of Wheat Belly

But I am new to the Super Gut approach and cannot yet report my own results. I intend to follow the four-week program as laid out and await the results with interest. I’m also trying to get That Nice Boy I Married in on the program. Again, I already have the needed bacteria in hand to make the yogurt to clear out the bad stuff; I also have clove oil and have ordered curcumin to fight fungus. Happily, we both like yogurt, and TNBIM is amenable to giving it a try.

More news when I have it.

More Low Carb Recipes & Articles by Dana Carpender