About Dr. Jeffrey Bland
For the past 35 years Dr. Bland has traveled the globe teaching the tenets of functional medicine to over 100,000 healthcare professionals. In this episode, Dr. Bland reveals new science linking our health to interactions between our diet, gut microbiome and the expression of our genes.
Dr. Bland is author of the best selling book The Disease Delusion: Conquering the Causes of Chronic Illness for a Healthier, Longer, and Happier Life
Contact Dr. Bland
03:12 Inception of Functional Medicine: In1989 Dr. Bland hosted a group of key opinion leader doctors to ponder the future of medicine and how to shift the tide of chronic illness. The term Functional Medicine was created. Loss of some sort of function precedes disease. The focus is on the origin of the disease rather than what it is. How do we treat the cause, rather than mask the effects with symptom suppressing medications. The Institute of Functional Medicine was created in 1991. Over 100,000 practitioners have been trained. The first Functional Medicine Clinic has been opened in the Cleveland Clinic.
07:13 Dr. Bland’s Proudest Functional Medicine Moment: That would be the recognition that the body works as a system, unlike traditional western medicine that views an individual group of organs working in isolation. The body is a complex web of interacting parts. Every organ speaks to every other organ.
09:39 Regulation of Genetic Expression: In order for our genes to have an impact upon our health, they need to be expressed at the cellular level. Deep within the nucleus of our cells is our book of life, or human genome. It is coded in 23 chapters called our chromosomes. Half of the chapters were from our mother and half from our father. Within the 23 chapters are thousands of stories. The stories are our genes. We have discovered that we influence how and which of these stories are told. Carrying a gene for a specific disease does not mean you will get that disease. Most of us have certain genes that may lead to susceptibility to certain diseases, but most often they do not get expressed because we are resilient.
12:46 Paper Clips and Sticky Notes on our Genes: There are certain marks that are placed upon our genes as a consequence of things that we do or things to which we are exposed. They are either paperclips, which mean don’t read here, or sticky notes that mean read here leading to proper function and disease resilience. These are often under our control based upon how we choose to live, what we eat, what we think about, and environmental exposure to pollutants, our activities, and our social relationships. These are all signals that modify how genes are expressed.
15:33 Impacts of Preconception Exposures: Investigators out of McGill University studied who were in utero during the great ice storm of 1998 in Canada. People were subject to extreme cold exposure in their homes for a few weeks. Did the stress from this event have an impact upon the imprinting of the genes of the unborn children? The study showed that methylation patterns of the genome were altered. They were genes related to immune function and the management of insulin and blood sugar.
17:41 Flexible Gene Imprinting: Our daily behaviors and diet influence gene expression patterns. It is not irreversible. We can modify how the genes are expressed by changing our behavior.
19:26 Activating Bliss Genes: The seven core physiological processes are the processes that control how our genes are expressed. One which is important in remediating function is the detoxification system and its interrelationship with the gastrointestinal immune systems. These are the first steps in turning back the messages that modified how our book of life is being read.
20:59 The Value of Genetic Testing: Even though genetic testing is valuable, there are limitations. Having a genetic characteristic doesn’t mean that it will be expressed. The gene information which is now presented to the public is to talk about disease risk genes. This is disease centered and not health centered, so the results are a cause for worry. A majority of the information in our genes is disease resilience. The interpretation is key.
25:13 Food is Information: We grew up thinking of food as enjoyment, satiety, and health-giving nutrients. Food is information for our genes. The new field of nutrigenomics or nutrigenetics studies the interrelationship between nutrients in food and how genes and their expression pattern are modified. It is not just about vitamins and minerals. It is also about the thousands of other material that are found in food called phytochemicals. These are unique to a specific plant family. These effect gene expression in unique ways. This revolutionary discovery is recasting nutrition in health and disease.
29:15 Phytochemcials and Our Gut Microbiome: In food processing many phytochemicals are removed, to our detriment. We are truly a system made of human cells and the interaction between human cells and bacterial cells called symbionts. The second largest mass of tissue in our bodies is the 2 to 3 pounds of bacteria in our digestive tract. The gut houses at least 50% of our immune system and it speaks directly to the bacteria in the intestinal tract. The food, bacteria, and human interaction is more important and complex than we ever thought.
32:24 Endotoxin: Within gram negative bacteria in our digestive tract there are a series of chemicals that make up their cell walls called lipopolysaccharides (LPS), a combination of sugars and fats connected together. Bacteria have cell walls. Humans have cell membranes. Antibiotics prevent bacteria from creating a cell wall. When bacteria die, they release their degenerating outer skin. The LPS can move across the GI mucosa that keeps the hostile and pathogenic from entering our bloodstream. Thus the LPS enters our blood and has access to our immune system. It triggers systemic inflammation. When we eat a high fat/high sugar diet, within the next few hours, the LPS creates chronic systemic inflammation throughout the body, increasing the risk of most chronic diseases, including dementia and diabetes.
36:06 Mitigating Endotoxin: Phytochemicals consumed along with the high fat/high sugar meals offsets the endotoxins. Phytochemicals desensitize the activity of the LPS substances so they produce less inflammation. When phytochemicals, like curcumin, are absorbed into our bodies, at the cellular level they cool off our immune system and silence our cells that transmit inflammation signals.
37:56 Taste Receptors and Gut Hormones: The intestinal brush boarder cells is the thin lining of our intestinal tract. It is only one cell thick. They have receptors, like antennae sampling the environment. These receptors on the L cells of the small intestine, pick up information about the contents of the diet. They signal a status report to the cell. Some of these receptors are identical in their composition to the taste receptors for bitter on the tip of your tongue. This means that our intestinal tract is tasting our diet. When the receptors contact bitter foods, it stimulates those cells to enhance the expression of certain genes that are involved with the production of hormones called incretins. These hormones are released into the blood and increase your body’s ability to use insulin effectively, lower the risk of diabetes, and lower inflammation, working throughout your entire body. Within the intestinal tract, they work to modulate the way our body response to our diet and our lifestyle. Other upstream intestinal receptors on N cells respond to sugar by producing ghrelin, which increases the risk of insulin resistance and increases inflammation.
42:12 Old Ways of Eating Are Best: Natural, minimally processed, diverse diets of natural color derived from vegetable sources is best. It is the way our ancestors ate and science confirms that it is best.
43:01 Synthetic Sweeteners: Sugar substitutes, which contain no sugar, effect blood sugar in a way that encourages diabetes. The sugar in our blood doesn’t come directly into our bodies from the sugar we eat. It is from a complex process from the sugar we eat and the sugar created in the liver, as well as how our bodies manage sugar within other cells in our bodies. This is all regulated by a complex network of hormones. The regulation of sugar is done by cells in various places around the body. Some of these reside within the intestinal tract. Synthetic sweeteners create the sensation of sweet and induces certain effects as though it was sugar, impacting hormonal patterns that regulate sugar and regulate the communication with our gut bacteria. In 2 to 3 days of a dietary change, gut bacteria changes.
45:33 Natural Sweeteners: Dr. Bland believes in everything in moderation. Our current cultural opinion is that if it isn’t sweet, it doesn’t taste good. The stronger the sense of sweet in the diet, the more it desensitizes our perception of sweet. It is the same with salt. To sensitize to sweet and salty, go on a low salt/low sugar diet for 3 weeks.
47:51 Dr. Bland’s Favorite Nutrient: Magnesium or folic acid have demonstrated significant historic insufficiencies and those insufficiencies have adverse impacts upon health. Zinc and vitamin C for overall impacts upon health. His phytochemical choice is cruciferous vegetable family called glucosinolates. They modulate features of detoxification and antioxidant function.
49:29 Dr. Bland’s Elevator Pitch: Eat colorful vegetables that were once alive. Try to get 10,000 steps of walking each day. Do your best with sleep hygiene to ensure that you are getting 6 hours minimum of sleep each night. If we all did these 3 things, we would not have the rampant increase in obesity, insulin resistance and diabetes. We would have better students in school and a better workplace environment.
Full Text Transcript
Mike Mutzel: Welcome back, everyone. It’s Mike here. So excited for today’s show. We’re at Episode #21, and we’re going to discuss how food is information and explore the intersection between our diet, gut microbiome, and the expression of our genes with none other than the father of functional medicine, Dr. Jeffrey Bland. For the past 35 years, Dr. Bland has traveled the globe, teaching the tenets of functional medicine to over 100,000 thousand healthcare professionals, including myself. Unbeknownst to him, Dr. Bland has been a huge mentor for me and many others. So, a little bit about Dr. Bland’s very productive career: He was a Research Director at the Linus Pauling Institute, he cofounded the Institute of Functional Medicine, and started the Personalized Lifestyle Medicine Institute. Last spring, he authored the best-selling book, “The Disease Delusion: Conquering the Causes of Chronic Illness for a Healthier, Longer, and Happier Life.” Lastly, but certainly not the least, Dr. Bland has interviewed hundreds of the world’s top healthcare professionals and scientists on his Functional Medicine Update, FMU audio magazine. He hasn’t missed a beat on that; I’ve learned so much from that. I would highly recommend you check that out at his website, jeffreybland.com. So, Dr. Bland, thank you so much for being here.
Dr. Jeff Bland: Mike, thanks so much. It is such a pleasure to be with you. Thanks a million.
Mike Mutzel: I’m very excited today. So, before we dive into food is information and all the interactions between nutrients and gut microbiome and the epigenome, if you could share with us the candid story you delivered at the last annual international symposium about how you developed and coined the word, “functional medicine.”
Dr. Jeff Bland: It was really a collaborative process. It started about 1989. I was going to say 1898/99. Sometimes, it seems that long ago, but actually, it was 1989 that a group of doctors and I who I had been traveling quite a bit and these were some key opinion leaders that I thought really were starting to think about what the future of medicine might really hold and how we could change the paradigm slightly to better address this rising tide of chronic illness, and so my wife and I hosted a three-day meeting in Victoria, British Columbia on Vancouver Island with a whiteboard kind of objective just, without any hold barred, to talk about how these individuals, about 35 of them, might see the future of medicine in the hopes that we can kind of come to a collaborative understanding of where we thought we can make a positive impact on the change in healthcare. And out of that, with some really extraordinarily conversation, and I think back, I can’t believe the forward thinking group that was there because much of what we were talking about back then is just now starting to be seen as a really new stuff, and so I think we were probably 20-30 years ahead of the time when we were having these discussions. And out of that emerged as the thought that this new medicine probably wasn’t going to be called integrative, holistic, unconventional, orthomolecular; it was going have to have some other kind of term that didn’t have any negative connotation that everyone could affiliate with across different disciplines within healthcare, and that the healthcare consumer could also understand, and so as I am kind of put my head to it the last night at the meeting, I came back the following morning, I said, “You know, I’ve been thinking about what precedes the onset of diseases and what could we really kind of rally around that might be inclusive to all disciplines of healthcare.” And I said, “It’s really loss of function, whether it’s physical function, cognitive, emotional function, or physiological function, all forms of healthcare seem to deal with function of the human body and the loss of function precedes the onset of disease, and so it’s an earlier way of actually looking at the trajectory towards a disease,” and we all have been bounced at around throughout the day and finally agreed there were some issues as to why functional medicine might not be the right term, but really, what was going on right now in the literature with regard to radiology, cardiology, and endocrinology is that these disciplines were all starting to talk about function – functional MRI and functional endocrinology and cardiovascular function. So, we said, “Maybe this is a good term to start our journey on going forward.” So, we chose to call it “functional medicine,” which is asking not which to call what a person has, but really where it came from, focuses more on the origin of the disease rather than what it is, and how do we treat its cause rather than just mask its effects with symptom-suppressing medications, and that then led to this Institute of Functional Medicine being formed in 1991. We had our first meeting right here and there was this history we had, I think, our hundred thousand healthcare provider go through one of the courses last December of 2013, so it’s starting to get traction. We have a Textbook of Functional Medicine that’s now on a number of medical schools, and we have now the Functional Medicine Clinic, which just opened a few weeks ago in the Cleveland Clinic as a freestanding clinic providing functional medicine services in arguably one of the largest medical institutions in the world. So, I think it’s starting to gain some credibility and some stickiness.
Mike Mutzel: Oh, I love that. I have the Textbook of Functional Medicine right here on my desk, and have had it for quite some time. Thank you for all the work that you’ve done, and really, leading the charge here. Now, before we dive in, what’s been your proudest moment since founding the Institute of Functional Medicine and coining the word “functional medicine”?
Dr. Jeff Bland: Well, I have to say there are specific takeaways in terms of therapeutic concepts that I think we developed over the last 25-30 years, and I’m proud of it. But if I was to lump them all together, I think it’s the recognition that the body works as a system, not as an individual group of organs that kind of work in isolation. As you probably well recognize our medical system and subspecialty training, it’s kind of focused on knowing more and more about less and less until we, in the extreme, could know everything about nothing. So, we’ve got all these various specialists that divide the body into certain turfs, which we call the “organs,” and then each one of those specialist has their own drugs that they use to treat, their own diagnosis, their own language, their own country clubs, and it’s as if the body is separated into these various independent parts and all diseases are independent and all our organs are independent, and we recognize that in light of 21st century, understanding of physiology that that’s absolutely incorrect. The body is a complex web of interacting parts, every organ speaks to every other organ, and in order to understand complex disease, we really have to look at it more as a system than as individual organs that we take one at a time and kind of try to understand it in isolation, and I think that concept which we’ve been really focusing on now for 30 years since the origin of this monthly audio magazine. I’ve done that for 33 years, called “Functional Medicine Update.” It’s starting to be understood. Here in Seattle, we have the Institute for System Biology, founded by Dr. Leroy Hood, arguably one of the top scientists from United States; the guy who’s credited for developing the five instruments that were used to decipher the human genome, and he’s been focusing on P4 medicine, which is basically a system’s form of medicine that deal with personalized, perspective, participatory, and preventive. So, I think that we are really starting to see a shifting paradigm in healthcare, and it’s not soon enough with all the rising tide of chronic illness we have now not only in the United States, but worldwide.
Mike Mutzel: You hit on some things that I’d love to dive deeper, and you talked about a lot of systems and interacting parts in the function of the entire body, so let’s talk about the epicenter of the cell and the nucleus, and talk more about the control of genetic expression and how our nutrients interact with our genes, and as you eloquently put, sticky notes or paperclips. So, let’s talk about this epigenetics and the environmental control or regulation of genetic expression.
Dr. Jeff Bland: Well, thanks. Again, I think this is one of those aha moments. When you’re working in a field, and I think this is probably common for all of us, you tend to believe that somehow everybody understands what you understand. You used to assume that somehow, certain things are self-evident, but I’ve come to recognize, even with various sophisticated medical doctors that certain things that, I think, are self-evident about this genetic agent, which we live are not self-evident, and one of those at the head of the list is just what you’re talking about, that the genes, in order for them to be seen as having an impact on our health, have to be expressed at the cellular level. So, in order to understand what I mean by “expressed,” what I’m really saying is that within every cell of our body, locked deep within this vault that is more secure than Fort Knox, which is called the nucleus of our cells, is our book of life, our human genome, and our book of life is coated in 23 chapters, and those chapters are called our chromosomes, and half of those chapters were bound in from our biological mother, and the other half from our biological father, and within those 23 chapters are literally thousands of stories, and these stories are our genes. And so, our book of life is a complex tale of joy, of strife, of even Greek tragedies are buried in there, which we call “oncogenes” that are cancer-initiating genes. So we have all these stories that are locked within our book of life. Most of us, as we grow up and grow older, would like to read the stories in our book of life, what I call “bliss gene stories;” they are the ones that produce good health, success, energy, vitality, loving relationships, all of those things that are associated with a good aspect of our human genome, our book of life, and we’d like to kind of put to sleep those stories and not read them very frequently at all, but the tragedy stories that have to do with health crisis and so forth. For a long period of time, it was felt that we had little control over what stories are going to be read; you know, it’s just the luck of the draw. After all, we got our parents within after them, and whatever their genetics were, we got the luck of the draw, so we already got heart disease genes, cancer genes, or bad day genes. That model has pervaded medicine for more than a hundred years, and it’s rapidly changing because we now recognize that carrying a gene that encodes for a specific disease does not mean that you’re going to get that disease. In fact, for most of us, we have characteristics in our book of life, certain genes that might lead to increased susceptibility to certain diseases, but they never get expressed; they don’t get expressed and therefore, we don’t get those diseases because we are resilient because we’ve done things to cause other genes to turn them off, to keep them at bay, and to silence them, and this has to do with then what you’re alluding to as it relates to paperclips and sticky notes. There are certain marks that are placed on our genes as a consequence of things that we do in life or things that we’re exposed to, that either are paperclips meaning, “Don’t read here. These are extricated portions of our books, we can’t read these stories,” and we’d like the paperclips to be on things like our oncogenes that might encode for increased incidence of cancer, and then there are other marks that are put on our genes that are sticky notes that say, “Read here,” and those are the ones that lead to proper function and disease resistance or resilience. We now recognize, and this is probably the major breakthrough of understanding in the 21st century; this is a paradigm shifting, extraordinary discovery that we have in science recognized that the putting on or off of these paperclips and these sticky notes that then regulates how our genes are expressed, is much more under our control based upon how we select to live than we ever previously recognized, that in fact, what we eat, what we think about in terms of life, of the environmental exposure to pollutants, the nature of our activity patterns, our social relationships, all of these are signals, and I want to emphasize when I say “signals,” which sound like a radio or TV signal, and that’s what we’re really talking about, is signals that come in from our environment through what we eat and how we live that actually modify how these sticky notes and paperclips and how they allow the expression of characteristics, so there’s a lot more control over our health throughout the whole of the lifecycle, but certainly, in our middle and late ages, we’re much more in control than what we actually have given ourselves credit for if we send the right signal to our individual genes, and that leads to the concept of personalization, which is our age; it’s not medicine for the average, it’s medicine for the individual. Real people is where the action is.
Mike Mutzel: Let’s explore that a little bit further. From what we’ve read, we know that there’s key epigenetic imprinting during developmental windows like the first trimester of life. For example, exposure to famine, toxins, or stressors can lead to later increased predisposition towards chronic diseases, which will be maybe the paperclips that you looked at, but then we just talked about the signals and so these happy thoughts, phytochemicals in the diet, stress reduction, exercise can lead to the sticky notes that can tell the DNA to be read there. So, how quick is this and how can we overcome things that we can’t control like adverse environment preconception?
Dr. Jeff Bland: Well, I think there is the question of our age actually. I think that’s an extraordinarily well-framed question. I just read a paper that appeared in the last couple of weeks that really speaks a little bit to what you’re talking about, and that is some investigators at McGill University, (Now, this is the laboratory of Dr. Tsai), but in the laboratory, used to be Hans Selye that reach in the laboratory in McGill, the father of the concept of stress, and he’d been studying this concept of epigenetic modulation, as you mentioned, of gene expression in his group a number of years. They just did a review of the offspring that were conceived in 1998, and born the subsequent nine months during what was considered the great ice storm of Nova Scotia in Northern Canada, and this was a very, very severe cold snap that cause power outages in most of the outlined communities, and so people went into extreme cold exposure in our homes for a period of a few weeks, and so the question that was raised was did this exposure to this environmental factor, which was a big stress factor, have any impact on the imprinting of the genes in the children that were conceived and then later born after this big ice storm, and the answer appears to be yes. When they looked at the patterns of imprinting of the sticky notes and the paperclips (in this case, they look specifically at the methylation patterns of the genome), they found that there was a significant alteration in the children conceived and born during this ice storm as mothers were exposed to extreme cold versus those that were not, and the genes that were modified in their expression happened to be related to changes in immune function and changes in management of insulin and blood sugar, which the suggestion is these children, and as they grow up, now, they’re being born in 1999, so we’re talking about 15 to their adolescent, so over the next 25 years or 20 years, will have an increased prevalence of diabetes as a consequence of this exposure that occurred at conception; so, that’s one type of imprint. Another type of imprint is the type of imprint that I say is more flexible, meaning can be put on and taken off more easily, and these are the things that many of us do, day in and day out, in our lifestyle, so we may elect for whatever reason to eat a diet that’s nutrient-deficient, or we may eat things that are food allergy, we may eat foods that have toxic trans fats in them, and the question is, “Would that change the gene expression patterns that alter our health?” and the answer is, “Yes, it does.” “Well, is that irreversible?” and the answer is no, but if we modify our diet appropriately and we get on to what’s considered the right diet for our specific genotype, those marks that I just described are labile, meaning they can be put on and put off or taken off, which means they’re much more correctable, and I think this is where the action is for most of us. Most of us were not, when we’re conceived, our mothers were not exposed to extreme cold, so we have kind of hopefully an easier start in life. So, the things that happened to us as a consequence of our own decision making – how we eat, how we live, who we hang out with, the air we breathe, chemicals we’re exposed to, and all those things, are much more under our control as we grow older, and those are the ones that we can modify; if we’d made some bad decisions earlier, we can change those and modify how the genes are expressed.
Mike Mutzel: Now, in your opinion, what are some of the best ways to beneficially modify or increase the so-called bliss genes and put to sleep the tragedy stories? Any key nutrients, any key exercise regimes or stress reduction strategies from what interactions that you’ve had with experts and in your experience?
Dr. Jeff Bland: Yes, I think so, and one of the things that I try to do in my book, “The Disease Delusion,” is I try to summarize what we’ve learned in functional medicine over the last 30 years about these what I call seven core physiological processes, the processes that kind of control how our genes are expressed, and they open it up called our health or disease patterns as we grow older, and of those seven, one of them which is extraordinarily important, I think, for remediating or improving function is the detoxification system and its interrelationship with another of the key physiological processes, which is the gastrointestinal immune system. So, those two together, two of the seven, are very, very important as first steps in turning back some of the messages that epigenetically modified the way our book of life is being read, if we are waking up with fatigue, pain, and low energy, and chronic symptoms, and we’ve got these issues that relate to inflammatory conditions. I think those are the two areas working together, or I would always suggest starting because there are things that are easily done by a person to kind of turn the clock the other direction.
Mike Mutzel: So, before we talk about detox and gut immune, which I’d love to talk more about, let’s dive into the clinical utility of doing gene testing. We now have companies like 23&me, and there’s various SNP testing. In your opinion, as you just said to me, the signals in our environment are like affecting the expression of these genes, so how important is genetic testing for folks?
Dr. Jeff Bland: Well, I think that’s another really important question. First of all, I’ll just give a quick answer and then try to fill in why my answer is going to be in the affirmative. I think genetic testing is valuable. Now, with that said, I think it has significant limitations that one needs to understand for the reasons that you’re alluding to, and that is just because you have a certain genetic characteristic, it doesn’t mean that it’s going to be expressed into your function, and so you can’t say that any specific gene is necessarily going to either be bad or good for you unless it’s expressed. Now, the other part of that, which I think is extraordinarily important is the one that most of the gene information is now being presented to the public when they get their data back is to talk about disease-risk genes, and I think this is kind of really a negative story; it’s all around disease, it’s not around health, so most people are very worried when they get their data back. They kind of open it very cautiously because they don’t want to see anything that’s really going to be a serious message of a disease that’s impending, but I think that the message actually should be recast, that same information that people worry about as it relates to disease risk. Actually, the majority of the information in our genetic evaluation is about our disease resilience; in other words, about our ability to be resilient against disease, how many times that people get back their genetic information and it talks about the resilience about, “Wow, are you lucky, you got born with these genes – if you do this and this, it’s going to give you resilience against the heart disease, or resilience against diabetes, or resilience against autoimmune disease, or dementia.” And that information is the predominant information in our genes; it’s that which gives us good function throughout decades of living. I mean, we all know people that live 90 or 100 years of age that are still functioning. It wasn’t that they never had a gene in their body that was associated with the potential disease; it’s the resilient genes took over and predominated. So, I believe a lot of genetic testing is related to how we use the information. Are we always looking for the negative, which is the disease, or are we looking for the positive, which is the resiliency? And the way that I talk about data that are coming back from genetic testing for people is to try to look for whatever the predominant good spots in their genetic lineage that gives them extraordinarily abilities to resist certain things and optimize the function of those genes and try to just look at the negative side of the story in the context of how we optimize the positive so we can keep silent the negative. And I think if we take a different attitude about genetic testing and recognize it’s not a recipe for disease, it’s information about our health; it tells us how to empower our health attribution rather than our disease risk, then we have a much different way of looking at that information.
Mike Mutzel: Oh, I love that, focus on the positive. Well said. So, any companies that you recommend for testing?
Dr. Jeff Bland: Well, I think every one of these companies is providing genetic information, being it 23&me or Pathway Genomics, and there’s a myriad of companies that are now coming up with specific types of genome profiles; all of that is useful as long as they’re reputable laboratories doing good work. It’s all in how the information is interpreted. I mean, as you know in life, information can either be empowering or it can produce distress, and when you get the information back to be in an environment with someone who can guide you through discussion of it in the context of balance between the disease risk and the health promotion resilient characteristics. So, this is where I think people that are professionals in the space and have studied these genetic profiles and understand the strength and weaknesses of them can be very, very valuable to get them most and positive balance in interpretation.
Mike Mutzel: Perfect. Now, let’s dive deeper into what you hit on positive ways to increase the signaling towards our genes and so forth. Talk about food and how food’s information, but also talk about the interaction between the foods that we eat and the 100 trillion microbes that we call the gut microbiome.
Dr. Jeff Bland: That’s another great step in this discussion. So, for most of us, the way we grew up thinking about food as probably in three levels. We thought about it as food for enjoyment – we like the flavor, it’s pleasure-seeking, we like hanging out with people over meals and talking good times, a lot of our best experiences in life were social engagements that involve eating; that’s number one. Number two is related to satiety and quenching of hunger – when you’re hungry, that means you need energy, and so you go to food as the source of energy. And then number three is food as the source of health-giving nutrients; so, we think of all the fabulous 50 essential nutrients, which include the vitamins and the minerals, essential fatty acids, essential amino acids, and all of that kind of nutritional chemistry stuff that gives rise to the prevention, not only of things that could be very, very favorable, but also optimizes our body’s function because we need those nutrients for our function. So, those to me are kind of the three common ways that people think of food, but there’s a fourth way that I think probably supersedes all three of those, and that is, as you mentioned, that food is much more than just a collection of nutrients and a lot of fun in eating, it is a source of information for our genes, and this is where I think we’re not talking about a major breakthrough and discovery of the role that diet, nutrition and food plays in health. It’s only within the last 20 years since human genome was deciphered that we’ve seen the development that we call “nutrigenomics” or “nutrigenetics,” and that’s the interrelationship between nutrients and food, and how genes and their expression pattern are modified. It’s not just solely on the part of the fabulous 50 vitamins and minerals, essential amino acids, and the essential fatty acids; it’s also the literally thousands of other materials that are found in foods that were often in plant foods called “phytochemicals,” things that are unique to a certain plant, like we know that the cruciferous vegetable family – cauliflower, Brussel sprouts, cabbage, and broccoli – those vegetables have a certain odor to them, kind of a sulfurous odor, and that’s because they all as a member of the family contain what are called “glucosinolates,” these are phytochemicals that contain certain sulfur-containing materials that are unique to that plant family, and it turns out that, as it relates to those particular phytochemicals, have been found to affect gene expression in very unique ways, so if you eat those vegetables, you have a certain effect on information going to your genes that turns on and turns off certain genes. Similarly, if you eat blueberries or member of the purple berry family, you get a different set of phytochemicals that affect the different set of genes; or if you eat curcumin from turmeric, the spice, you turn on the different set of genes. And so, what we’re starting to recognize is there are literally thousands of phytochemicals found in various foods and spices are also affecting our gene expression pattern and thereby affecting our health, and it’s this new revolutionary discovery that I think is recasting the role of nutrition in health and disease; it’s opening up all sorts of new ways of personalizing these benefits to an individual, and also, recognizing how things that are bad in our diet that we’ve gotten through processing or chemicalization of the diet can have deleterious effects on the gene expression. So, it’s both a good news and a bad news story.
Mike Mutzel: I love that, Dr. Bland, and recently have discovered how the phytochemicals not only interact with the genes like you’re talking about, and positively increase these bliss genes and downregulate the tragedy stories, but certain gut bacteria actually contain the enzymes that are able to break down the polyphenols whereas more “pathogenic or inflammatory” gut bacteria don’t contain these enzymes. So, do you want to speak to the fact that polyphenols also speak to our gut microbiome?
Dr. Jeff Bland: Oh, yes. In fact, I just came back from a fascinating and wonderful meeting in Quebec City, Quebec, Canada, which was titans from around the world discussing their research on the role of phytochemicals in modulating a whole series of different disease states and different conditions that really do alter gene expression and showing how so many of these things that we have kind of taken for granted; in fact, in food processing, often these phytochemicals have been removed from foods to make foods in sugar and fat and processed, and so they were showing that the removal of these chemicals has not been to the chemicals plant-derived materials, has not been to our benefit; in fact, it’s been to our disadvantage. So, the role that relationship between our diet and interaction with these living creatures, these trillions of bacteria that live in our intestinal tract, is now emerging to be one of the most important features that ultimately regulate how our genes are going to be expressed. This is a very complex story, and for many people that are new to the field are like, “Whoa, this is an overwhelming.” I mean, we got all these bugs that are sitting around there in our gut, and those aren’t bad, they’re good for us, and those interact with our food and they produce substances that go into our blood and they speak to the cells over around our body, and turn on and off genes at distant sites like the brain or the heart, the liver and the pancreas, and the answer is yes, that’s what’s emerging. It’s an emerging story that is truly revolutionary that we are a system, and our system is not just made up of human cells; our system is made up of the interaction between human cells and these favorable bacterial cells, these are called “symbions” that live within our intestinal tract. In fact, most people don’t recognize it, but the second largest mass of tissue or the cells in our body happens to be in the gastrointestinal; there’s about 2 ½ to 3 pounds of bacteria in the average person living actively in our intestinal tract that have their own personalities, and they’re producing their own secondary substances that are affecting the immune system in the gut. The gut is where 50% of our immune system is localized, and is speaking directly 24/7/365 to the bacteria that live in the intestinal tract, so we might have a good family of what’s called the microbiome, these families of bacteria living in our gut. If you have a good one, then it speaks favorably to our genes; if we got the imbalance with some of these parasitic bacteria, clostridia and various types of the conjugating bacteria that can live in our intestinal tract, now it sends a message of alarm to our genes and we start getting inflammation and increasing risk of all sorts of disease. So, I think we now recognize that food, bacteria, human interaction is much more important and complex than we originally recognized.
Mike Mutzel: And we know one way that we can send the alarm messages to our immune system would be bacterial debris. I love how you talked about endotoxin as bacterial debris, and you’ve interviewed Patrice Cani and Natalie Delzenne, so talk about when we sit down and having to forbid to go to McDonald’s and have a BigMac with French fries and a Coke, what happens to that bacterial debris and how does it cross our GI tract and then what are the consequences there?
Dr. Jeff Bland: Yeah, that’s really where the time meets the road, so these bacteria that live in our intestinal tract, some of them, which are called “gram-negative bacteria,” and the term “gram-negative” has to do with the way that their cell walls are put together in their unique outer kind of skin of these bacteria, and in those bacteria, they have a series of chemicals that make up their cell walls that are called lipopolysaccharides; they’re a combination of certain fats and sugars that are connected together to make up the structure and the lattice work of their cell walls. Now, just to give our listeners a little bit of thought, bacteria have cell walls, humans have cell membranes, so we differ from bacteria in this outer skin of our cells, in that we have membranes, and so ours have a different composition than that of a bacteria that have cell walls, and this is actually been one of the ways that antibiotics have been very helpful because antibiotics prevent the bacteria from making a cell wall because we don’t have cell walls, it doesn’t hurt cells presumably, it only hurts bacterial cell walls, it can’t make their outer skin. So, the outer skin or the cell wall of gram-negative bacteria containing these lipopolysaccharides, when the bacteria die or undergo death by one of the mechanisms, it releases its outer skin and it kind of falls apart, and these lipopolysaccharides, which are abbreviated “LPS,” can then go into the intestinal contents and can actually transverse or move across the GI gastrointestinal mucosa and this barrier of defense that keeps the hostile stuff in our intestines there and doesn’t allow to get to the body. These little molecules can then, through a leaky situation, can pass through the intestinal tract and get into the blood and have access to our immune system, and when they do that, they are extraordinarily active at very, very low levels of alerting the immune system that there are foreigners on board, that this is a haul up the heavy artillery and be ready to do battle, and that’s called the inflammation system. So, it activates the immune system into a state of arousal so it moves it into a state of what we call the “god of war, Mars,” that’s hot and red and painful, and so now we have a systemic inflammation situation. When a person eats a very high-fat, high-sugar diet, and this study has been done in many, many apparently healthy people and published through the last three years, what it does is after they eat within the next few hours, it sets up in their blood due to the release of these bacterial cell wall debris; it sets up the state of metabolic inflammation, that’s a chronic state of inflammation, it’s not like an acute inflammation when you have an injury and your knee swells up. It’s a chronic, systemic inflammation that travels all over the body, and it increases the risk of virtually every one of the chronic diseases – diabetes, heart disease, dementia, arthritis – they’re all increased. And so, this is why individuals feel that our Western diets, which we’re now exporting to the other parts of the world, have been so seen to be increasing the risk of these degenerative diseases.
Mike Mutzel: Yeah, and one of the utilities of phytochemicals, as we’ve been talking about, how they speak to the genes and they beneficially optimize the gut bacteria, is that phytochemicals are consumed with these high-fat sugar meals. Don’t they offset this endotoxin, Dr. Bland?
Dr. Jeffrey Bland: Yes. I think that’s a very important point. There are a couple of roles that these phytochemicals have. One of which is to kind of desensitize the activity of these LPS substances so they don’t have quite the inflammation-producing effect, and secondly, when they’re absorbed, these phytochemicals are absorbed in the body, like curcumin from turmeric, they are found at the cellular level to cool off our immune system and also cool off cells that are involved with transmitting; think of this as a relay race, where different cell types and different tissues and different organs are passing on this message one to the other through this relay race called inflammation. They shut off that relay race systemically; they turn down the crosstalk between the immune system and the cells in the pancreas, cells in the liver, cells in the muscles, or the cells in the heart. So, it basically damps the inflammation-inducing mechanism. So, as we have moved away from a natural diet rich in plant foods into this kind of highly processed diet of white foods that are white flour, white sugar and white fat, and a lot of the animal products, we have lost that ability to damp this mechanism that relates to metabolic inflammation.
Mike Mutzel: Metabolic inflammation; I loved that, Dr. Bland. That’s something that I’m so excited about, so passionate about as well, and for those that want to learn more about this metabolic inflammation and endotoxin and that bacterial debris, you can go to bellyfateffect.com. I have free three-part video series that dives into this and you can learn more about that. So, Dr. Bland, let’s dive into now, the bitter compounds and the taste receptors and really how the phytochemicals in our diet and the protein structure of foods speak to our taste receptors and how those affect our gut hormones and appetite and satiety.
Dr. Jeff Bland: Yeah, that’s, I think, a very fascinating, again, part of the revolution story. So, we’ve talked about the influence that certain bacteria have; when they die, they’re releasing their cell wall debris, which call LPS, and then inducing the inflammatory process. It turns out that when you look at how this effect occurs, it occurs right at that really very thin lining, much thinner than a lining of a hat, which we call the intestinal brush border cell; it’s the thin lining of our intestinal tract, one-cell thick, and it turns out that on those cells, which are the cells that are indirectly interacting with the stuff in our intestinal tract, so the food we’ve eaten, the digestion, and the bacterial debris, there are receptors I call, they’re like antennae that are sticking out sampling the environment, and in our small intestine, these are called L cells, just as a nature of the way they’ve been anatomically defined. These antennae pick up information as it relates to the contents in the diet and signal to the cell what’s going on, and those receptors on the surface of the L cells, some of them are identical in their composition to the taste receptors for bitter at the tip of the tongue. Now, what this means is our intestinal tract is actually tasting our diet, which may sound very peculiar to the average person, but it’s picking up the same message down lower of the intestinal tract as out tongue picked up in our mouth the taste of bitter. Now, what does that do? It doesn’t make us feel the taste of bitter; it does something different when it happens down lower in our intestinal tract. What it does is it stimulates those cells to enhance the expression of certain genes that are involved with the production of hormones called “incretins.” These incretin hormones are substances that have names like glucagon-like peptide-1 or GLP-1; these are hormones that are released then into the blood, and what they do is that they increase the body’s ability to use insulin effectively, they help to lower the risk of diabetes, they lower inflammation, so they work throughout the whole body. Once released to the intestinal tract, they work systemically to actually be favorable in modulating the way that our body responds to our diet and our lifestyle. Now, there are other receptors in our intestinal tract that are upstream from these L cells, these are called M cells, and they have receptors that respond by producing a substance called ghrelin, and ghrelin does the opposite; it increases the risk to insulin resistance and increases inflammation, and the ghrelin is produced from the M cells from binding to sweet, meaning sugar. So, sugar induces one effect, and certain bitter molecules, particularly those that are found in certain bitter foods, have the effect of doing the opposites. So, the concept is that by eating diets that have these favorable phytochemicals in them that stimulate the cells to gene express the right types of hormones in our intestinal tract, we can actually modify how our body responds in terms of things like blood glucose and cellular physiology. Now, in the past, to make the complicated story simple, people ate these unprocessed, natural diets that were derived from growing things in the soil and then eating them fresh; they didn’t have to worry about all those gobbledygook that I’m talking about because that was the natural way that people ate every day. As we hover and got to this highly processed diet or these things were removed. Now, we have to relearn like back in the future what we used to know, and now we have a bunch of language from the scientist that tells us, “Hey, these things were good for us because they stimulate the appropriate response after eating to express the good chapters in our book of life.” So, my long list of language is really, if I could compress it, just teaching us that natural is best, minimum process is best, as best thing with diverse diets, eat diets of color so that would mean natural colors – orange, red, blues, violets, browns in foods that are derived from vegetable sources because they contain all these favorable phytochemicals that help do the work for us free of charge.
Mike Mutzel: So, do Skittles account? They’re colorful.
Dr. Jeff Bland: Well, I guess if you’re a Seattle Seahawks’ fan, you may like Skittles for another reason, but it’s certainly not for the colors that we’re talking about here.
Mike Mutzel: Right. I love that. Well, offline, we’re talking about synthetic sweeteners and how synthetic sweeteners, based upon what you said, I’m guessing they talk to the L cells and they also perturb the gut microbiome and affect blood sugar regulation. You know the research throughout that study. Do you want to dive into that?
Dr. Jeff Bland: Yes, it’s very interesting. I was back last week at the Massachusetts General Hospital and Harvard Medical School in a meeting with the chief of medicine there, and he was the referee of that paper that appeared in Nature Medicine that talked about synthetic sweeteners and its effect on diabetic risk, and I think it’s very, very ironic for most people that are hearing this story to think that’s something that a sugar’s substitute that doesn’t have sugar in it could affect blood sugar in such a way to encourage diabetes. It’s just doesn’t seem – how that could work because we all think diabetes as a sugar problem, but here is something that’s not a sugar at all that’s producing a sugar problem, and that’s because the sugar in our blood doesn’t come directly into our bodies from the sugar we eat. The sugar in our blood is a complex process a little bit of the sugar we eat, but a lot of how our body makes sugar in the liver and how it manages sugar in other cells, and that’s all regulated by a complex network of hormones like insulin and glucagon, and insulin and many, many others. I won't go into human growth hormone and so forth. So, the regulation of sugar then is controlled as we are talking about by cells in various places around the body. Some of which reside in the intestinal tract, so if you are feeding a synthetic sweetener by the concept that it’s producing the sensation of sweet even though it’s not sugar, it’s inducing certain effects that are like that of sugar at these receptor sites, that are the antennae I talked about, and changing these hormonal patterns that regulate sugar and also regulate the communication with our gut bacteria, so it can change our intestinal bacteria from good to not so good, and we now recognize from studies that were actually published last year that it only takes two to three days for a person to change their diet before their gut bacteria changes, and so when a person travels and eats funny foods, or they are under stress, or not eating regularly, or they’re taking certain drugs and alcohol, they’re drinking more alcohol, all of these things very rapidly can change the breakdown of our gut microbiome and change the effect it has on our body and our health, and synthetic sweeteners appear to be one of the longer list of things that can contribute to this change.
Mike Mutzel: So, what’s your opinion then on stevia and more natural but zero-calories sweeteners?
Dr. Jeff Bland: Well, I’m a believer of everything in moderation. So, I think the first issue is that we’ve raised at least one generation, and maybe going on two now, of kids that think if it’s not sweet, it’s not tasty, and you probably have seen and talked about the fact that there is very strong evidence indicating that a stronger a sense of sweet in the diet, the more it desensitizes our perception of sweet, so it takes higher degrees of stimulation of sweet in order for people to think something is sweet. So, what’s happened over time, and this is by the way the same thing with salty as well, that as salt and sweet have increased in our diet, people become more immune to the taste of sweet and salt, which means they have to amp up by adding more and more sweetener and more and more salt in order to get those flavors sensations. Now, how do you turn that the other way? Well, you know as well as I, if you’ve got a person for three weeks on a low-salt, low-sugar diet (this is kind of a form of a detoxification approach), that over those three weeks, their taste sensation to both sweet and sugar will change, and if you put them back after those three weeks on the diet where they started three weeks ago, with the cinnamon, sugar and salt, they’ll say, “Oh, this is so sweet and so salty, I can't even stand it,” and that’s what happened to our children. They have become desensitized to salt and sweet, and so we have way, way too much of these in our diet, and that even is further amplified with these synthetic sweeteners or even natural sweeteners like stevia. Everything has to be sweet. We’re continually reinforcing that message of really blunting our proper taste perceptions.
Mike Mutzel: I can really resonate with what you just said. My daughter’s about two and a half years old, and she’s only eating whole real food, and so when she’s around bread or things that in daycare or birthday parties of other children, she doesn’t even like these different foods because to her, they taste funny, so I think it’s really important for parents just to raise our children like you just said, Dr. Bland, eating real whole phytochemically rich food so that we’re giving the proper stimulation to these receptors and training the brain properly. So, well said right there. I have two final questions. This is something I ask every guest on the show. If there was one nutrient or herb that you just couldn’t live without and would love to recommend to everyone, what would it be?
Dr. Jeff Bland: Well, I guess if I went with the population-based studies that have indicated the biggest impact on all sorts of health and related issues, for a nutrient that’s insufficient in many people’s diets, if it was a mineral, I’d say magnesium; if it was a vitamin, I would say folic acid. And I think these two nutrients have demonstrated very significant historic insufficiencies and have their four adverse effects upon health. If you wanted to talk about therapeutic nutrients as it relates to overall effects on health; I would have to say probably in the vitamin and mineral category, probably zinc and vitamin C; in the phytochemical category, I would probably say that it’s the cruciferous vegetable family, phytochemical so-called glucosinolates because they modulate so many important features of detoxification and antioxidant function including things like nuclear regulatory factor-2 and it’s interrelationship to antioxidant, metal detoxification, and the getting rid of foreign chemicals. So, I think that would be my choice.
Mike Mutzel: Love it. I agree with that. I love sulphoraphane and all the different glucosinolates.
Dr. Jeff Bland: Right.
Mike Mutzel: Tons of research there. So, last and final question. Let’s create a situation where you’re in an elevator with some important congressman, maybe Barrack Obama, and you have 30-60 seconds or so to, tell them some sort of health advice that you wish they could pass on to America and really instill in Americans something that they should be doing every single day that would improve the health of America, and free us from chronic disease. What would you tell them and why?
Dr. Jeff Bland: I think that’s a really, really great question, and that’s the sound by an elevator pitch. I think there are three things that can be implemented immediately by most people. And that is number one, eat close to the ground, things that have multiple colors, so basically, as much as possible, eat things that look like they were once alive and from the vegetable kingdom. Number two, try to get 10,000 steps a day of walking. I don’t care if it’s up downstairs, level walking, whatever, try to get 10,000 steps, and there are many ways. You can use a pedometer or you can count that in their devices; I’d like to fit in all sorts of ways that one can keep track of their steps each day. And then three, do all you can with sleep hygiene and make sure that you’re getting six hours of minimum sleep a day, and if you can’t get six hours of uninterrupted sleep, then you start asking questions, “What’s interrupting it?” Are you eating too late, are you drinking alcohol, are medications interrupting your sleep, do you need stress management, are there certain things that are impeding your respiration at night like sleep apnea because you have insulin resistance? So, those will be my three major words. If people did those three things, we wouldn’t have the ramping obesity we have, we wouldn’t have a ramping increase in insulin resistance and diabetes we have, we’ll have better students in school, we’ll have better workplace environments – lots of good things will happen if we can implement those three things.
Mike Mutzel: I love that. Well said. Dr. Bland, how can our listeners learn more about your work and connect with you online?
Dr. Jeff Bland: The best and easiest way is just to go to jeffreybland.com and we can direct them from that website to all sorts of videos and blogs resource material that they can download, and some information questionnaires they can take to assess their own unique health issues. But I think probably that jeffreybland.com will certainly be a good start.
Mike Mutzel: That’s fantastic. I’m going at the show notes transcribed everyone, so you can go to highintensityhealth.com/drbland. There will be links to Dr. Bland’s book, his website, Twitter, Facebook, and FMU as well. So Dr. Bland, thanks so much for all the wisdom you shared with us, and hope you have a fabulous sunny day here in Seattle.
Dr. Jeff Bland: Well, Mike, I want to thank you. I think what you’re doing to spread the news to raise the bar to help empower people. This is the most important asset we all have, which is our health, and you’re doing a fantastic job in giving information as news to people that really need it.
Mike Mutzel: I really appreciate it. You’ve been a mentor to me forever, so I’m just so honored to have interviewed you, and this was fantastic, so thanks so much.
Dr. Jeff Bland: Well, I’m really proud of you part of your team, and thanks a million for all that you’re doing.