Basic Vehicle Maintenance: The Digestive System
Originally published as a four part series of articles for The Dragontree Holistic Day Spa
When I sit down to write an article, I often feel like I’m having a conversation with you, the reader. Except that it’s a one-sided conversation, in which I never ask you about yourself and I just monopolize the whole exchange. So. . . how about a little more about me? I grew up building robots, programming my own video games, and distributing surveys on bizarre topics around my high school. In the enneagram system of personality analysis (remotely like Myers-Briggs), I’m what’s known as a “number five” – AKA “The Investigator” or “The Scientist.” I have spent many a night jumping from one Wikipedia article to the next, or curled up with a thousand page book on herbs.
One of the topics I like investigating the most is major historical shifts in human health, behavior, and life expectancy – i.e., big changes in small periods of time. If you were to follow the trend of human life expectancy over the course of our existence, you’d see a very, very gradual slope upward and then a sharp jump in just the tiniest, most recent slice of time. This sharp upward jump began at different times in different parts of the world, but in the United States, as recently as 1850 the life expectancy at birth for a white male was just 38. Today it’s about 76.
It’s really a profound thing. Modern humans have been around for about 200,000 years. This 150 year revolution of life expectancy has occurred in just the last 0.00075% of our existence. Incidentally, a historical graph of world population shows a similar trend. It increased very, very slowly, and took a few massive hits, especially during the fourteenth century. (As centuries go, the 1300s were pretty much the crappiest ever. They were marked by famine, plague, crime, and general idiocy.) After that, the population continued to grow again, but still rather slowly compared to what began to happen around 1800. In 1800, the world population was 1 billion. In March of 2012, it hit 7 billion.
An anthropologist from another planet looking at a graph of these trends would probably point to that last slice of time and ask, “What the hell happened there?” Well, there are two very important words I used in a sentence about life expectancy a couple paragraphs ago: “at birth.” At birth, a white baby boy in 1850 was expected to live to 38.3 on average. But if he survived to age ten, his revised life expectancy would be 58 – a huge improvement.
At birth, a white baby boy in 2011 was expected to live to 76.3. If he survived to age ten, his revised life expectancy would be 76.9. There’s barely a difference.
If that child from 1850 made it to age 50, his life expectancy would then be 72. Today’s white boy at age 50 would have a life expectancy of 79.6. Again, there’s barely a difference. So, as you can see, the narrowing of the gap has occurred almost entirely in the early years of life. And there are two important conclusions to be made from this.
First, the tremendous increase in life expectancy at birth can be attributed primarily to three things – better sanitation and cleaner living conditions, better safety standards, and better medicine, including vaccinations. Whatever issues we may have with vaccines (and there certainly are some), it’s undeniable that they’ve decreased child mortality.
Second, we’ve made a much smaller dent in the maximum human lifespan. As an adult British aristocrat in the 1200s, you could expect to live to age 64. By the 1500s, if you made it to age 21, you’d probably live to be about 71. And in the past several centuries, these numbers have barely changed.
Nowadays, if we want to live longer we need to take the long view, since most of us won’t die of infections or accidents. The things old people die of are often decades in the making. The primary killers are coronary heart disease (disturbance in blood supply to heart muscle) and stroke (disturbance in blood supply to the brain), both of which are blood vessel issues. Blood vessels don’t just get hard, clogged, or weak overnight, so there’s a huge opportunity to make a positive difference in this process.
As I see it, there are three main interventions that have the most impact. The first is nutrition, and my nutshell recommendation is to strictly limit consumption of sugars and flour, moderately limit red meat and dairy consumption, and have plenty of vegetables, herbs and spices, fruits and fish. The second is exercise, and the best exercise is a form you enjoy and that you can happily do every day. The third is connection – connection to people, connection to nature, connection to whatever you call the greater power that keeps it all going.
I’ll be writing more about these trends and, in particular, the nutrition factor, this month. Meanwhile, I encourage you to choose one of these areas of positive intervention to focus on each day this week – food, exercise, or connection.
Last week I wrote about the tremendous jump in average human life expectancy that occurred just in the last 200 years. It went from 30-something to 70-something. The thing is, this change was almost entirely due to a reduction in child mortality. If we compare people who survived childhood several hundred years ago to adults today, there hasn’t been much improvement in how long we can expect to live. Now that we’ve diminished the risk of dying as a child – due mostly to better hygiene, medicine, and safety – it’s time to focus on what we can do to help adults live longer. Especially because we’ve got a hell of a lot of aging Baby Boomers.
One of the most valuable things we can do to improve our lifespan is to eat better. There are certain natural limits on human tissue, such as the number of times a cell can divide, but it’s possible to get more life out of this vehicle by treating it well. You know this is true of your car – if you drive it hard and put crappy gas into it, you’re going to run into problems sooner – so it shouldn’t be hard to understand that this pertains to bodies also.
Nutrition is about a lot more than fuel quality. The way the fuel is introduced (how frequent, how much, what time, whether it’s warm or cold, etc.) and the functionality of the fuel processing mechanisms (digestive membranes and muscles, secretion of gastric juices, gut flora, etc.) can make a huge difference in our health. I can’t tell you how many people I know who have thrown up after drinking a shot of wheat grass juice or a handful of vitamins. High octane fuel isn’t everything.
Engines don’t do well with cold gasoline or oil, and they don’t like being flooded either. In the same way, our bodies do best with food that’s prepped a bit before it enters the stomach, and the food should be introduced at a rate and quantity the body can keep up with.
Cold food and drink aren’t great for the digestive organs. Twelve years ago, I met a beautiful woman at a spa where we both worked, and one day she told me that for years she had suffered from digestive upset. Without a chance to do any investigating, I asked her, “Do you drink cold things?” and she confirmed that she did. I advised her to stop, not really expecting it to be a solution, but hoping it might help. A few weeks later she reported that ever since cutting out cold drinks, her digestive upset was completely gone. A couple years later, we got married. Need I say more?
So, fuel prep step one is to make sure mostof your fuel is room temperature or warmer. A bit of cold stuff here and there is ok, especially when the engine is already warm (i.e., in warm climates). Second, most of your fuel should be cooked. Your body assimilates cooked food better than raw. This varies somewhat, based on how strong your digestion is and what your climate is like. Stronger people can handle more raw food, as can those who live in warm places. Winter is a good time for cooked food.
We all have a built in fuel conditioner, AKA “mouth,” and it’s worth taking full advantage of it. The mouth part of digestion is often undervalued. It does so much: It warms food up. It pulverizes food into a tiny bits that will be easy for the stomach and intestines to work with. It moistens dry food by mixing it with saliva. It exposes food to antibodies and enzymes that help kill bacteria that may be present. And it introduces enzymes that break down starches and fats. If we don’t chew much, we miss out on these vital elements of the digestive process.
So, step three of the fuel prep process is to chew everything thoroughly. It’s important to do this with liquids, too, like juices and smoothies, which are otherwise easy to dump directly into the throat, skipping the mouth part entirely. Also, don’t talk while you’re chewing. Besides disappointing your mother and ruining your chances if you’re on a date, it makes you swallow air, and most gas comes from swallowed air. Really get into chewing and savoring. The stomach can’t savor, so if you like the way your food tastes, let it hang out for longer in your mouth.
I’ll cover more on vehicle maintenance next week, but rather than give you too much to digest at this point, your homework is just to focus on these three easy steps of fuel preparation.
I started this series by explaining that, while we have greatly improved humans’ odds of surviving childhood, we haven’t made as much progress in prolonging the lives of older people. Old people tend to die of conditions that are long in the making, and there aren’t many ways to intervene in these processes near the end of life. The biggest value in life extension comes from adopting good habits earlier, such as healthy eating, exercise, and a spiritual or meditative practice.
In the last article I compared the body to a car, and asserted that fuel quality isn’t everything. We always hear about what we should and shouldn’t eat, but how our fuel is introduced to the body is as important to our health as the fuel itself. Previously, we looked at food preparation and the vital role of the mouth; now let’s travel a bit further down the rabbit hole. (Note: the gastrointestinal tract is not an actual rabbit hole; I do not condone swallowing live rabbits.)
Food goes in your mouth, travels down a tube called the esophagus, and pushes through a ring of muscle known as the lower esophageal sphincter (or LES) to enter your stomach. The LES is vital for keeping the top of your stomach closed, so food doesn’t back up and stomach acid doesn’t burn the lining of your esophagus. When you overfill your stomach, at least four bad things happen – it stretches the stomach, it promotes weight gain, it compromises digestion, and it puts lots of back pressure on the LES.
A stretched stomach is a feature of every overweight person. Fullness of the stomach is not a healthy way to gauge when to stop eating. If you routinely fill your stomach to capacity, it will inevitably expand, and you’ll need to eat more to get that full feeling. There’s a perceptible difference between enough and full, and enough is usually much less than full. Okinawans, known for their longevity, have a cultural practice of eating to just 80% of capacity. At 80% full, you will not be hungry, although you may convince yourself that you are, being used to that full stomach feeling. Undereating promotes longer life.
If the stomach is packed, it’s like an overly full washing machine. The clothes don’t circulate – they just get damp and wrinkly. Likewise, we don’t digest our best when the stomach is filled to capacity. A history of overeating tends to deplete the stomach, which can result in insufficient acid secretion. We need lots of acid to digest food (especially protein, minerals, and vitamin B12), to stimulate emptying of the stomach, to quickly dismantle potential allergens, and to kill bacteria and viruses that may have entered the GI tract. Low stomach acid is very common among older adults. I usually give patients hydrochloric acid in a form called betaine hydrochloride, though I’ve encountered many who have gotten good results from using apple cider vinegar in capsules or taken in some water.
If we frequently cram the stomach, the LES tends to become less competent at staying tightly closed. Especially when combined with shallow breathing, low stomach acid, sitting a lot, frequently wearing a tight belt or seat belt, and having a big belly, the result is acid reflux – AKA heartburn or gastroesophageal reflux disease (GERD). I don’t know if you’ve noticed, but a lot more people get acid reflux than in the past. When I began my practice, I didn’t encounter it that much. Now it seems every other patient is on an acid blocking drug. One reason is that portion sizes have increased and mealtimes have gotten shorter and less relaxed, so we eat both more and faster.
Sometimes a person with a history of acid reflux will develop pre-cancerous changes in their esophagus known as Barrett’s Esophagus, and in these cases, an acid blocker might be prudent (though I still recommend fixing the cause of the reflux). For everyone else, they are a bad idea except for occasional use. Over time, all of the functions of stomach acid I mentioned above can be expected to become compromised – nutrient absorption, killing of pathogens, breaking down allergens, etc. We’re already starting to see unusually high rates of uncommon infections in people on these drugs. There are lots of better and more natural approaches for relief, such as d-limonene, which comes from orange peel oil, and soothes and protects the esophagus. But the best thing you can do is to eat less food, do it slowly, prepare it as I explained in the last article, and chew thoroughly. It will not only improve your health, it will also bring you back to specialness that is the ritual of nourishing yourself.
So far in this series on nutrition, I explained how the manner in which we eat can affect us as much as our food choices can. We looked at the vital roles that cooking and chewing play in digestion, and the importance of eating slowly and not too much. And I described the digestive tract from the mouth to the stomach. I think it’s important that everyone understands at least the basics of how their organs work, so let’s look at the rest of the digestive tract this time.
Although we may have teeth and reality TV, we’re more like worms than we like to think. We’re all just a bunch of cylinders, with a tube of the outside world running through us. Worms put dirt in theirs, we put marshmallows in ours.
After the mouth, esophagus, and stomach, food enters the small intestine, which is about 23 feet long. It’s where most nutrient absorption takes place, and all the value of good nutrition hinges on good absorption. At the beginning of the small intestine, a bunch of gastric juice is injected from the pancreas and gallbladder, which neutralizes the acidic food coming from the stomach, and makes the nutrients more absorbable. The pancreas produces a blend of digestive enzymes that break down the different components of food – fat, carbohydrates, and protein. The gallbladder squirts out bile (which is produced in the liver) to make fats absorbable.
The lining of the small intestine is composed of many folds, covered with tiny hair-like protrusions called villi (which are further covered with tinier hairs called microvilli). These greatly increase the surface area of the small intestine to maximize nutrient absorption. Some inflammatory conditions, such as celiac disease (gluten intolerance) and bacterial overgrowth of the small intestine (SIBO) can damage this membrane, leading to malnutrition.
The small intestine is followed by the much shorter but wider large intestine (most of which is called the colon). Food spends a very long time in the large intestine, where water and some remaining nutrients are absorbed, and stool is compacted and waits to be liberated. Finally, the stuff we can’t digest, along with waste products from throughout the body, leaves the rectum as stool. About 60 percent of its dry weight is bacteria.
Where does it come from? Riding along with us in our intestines are about 100 trillion microorganism passengers. There are about 500 different kinds, most of which are bacteria. They’re known as our “gut flora,” and they do all sorts of useful things for us, such as helping us digest things, protecting us from harmful microbes, synthesizing some vitamins, stimulating growth of intestinal cells, and assisting the immune system. We acquire these microscopic pals by eating food that’s contaminated with them or deliberately cultured with them (like yogurt and sauerkraut), and by taking them in supplements known as probiotics.
So, as we’ve seen, our environment (what we select from it based on taste) literally passes through us. We make the outside world into ourselves. It’s a practice worth taking seriously. Besides the healthy eating practices I discussed previously, some of the main factors in good absorption are having enough gastric juice, having healthy gastric membranes, having a strong and healthy population of gut flora, and having a relaxed nervous system.
Cultivating a relaxed nervous system has many additional benefits, so spend time in nature, eat in a calm environment, get massages, meditate, do whatever works for you to become peaceful. As for gastric juice, insufficient enzyme secretion is pretty common. Consider a good digestive enzyme complex, taken at the beginning of a meal. I’ve had at least a hundred patients who have overcome longstanding digestive problems just by supplementing for a while with digestive enzymes. Some people who have trouble digesting fat do well to take a product that also contains ox bile. Finally, promote healthy gut flora by eating live, fermented/cultured foods on a regular basis, and occasionally taking a course of probiotics (especially after using antibiotics).
Dr. Peter Borten
P.S. After years of teaching people about nutrition, I recently decided to create an online video-based nutrition course called How to Eat. If you’re interested in learning more about nutrition, including both Eastern and Western points of view, I encourage you to check it out. My goal is to have participants gain a lifelong, intuitive understanding of how to feed themselves, and to learn how to eat for optimal energy and weight. You can check it out here.