[If you learn best by listening, I recommend this podcast interview of Dr. Mahmoud Ghannoum. As the Director of the Center for Medical Mycology at Case Western Reserve University and an authority on the role of gut microbes on the immune system and health, he strikes just the right balance between listenability and knowledge of a deep subject. If you want ONE LISTEN to understand the key points of gut health, the microbiome, leaky gut, and how they impact health, this may be the most pleasant 61 minutes you’ll spend with an expert who sounds like Count Chocula. – pbk]
To recap the good parts version of autoimmune processes affecting a whole lot of us:
- The most common major illnesses — atherosclerosis, cancers, obesity/diabetes, neurodegenerative conditions, and even infectious disease — involve the immune system being out of balance or attacking parts of ourselves, and causing dysfunction
- 70-80% of the immune system is in our guts
- Leaky gut is the common denominator “starting gun” that sets off our immune systems
- Leaky gut — when the 1-cell thick lining of our intestines breaks down and allows things besides nutrients to pass into our bodies and throw off our immune system — is affected by several factors, but nutrition is the biggest one within our control
The next piece of the puzzle?
- The immune system going haywire, aka autoimmunity, is also affected by several factors, several being OUTSIDE of our control, but nutrition again being the main thing we can own, centered on the center of the immune system itself
When your immune system loses its shizz
Poor nutrition alone doesn’t cause disease, although it’s a BIG contributor. Spoiler alert: processed foods, excessive sweets, and grain-based carbs are a problem. But there are lots of folks eating and promoting these who aren’t falling down dead, at least not obviously.
In order to have autoimmunity — your immune system doing unpleasant things to your own body — 3 things have to happen:
- Antibodies have to form (these targeting molecules can just sit around, though…)
- The Regulatory arm of the immune system has to go offline (fail-safes have to fail…)
- The immune system has to be stimulated to attack (and…here we go)
Eventually, enough damage builds up that disease symptoms appear.
Food choices affect each of the 3 preceding steps.
Food choices can lead to leaky gut, which allow antibodies — attack and flagging proteins — to be formed in response to food, bacteria, and other particles that pass into our immune systems through our gut.
Food choices can cause gut dysbiosis — changes to the type and number of healthy bacteria in our gut — and hormonal changes that can interfere with the Regulatory half of the immune system. The immune system isn’t all “go, go, go!”; it has a critical part that recognizes your cells as something not to be attacked, and can tamp down the attack function when it’s no longer needed. Food choices can interfere with this “Whoa, Nelly” action and allow the targeting of self to proceed.
Food choices like gluten and excess sugar can provide the molecular triggers setting off immune system cascades, and regular choices over time allow damage to accumulate.
The bad news is that food can trip us up at each of the 3 prerequisites.
The good news is that better food choices can apply the brakes at each of the 3 prerequisites.
What about non-food influences, like genetics?
Take home: not the biggest driver of disease.
Sucky genetics increases your chances of coming down with the autoimmune condition that afflicted Uncle Harry. The situation sucks because a) we didn’t pick our relatives, b) we can’t (yet) drill down and swap out our DNA, and c) there’s a sense of inevitability about family medical history, aka I’m effed, aren’t I?
It turns out that autoimmune family history isn’t inevitable. As Sarah Ballantyne, PhD points out in The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, “While autoimmune disease runs in families because the genes that make us susceptible to it are inherited, genes account for only about 1/3 of that susceptibility; the other 2/3 comes from…the environment, diet, and lifestyle.”
The genetic driver behind general disease is even smaller. Per the CDC, “One of the promises of the human genome project was that it could revolutionize our understanding of the underlying causes of disease and aid in the development of preventions and cures for more diseases. Unfortunately, genetics has been found to account for only about 10% of diseases, and the remaining causes appear to be from environmental causes.”
The prime driver is what we generally think of as “environment,” but what is now formally referred to as the exposome: the sum total of internal and external non-genetic exposures during a lifetime, which activate or deactivate genetic instructions that ultimately lead to disease.
There are notable exceptions, like the BRCA genes that can cause 7 of 10 women to develop breast cancer by age 80, or the single-gene mutation that causes cystic fibrosis. But most conditions with a genetic component are driven by mixture of genetic and environmental factors, and if environmental triggers aren’t present, the genes don’t “go off.”
What about toxins and infections?
Toxins and infections are also negative influences on disease expression. It’s known that infections common to childhood, like Fifth’s Disease (aka “slapped cheek syndrome” from a virus causing a facial rash) and mononucleosis (aka “the kissing disease” caused by the Epstein-Barr virus) are associated with increased risks for developing conditions like lupus, multiple sclerosis, Guillan-Barré syndrome, Alzheimer’s disease, chronic fatigue syndrome, and ulcerative colitis. Ditto for toxin exposures like tobacco and heavy metals (like mercury, aluminum, cadmium, lead, gold).
[And yes, I’d be remiss if I didna point out that an active COVID-19 infection increases one’s odds of developing a whole host of chronic symptoms including brain fog, memory loss, depression/anxiety, headaches, chronic fatigue, shortness of breath, insomnia, menstrual changes, and decreased exercise tolerance. As well as developing multisystem inflammatory syndrome (MIS), a recognized autoimmune condition where the immune system can attack multiple body parts.]
While it’s possible to treat toxic levels of certain heavy metals, many toxin exposures from childhood are considered a done deal: if you’re 40+, the previous exposure has tweaked you and upped your vulnerability. Ditto for childhood viral or travel-related infections and previous smoking: there’s no time machine to step into and prevent the infection that stamped you 35 years ago, or to unwind the 30 pack-year history of puffing on cancer sticks.
What can be done is sidestepping triggers that are within our control. And several of those, including sleep sufficiency, stress reduction, exercise and circadian alignment, and nutrition, are significant.
Translation: Maybe I’m not effed after all.