The Mediterranean Zone (13 page)

Another important reason polyphenols should be considered essential nutrients is because we are only partially human. We are really composite organisms with ten times more microbes (primarily bacteria) inside our bodies than human cells. Most of the bacteria in our bodies reside in the gut and especially in the colon. If you take into account relative contributions to the amount of DNA in our body (including the bacteria in the
gut), then only 1 percent of our total DNA can be considered human. Gut bacteria—and how polyphenols can modify their composition in the gut—may be more valuable to our health than vitamins. In fact, most of the polyphenols that we ingest are used primarily to manage the 100 trillion bacteria in our gut.

To get enough polyphenols to maintain optimal health, I usually recommend that you consume about 1 gram on a daily basis. This means that controlling the balance of our gut microbes requires eating a lot of vegetables and fruits. The levels of polyphenols in fruit is about 0.2 percent of their total weight. The polyphenol content in vegetables is even less (about 0.1 percent of their total weight). This means you have to eat either 1 pound of fruit or 2 pounds of vegetables per day to reach my recommended level of consuming 1 gram of polyphenols. The polyphenol content of unsweetened cocoa powder is much greater at 3.5 percent of the total weight, but most individuals are not going to be eating a lot of unsweetened cocoa powder.

When you consider these numbers, all of a sudden the likelihood of achieving good health with adequate levels of polyphenols begins to seem like mission impossible. Of course, other polyphenols can be added to your diet with the liberal consumption of spices, red wine, and extra-virgin olive oil, all key components of the Mediterranean diet. Or you can add polyphenols by supplementing your diet with purified polyphenol extracts, a more high-tech solution.

The first step in consuming enough polyphenols is finding sources you like to eat. That’s a lot easier in Mediterranean countries where fruits and vegetables still make up a significant portion of their standard diet. Coffee is the primary source of polyphenols for Americans, and our consumption of fruits and vegetables is rather pathetic. The average American consumes about 450 mg of polyphenols per day with most of that coming from coffee. (Each cup provides about 100 mg of polyphenols, and average consumption is about 3 cups per day.)

The power of polyphenols is the combination of the amount you consume as well as the amount that is actually absorbed by your body. At low levels, they are powerful anti-bacterial agents in the gut, but very little is absorbed by the body. At higher levels, they act as anti-oxidants and anti-inflammatory agents within the body. At still higher levels, they become anti-aging agents that can significantly increase longevity. Unfortunately,
the polyphenol levels that the average American absorbs on a daily basis are way below the minimums needed for demonstrating a significant improvement in health. This is why following the Mediterranean Zone has such profound benefits in such a short period of time, because we are consuming much higher levels of polyphenols that have multi-factorial benefits on health.

In the next chapters, I will discuss each of the areas in which polyphenols can profoundly impact human health.

O
ne reason polyphenols are so critical to human health is because we actually have two brains in our body: the brain inside our skull that contains our personality and cognitive thinking, and the brain we never think about, the one found in our digestive system. Unlike our nicely contained thinking brain, our second brain is smelly, slimy, and messy. Yet these two brains are in constant communication with each other, and the levels and types of bacteria in the gut have an important role to play in this communication. Keeping those rowdy 100 trillion bacteria in line means maintaining a healthy level of good bacteria in the gut—a primary job of polyphenols. This is why improved gut health is one of the main benefits of following the Mediterranean Zone. As you increase the levels of polyphenols in your diet, you also increase one of your primary dietary defenses for managing inflammation in both your digestive brain and thinking brain.

We have been co-evolving with bacteria since the beginning of our species some 200,000 years ago. Of the millions of different bacteria in the world, only about five hundred to a thousand different types actually reside in our gut. Probably more than 99 percent of the 100 trillion bacteria
consist of thirty to forty types of bacteria. This indicates that the composition of our gut microbes is not the result of some random process.

The 100 trillion residents in our gut can be either friends or foes. I say
friends
because they can help digest carbohydrates that are not easily absorbed (unabsorbed carbohydrates cause diarrhea), produce certain vitamins, train the immune system in the intestine to be on alert for really bad (pathogenic) bacteria that may enter into the digestive system, and take a defensive position on the surface of the gut to prevent bad bacteria from getting a foothold. It’s a great symbiotic arrangement for both the good bacteria and us. The chosen bacteria get a safe environment with lots of nutrients, and in return they provide us real protection from their potentially dangerous microbial cousins.

Since about 30 percent of the total solid component of our stools is composed of dead bacteria, to maintain this symbiotic relationship, the gut microbiological community needs to be continually stimulated to grow and replenish itself. Polyphenols act as the ultimate prebiotics in stimulating friendly bacterial growth. It is the more rapid growth of the colonic bacteria in the gut that increases stool size, not merely the fiber content of the diet.

Polyphenols also act as anti-microbial agents against bad bacteria (as well as viruses, fungi, and parasites). The bottom line is that as long as you have a constant dietary intake of a lot of polyphenols, you are going to have good gut health, and that translates into improved overall health. Unfortunately, pharmaceutical progress can get in the way of a good thing.

One of the gifts of pharmaceutical progress has been the advent of antibiotics. If there was ever a wonder drug, it must be antibiotics. In fact, they work so well that the drug industry no longer likes them because they are both inexpensive and are needed for only short periods of time (resulting in fewer profits to the drug companies). In the 1950s farmers discovered that if they gave low levels of antibiotics to their cattle, pigs, and chickens, their livestock would grow faster. The increased growth was because the animals were getting fatter. Unsurprisingly, more than 80 percent of antibiotics produced today are used for veterinary purposes as opposed to treating human disease. No one thought too much of this until the obesity epidemic in America began nearly forty years ago. Only recently, with the advancement of genetic techniques, has it been possible to investigate the
connection between bacterial composition in the gut and obesity and other chronic diseases.

It is known that obese individuals have a different bacteria composition in their gut than lean individuals. That is only a correlation with obesity, not a definite cause. However, it is known that obesity is caused by cellular inflammation in the fat cells. Could it be that a poor composition of bacteria in the gut might further increase cellular inflammation in those fat cells and facilitate its spread to other organs in the body? Here I think the answer is a definite yes.

However, it takes two to tango. For cellular inflammation to spread, you need the combination of not only (1) insufficient levels of good gut bacteria, but also (2) increased cellular inflammation in the membranes lining the gut. Just as you have two brains, you also have two skins on your body. There is the outer skin that is impermeable and keeps the microbes from the outer world from invading the body. Your second skin is far more complex. This is the lining of the gut. It not only has to prevent any bacteria from entering the body, but also must be a dynamic filter to allow digested nutrients to enter and at the same time to communicate (via hormones) the realtime nutrient status in the gut to the brain in your skull. If communication between the gut and the brain is compromised, then your brain is constantly led to believe that there are not enough nutrients in the digestive system—and it keeps sending signals for you to eat more food. The lack of satiety coming from disruption in gut-and-brain communication is also accompanied by increased cellular inflammation throughout the body, which leads to the development of obesity, chronic diseases such as diabetes, and accelerating the onset of Alzheimer’s.

To understand how this happens, you have to understand a little about toll-like receptors. I will explain more of this in greater detail in the Appendices, but here is a short overview. Toll-like receptors are molecules that act as biological sensors to detect bacterial fragments. These sensors occupy the cell surface of every living cell in the body. Although these toll-like receptors are ancient, our knowledge of them is recent. In fact, the 2011 Nobel Prize in Medicine was awarded for understanding their impact on human health.

We have ten unique toll-like receptors, each capable of recognizing different microbial fragments. If a microbial fragment, leaked from the gut into the bloodstream, activates any of the receptors, cells prepare for a
potential microbial attack by immediately increasing the expression of inflammatory proteins from its nucleus containing your DNA. All of this is done through the most primitive part of our immune system, the innate immune system. Continued activation of these toll-like receptors by leaking bacterial fragments from the gut into the bloodstream results in the generation of chronic low levels of cellular inflammation. This disrupts hormonal signals, especially of insulin, and can lead to insulin resistance. Once insulin resistance sets in, it begins a downward spiral effectively resulting in obesity, diabetes, and acceleration of other chronic inflammatory diseases (such as Alzheimer’s).

As the levels of good bacteria decrease in the gut (because of lack of adequate levels of polyphenols in the diet), more pathogenic (really bad) bacteria have the opportunity to enter the bloodstream. You can decrease the level of good bacteria in your gut by (1) frequent courses of antibiotic treatments from your physician, (2) ingesting animal products that were fed a steady diet of antibiotics, and (3) by not consuming enough polyphenols. Add to this an increasing intake of omega-6 fatty acids and decrease in omega-3 fatty acids in the general diet, and you are virtually assured the lining of the gut will be inflamed, giving rise to gaps in an otherwise strong biological barrier to prevent the entry of bad bacteria and large, undigested proteins. This is what is called leaky gut syndrome. Now more bacteria (as well as other intact dietary proteins such as those found in gluten-containing or dairy products) are able to enter into the bloodstream and the levels of cellular inflammation are increased throughout the body. When that happens, you gain weight, accelerate the development of chronic disease, and age faster.

Obviously, your primary dietary strategies to lose weight, maintain wellness, and age at a slower rate have to be based on maintaining a healthy gut. This means eating about 2 pounds of vegetables per day. This isn’t as hard as it seems. For example, two pounds of vegetables might be composed of two large red peppers, one large red onion, ½ pound of asparagus, ¼ pound of broccoli, and ¼ pound of cauliflower. Cut them up and roast them with a little extra-virgin olive oil at night and then eat them throughout the next day. Alternatively, you could use a couple bags of steamed frozen vegetables. Their preparation takes only about 6 to 8 minutes in a microwave. You can also supplement your diet with a daily glass of red wine. One glass of red wine has the polyphenol equivalent of eating
about 100 mg of polyphenols. If you’ve already done the math, you’ve figured out that if you drank ten glasses of red wine per day, you wouldn’t need to eat any vegetables at all. Good math, but bad biochemistry since that level of alcohol wipes out virtually all of the health benefits of the polyphenols.

Getting enough polyphenols for gut health requires some dietary discipline, but keep in mind your health is one of the things money can’t buy. And much of your future health will depend on controlling cellular inflammation in the stinky and slimy second brain known as the gut. Every time you sit down to a meal, you have an opportunity to invest in your future health. Following the Mediterranean Zone makes that investment strategy easy to follow. Furthermore, if you mess up with one meal, the guidelines of the Mediterranean Zone tell you exactly what you need to do to get right back into the Zone.

W
e often think of free radicals as dangerous to our health, but free radicals, such as inflammation, are critical to support life. Free radicals allow you to convert dietary calories (food) into chemical energy, create hormones and other complex molecules, and provide the most powerful agents we have to kill invading microbes. However, unless you manage the levels of these constantly generated free radicals, they will start attacking normal tissue, and you will age at a faster rate. The scientific name for such excess free radical production is oxidative stress. To maintain optimal health, polyphenols are critical for controlling the level of free radicals.

Our immune cells (neutrophils and macrophages) make a wide array of free radicals, including a biological form of Clorox known as hypochlorite. In addition to this biological bleach (which kills microbes very effectively), there are other types of free radicals generated by our immune cells, such as:

Hydroxyl (OH•)

Peroxyl (ROH•)

Peroxynitrite (ONOO•)

Superoxide anion (O
₂
•)

The one thing that these free radicals all have in common is an unpaired electron (•) that hates to be alone and will go out of its way to extract another electron to keep it company. This extraction of electrons from other biomolecules is one of the key steps in metabolism that allows the synthesis of very complex molecules. If free radical generation is not constrained, then the oxidative stress that is generated leads to DNA fragmentation and cell death. Polyphenols sacrifice themselves by donating one of their hydrogen atoms to the free radical to effectively quench excess free radicals, reducing the levels of oxidative stress within the cell.