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In the past month's 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).
If you’re interested in learning more about the big picture of eating and nutrition, check out the four week course I developed for The Dragontree, called How to Eat.
Be well,
Dr. Peter Borten
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IF WE’RE NOT SUPPOSED TO EAT ANIMALS, HOW COME THEY’RE MADE OUT OF MEAT?
I saw that line on a bumper sticker when I was about 16, shortly after becoming a vegetarian. I laughed heartily at it; it was a good reminder not to take myself too seriously.
I stopped eating meat mostly because I just didn’t like it. But in the early 1990s I encountered John Robbins’s Diet for a New America, and my reasons for not eating flesh became more numerous. If you aren’t familiar with him, Robbins is the vegan son of the cofounder of the Baskin-Robbins ice cream empire, and he left the ice cream business in part because of his opposition to the mistreatment of cows and his emerging belief that humans shouldn’t consume animal products. In Diet for a New America he explores the ethics of factory farms, the environmental impacts of animal production, and the health effects of consuming dairy and meat. It made sense to me and I felt empowered in my position.
But when I began grad school in Chinese Medicine some years later, my Asian professors were perplexed by the high rate of vegetarianism among the students. They asked us, “Why wouldn’t you eat meat if you can afford it?” To them, vegetarianism was an involuntary choice necessitated by poverty. They pointed to our sharp canine teeth and the place of meat in the history of human diets. They weren’t familiar with any of the issues or fads around meat eating and vegetarianism; they only cared about what’s best for human health. So I decided to set aside my biases and earnestly seek the truth.
When I began my clinical internship, I met numerous vegetarian patients – and even more vegans – who were weak and had insufficient immune function. Their pulses, which should have felt something like a jumping piece of spaghetti at the wrist, were often more like a faintly twitching thread. Often, they were under the impression that not eating meat in itself would make them healthy – even if they never gave much thought to what they did eat instead.
In my practice, ethics and preferences began to take a back seat to biological necessity. When these patients began to eat meat – often because I advised them to experiment with it – nearly all of them felt stronger and healthier. I even met some people who thrived on meat, whose bodies seemed to crave meat over anything else and whose only intolerances were to certain plant-based foods. Eventually I started eating a little meat now and then. (I can’t say I noticed much difference in my health from doing so, but I was already eating plenty of animal protein in the form of eggs and yogurt.)
Coincidentally, meat was making a big comeback. When I first moved to Portland, it had a large selection of vegetarian restaurants. Fifteen years later, many of these had been replaced with restaurants that were unapologetically meat-based with barely a flesh-free dish on the menu. Elk burgers, pork bellies, and lard were so hot. With the advent of Paleo diets, people were flocking back to meat as if it they’d been deprived their whole lives.
Meanwhile, I became a father, I became more connected to the earth, I realized I had never really forgotten all those points that Robbins made 30 years ago, and I found it increasingly difficult to be willfully ignorant of the impacts of my choices of consumption. One of those impacts is that meat production – in the prevailing manner and scale – is devastating to the planet.
Thus, I found myself in the middle of the complex intersection of nutrition, industry, environment, ethics, and politics – and I’ve never again had an easy answer to the question of whether people should or shouldn’t eat meat.
We’ll look more closely at the pros and cons of meat consumption next week. I’d love to hear about your experience with – or without – meat in the comments below.
Be well,
Dr. Peter Borten
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Bitterness is a taste most of us try to avoid. Expressions such as “bitter enemies” and “a bitter pill to swallow ” show how averse we are to this flavor. We greatly prefer the other three primary flavors – nearly everything Americans eat is a combination of sweet, salty, and sour. These are sometimes accented with spiciness or “piquancy” and the rich quality known as umami. (Umami is a harder taste experience to describe, but it’s often translated as a “savory” or mushroomy quality, and it is the specific enhancement imparted by MSG.)
Perhaps we dislike bitterness in part because it’s the flavor our taste buds are most sensitive to. Compared to our perception of saltiness, sweetness, and sourness, we can pick up an infinitesimal degree of bitterness in food or drink. This is probably a useful adaptation, since many poisons are bitter. But many medicines are also bitter, and there are certain medicinal qualities that many bitter substances have in common. I believe that consuming moderate amounts of bitter foods is a healthy thing. It also provides a vital balance to our relative overconsumption of the other flavors.
In the ancient healing systems of China and India the therapeutic properties of foods and herbs are thought to derive largely from the flavors they possess. The flavors themselves are considered to be energetic characteristics that affect the body far beyond our perception of them at the tongue. Textbooks of Traditional Chinese Medicine (TCM) and Ayurveda will often state that a certain herb has a certain therapeutic action because it has a certain flavor and an affinity for a certain part of the body.
Sweetness, for instance, is seen in TCM as having a nourishing and consolidating effect on our energy. This is why so many comfort foods are sweet, and most naturally sweet foods (like rice and bananas) tend to be easy on the digestion. But by the same token, too much consolidation can have a clogging effect. This makes us pack on the pounds – especially around our bellies – when we eat too much sugar, and it also makes us feel ill the day after Halloween.
Spiciness or pungency, by comparison, has an opening or expansive energy. It promotes movement, gets our blood flowing, warms us up. And it may even open our pores and sinuses – causing us to sweat and feel clearer in the head. Sourness has a moistening and astringent effect. This is why sour drinks often seem even more thirst quenching than water alone.
Bitterness has a descending or draining energy. Bitter herbs often help drain and clear excesses from our system. Many bitter herbs are detoxifying, and they often promote urination or bowel movement. Bitter herbs frequently act on the liver and gallbladder to promote bile production and secretion. Bile is essential for the digestion of fats, including the fat-soluble vitamins A, D, E, and K. Bile also stimulates the bowels and kills some bacteria that may be present in our food. These effects are especially useful after overconsumption of rich foods.
The stomach is understood in Chinese medicine as having a downward directionality. That is, it receives food from the esophagus above, and, after working on it with its gastric juices, should send it down to the intestines. When the stomach isn’t functioning properly, because of illness, overeating, stress, food sensitivity, or eating too fast, the stomach’s contents may fail to descend, or may even go upward instead. When it goes up, it’s called “stomach Qi [energy] counter-flow” or “stomach Qi rebellion.” Examples are acid reflux (heartburn), belching, nausea and vomiting, bloating, hiccups, dizziness, and just plain feeling yucky in the middle and upper body. Because of their descending and draining qualities and their action on bile production/secretion, bitter foods and herbs are often very helpful for these conditions.
There is just a small handful of bitter things an American is likely to encounter. Two of the most common are beer (in which the bitterness comes from hops flowers, which are used to offset the otherwise overly sweet taste of grain malt) and coffee (which we usually de-bitter by adding milk and/or sugar). Unfortunately, these are not the healthiest of bitter medicines, though I do believe they can have some benefits. Nearly all leafy greens have some degree of bitterness, especially arugula, endive (escarole), chicory, and young dandelion greens. These are excellent, though fairly mild, bitter medicines. Coffee (usually as espresso) and salad are often consumed after meals in Europe to stimulate digestion.
Stronger bitter herbs are usually encountered only in preparations made specifically to highlight their bitterness. These are used in alcoholic beverages and as after-meal digestifs. Gentian root is the classic bitter herb. It is used to produce Angostura bitters, originally prescribed for sea sickness and stomach problems, and now an ingredient in several mixed drinks. Herbalists of the European and American naturopathic traditions consider gentian and other bitter herbs to have the ability not just to stimulate gastric activity, but to improve the tone and function of the digestive system.
Rudolf Weiss, a famous German doctor and pioneer in herbal medicine, said of gentian, “A pure bitter (the bitter taste is detectable even at a dilution of 1 part in 20,000). Stimulates gastric secretions and motility and improves tone. It is active as soon as it is absorbed through the mouth’s mucus membranes.” The old school American herbalist, John Christopher, said gentian is “one of the most valuable bitter tonics and best strengtheners of the human system.” He called its effect “invigorating.” When used to invigorate the digestive system (as opposed to promoting digestion after a big meal), a squirt of gentian tincture is typically taken in water 20 to 60 minutes before eating.
Quinine, which comes from cinchona bark (a South American tree), is famous as the first effective treatment for malaria. It’s intensely bitter and it shares some medicinal properties with gentian and other bitters. The bitterness of quinine is the standard to which all other bitter substances are compared.
Quinine is most often encountered in tonic water, which goes very well with a wedge of lime and some good gin. Cinchona (AKA Peruvian bark) has attracted some attention recently because it’s the distant source of the contentious COVID treatment hydroxychloroquine. However, this herb and its derivatives all possess a certain degree of toxicity. The amount of quinine in tonic water is strictly regulated for this reason, and there have been a few unfortunate deaths from over-zealous users of the related substance chloroquine.
Citrus peel is a wonderful bitter agent. It can be used fresh, extracted in alcohol, or dried and aged and taken as a powder or tea. Fruity and floral tones make it more interesting and less of a pure bitter than gentian or quinine. Any citrus peel can be used. Common fruits used for bitters include lemon, lime, orange, tangerine, bitter orange, and grapefruit. A delicious example is the famous Italian limoncello, a liqueur made from Sorrento lemon peel (or whole lemons).
Other common bitters include barberry root bark, goldenseal root, rhubarb root, artichoke leaf, cascarilla bark, wormwood leaf, yarrow flowers, and more. Over 20 years ago, when I was a novice herbalist, I had a friend who had gradually developed nausea, bloating, and a poor appetite. Most foods made her feel worse. At the time, I was focused on barberry and suggested that she might try some. I didn’t speak to her for a while after that, but a few months later she reported, “I love barberry! It fixed me!” She had been taking it as a tea twice a day and not only were her digestive symptoms gone, she also felt strong and vital in way she hadn’t experienced since childhood.
A wide range of aromatic herbs may be combined with bitters to enhance their effect when used to soothe the digestive tract. Mint, anise, caraway, cardamom, cinnamon, coriander, fennel, ginger, and thyme are some common ones. These bitters and aromatics are available in a vast array of commercial preparations, most of which originate in Europe. However, there has been a resurgence of interest in bitters in the United States, with boutique manufacturers popping up alongside thriving foodie cultures.
Consider broadening your taste horizons, or at least offsetting your sweet, sour, and salty consumption with a bit of bitter. See if you feel lighter than usual after dinner if you have something bitter. Even if your taste buds don’t love it, your body might.
Share with us about your experience with bitter foods and herbs in the comments section.
Be well,
Peter
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In the past month's 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).
If you’re interested in learning more about the big picture of eating and nutrition, check out the four week course I developed for The Dragontree, called How to Eat.
Be well,
Dr. Peter Borten
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Very thoughtful written and thought provoking! I have done a couple of juice cleanse events down in Palm Springs and felt like they made a difference. Looking forward to your suggestions on cleanses!
Thanks, Alecia!
I am due for a cleanse. Thank you for the seed.
You’re welcome!
Great article Dr. Peter!
Thanks, Elif!
Thank you Peter! As usual I so appreciate your balanced approach, anchoring the buzz in knowledge, depth and reflective practice. You do so with respect and ever for the goal of increasing our individual inner wisdom. I’m grateful for your grounding and inspiring messages!
Thanks for the kind words, Diana! I’m happy to have provided something useful.