By ANAHAD O’CONNOR Well.Blogs.nytimes
For much of his life e, Dr. Vincent Pedre, an internist i
n New York City, suffered from digestive problems that left him feeling weak and sick to his stomach. As an adult he learned he had irritable bowel syndrome, or I.B.S., a chronic gut disorder that affects up to 10 percent of Americans.
Through the process of elimination, Dr. Pedre discovered that his diet was the source of many of his problems. Cutting out dairy and gluten reversed many of his symptoms. Replacing processed foods with organic meats, fresh vegetables and fermented foods gave him more energy and settled his sensitive stomach.
Dr. Pedre, a clinical instructor in medicine at the Mount Sinai School of Medicine, began to encourage many of his patients who were struggling with digestive disorders to do the same, helping them to identify food allergens and food sensitivities that could act as triggers. He also urged his patients to try yoga and meditation to alleviate chronic stress, which can worsen digestive problems.
Dr. Pedre now has a medical practice specializing in gastrointestinal disorders and is the author of a new book called “Happy Gut.” In the book, Dr. Pedre argues that chronic health problems can in some cases be traced to a dysfunctional digestive system, which can be quelled through a variety of lifestyle behaviors that nurture the microbiota, the internal garden of microbes that resides in the gut.
Recently, we caught up with Dr. Pedre to talk about what makes a “happy gut,” how you can avoid some common triggers of digestive problems, and why fermented foods like kombucha and kimchi should be part of your diet. Here are edited excerpts from our conversation.
How did you end up focusing on the treatment of digestive disorders?
It starts from having grown up with a sensitive digestive system, which was very challenging my entire life. But it wasn’t until I went to medical school and then ultimately learned functional medicine that I really understood what was going on inside the gut. I experimented and changed my diet and tried probiotics and started to resolve my issues. At first I was just doing this because the gut was one of those places where you could make a big difference for patients. I was seeing rapid results. My patients started referring their friends and before I knew it that part of my practice had grown tremendously.
You say that functional medicine informed your ideas about gut health. What is functional medicine?
Functional medicine is a branch of medicine that looks at the body as a system. It is patient-centered rather than disease-focused. We spend more time with our patients listening to their histories to look for interactions between genetic, environmental, mental and other lifestyle factors that can influence the course of their diseases. I think it’s best equipped to deal with the ever-increasing complexity of conditions that patients are going to their doctors for.
What is a “happy gut”?
A happy gut is a gut that is able to do all of the work of digestion. It has a healthy microbiome, it’s able to extract all the nutrients you need from your food without causing any pain, discomfort, bloating or distress, and it creates a bowel movement at least once a day.
Why did you write this book?
I wanted to be able to help more people than I could possibly reach through my practice. And as I was working with people on gut issues, I also came to realize what an essential role the gut plays in so many other aspects of health.
How common are digestive issues in America?
The estimate is that around 70 million Americans suffer from some sort of gut issue, including I.B.S. And I think if you broaden that out to people who suffer intermittently from some sort of gut distress, the number is much larger. There are also many people who maybe don’t realize they have a gut issue but are experiencing other related health issues.
What are the most common gut issues you see?
The biggest one would be irritable bowel syndrome. Behind that there could be something called dysbiosis. That’s basically an imbalance between the good and the bad bugs in the gut. That includes bacteria, yeast and parasites.
What are some of the more common causes of the gut problems you see?
The majority of it comes down to two main factors: diet and environment. And within that, environment can be defined broadly. The overprescribing of antibiotics is a big problem. There was a study recently that showed that just one course of antibiotics will alter the gut flora for up to 12 months. The study looked at a very common antibiotic, Cipro, which we commonly use to treat urinary infections, traveler’s diarrhea and food poisoning.
Can you elaborate on the diet aspect? What are some of the more common offenders?
It’s a variety of things. A lot of people are sensitive to wheat, gluten, soy and dairy products. It could be individual dairy proteins like casein or whey. Humans lack a certain enzyme that breaks down the casein protein. Some people are more susceptible than others. And that can lead to food sensitivities. For some people it could be food additives, or things like preservatives, artificial sweeteners and food colorings. For some people it can be enzyme deficiencies.
What’s the diet you advocate in general?
I think that it should be individualized for every person. But in general I tell my patients to basically eat mostly plants. My approach is a combination of Paleo and vegan. I advocate eating a lot of vegetables, complemented by meat. You should try to choose meat that’s organic, hormone-free and grass-fed. I also believe in incorporating a healthy amount of fats like omega-3’s from avocados, cold-water fatty fish, nuts and seeds.
You also advocate cultured foods, correct?
Yes. Cultured foods have a long tradition. If you go back in history, culturing was a way to extend the life of food and preserve it. But cultured foods also help nurture the good flora in our guts. Whether it’s through a yogurt or kefir or fermented vegetables like kimchi, or a fermented probiotic drink like kombucha, fermented foods are going to help promote a healthy, balanced gut flora. We know that the gut flora can shift very quickly depending on your diet. And I think it needs this continued support from cultured foods.
What is your diet like?
My diet is very similar to the “Happy Gut” diet that I write about in the book. I try to make the majority of my diet salads, greens and steamed vegetables. I bring in healthy fats through nuts and seeds, ideally sprouted. And I love kombucha, so that’s a regular part of my diet. I stay away from dairy and gluten, and during the season when the farmers’ market is near my home, I like to buy my produce there so I can support the local farmers. I also try to minimize my exposure to pesticides.
What do you expect people will take away from this book?
I hope people who are suffering from gut issues and other conditions that may be related to gut health – like fatigue, migraines, allergies and asthma – will see that there is a way to achieve wellness by changing the way you eat and the way you approach your lifestyle. I hope people will learn that it’s more than just a diet. It’s a 360-degree approach to your lifestyle, and the way you balance your stress is just as important as the way that you’re eating.
Neither one is fun, but there are some key differences between food allergies and digestive problems. One example: With a food allergy, you might get hives but you probably won’t with a digestive condition. Find out how to determine which is behind your symptoms.
Matthew Johnson MD, FACS 