Food Freedom Friday Edition 260 - Digestion Question

There are several common complaints I often hear when I recommend increasing protein and reducing carbohydrates that can make people wonder if this diet is right for them, or cause them to abandon it before experiencing the benefits. Most often I see questions that people lose their appetite to eat enough or, on the other hand, that they fail to feel full or satisfied; that they lose their appetite for fat or meat; that they struggle with diarrhea or constipation; and sometimes that they do not experience immediate weight loss.

I believe many of these complaints can be directly related to poor digestion, originating in the stomach, pancreas and especially the fat metabolism functions of the gallbladder.

The process of digestion begins with chewing in the mouth. Food then travels to the stomach where sufficient levels of hydrochloric acid are needed to begin the process of breaking down the food. Next it travels into the duodenum, the lower part of the stomach, where pancreatic enzymes are secreted to break down proteins and fats, and where bile is secreted from the liver and gallbladder to break down fats into fatty acids. These food particles can then move into the intestines where nutrients and fatty acids are absorbed into the blood stream and used by the body. If the body is not able to perform any of these functions sufficiently, you may fail to experience the benefits of the micro and macro nutrients of your food, and experience symptoms directly related to poor digestion.

Digestive dysfunction can cause a myriad of problems (probably most notably long-term nutrient deficiencies) for people eating any diet, but they manage with minimal symptoms by eating foods that are simple to digest. If one has pre-existing digestive dysfunction, increasing animal protein diet may demand special attention to the digestive system.

In reality, a diet filled with processed grains and sugars is the last thing that's helping your digestive system...

There are several reasons increasing animal protein may exacerbate digestive dysfunction. The fats found in animal products contain longer chain fatty acids than those fats from plant products and therefore require extra work to digest. Even commonly used keto fats like coconut oil and MCT oil, do not depend upon bile emulsification or pancreatic lipase for assimilation like animal fats. A dysfunction in the gallbladder or pancreas will not cause issues with these fats the same way it will for digesting animal fats.

Protein is also a more complex molecule than that of fat and especially carbohydrates and requires some extra work and time to digest. When proteins are not digested properly, they often remain in the digestive system and putrefy.

Carbohydrates are a fast-burning, simple source of energy, that are easy for the body to digest. This is one of the reasons foods like crackers and white rice are recommended for stomach upset.

This does not imply that a diet higher in protein is bad, or even bad for someone with digestive issues! In a healthy state, which can be achieved by identifying and addressing the root causes of compromised digestion, proteins and animal fats can easily be digested properly and the body can reap all the benefits.

Causes Of Digestive Dysfunction

High Carbohydrate Diet

Low stomach acid can easily result from the carbohydrate load of a Standard American Diet, most likely due to inflammation and its effect on the microbiome.

Stress

Chronic stress, which is extremely common in modern culture, puts the body in a "fight-or-flight" type response. This in turn devotes the body's resources to life saving functions rather as opposed to digestion. Over time stress can significantly impair all digestive processes, especially stomach acid levels.

Impaired Microbiome

Keeping the digestive system functioning efficiently is one of the many important functions of your gut bacteria. Without healthy gut bacteria, stomach acid, bile production, and macro and micro nutrient absorption are impaired. An impaired microbiome has many causes including chronic stress, exposure to toxins, antibiotic usage, a history of poor diet, low exposure to environmental and dietary bacteria, and even factors occurring very early in life. Someone born via C-section or not breastfed as a baby can suffer an impaired microbiome throughout their life without some intentional intervention to make up for the important, early bacterial exposure they missed.

Proton Pump Inhibitors & AntAcids

There are a variety of over-the-counter and prescription drugs that are designed to inhibit stomach acid for acid reflux relief. These directly inhibit the critical digestive functions of stomach acid and over time can significantly repress digestive function in general. Ironically, acid reflux is actually associated with low stomach acid. This is not caused by a dysfunction of too much stomach acid, but by the esophageal sphincter letting acid into the esophagus, which is usually associated with low stomach acid and other digestive dysfunction.

Poor Diet

The main culprit in impaired bile function is not overuse of fats, but rather a history of a low-fat diet, or a diet filled with poor quality, processed vegetable fats. Bile is produced in the liver and stored and concentrated in the gallbladder where it is secreted to help with fat digestion. When sufficient fat fails to trigger emptying of the gallbladder, bile remains in the gallbladder and becomes sluggish and creates stones. This results in the inability to secrete sufficient bile in the future, and could be painful.

Liver Damage

The liver has many important functions including those involved with digestion, impaired liver function can affect bile production. Sources of liver damage include low stomach acid, a high-carbohydrate diet, and toxic overloads.

Symptoms of digestive Dysfunction

Nausea

Bile from the liver and gallbladder is essential for both breaking down fats and eliminating toxins. Without sufficient bile, toxins can build up and result in nausea associated with eating.

Inconsistent Stool

Your stool can be very indicative of what might be happening in your body! Floating stools, greasy or shiny stools, light or clay colored stools are clear indicators that your body is not digesting the fat in your diet well. Without sufficient bile, the fat you eat is passing right through you and showing up in your stools, rather than getting broken down into the fatty acids and being used for nutrient absorption and energy. Since fat and water do not emulsify, the undigested fat in stools causes them to float. Shiny looking stools, are also a good indicator of fat malabsorption

Diarrhea & Constipation

Although these symptoms are opposites, both can be signs of impaired digestion. When bile is improperly reabsorbed in the small intestine, (often as a result of the walls of the small intestine being compromised by undigested food particles originating in the stomach and duodenum), the bile in the small intestine can cause diarrhea. On the other hand, undigested fat in the small intestine as a result of insufficient bile flow can stick to the walls of the small intestine and cause constipation. If diarrhea or constipation last more than four to six weeks after increasing your animal protein consumption, impaired digestion may be the likely cause.

Intolerance To Eating Fat &/Or Protein

This are simple, strong signs from your body that it is not digesting fats or proteins. If fats are not tolerated, the issue almost certainly resides in bile production, while undigested proteins most likely stems from low stomach acid.

Bloating, Burping & Gas

Generally bloating and gas are indicators that your body is challenged to digest a certain food. This explains why it is commonplace to experience them when eating foods like grains and high fiber which are tough to digest. If bloating, belching, or gas occurs from simply eating animal-based products, it can be a sign that this food is not being digested. Gas builds up in the digestive system as undigested foods, especially protein, putrefy and create gas.

Experiencing these symptoms within an hour of eating is a sign that this is happening higher up in the digestive system, probably as a result of low stomach acid, while symptoms an hour or more after eating are probably a sign that the undigested food is further along, associated with insufficient pancreatic enzymes.

Lack Of Hunger

If you are following a ketogenic or carnivore diet and wake up not feeling like eating until late morning or lunch time, the first assumption is that this is \ a good sign of fat adaption, as you are hungry less often and your body is affording you the opportunity to fast a little each day. However, it could also be a sign that food is digesting too slowly from the night before because of insufficient hydrochloric acid and/or pancreatic enzymes.

Weight Loss Resistance

Weight gain and weight loss stalls on keto and carnivore are hot topics that are still being fully understood. Although these cases are the exception, not the norm, and any high-fat, low-carbohydrate diet is without a doubt the best method for losing weight, there are people who struggle to lose their fast when following these protocols. Impaired digestion of micro and macro nutrients can affect weight gain and weight loss through impaired satiety and metabolism.

Food Sensitivities

Allergic reactions to certain foods should not be considered an unavoidable, genetic phenomenon. Often, they are a sign of impaired function in the small intestine. When insufficient stomach acid and pancreatic enzymes result in improperly digested food making it to the small intestine, it can compromise the lining of the intestines and cause these undigested food particles to leak into the bloodstream. When the blood receives these particles instead of the micronutrient and macronutrient by-products it is expecting from the digestive system, it is ill equipped to handle these larger molecules and the immune system produces antigens against them, causing symptoms of a sensitivity or allergic reaction.

It makes sense that a many exploring a higher protein and lower carbohydrate diet are doing so because they had reacted badly to so many other foods. This may not need to be the case after addressing dysfunction higher up in the digestive system.

Insatiety, Binge Eating

If food, especially high-quality animal protein, seems to not be be filling you up, causing you to constantly feel hungry or overeat, it may be due to a compromised digestive tract. If pancreatic or bile insufficiency is keeping fats and proteins from being absorbed, it simply feels like you are not eating these foods at all, because, in reality, you are not. This means you might also expect other symptoms associated with a low-fat, low-protein, or even low-calorie diet, including low-energy and nutrient deficiencies. Undigested food in the stools is a further sign of pancreatic insufficiency.

Supporting Digestion

The good news is that increasing your protein, eating real food and reducing your carbohydrate load, work really well to help re-set these impaired digestive processes.

If your gallbladder is sluggish due to a history of low or poor fat diets, it can re-adapt with increased fat in your diet. The old, sluggish bile that is trapped inside the gallbladder will eventually get released as a higher-fat diet begins triggering bile release. Then the cleared-out gallbladder will be able to resume functioning well.

If a history of a poor, high-carbohydrate diet has caused low stomach acid, it will rebuild as you move to a quality higher fat, higher protein diet. Often, acid-reflux is one of the first symptoms to disappear making the shift.

It has been posited that one of the main culprits behind pancreatic enzyme insufficiency is the blockage of pancreatic ducts by fiber. It should come as no surprise then that following a low or no-fiber diet would free up these pancreatic enzymes.

Removing sugar and, although controversial, fiber, from your diet will stop feeding harmful gut bacteria allow your beneficial gut microbiome to rebuild.

All of these body processes are connected, and as they each heal, in time, the others will be able to as well. For example, sufficient pancreatic enzymes will be able to properly neutralize stomach contents and prevent unintended acidity from damaging the gut bacteria, which will therefore be able to support proper stomach acid and bile production.

There are several things you can do to support your dietary transition, which may be required to re-set particularly insufficient digestive processes, or are simply good practices to help ensure optimal digestion.

Chew More

The digestion process starts in the mouth and simply focusing on chewing your food more can set your digestive process up for ultimate success further down .

Relax While Eating

Similarly, ensuring you are eating in a relaxed, parasympathetic state will ensure the digestive system is unimpaired and the functions of digestive organs can heal. Whenever possible, avoid eating while driving, working, or any time you feel anxious.

Eat More, Less Often

Bile accumulates in the gallbladder as a result of a steady production from the liver. Frequent eating will trigger bile to be secreted before it has sufficiently accumulated in the gallbladder. Eating less frequently will give the bile the chance to re-set and be able to handle the fat load of eating more animal protein.

Rebuild The Microbiome

By avoiding sugar and fiber and eating lots of micro-nutrients, increased animal protein should give the digestive system great resources to rebuild, however, if you suspect your microbiome needs some outside help, try a probiotic supplement or try to include low carbohydrate fermented foods in your diet.

Bile Salts, Ox Bile, Hydrochloric Acid & Pancreatic Enzymes

The functions of the stomach, gallbladder, and pancreas can be directly supported with supplementation of stomach acid in the form of betaine hydrochloric acid, bile acid and bile salts, and pancreatic enzymes. Please consult with a knowledgeable professional before adding these to your protocol to ensure they are used correctly and not doing any harm!

It is important to acknowledge and understand that there may be an adaptation process when transitioning your diet and optimizing your protein intake. Assessing and supporting your digestion will go a long way in supporting your body and getting you experiencing all the benefits of a nutrient dense food plan in no time!