Constipation refers to bowel movements that either occur less often than expected or with a stool that is hard, dry and difficult to pass. (Types 1-3 on the Bristol Stool Chart, below.) A healthy adult should pass one to two stools a day, although some otherwise healthy adults pass a stool every other day. There are a number of reasons one might not pass feces, including diet, fluid intake, medications, stress, anal pain from hemorrhoids or fissures, lack of probiotic gut bacteria, laxative abuse, specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s, change in circardian rhythm (due to irregular sleeping while traveling) and a poor posture while eliminating Continue reading Dealing with Constipation
This article, reprinted from Dr. Mercola is very important on the relationship between gut bacteria and the brain:
By Dr. Mercola
While many think of their brain as the organ in charge of their mental health, your gut may actually play a far more significant role.
The big picture many of us understand is one of a microbial world that
we just happen to be living in. Our actions interfere with these
microbes, and they in turn respond Continue reading Are Probiotics the New Prozac?
Anyone who consults with me knows that I always suggest taking herbs in a way that allows you to taste them. That means that I usually use teas, tinctures, syrups, herbal jams like chayawanprash or turmeric honey, pickled herbs, overnight infusions, herbal decoctions or powdered herbal extracts that are added to water. The only time I really approve of using capsules is when giving the severely bitter anti-parasite herbs (usually a long term proposition and the bitterness is for the parasite) or when a person is so debilitated that they will miss dosages unless they have pills to tide them over until they can brew up their herbs. In that case Continue reading Why you should taste your herbs
The New York Times had an article this week, Herbal Supplements Are Often Not What They Seem, that suggested that herbal capsules may not contain what they say, often containing different species in the family or fillers. The study cited is found here.
As one of my clients was expressing anxiety about the news I flashed on how I deal with it: I prep. Yes,I am a lefty, liberal non-apocalyptic herbalist prepper who thinks guns in cities are more likely to harm innocents than defend families and I think the government wants to help but will be stretched too thin. But my scouting years suggest being prepared Continue reading The Prepping City Herbalist
With so much sperm per ejaculate, it seems that sperm quality would hardly matter in infertility. A healthy male discharges 50 million sperm in one ejaculation. During sexual intercourse, of all those millions of sperm, only a couple hundred will make it to a mature egg that is ready to be fertilized. But 40% of infertility is from the male, including males who passed the semen analysis tests. The average sperm count today is between 20 and 40 million per milliliter in the Western world, having decreased by 1-2% per year from Continue reading Twenty factors that affect male fertility
In Part 1 we looked at foods to eat. In Part 2 we discussed foods to avoid. And in Part 3 we discussed nutrients and supplements. There are specific issues for people with Parkinson’s that affect the ability to eat and drink at all which we will cover in this section.
People with Parkinson’s tend to demonstrate a kind of withering or dehydration which we refer to in Chinese medicine as yin deficiency. Yet acquiring adequate nutrition in the form of soups, or congees for instance, which would help Continue reading Special issues with Parkinson’s and Nutrition: Part 4
While Dr. Terry Wahls‘ experience with MS shows food to be more effective than supplements at providing nutrition for neurological diseases, there is a place for supplementation with vitamins and minerals, provided they are taken together with food to make up for deficient nutrients in our foods. Paul Bergner researched the decline of minerals Continue reading Useful Supplements for Parkinson’s Disease: Part 3
In Part 1 I discussed what to eat if you have Parkinson’s Disease. PD is only partially genetic and can be induced by exposure to pesticides, herbicides and other chemicals, some of which are found in food.
This is what to avoid: Continue reading What Not To Eat With Parkinson’s Disease,Part 2
Nutrition for Parkinson’s Disease has four components: What to Eat, What Not to Eat, Useful supplements and How to Eat, given symptoms of the disease. This will be a four piece series. Some of it is basic: the foods and superfoods that enrich the diet. Some is specific to the typical complaints from either the disease, the medications and the often restrictive lifestyles that PD patients often adopt. And the how-to acknowledges that the disease creates some physical problems that adaptive devices might help.
Nutrition for Parkinson’s Disease Part 1: Continue reading Nutrition for Parkinson’s Disease- Part 1
I spoke with a medical doctor, a women’s urologist, the other day about a mutual client. The discussion was frustrating for both of us, with disagreements about what I thought were perfectly obvious physical characteristics. Afterwards it hit me that we were speaking different languages with enough overlaps that we didn’t realize there were two different sets of definitions. For those of you going between two practitioners with different paradigms or for practitioners of Chinese or Naturopathic medicine who need to communicate with medical doctors, I thought I’d write about this. Continue reading Doctors speaking a different medical language with a 70% overlap
Changing diets and lifestyles are hard work. Most people want a magic bullet to make their conditions go away, especially with the newest exotic fruit juice from a faraway tropical island. (Noni, anyone?) My friend Alan Tillotson wrote this: Continue reading The Newist Magic Bullet
After a trip to Guatemala where a few of us ended up with severe parasites and after the death of my friend Keiko Golambos to virulent malaria, I was asked to put together an emergency travel kit for international outreach. This is a kit for Continue reading What Is In Your Natural First Aid Travel Kit?
Yom Kippur is coming and people will be fasting. I was asked to put together some information on what will allow people to have a good fast that will allow them to focus on the meaning of the holiday without keeling over from blood sugar fluctuations. Here are a few tips to keep the fast from debilitating you and to keep hunger pains from being a major distraction. (You will still know you are fasting.):
- In the weeks preceding Yom Kippur consider shrinking your stomach by reducing portion size. You can get used to less food intake which will lessen the shock.
- From the first of Elul, reduce carbohydrates like bread and sugar. This allows your body to get used to not depending on regular sugar rushes. (Starches become sugar within minutes.)
- Keep those honey cakes and sugary treats for a sweet new year to the first part of the 10 days before Yom Kippur and only take a little starch the day before. You don’t want to have huge fluctuations in blood sugar.
- The day before eat proteins and fats that will not cause your blood sugar to rise and crash. You can prepare with either a meat or dairy meal. Eggs, beans, fish, cheese, chicken, quality meat if you can get it, nuts, butter, and avocado will help maintain your blood sugar. Continue reading Foods and Herbs to Prepare for a Fast
I have always found the scheduling of Rosh Hashana, Jewish New Years to be far superior to the nethertime after Christmas and the Winter Solstice. Rosh Hashana better aligns with the autumn, the new school year and you get to enjoy it in pleasant weather for the most part. It starts a 10 day period called the Days of Awe where you take stock of your shortcomings and make amends before Yom Kippur.
Rosh Hashana is celebrated with a feast that symbolically aligns us to the holiday’s purpose. A special round challah (gluten free recipe here) celebrates the cycle of the seasons. Size isn’t important, so if you are eating paleo or are triggered by bread take just a tiny piece or buy a challah roll to divide. A fish head stew reminds us to align the brain with our practice, and carrots in the stew would be to lessen God’s judgement against us, based on the word in Hebrew. The many seeds of the pomegranate are to remember the 613 commandments, and to ensure fertility. Honey is used for the sweetness of the mitzvahs, but a dip of apple slices in a small amount of local honey will fulfill the symbolism with more health than a honey cake. Finally the feast is celebrated with a kiddush cup of wine or grape juice. The picture at the right also shows the shofar, a ram’s horn, used to herald the two days with a hundred blasts.
Brooklyn has a diverse richness found in few places and people form unlikely alliances. Two years ago, I was out on Seventh Avenue, the main street of Park Slope. The Reform Jewish Congregation Beth Elohim had roof trouble and had to move its Rosh Hashana services to Old First Reformed Church which is located on Seventh Ave. A Chabad Hasidic Jewish rabbi had brought his shofar to the street to convince non-observant Jews to practice rituals. He greeted the ushers, stopped in front of the church, sounded the shofar for the Reformed congregation, using the full range of four soundings, wished everyone a happy new year and continued on his way.
And in other New Years activity, a shofar flash mob at Lincoln Center from Art Kibbutz NYC:
I was recently asked, under the anonymity of a Google comment, how I can be into herbs and health when I am clearly fat, I’m sure the question has been let unasked a lot more than it was voiced. And my first instinct was to get all defensive: the great American herbalist Michael Moore was fat. The great Annishinabe medicine woman and ethnobotanist Keewaydinoquay Peschel was fat. What does fat on your body have to do with what you know, anyway?
The short answer is that once you are fat, unless you are slightly fat or you had a short term weight gain, it is incredibly difficult to reverse. You can lose weight, but it doesn’t last. You can do quite a bit to stay healthy via your diet and lifestyle, but you may end up healthy and fat.
I’ve been fat since age 5, with a short break during my late teens and 20s when I felt like and metabolically was an underweight fat person. Maybe it was my grandmother’s Native genes clashing with a 1960s Standard American Diet- I took after her rather than my parents. Maybe it was a reaction (mine? my parents?) from nearly dying as an infant from weight loss due to digestive problems, although I didn’t notice them pushing food. Perhaps I caught one of those obesity-promoting adenoviruses. Maybe it was all those fattening antibiotics I had for ear infections before anyone considered that dairy might be the culprit. Perhaps my body had to sequester exposures to pesticides painted on the walls at the cabin. Maybe I overate when they pulled me out of my sweet smelling acacia tree to send me to a dismal school and my happiness quotient fell. In any event I was on Metrecal, the Slimfast of the day, by the first grade, embarrassed as we discussed our breakfasts in health class. Junior high was torture, where I was relegated to the few chubette clothes available, until I discovered Guatemalan skirts and peasant blouses. I focused on learning instead of socializing.
I had by this time become quite expert on calories, carbohydrates and food exchanges, not to mention setpoints and portion sizes. My doctors had suggested everything from locking cupboards, to liquid meals to diet pills that left me wired, but I believed there might be better ways. I was under orders to lose weight by any means possible. I biked, swam in the summer, lived on a hill so steep the school bus couldn’t drive up so I walked it instead, went hiking in the woods behind our home, and had daily physical education classes taught by self-hating drill sergeants, I wasn’t exactly a couch potato although I preferred reading, acting in school plays and establishing an underground school newspaper to afterschool sports.
I finally lost weight when I left home, had a new start, and went on a zero carb diet (in Italy, yet.) I kept most of it off when I got home because I lived a mile’s walk from campus and took five 1-2 hour dance classes a week, blessedly subsidized by parents and low tuition. And as a young single who chose a bike rather than a car, I swam daily and went scubadiving on weekends, so it only slowly crept back. But the job ended, I moved to New York where work hours were long, picked up an inactive husband who preferred restaurants to Appalachian trail hikes and saw my weight skyrocket with the hormonal changes of pregnancy. Periods of stress drove my cortisol through the roof. By the time my children were born I was over a threshold where I could lose weight without getting sick or exercise without injury. Not that I didn’t try: Weight Watchers, Optifast, vegan diet, vegetarian diet, Atkins diet, metabolic bump diets, macrobiotic diet, fermented foods, paleo diet, Paul Bergner’s insulin resistance class, hypnosis, therapists, personal trainers, one- hour exercise sessions that didn’t work, two- hour exercise sessions that burned fat but left me too exhausted to work. There was a lot of good stuff in many of those plans. I lost some weight. And I gained everything back.
Was I perfect? Of course not. As a teen I had justified saving calories from eggs for ice cream (after all, a calorie is a calorie isn’t it?) I have caught myself eating emotionally, but it was aberrant enough to stand out and my thin friends do the same on occasion. Portion size may be an issue, but the fat cells themselves call out constantly to eat more, something not true of thinner people. Occasionally I go on tiramisu jaunts. I go between wondering if I am gluten-sensitive or just carb-sensitive and go in and out of drinking milk.
The International Journal of Obesity says that of people who lose 75 or more pounds, 95-98% gain back every pound within 3 years, 2/3 of them within the first year. Even Oprah who can afford cooks, a personal trainer and all the backup possible gains it back. People who keep weight off are a statistical aberration, unless the gain was transient. Younger men who haven’t been obese long and are willing to, say, become exercise instructors or indulge in full time physical labor stand the best chance of joining that elusive 2-5%. as do people who spend the rest of their lives monitoring every mouthful and every bit of exercise. The National Weight Control Registry tracks strategies and data on those who lose at least 33kg and keep it off or 5 years. Even they say that only 20% of dieters are successful at a 10% weight loss for over one year. You have to make your life about keeping weight off and maybe change your work to something physical all day.
I haven’t tried everything. Tapeworms, for instance seemed to work for Maria Callas, but I’m squeamish and like my B vitamins. Nor have I tried surgery, although I did check it out. The painful death of my pharmacist after gastric bypass surgery destroyed any question I might have had about a procedure that creeps me out on the face of it. (What colonizes that empty length of intestine cut off by the surgery?) Two of my obese patients had the surgery and are still fat- and one lost her spleen during the operation. And while a lap band seems less intrusive, I watched one patient struggle for a year with infected ports. For a cool $25,000 plus extra surgery for the sagging skin you get an 80% complication rate and 5 years of becoming thinner before you gain it back. Even if you get thin, you are metabolically fat compared to an always thin person, with every deflated cell urging you to eat at any moment. And the yo yo is harder on your heart and toxin release harder on your brain than just staying fat. Thanks, I’ll work on health at any size.
The truth is, despite Joy Nash’s wonderful YouTube Fat Rants, fat is a matter of shame in our society. We don’t criticize the selfish or the vain nearly as much as the fat. Obesity is treated as a character flaw instead of just extra avoirdupois. It is extra flesh not failure incarnate. Heck we have a worldwide epidemic of obese 6 month olds who probably eat and move much like infants always have, so it makes no sense to blame. And we need to get real about it.
I have no question that if I had bypass surgery and lost weight that people would congratulate me on becoming healthier and it might well help me get a teaching job or keep patients. It would not be true. My digestion would be permanently ruined, I’d weaken the muscle in my heart along with all the other muscles (non ketogenic weight loss lowers your muscle mass and the heart is mostly muscle) and I would have scars through my meridians. To be fair my feet and knees would feel better and I might have more energy during the low weight phase, but the assumption of health would be falsely generalized. It is possible that I would live up to 3 years longer, although those figures were not derived by comparing fat and formerly fat people and they certainly didn’t sort out the physically fit fat people for comparison. We aren’t talking decades of life. Besides the most recent word is that thin people with big bellies die sooner than the obese.
What I can do, even if the fat is intractable, is something about is my health and fitness. A low carbohydrate diet including good fats, green vegetables, seaweeds, low glycemic flavonoid-rich fruits and clean protein will keep my blood sugar down and normalize my cholesterol and triglycerides. Exercise will keep my circulation and lung function intact. Weight training will build muscle mass. Yoga, qigong, MELT or Pilates will stretch my muscles and strengthen my core. Regular acupuncture, massage or craniosacral balancing will keep me centered and enough sleep will allow restoration.
Most important I love the work I do and would rather be fat than work at a different, more physical job or spend an additional hour at the gym when I could be spending time figuring out how to affect patients with difficult problems that don’t lead to easy resolution. While my preference for treating zebras, as difficult cases are called, may not make me thin or rich, at least I learn things that help others.
So what have I learned about weight loss?
- Statistics on health and Body Mass lump couch potatoes together with the fit fat people. You don’t want to be a couch potato. If you work out regularly and eat well, your main problems will be structural.
- Overweight people react differently to dieting strategies than do obese people. Formerly fat people are metabolically quite different than always thin people of the same weight. Don’t assume that everyone can do the same thing to either lose weight or stay thin.
- Most fat people do best on low carbohydrate diets, without appreciable grains. Even if you might have done well with grains pre-obesity, your metabolism is probably damaged by long term weight gain. Go Paleo, for good.
- If you want to lose weight, you need to restrict food even on a low carb diet. You may be too satisfied to overeat, but many fat people have lost touch with their body’s signals.
- Ketosis (not the dangerous ketoacidosis) metabolically causes you to lose fat rather than muscle, provided that you don’t overeat. There are entire civilizations in ketosis (traditional Inuit, Bantu, hunter-gathers) who are not in active weight loss. Nonetheless I know of no better start for fat burning.
- To start a ketogenic diet, mineralize yourself with magnesium, potassium, iodine, trace minerals, sea vegetables and kale. Otherwise the first two weeks while you are transitioning from glucose-burning to ketone (fat) burning will be hell. Which is probably why Atkins allowed free consumption of fats during that induction period.
- For a long term diet, a food plan that hovers between ketosis and low carb just above ketosis is probably the best. Green vegetables and clean fish or pasture-raised meat, eggs from outdoor chickens and small amounts of berries, yellow fruits and vegetables or pickled root vegetables should be the basis of your diet.
- This actually can be done with a vegetarian diet but will be a lot more interesting with animal protein. The infamous low glycemic vegetarian diet that beat the ADA diet for diabetes was basically vegetarian Atkins.
- Weight gain after periods of intense stress may be more benign than other self-medication (although others may not act as if it is.) The weight won’t necessarily go away when the stress does or just because you take up yoga, even Birkram.
- There is a threshold beyond which losing weight is close to impossible without extraordinary changes, so don’t get there. Overweight is better than obese.
- The kind of extraordinary changes that allow weight loss include moving away from family and friends who may reinforce inactivity or stress, changing to a very physical profession, radically increasing exercise and changing the kind of food you need and a spiritual renewal that doesn’t involve lots of sitting or reading. Move to a 5th floor walk-up or work a half hours walk from home to build in exercise. You also need to make peace with monitoring everything you eat, monitoring exercise and monitoring weight.
- Some people become fat in reaction to sexual abuse, negative feedback from family members, dissatisfaction with a lack of purpose, or to hide sources of shame. Others pick up a sense of shame after they become fat. Continued emotional eating may or may not play a part in this reaction. Getting rid of the shame is essential to your well-being, whether or not it converts to being thin.
- If you suddenly gain weight, loose it as soon as possible so that your setpoint weight doesn’t increase.
- When you take medications like steroids, antidepressants, antipsychotics, long term antibiotics or insulin you will probably gain weight, often substantial amounts. Statins can cause diabetes, but are pushed on people with insulin resistance. It may be worthwhile, but consider the effect in evaluating your course of treatment and also whether protective lifestyle changes are realistic.
- Most benefits of weight loss happen in the first 10%.
- After 10% weight loss, your setpoint tries like crazy to make you regain the lost weight.
- While some people can, I have never lost weight from exercise alone but I also don’t lose significantly without exercise, including interval aerobics, weight training and stretching. Don’t skip the stretching, because heavy weight predisposes you to injury if your muscles are in the wrong place.
- If you lose weight, you will free toxins locked up in your fat which may be redistributed in your organs. Take detoxifying herbs like dandelion, chickweed, Oregon grape, triphala or coptis and seaweeds to tie them up. Getting sick will derail your exercise program.
- Extra weight is especially hard on your feet, hips and knees. A heel spur or knee problems will also derail exercise. Get good shoes, watch Katy Bowman’s biodynamic body DVDs, stand on little balls to massage the small areas of your feet, vary your exercise and be proactive about foot, leg and hip care.
- Modify exercises to function like they should, not to look like what thin people do. Maybe that means your toe touch only goes to your thighs. Maybe your push-up is against a wall, not the floor. And you need a total substitute for the plough asana if your bust or belly won’t let you breathe.
- Minerals are essential, especially magnesium which is no longer in soils in appreciable quantity, iodine, potassium, chromium and trace vegetables. Seaweeds are the main food source of minerals. Additionally octacosanol will bring down triglycerides.
- If your endocrine system is unbalanced, try adaptogen herbs like rhodiola, ashwaganda, ginseng and eleuthero.
- Weight loss herbs basically fall into a few categories: detoxification, bulk laxatives, liver support, starch blockers, fat blockers and thermogenic herbs. Studies are minimal and are often done on small groups of slightly overweight people.
- Thermogenic (heating) herbs like cayenne are fine if you run cold. Otherwise go to cooler circulatory herbs like turmeric, frankincense, myrrh or chuanxiong. A bit of pepper, long pepper (pipalli) or prickly ash will help the herbs to penetrate and won’t be too hot in small doses.
- Starch blockers, from phaseolus beans usually give you gas while you don’t assimilate the starch. Just stay away from starch.
- Liver herbs like dandelion leaf, green coffee extract, Oregon grape, berberis and milk thistle will help you convert fat and get rid of toxins that were locked up in your fat. Also see detoxification herbs.
- Fat blockers are basically liver herbs that cause you to dump. The pharmaceutical version Olestra (orlistat) can cause explosive diarrhea and deplete you of fat-soluble vitamins and EFAs, but does cause your body to dump toxins. A less intensive intervention using 7 fat free Pringles a day got rid of both persistent organic pollutants like chlorohexabenzene and fat in some studies. Pringles of any sort are not food, but personal experience using fake fats to get rid of artificial toxins were not notably successful.
- The only laxatives I would suggest are triphala, a nourishing and detoxifying group of fruits, and if you are constipated, psyllium, flax or cannabis seeds (sterilized and legal in Chinese medicine stores.) If it is really bad one dose of senna, cascara sagrada, aloes, or da huang (rhubarb), but only for the first bowel movement. Eat seaweeds and okra. Take probiotics or probiotic foods. Drink lots of water.
- Did I say drink lots of water? And yes, some of that can be coffee or teas. Best to avoid diet drinks, even the fairly benign stevia-sweetened ones. Or save them for special occasions. Taste can trigger your insulin secretion.
- Go for periods of time without appreciable carbs, like between dinner and lunch with salmon salad or a veggie frittata for breakfast. When your blood insulin goes up you can’t burn fat or make muscle.
- Don’t graze. See above for why.
- Eat before exercise, which brings your insulin curve back down. If you eat or swill a sports drink afterwards, you defeat the metabolic effect of exercise. (Marathoners or Iron Men are an exception and aren’t losing weight, but if you have read this far it probably doesn’t apply to you!)
- Exercise after eating, even a short spin around the block.
- Take pride in what you do well, how you affect the world and in who you are. There will always be people willing to see you as a size rather than a person. Don’t fall for their shortsightedness.
Green coffee beans are the unroasted seeds of the coffee plant. I purchased some last year after reading that they tasted better when immediately roasted. My initial efforts were unimpressive so I put them aside.
A month or so ago I started getting emails promoting green coffee extract “as seen on Dr Oz.” Since I frequently write about the virtues of coffee, I clicked on one which had the show embedded. The claims sounded too good to be true, so I started searching PubMed. And there is compelling research,including human research that was done on overweight (but not obese) humans.
Roasted coffee is one of the few bitters that Americans regularly consume, one of the highest sources of flavonoids and intake is associated with lower diabetes, by 67%. Some of the benefit is due to caffeine, some to chlorogenic acids, some to magnesium and other constituents like trigonelline and some to roast products. Decaffeinated coffee also has similar effects., Parkinson’s disease, asthma, inflammation as measured by C Reactive Protein (CRP) and a host of other benefits. Epidemiological evidence has shown that a high level of coffee consumption lowers the risk of type 2 diabetes
Coffee is a complex aqueous beverage and there is a great risk that assuming the effects of a single constituent like caffeine represent the effects of the whole herb. While widely denounced in health columns until recently ( some people either do not do well on coffee or abuse it) the benefits of coffee have brought an appreciation that the beverage is more than caffeine.
Marketing has focused on chlorogenic acid (or more properly chlorogenic acids) as the main source of benefits, although one rat study showed that green coffee extract works better than chlorogenic acids alone. Chlorogenic acids are a group of cinnamic acids found in blueberries, peaches, prunes and bamboo shoots as well as in coffee. They are anti-inflammatory antioxidants that reduce the release of glucose into the bloodstream. Contrary to what you will read on the web, some of the chlorogenic acid survives roasting, albeit in lower and different ratios. Unroasted green beans have chlorogenic acid levels from 61-86 %, while roasted beans have levels of 31-41%.
Apparently you can choose your favorite coffee source and still get some benefits for your liver. Dark roasted coffee is higher in a detoxifying compound called N-methylpyridinium (NMP) while light roasted coffee has more detoxifying 5-O-caffeoylquinic acid (CGA) and green coffee is higher in chlorogenic acids. Dark roast coffee is more effective than light roast coffee in reducing body weight, and in restoring red blood cell vitamin E and glutathione concentrations in healthy people. This may because dark roasted coffee beans have less caffeine which stimulates absorption of glucose than medium roast arabica beans and both have less caffeine than robusta beans. (Caffeine may counteract that glucose absorption effect by stimulating metabolism because it alone has a small weight loss effect.) Chlorogenic acids interfere with glucose absorption. But chlorogenic acids are a group and one study indicated that roasting changes the proportion so unroasted and roasted beans will have different effects.
Green coffee takes the prize in weight loss. There have been a number of studies showing the benefits of green coffee extract to the liver, fat and glucose metabolism and weight. In one by Shimoda et.al., mice fed green coffee extract lost more fat than those fed caffeine or chlorogenic acid, although all lost weight. The green coffee extract mice lost visceral fat and lowered triglycerides. The researchers concluded that green coffee extract inhibited both fat absorption and fat metabolism in the liver.
Other studies concluded that coffee extracts lowered fat and sugar intake with a variety of mechanisms listed below and that the constituents were bioavailable, used in both the small and large intestines. A human study found daily consumption of coffee that was rich in the compounds that are found abundantly in green coffee beans, and also in roasted beans, did indeed result in lower food intake which reduced weight and body fat, along with increased glutathione and Vitamin E.
In one small human study of instant coffee enriched with chlorogenic acid, reductions of 6.9% in glucose absorption were found. The same scientists did a 12-week, placebo-controlled human study with thirty overweight or obese humans who took either the extract or a placebo, dissolved in instant coffee. The chlorogenic acid enhanced extract produced an average 11 pound weight loss with a decrease in glucose absorption and an increase in glucose utilization. The researchers suggested that the lower availability of glucose could cause the body to increase the metabolism of fat reserves, eventually decreasing body fat and BMI.
In the best known study cited by Dr. Oz, 16 women and men from India lost 17.6 pounds average or 10% of body weight in 22 weeks, with over 16% fat lost. This means that fat was preferentially lost. This was aso subjects were not on the coffee extract for the whole time. They were on high dose green coffee extract (1050 mg) for six weeks of the trial, lower dose green coffee extract (750 mg) for another six weeks and a placebo for the other third, in three groups which rotated which blinded portion they were on. Between each arm of the study they went without treatment (a two week washout period.) The participants consumed 2400 calories a day (15% protein, 25% fat and 60% carbohydrate), but reportedly expended only 400 calories which should have resulted in a weight gain. (Exercise is referenced but not specified in the study. It was discussed on the Oz show so may have been described elsewhere and I suspect that the 400 calories refers to a specific exercise program rather than total daily motion, but this is conjecture based on the study saying that exercise was discussed at each meeting.)
There are some concerns about this trial, which has had better results than other studies. The other studies had lower dosages so it wasn’t surprising that results were more dramatic. However:
- The trial was quite small. 12 people do not make a reliable study.
- While we know that the sample included overweight men and women who were nondiabetic and without thyroid dysunction, not taking medication affecting blood sugar, we do not know how they were recruited or what their expectation was which could affect placebo effects.
- While a crossover trial eliminates differences between groups it also sets the expectation that everyone will be given an active ingredient at some point. So it can enhance the placebo response.
- The group was divided into groups with either the placebo, high dose or low dose first. This is standard for a crossover trial. However the placebo-first group lost weight in the first six week arm. All groups continued to lose weight during the washout periods. That could be explained by a long term effect on the liver, but the placebo-first group shouldn’t have lost weight during the first arm of the study or its initial washout period.
- There could have been an additional placebo effect from just participating in the trial and recording food eaten on the placebo-first group. Its weight loss was less than the green coffee extract groups. It could be due to drinking a full glass of water before the meal, triggering satiety. Or there may be a problem with accuracy in recording food and exercise.
- The placebo and high dose were given three times a day and the low dose only twice a day, so participants were not really blinded. However it was a crossover trial so they knew the supplements would change and that defect doesn’t greatly concern me.
- Food intake was self recorded, but it was done on a daily basis so bias is likely to be small.
- Since the diet was apparently prescribed, we should have more information on it. Did it lower carbohydrate intake for the participants?
- We do not know if the study was done on people who already drink coffee. Since the study was done in India where people tend to drink tea, the addition of green coffee extract may be different than to people who already drink coffee.
- The trial was done on people who were overweight, not obese. Obese people are metabolically different from the merely overweight, and this group has yet to be studied.
- The trial was only 22 weeks, with supplementation given for 12 weeks. That is probably not enough time for a study dealing with weight and the follow-up was also minimal.
My conclusion is that the preponderance of evidence from human and rat studies indicates a likely but not proven effect on weight and perhaps more importantly the liver. While there is much to be studied, the supplement is safe, low in caffeine and seems to be without reported side effects. The participants may well have done other things to supplement its effect- most of us will do that too. It may or may not work as well with the obese or with people who already drink coffee. There is still enough for me to try it along with a low carb diet (since I am more concerned with fat loss than proving the effectiveness of the ingredient) but I am not expecting changes as dramatic as in the trial.
How Does It Work?
Michael Downey of the Life Extension Institute has an excellent review of research on green coffee extract and cites the research behind most of the points listed below. Otherwise in text links show references. Although research is at its early stages, there is evidence for multiple mechanisms of action. Research shows that green coffee extract interferes with glucose transport and the production and storage of fats; and promotes utilization of glucose and breakdown of fats:
- hydrolysis of the enzyme glucose-6-phosphatase irreversibly. This mechanism allows chlorogenic acid to reduce transformation of glycogen into glucose in the liver. s have been shown to inhibit the
- It reduces the absorption of new glucose.
- It reduces the formation of new fat by reducing the sterol binding proteins
- In addition animal studies have demonstrated chlorogenic acid lessens the hyperglycemic peak , so blood sugar (and blood insulin) will not spike.
- Green coffee extract inhibit the enzyme amylase, which breaks starch into sugar so would decrease the absorption of sugar and calories. (So don’t take digestive enzymes with your food.)
- It inhibits pancreatic lipase which breaks down fats.
- It interferes with the absorption of glucose molecules in the small intestine and sends them to the distal end of the small intestine where they are less likely to be absorbed.
- It inhibits the enzyme alpha-glucosidase, which breaks apart complex sugars and enhances their absorption into the blood
- It detoxifies the liver.
- It reduces triglycerides.
- It increases glutathione but not as much as dark roast coffee.
- It increases insulin sensitivity by increasing signal protein for insulin receptors in the liver.
- Green coffee extract reduces fatty acid and cholesterol synthesis.
- Green coffee extract enhances whole-body metabolism, as shown by greater oxygen consumption.
- It alters body fat distribution.
There are two sets of reasonable dosage recommendations. Life Extension recommends green coffee extract standardized to 50% chlorogenic acids at 400 mg three times a day 1/2 hour before meals instead of Dr. Oz’s 800 mg twice a day dose given a half hour before the two largest meals with a glass of water. This is because people with a tendency to hypoglycemia could theoretically go too low and get dizzy or worse. The figure suggested on the Oz show seems to be a compromise of the values in the Indian trial, especially since there wasn’t a huge difference between the lower and higher doses. Doses lower than given in the low dose arm had shown a lesser effect in earlier studies. But there is nothing sacrosanct about the 800 mg figure and you should listen to your body.
As long as you purchase it from a reputable company I wouldn’t worry about excipients to keep the extract from flowing freely. That seems to be a marketing gimmick which doesn’t affect absorption appreciably. If there are multiple ingredients- for instance raspberry ketones- check for explicit numbers on each ingredient. Do not accept “1000 mg of a proprietary extract containing green coffee extract and …” because you can’t tell the dosage. There is probably fake green coffee extract out there after the Oz show so open a capsule, looking for a tan powder that tastes quite bitter if the source is questionable. If it tastes like mocha, it is fake.
Doing it Yourself
There are two ways to process green coffee yourself, making a brew or making a tincture. They are likely to offer a different balance of constituents since alcohol-soluble constituents are not always water soluble and alkaloids like caffeine may come out more strongly with water. The green coffee in the studies was first ground and then soaked in alcohol which then was evaporated to make a dry extract. If you need the coffee ground I suggest using a commercial grinder in the place where you purchase the beans. I have tried both a Vitamix and a Braun coffee grinder on my green beans, but since the beans are not dried and brittle from roasting, both methods left sizable chunks. Soak the ground coffee in 90 proof alcohol at a 1 g/5ml ratio for two weeks and strain out well, squeezing the bean powder. It is probably easiest just to take the tincture as is, but you will need to experiment with the dosage. Start with 30-60 ml three times a day a half hour before meals. You can also purchase the dry extract wholesale and add a reasonable amount to your coffee, taking it before meals. Or you can do a water extraction by either making a tea or mixing it in with coffee. This may extract different constituents and should be regarded as experimental. Add the green coffee to your usual coffee measurement because it dilutes the taste otherwise. Or put it in your French press and let steep before drinking. It is bitter but lacks the roasted aroma we usually associate with coffee.
I like the idea of combining the green coffee extract with dark roast coffee which has been shown to enhance weight loss, increase glutathione and increase vitamin E. The synergistic effects bring us closer to a whole herb beverage.
Sources are linked in the text, but special mention to:
Reduce Blood Glucose and Shed Pounds Fast Lifeextension.com
Randomized, double-blind, placebo-controlled, linear dose, crossover study to evaluate the efficacy and safety of a green coffee bean extract in overweight subjects full study Diabetes Metab Syndr Obes
See Related Posts:
I was asked about whether vinegar is a good thing to consume because of its effects on probiotic bacteria. The suggestion was based on the idea that the acidity of vinegar might kill off beneficial bacteria. The questioner heard that lemon juice might be better.
Acidity is measured by a scale called the pH scale which goes from zero to 14. Neutral is 7.0, acid is lower than 7 and alkaline is a number larger than 7.0. Your blood must stay within a very narrow range on the most barely alkaline side of neutral and if it threatens to go outside the range, your body automatically adjusts your breathing or urinary output to bring it back.
First off, the pH of vinegar and lemon juice are about the same and less acidic than a healthy stomach during digestion, which is between 1.5 and 2.5. (Wikipedia gives a wider range, but averages are not the same as optimal.) The pH of distilled vinegar is 2.4. When the pH gets low enough it triggers the esophageal sphincter to close, preventing acid reflux and after the food has been disinfected and broken down, it triggers the lower sphincter to open. So if you have reflux it is because your stomach acidity is too low (numbers too high) to close the sphincter and consuming vinegar or bitters before meals may help.
The bacteria in the gut evolved to survive in an acid environment. (Note the name in Lactobacillus acidophilious “Acid-loving”) When the acidity is insufficient, the bacteria won’t be happy, but it doesn’t need to be as low a pH as in the stomach which has special mucosa to protect it and needs to disinfect and break down food. Bile from the liver at a pH of 7.0-7.7 raises the pH of the food bolus after it leaves the stomach. The pH of the gut is probably around 4, which is what is needed by healthy gut bacteria. Fat breaks down in the gut along with the residual products that survived the stomach.
It would not be correct to say that because a high concentration of acetic acid is poisonous, that vinegar should be avoided. The dose makes the poison and virtually everything we need to take in – oxygen, water, essential minerals like iron and magnesium, essential fatty acids- is poisonous in a large enough range. Although pure acetic acid is classified as a weak acid, concentrated acetic acid is corrosive, and could attack the skin. Vinegar on the other hand protects the acid mantle of the skin which is needed by our protective skin bacteria. Why take it? The acetic acid in vinegar which is about the same acidity as our gastric juices, produces acetyls in the body which are fundamental to all forms of life. When bound to coenzyme A, acetic acid is central to the metabolism of carbohydrates and fats. This is why a spoonful of vinegar at meals is often suggested for dieters.
Note that while most table vinegars sold are 5% acetic acid (with a range of 4-8%), the base material may affect the pH of the vinegar itself. Balsamic vinegar has two different origins: true balsamic vinegar is made from a concentrated grape must, aged for years in a variety of different wooden casks. The commercial balsamic sold in supermarkets is typically made with concentrated grape juice mixed with a strong vinegar, which is laced with caramel and sugar.
If you want to make a good balsamic vinegar without all the additives, take a jar and fill it with white pine, balsam fir or other conifer needles that aren’t too resinous. Fill with apple cider vinegar and let soak, with needles covered, for 4 weeks. It isn’t dark, but it is tasty. My experiments with commercial wine vinegars have not been successful, but you would probably do well with a home made wine vinegar which tends to be stronger.
Distilled vinegar as shown below has no nutrient value, and I reserve it for cleaning because of its disinfectant value.
Nutritional Content of Vinegars (per cup)
|Balsamic||Apple Cider||Red Wine||Distilled|
|pH (most acidic reported)||2.4||3.1||3.2||2.4|
|Compiled from: Nutritiondata.self.com|
Now vinegar itself may be probiotic, much like kombucha, which is basically a vinegar grown on a sugar sweetened tea base. The mother of vinegar, also called Mycoderma aceti or scoby, is a biomass of mostly Acetylobacter bacteria which has been valued over history for producing vinegar, along with beneficial yeast. If you leave apple or grape juice or wine exposed to the air and protected from fruit flies, you may get wild acetylbacter and yeast, or more reliably you can inoculate it yourself to produce vinegar. Bragg’s vinegar for instance is not completely filtered and you can see small amounts of the mother. If you add it to a an acid juice and leave it in a warm place you will eventually see a round gelatinous mass floating near the surface or stringy pieces in earlier stages. This is the mother of vinegar.
You can also purchase mothers of vinegar from Northampton Beer and Wine, Amazon, a local brew and wine shop or use a kombucha scoby. (A mother of vinegar can also be used for kombucha- the bacterial masses are made up of a variety of organisms and they will each adapt differently to the base used.) Kombucha mothers, for instance have a predominance of Gluconacetobacter which makes gluconic acid from the glucose in the sugar -the Acetobacter will flourish instead when grown in apple juice where fructose predominates. Purists who grow kombucha (at least commercially where they can check it) may also have the probiotic yeast Sacchermyoces kombuchaensis. However kombucha which is fermented too long becomes an acid vinegar. All scobys and mothers of vinegar vary, especially since vinegar can be grown on wine, grape juice, apple cider, malted barley, rice, or a variety of other bases, provided they are sufficiently acid. Don’t worry about it too much unless you don’t like the flavor. If you are making your own and want to add herbs, do wait until you filter out your mother because I have killed mine by adding herbs during fermentation. (Makes sense- most culinary herbs help preserve foods from bacteria!)
I had an unexpected growth of a mother when I tried Paul Bergner’s recipe for colloidal magnesium: one part Philips Milk of Magnesium to five parts apple cider vinegar. I left one capped, about 2/3 full on my top shelf. When I returned eight months later there was a four inch thick mother.
Live vinegar then is quite good for your your probiotic organisms and I recommend it for your health. It helps break down food if you take it with meals, lowers blood sugar spikes, metabolize fat, makes magnesium available for cramps and can be a great live food.
- Does it matter if I eat acid-forming foods? Not when you look at the research. (acupuncturebrooklyn.com)
- Dietary Protein and Bone Health: A New View by Dr Karl Insogna (wisdom_magazine.com)
- Vinegar, lemon juice and lactic acid fermented fruits and vegetables can reduce blood sugar spikes, lower the glycemic index of foods being fermented and can cause weight loss. Information on how to make lactic acid fermented foods. (acupuncturebrooklyn.com)
- Phys Ed: Can Pickle Juice Stop Muscle Cramps? (well.blogs.nytimes.com)
- Vinegar or Acid Food Helps Blood Sugar Go Down (acupuncturebrooklyn.com)
- If you fall for this “water fad” you could damage your health. (mercola.com)
- How to make vinegar from leftover wine (gangofpour.com)
- Kombucha pictures from the Happy Herbalist (happyherbalist.com)
- Kombucha SCOBYS vs. Mothers of Vinegar (MOVs) (www.kombuchafuel.com)
There is a widespread idea among health-seeking eaters that one ought to avoid meat, dairy and other “acid-forming foods” in favor of vegetables. The theory is that your body needs alkalizing foods or acid blood will leach minerals from your bones . Generally the effect is to get people to eat more vegetables, but after reading about this for 20 years I have to say that the evidence for the theory itself isn’t compelling.
First, what is an acid-forming food? Lemon juice is acid but it stimulates the release of magnesium which alkalizes. Vinegar (another acid) gets classified both ways, but it does function similarly to lemon juice. The makers of alkaline water like Kangen believe that alkaline water makes the body alkaline. Generally meat, dairy, sugars and some fruits are shown on the “acidifying” side while vegetables, good oils and most fruits (except blackberries) are shown as “alkalizing”. Some of the foods on lists are backed by research from the 50s and 60s, while others are conjecture. The problem is that the body has complicated feedback systems, food is eaten in groups and at different times of the day and constitutions differ.
A healthy stomach secretes gastric acid at a pH of 1.5 to digest food, including meat, and that extreme acidity triggers the esophageal sphincter to shut. The acid kills disease-bearing organisms and opens the sphincter at the bottom of the stomach to let the food get treated by bile, probiotic organisms and the intestines. If you have reflux, you generally have too little acid, so the esophageal sphincter doesn’t close and the lesser acid bubbles up where it can cause harm. (Starting the meal with bitters can help your liver and stomach produce sufficient acid, but you may need to take betaine hydrochloride, especially if your gallbladder has been removed. ) So if your body is producing hydrochloric acid at an extremely low (acidic) pH of 1.5, how does eating beef with a less acidic pH of 5.5 hurt your body? And why would lemon juice with a pH of 2 be better than meat?
So is alkaline blood good for your health? Well no. First of all you need to keep your blood essentially neutral with the slightest alkalinity. Second eating acid or alkaline food has very little effect on your blood pH because you automatically breathe deeper or pee more (but it does affect urinary pH). And if it were an issue, why do alkaline conditions translate into disease? For instance, low-protein vegans with alkalizing diets tend to have alkaline UTIs. Mercola believes that alkaline water is only safe for short term detoxification. A study published in the Journal of Biological Chemistry found that alkalosis (rising cellular pH) causes alkaline-induced cell death as a result of altering mitochondrial function. Mitochondria are the powerhouses of the cell and their dysfunction causes serious diseases like diabetes and Parkinson’s. Researcher Robert Gilles, who has studied tumor formation and acidity found that tumors make their own acidity even in an alkaline environment. Scientists developing new anticancer agents that selectively kill tumor cells by interfering with the regulation of intracellular pH, have found that alkaline treatments do not have the desired effect – but strongly acidic treatments do. A Swedish well water study found that drinking either significantly alkaline or acid water was undesirable, which suggests that drinking water with a pH between 6-8 is best.
Some old studies did show that eating a high meat diet could stimulate the release of calcium in the urine, but that effect stops after a few weeks (and the initial studies were only a week or two long.) Ten years ago a research group at Yale and the University of Connecticut under Dr. Karl Insogna began investigating the effect of dietary protein on bone health, believing that to be true. Actually it proved that urinary calcium was not from bones, but caused by a more efficient calcium uptake in the gut from dietary protein.
The body has mechanisms to keep the pH (measure of acidity or alkalinity] within a very narrow neutral range of 7.38 and 7.42. If your blood pH is 6 (slightly acid) or 8 (slightly alkaline), you can sicken and die. So your body has a variety of ways to buffer acidity or alkalinity. The body regulates the acid/alkaline balance primarily through the amount of carbon dioxide ( CO2) exhaled in the lungs and the acidity of urine. If the blood pH drops too low and becomes acid, the body will compensate by increasing breathing, expelling CO2, so fewer hydrogen ions are free and the pH will rise back to normal. For too much alkalinity the opposite occurs. Any shifts in acid/alkaline balance in the blood are minor and transient.
As Wikipedia says:
The body’s acid–base balance is normally tightly regulated, keeping the arterial blood pH between 7.38 and 7.42. Several buffering agents that reversibly bind hydrogen ions and impede any change in pH exist. Extracellular buffers include bicarbonate and ammonia, whereas proteins and phosphate act as intracellular buffers. The bicarbonate buffering system is especially key, as carbon dioxide (CO2) can be shifted through carbonic acid (H2CO3) to hydrogen ions and bicarbonate (HCO3–) as shown below.
Acid–base imbalances that overcome the buffer system can be compensated in the short term by changing the rate of ventilation. This alters the concentration of carbon dioxide in the blood, shifting the above reaction according to Le Chatelier’s principle, which in turn alters the pH. For instance, if the blood pH drops too low (acidemia), the body will compensate by increasing breathing thereby expelling CO2, and shifting the above reaction to the left such that less hydrogen ions are free; thus the pH will rise back to normal. For alkalemia, the opposite occurs.
The kidneys are slower to compensate, but renal physiology has several powerful mechanisms to control pH by the excretion of excess acid or base. In response to acidosis, tubular cells reabsorb more bicarbonate from the tubular fluid, collecting duct cells secrete more hydrogen and generate more bicarbonate, and ammoniagenesis leads to increased formation of the NH3 buffer. In responses to alkalosis, the kidney may excrete more bicarbonate by decreasing hydrogen ion secretion from the tubular epithelial cells, and lowering rates of glutamine metabolism and ammonium excretion.
So my conclusion is that moderation is key, where water should not be significantly far from neutral and food should have a balance of acidity and alkalinity. Eat real food, organic pasture-raised meat, local fruits and vegetables and don’t sweat the pH.
I don’t endorse this chart, but it shows common beliefs about alkalizing foods. It isn’t that simple:
- Dietary Protein and Bone Health: A New View by Dr Karl Insogna (wisdom_magazine.com)
- Vinegar, lemon juice and lactic acid fermented fruits and vegetables can reduce blood sugar spikes, lower the glycemic index of foods being fermented and can cause weight loss. Information on how to make lactic acid fermented foods. (acupuncturebrooklyn.com)
- Phys Ed: Can Pickle Juice Stop Muscle Cramps? (well.blogs.nytimes.com)
- Vinegar or Acid Food Helps Blood Sugar Go Down (acupuncturebrooklyn.com)
- If you fall for this “water fad” you could damage your health. (mercola.com)
This month’s Scientific American has an article on a subject close to my heart, “Your Inner Ecosystem.” Only 10% of the DNA in our bodies is human. In other articles I have advanced the idea that we are walking colonies of microbes, worms and fungi in a human superstructure, where ecological balance is the goal of health rather than purity. That begs the question of which creatures might be pathogenic- I certainly don’t want ebola in my ecology. Not only doesn’t it play well with my other creatures, but it is deadly.
Ebola is easy to classify. However some organisms are difficult to classify. Acidophilous is great in your gut, especially if you have difficulty assimilating nutrients but it can eat away at your teeth where you might prefer Streptococcus oralis. There are benign E. coli strains, sold in Europe but not the USA as probiotics, which tend to predominate in thin people while firmiciute bacteria like the Lactobaccili predominate in fat people and can make thin rats fat. Even low level staph infections on the skin may crowd out nasty drug-resistant MRSA.
Heliobactor pylori is another example. This bacteria increases acidity in the stomach, resulting in both the environment where it thrives and breakdown of food. However in susceptible individuals, it causes ulcers. When Dr. Martin Blaser, now professor of microbiology and internal medicine at NYU found H. pylori 25 years ago, he approached it as a simple pathogen causing ulcers- and with antibiotic treatment ulcer diagnoses have reduced by more than 50%. But in 1998 he published research showing that in the vast majority of people H. pylori is beneficial, regulating the acidity of the stomach properly. H. pylori was also linked to a reduction in adenocarcinomas. In 2008 he found that H. pylori regulates ghrelin which tells your body to stop eating. When ghrelin levels are high you become hungry. After you eat -unless your H. pylori levels are low- ghrelin levels plummet. In a study of 92 veterans treated with antibiotics to lower H. pylori for ulcers, gained weight in comparison to uninfected peers. Lower H. pylori is also linked to higher diabetes rates.
One of the curious things is that two or three generations ago something like 80% of children were hosts to H. pylori. Now fewer than 6% of children have the appetite suppressing bacteria, perhaps because of broader-range antibiotics and the inclusion of antibiotics in meat production which could account for less exposure to seed the microbiota. There is apparently preliminary information suggesting a second mechanism for this where antibiotics silence bacterial signalling for undifferentiated stem cells to make tissue other than fat.
The hygiene hypothesis also may affect the acquisition of H. pylori. Water is cleaner. Plant food trucked across the country may contain fewer live bacteria. Increased C-section rates may prevent the transmission of a mother’s microbiota to the infant in the birth canal. We have fewer commensal bacteria now altogether and H. pylori is a stunning example of the reduction of a bacteria that can help keep us thin.
However it appears that adding H. pylori may not be helpful once you are fat and possibly the age of acquisition is important. In further experiments people who were obese and diabetic had higher levels of H. pylori. Researchers think lowering H. pylori with antibiotics might help lower A1c levels in diabetics. Is H. pylori exerting a U-shaped influence where too little and too much cause weight gain? We don’t really know. In the human body with all its feedback loops, direct interventions work quite differently than in petri dishes.
Still, farmers have known for some time that adding antibiotics and increasing starchy feed is the best way to get animals fat for market. When we do this to ourselves and our children, it should not surprise us if we get the same result. While it is not a likely single cause of obesity and diabetes, its effect may be far from trivial.
Your Inner Ecosystem: Jennifer Ackerman http://www.scientificamerican.com/article.cfm?id=ultimate-social-network-bacteria-protects-health
Endosymbiosis: Lynn Margulis http://evolution.berkeley.edu/evolibrary/article/_0/history_24
Ecological and Evolutionary Forces Shaping Microbial Diversity in the Human Intestine http://linkinghub.elsevier.com/retrieve/pii/S0092867406001929
Gut Reaction: Environmental Effects on the Human Microbiota http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2685866&blobtype=pdf
Immune Gene Evolution May Be Driven By Parasites http://www.dana.org/news/features/detail.aspx?id=22816
The Body Politic http://seedmagazine.com/content/print/the_body_politic/ (picture from this article.)
Gut Bacteria Do More Than Digest Food http://www.hhmi.org/bulletin/aug2010/features/gut_bacteria5.html
Swapping Germs: Should fecal transplants become routine for debilitating diarrhea? Maryn McKenna http://www.scientificamerican.com/article.cfm?id=swapping-germs