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Diet and the Gut: Pathway to Health (or Disease)


This year, the National Breast Cancer Foundation estimates that nearly 339,000 women and 2,710 men will be diagnosed with breast cancer. It is the second leading cause of cancer deaths among women in the US.

For the thousands of women and men afflicted with breast cancer, and many other diseases, the key to survival may be found in the gut. The same may be true for keeping cancer, heart disease and other killers at bay—look to the gut and the foods we put in it.

Two recent studies, for example, highlighted by the American Institute for Cancer Research, found that breast cancer survivors who eat a diet high in vegetables and low in fruit juice, and who avoid carbohydrate-packed diets, “have a lower risk of dying during an average of almost a dozen years after their treatment ended.”

In another study, by Maryam S.  Farvid, PhD, et al., researchers concluded that “high total fiber consumption was associated with a reduced risk of breast cancer.”

These are just a few of many studies with similar findings. The link between diet/nutrition and illness or health has never been stronger.

According to the National Institutes of Health, in a study using data from the Centers for Disease Control’s National Health and Nutrition Examination Survey, “nearly half of all the deaths in the US in 2012 that were caused by cardiometabolic diseases were associated with suboptimal eating habits.” Cardiometabolic diseases include heart disease, stroke and type 2 diabetes.

More recent, a 2021 study published in Nature Medicine confirmed that diet shapes the health of the body’s microbiome.

What is the microbiome? The National Institute of Environmental Health Sciences defines it as “the collection of all microbes, such as bacteria, fungi, viruses and their genes, that naturally live on our bodies and inside us.” These are microorganisms—literally trillions of them—of different types, found throughout the body in such places as the gut, on our skin and in our oral and nasal cavities.

Gut Microbes: The Good and Bad

Among their value to us, microbes that make up the microbiome protect us against the bacteria, viruses and microorganisms that can make us sick. The microbiome also stimulates the development of our immune system and enables us to digest food to produce energy we need to live and grow. The Harvard T.H. Chan School of Public Health The Nutrition Source provides a good overview of the microbiome and how it works to benefit the human body.

Some of the microbes in the body, however, can be harmful. And their harmful impact can be felt when the balance of good and bad microbes otherwise peacefully co-existing in the body is upset. This is called dysbiosis, and it can lead to health problems such as diabetes, liver disease, allergies, inflammatory bowel disease and others.

What causes the microbiome to change, resulting in dysbiosis? To answer this question, we must consider how our microbiome was formed in the first place.

As Harvard’s The Nutrition Source explains, each of us has a unique microbiome originally determined by our DNA and exposure to our mother’s birth canal and breast milk. In time, environmental factors, such as the air we breathe, chronic stress and diet can affect our gut microbiome.

Among the dietary factors that can contribute to dysbiosis and disease are high-fat diets, processed foods, sugar and artificial sweeteners such as sucralose, among others.  Studies have linked consumption of these unhealthy substances to the presence of microbial biomarkers for diseases including obesity, heart disease, type 2 diabetes and general inflammation, which over time can lead to cancer.

What can we do to restore and/or maintain a healthy microbiome and avoid dysbiosis?  One clear approach, with 70%-80% of the body’s immune cells present in the gut, is to focus more on feeding the gut foods that are healthier for the microbiome, cutting out the foods that lead to dysbiosis.

Improving Gut Health

Foods naturally containing microbiota that can improve gut health include high-fiber foods, which generally include many fruits, vegetables, beans and certain grains.  Garlic, onions, leeks and asparagus are specific examples. These foods are considered prebiotics due to their makeup that feeds the beneficial microbiota in the gastrointestinal tract.

Sometimes, individuals who may have less robust microbiomes, such as older adults, or in cases where the gut biome has been disrupted by antibiotic use, medical professionals will prescribe the use of probiotics—supplements that contain live bacteria to restore balance in the gut.

The probiotics market in 2021 was valued at more than $58 billion and is projected to grow at a rate of 7.5% per year through 2030.

Probiotic foods include kefir, yogurt with live cultures, kimchi, sauerkraut, kombucha tea and pickles.

What the Employer Can Do

Executives concerned about the health of their organizations can take positive steps by helping improve the diets of their individual employees.

We all know that eating right makes good sense.  But do we understand how much the foods we eat contribute to disease, exacerbate chronic conditions, reduce productivity and add cost to our benefit plans?  And do we know the simple steps we can take to make big improvements?

In a 2019 study, researchers estimated that $50 billion in US healthcare costs resulted from poor diet leading to heart disease, stroke and diabetes.  That’s nearly 20% of total US healthcare costs annually.

Examining the specific drivers of cardiometabolic disease in the study, the researchers blamed low consumption of nuts and seeds as well as seafood omega-3 fats as the top causes of diet-driven costs.  The lowest annual per-capita costs were attributed to high consumption of red meat and polyunsaturated fats.

Recognizing the impact of poor diet on health and the cost impact of cardiometabolic disease and other problems, health benefit leaders can respond with policies and programing that improves employee awareness and encourages healthier food choices.

Many employers have worked to support better nutrition for their employees through any number of measures, such as swapping out candy and other nutrient-poor foods in favor of nutrient-rich foods in vending machines and cafeterias. Employers have also provided access to nutrition counsellors, developed partnerships with local farms to supply fresh, unprocessed food, donated to local food banks and promoted their offerings, and lobbied lawmakers to promote government programs serving populations in need of assistance.

The Workplace Health Research Network, a project of six leading academic centers, offered nine tips employers can follow to improve their employees’ nutritional knowledge, access to healthier food choices and build an organizational culture that promotes better nutrition habits.

In Curally’s program, our nurses work directly with plan participants to explain the benefits of a better diet and map out nutrition plans. Individual coaching and follow-up by the nurses are keys to their being effective in helping plan participants make better choices, improve their health and transform their lives.