Published: Feb 13, 2015
Author: BioCeuticals - Editor
Michael Ash is an osteopath, naturopath, clinical nutritionist and immunologist with some 30 years experience. Over this time he's built and sold one of the largest integrative health clinics in the UK. He's published innumerable papers, book chapters and given seminars to over 20,000 clinicians on the role of the mucosal-immune system and its relationship to health.
Click here to listen to the full podcast "Gut-Immune Axis with Mike Ash".
Andrew Whitfield-Cook: Mike, your lectures are foundational to the way that many practitioners think and practise because of the way you treat from the ground up, rather than symptomatically. Tell me what you’ll be talking about at the 3rd BioCeuticals Research Symposium.
Michael Ash: There are some really fundamental elements that I’ll be covering which relate to what you actually end up consuming. But the reason why you choose that food to eat or that food supplement to consume is going to be explored in a much greater level of detail than perhaps many would be familiar. We've been moving more and more towards this understanding that molecular tissue changes can be modified by food selection and lifestyle activity and if you understand some of the mechanisms that relate to whether some of these changes are going to be helpful or unhelpful to you, then you can begin to unpick your patients’ or your clients’ needs in a far more sophisticated way. But to do that requires a pretty good understanding of what takes place in the mucosal-immune system. Dietary impacts on health is probably one of the oldest concepts in medicine but it’s only in recent years - and by which I mean in the last two decades - that technical advances in analysis, including mass spectrometry, gnotobiology and bacterial sequencing has enabled us to understand the role of our human physiology to the point where we can isolate individual dietary components to affect specific illnesses. And so using specific dietary intervention gives us some really exciting potential for nontoxic physiological ways to alter the bacterial composition of our gastrointestinal tract, the related metabolic responses of those organisms, and then to alter the natural history of both the intestinal or local damage and systemic disorders.
AWC: Let’s talk about microbial metabolic fitness. What does the latest research show us?
M: Mitochondria receive signals from the caloric intake of the food that we have. One of the ways in which our metabolic functionality deteriorates - whether we say it’s type 2 diabetes or cardiovascular disease, metabolic dysfunction has a direct relationship to mitochondrial function. And metabolic fitness is a reflection of mitochondrial fitness and as we age, this is the sort of information that you’ll grasp to your chest, which is that if you ironically starve your mitochondria, if you deny them access to any food, they become more robust for a period of time. If you deny them food for too long, eventually they will start to disintegrate. The skill has been trying to work out what type of caloric restriction, what type of patterning works most effectively, and secondly what type of food you follow up with after that period of restriction provides your mitochondria and your metabolism with the best chance of maintaining a non-inflammatory state. So I’m going to be describing how different types of studies, mainly in mouse models but increasingly in human studies now, show that the way you advise people to choose timings of food as well as types of food really add some fuel to your outcome.
AWC: This is talking about fasting and refeeding with regards to dampening or reducing autophagy?
M: It’s a question of inducing and reducing inappropriate autophagy. The way that we tidy up mitochondria has its own little name; it’s called mitophagy. So in order for the enzymatic clearance of ancient mitochondria is done efficiently it requires us to utilise parts of mitochondria to inculcate those into their allies - which are the mitochondria that are not yet at the point where they are irrecoverable - and utilise that a bit like a recycling system. But if that recycling has been restricted because the way that we remove the particulates has become compromised - it’s a bit like your backyard being filled with rubbish when supposedly it’s been taken away efficiently. For example, time-restricted feeding is one of the ways of exploring nutrient imbalance, in other words to eat inappropriately for a period of time, and the hardest battling is no matter how positive or enthusiastic you might be as a person who recommends a lifestyle change to your poorly compromised human, it has to be translatable. It has to be something they can incorporate into their lives that it becomes repetitive and something that they enjoy. We’ve been looking at what type of way that you can advise people, based on solid outcomes that we’ve watched, to see how you would choose a technique of feeding that improves metabolic fitness via microbial and mitochondrial fitness - that includes periods of not eating. One of the most interesting ways is that you don’t eat except in an established 8 hour period during the week, so you have 8 hours where you can eat to a degree as much as you wish but outside of that 8 hours you don’t eat but you can consume liquid. The mouse models that are running on this look very impressive.
There’s no doubt no one has the entire answer. But the overall overarching statement you can make is that overeating tends to increase morbidity, reducing the total food intake whilst maintaining appropriate nutrient density across all mammals seems to demonstrate improved metabolic fitness and enhance quality of life for longer. We see the opposite in clinic most of the time - we see overeating and people doing everything they can to bring their quality of life to a close rather than doing all that they can to stretch that out to gain the most potential for longer.
AWC: This smacks true for practitioners who incorporate detoxification practices with their patients and I’ve got to say I do feel a lot of people don’t do detoxification well. Can you please tell me how important it is to first rejuvenate the gut before attempting any detoxification?
M: There’s often an enthusiasm to assist elimination ahead of restoration and it’s probably one of those decisions that are often made because protocol-driven care makes life much easier but it fails to recognise the individual needs of the person you’re seeing. My colleague Dr Joseph Pizzorno has a lot of information on toxic insults and how the gastrointestinal tract is such an important part of how we neutralise those risks and eliminate them. I would reinforce that by saying that if you ask somebody to give up agents they’ve worked very hard to store in an attempt to protect themselves from that agent, if we then say let’s stimulate various bioremediation pathways by increasing availability of key nutrients necessary to make those enzymes work more efficiently, but we don’t have a reasonable robust immune and bacterial composition of the GIT - which is where the majority of this will end up - we create a disturbance in that already compromised bacterial community. The systemic messages that challenge them induces can be catastrophic. It’s not good enough for the clinician to say this is a healing climax or a herxheimer response and hang in there, you’ll get through with it. It fails to understand and articulate appropriately the care necessary to achieve a safe and effective detoxification. And it sometimes means that protocol therapy has overridden conscious decision making by listening to the patient that describes to you what they want. So I say that your bacterial companions, your mucosal system, should be assessed prior to anybody undertaking a fasting induced detoxification or a bioremediation-induced combination of fasting and specific foods designed to aid that process.
AWC: A herbal compound that we have used in treating depression and things like that and it’s tied in with gut - and that’s curcumin. What role do you think curcumin plays in this?
M: The real joy of humans is that in order to survive as long as we have we have built into all of your tissues an incredible capability of utilising multiple signals in the space of overabundance and underabundance. No two indigenous populations consume exactly the same diet so we have acquired a huge capability of extracting from certain food compounds vital elements that facilitate our longevity. Then we spent the last 50-60 years beating up that incredible diversity to make sure that we favour agricultural and petrochemical industry selected 6-7 primary foods. Then we say something’s missing - let’s go and find a single component of which curcumin, tremendously researched and lots of potential benefits. But essentially what we are saying with curcumin is here is an anti-inflammatory, has multiple points of intervention, it changes multiple different pathways but in a fundamental way we are targeting that primary component of those finite responses, which is inflammation, which in turn switches off some of the immune dysfunction, which in turn reduces oxidative stress. So where we say we have unlimited insults but finite responses the temptation is to look for those finite responses and right at the very beginning I said we needed to have a multi-layered iterative strategy, which includes removing some of those insults, for which curcumin on its own as a suppressor of the insult, has a limited long term capability but without a doubt as part of our overall work - a very reasonable and safe herb to include.
AWC: It is really exciting that you are coming out to visit us again for the 3rd BioCeuticals Research Symposium. I look forward to what clinical pearls we can glean off you then.
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