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The trillions of microbes in our gut play incredibly important and complex roles in our health. I’ve written several articles on the gut microbiome and its connections to:

• skin health 
• allergies
• food cravings
• bone health
• ocular health
• the thyroid
• autoimmune disease
• brain health
• heart health

Because the health of our gut microbiome is so important, I’ve also extensively discussed why we should think twice about taking antibiotics. Thanks to more widespread appreciation of the gut microbiome, more and more patients and doctors understand the potential negative impacts of antibiotics on normal healthy bacteria. But a study published in March of this year suggests that many non-antibiotic drugs can also affect the microbiome. In this article, I’ll break down the findings of this study and discuss whether this is truly cause for concern.

Drug–microbe interactions

The interaction of drugs and the microbiome is not a new concept. It’s been known for quite some time that microbes influence the efficacy and toxicity of drugs, and several studies had previously found that metformin (1), PPIs (2), NSAIDs (3), and atypical antipsychotics (4) can all alter the composition of the microbiota.

Antibiotics can have adverse effects on the gut microbiome, but did you know that nearly a quarter of non-antibiotic drugs can as well? Learn which of your prescriptions might be influencing your gut microbiome – for better or for worse 

However, the effects of many other non-antibiotic drugs on the microbiome had never been assessed, even though many have known gastrointestinal side effects. The goal of this study, therefore, was to systematically profile interactions between drugs and individual gut microbes. It was titled “Extensive impact of non-antibiotic drugs on human gut bacteria” and published in the journal Nature.

For the study, the authors monitored the growth of 40 human gut isolates comprising 38 different bacterial species, which were grown in an anaerobic medium that largely “recapitulates the species relative abundance in human gut microbiomes.” The species were chosen based on their prevalence and abundance in the healthy human gut microbiota and their phylogenetic diversity. Most strains were commensal, or normal, gut flora, but the set also included four potential pathogens, including Clostridium difficile and the probiotic strain Lactobacillus paracasei.

They tested 1,079 pharmaceuticals that are commonly administered to humans, including:

• 835 with targets in human cells
• 156 with antibacterial activity (144 antibiotics and 12 antiseptics)
• 88 with antifungal, antiviral, or antiparasitic activity

Drugs have widespread activity against beneficial microbes

Unsurprisingly, many of the antibacterials tested had broad-spectrum activity, meaning that they inhibited pathogenic bacteria but also inhibited normal commensal bacteria. Of the 156 antibacterials tested, 78 percent were active against at least one commensal species, and most had activity against many potentially beneficial microbes. Additionally, 47 of the 88 antifungals, antivirals, and antiparasitics had anti-commensal activity.

The most novel finding, though, was that 203 out of the 835 human-targeted non-antibiotic drugs showed activity against normal gut microbes. That’s almost a quarter (24 percent) of non-antibiotic drugs having a significant effect on the gut microbiome. Most of these drugs only inhibited the growth of a few strains, but 40 drugs affected at least 10 strains!

The effects weren’t limited by drug class, either. Almost every type of drug tested showed some activity against normal gut flora. I’ve listed the categories below, along with the specific names of drugs that affected more than 10 microbial strains:

• Cancer therapies: 8-azaguanine, 5-fluorouracil, floxuridine, tamoxifen citrate, amethopterin, etoposide, doxorubicin hydrochloride, streptozotocin, aprepitant
• Anti-inflammatories: diacerein, anthralin, auranofin, methotrexate, zafirlukast
• Antihistamines: loratadine (Claritin), terfenadine, clemizole, astemizole
• Antidiabetic drugs: troglitazone
• GI disorder drugs: pinaverium bromide, oxethazaine
• NSAIDs: tolfenamic acid
• Antipsychotics: methiothepin maleate, thioridazine hydrochloride
• Antihypertensives: felodipine
• Antiarrhythmics: amiodarone hydrochloride
• Anticoagulants: dicumarol
• Hormones or hormone modulators: estradiol valerate, diethylstilbestrol, diestrol, tiratricol (thyroid hormone analogue), clomiphene citrate

The microbes affected

Microbial responses varied by drug, but the abundance of key commensals Roseburia intestinalis, Eubacterium rectale, and Bacteroides vulgatus were among the most sensitive. R. intestinalis and E. rectale are known producers of the beneficial microbial metabolite butyrate, a key promoter of gut barrier integrity, while B. vulgatus is an important producer of the metabolite propionate, which stimulates the release of gut satiety peptides and has been shown to help prevent weight gain (5). The authors write:

Overall, species with higher relative abundance across healthy individuals were significantly more susceptible to human-targeted drugs. This suggests that human-targeted drugs have an even larger impact on the gut microbiome, with key species related to healthy status […] being relatively more affected. (6) 

They also stressed that the doses used in the study to probe drug–microbe interactions were well within physiologically relevant concentrations and that their data are likely to underestimate the impact of human-targeted drugs on gut bacteria.

Lastly, there was a strong overlap between resistance against antibiotics and resistant against non-antibiotic drugs, suggesting that consuming non-antibiotic drugs could potentially increase the risk of acquiring antibiotic resistance.

On-target or off-target effects?

I want to stress that there is still much we don’t understand here. For instance, is an altered gut microbiome an on-target or off-target effect of the drug? As the lead author on the study, Dr. Peer Bork, pointed out in a press release, “This shift in the composition of our gut bacteria contributes to drug side-effects, but might also be part of the drugs’ beneficial action” (7).

In other words, your prescription might only be working because it is changing your gut microbiome. For example, metformin, a drug commonly used to treat diabetes, has been shown to alter the gut microbiome, increasing abundance of the beneficial microbes Akkermansia muciniphila, Butyrivibrio, and Bifidobacterium bifidum (8). Transplanting fecal material from humans receiving metformin into germ-free mice has been shown to improve glucose intolerance, suggesting that the microbiome is responsible for the therapeutic effects (9).

All that being said, metformin seems to be the exception, not the rule—it’s clear that many of these drugs are negatively impacting microbial composition. These off-target effects on the microbiome suggest that treating one disease with a pill could potentially be causing another disease down the road. In other words, taking a proton pump inhibitor might help control your acid reflux in the short term, but it will also cause a shift in your gut microbiome that predisposes you to irritable bowel syndrome (10), gut infections (11), liver disease (12), and other conditions.

While pharmaceuticals can be a valuable tool in the management of disease, this study further supports the notion that if we can address the root cause of disease and support a healthy gut microbiome, we’re much more likely to achieve lasting, long-term health.

Now I’d like to hear from you. Did you know about the effects of non-antibiotic drugs on the gut microbiome? Start the discussion in the comments below!

The post The Effects of Non-Antibiotic Drugs on the Microbiome appeared first on Chris Kresser.

http://www.thekitchn.com/feedburnermain

I’ve written a lot about meal planning and meal prep on Kitchn. In fact, I had (what I thought was) an efficient, tried-and-true system. I even thought of myself as somewhat of an expert on the subject, helping friends and family adopt a system that worked for them.

Then last year I wrote a cookbook on one-bowl meals called Buddha Bowls, and it changed everything. At first it totally turned my beloved meal prep routine upside down, but now — after working out the kinks — my system is better than ever.

These are the best meal prep lessons I learned from developing over 100 recipes and writing a cookbook all about one-bowl meals.

READ MORE »

http://www.thekitchn.com/feedburnermain

The shelves of bread at my local grocery store are a dazzling display of nut, seed, and grain diversity. Just a handful of producers offer more than 20 kinds of wheat breads in flavors like Honey Chia, Oatnut, and Quinoa. Some are thin-sliced and some are “long loaf,” and they can sport anywhere from just a few grains to a whopping 24.

It’s a lot to take in.

Of course, at the core of this seemingly endless array is the standby that pleases both health-minded adults and picky toddlers alike: plain ol’ wheat bread.

READ MORE »

http://www.thekitchn.com/feedburnermain

Just about all of our small appliances work with electricity, which means: cords! And the slow cooker is no exception. More than other occasional-use appliances, you want to be careful with your slow cooker’s power cords.

Why? Because you leave it going for hours on end — I mean, the whole point is to set it and forget it! And many of us start something in the slow cooker before work and leave it doing its thing all day, by itself, in the house. As I write this, I realize it sounds very risky, but reading through various manuals makes it seem totally fine. Phew.

Where all these manufacturers do want you to be extra-mindful, though, is with a slow cooker’s cord.

READ MORE »

http://www.thekitchn.com/feedburnermain

We started this website to help people cook more often and more joyfully, with the idea that the kitchen is the hearth of the home, the warm place. It is by spending time there that we connect and grow.

But sometimes it gets so hot in the summer, you have to draw the line. A few straight days of humidity and 90°F weather, and I do not feel like being in the kitchen at all, let alone putting together a big meal.

READ MORE »

http://www.thekitchn.com/feedburnermain

Just because the weather is finally warming up doesn’t mean you have to say goodbye to soup! Especially when you have an Instant Pot, which frees you from having to use the stove.

For those chilly spring and summer nights when you’re craving something nourishing and warm, this soup — packed with farro, chicken, and veggies — will comfort you like nothing else can.

READ MORE »

http://www.thealternativedaily.com/

If your toenails are changing color and starting to thicken, you may have onychomycosis — a.k.a. toenail fungus. This common condition begins with a white or yellow spot under the tip of the nail. Eventually, the fungal infection will travel deeper, beginning to discolor, thicken, distort and crumble the nail at the edge. And while […]

http://www.thealternativedaily.com/

“Mmm, I want a bit of sewage sludge to start my day,” said no one, ever. In today’s modern society, we are so far removed from where our food comes from. However, if most people knew what was going on behind the scenes, they would definitely consider becoming vegetarian before learning to grow all (or […]

https://www.girlsgonestrong.com/

You’re not sure what’s going on, why you keep doing this to yourself, or if you can stop.

You’re scared of putting on weight, you’re disgusted with your actions, but the absolute worst part is how out of control you feel. It’s like you can’t trust yourself anymore.

You’ve tried everything and nothing seems to work.

I know you don’t believe me yet, but you absolutely can stop binge eating. Thousands of people have gone through this, and have moved past it. I’m one of them, and I know you can do it too. That’s why today I’m sharing with you some of my essential tips to help you stop binge eating for good.

Realize That Binge Eating Is Not Your Identity

Yes, you’ve binged in the past, but that doesn’t mean it defines you, and it doesn’t mean you’ll be like this forever.

I’ve done loads of stuff that goes against who I actually am, and I’m sure you have too (we were all teenagers, after all!). It just means that your actions in that moment didn’t align with your values. It doesn’t mean that’s who you are, and it doesn’t mean you won’t ever stop.

I know, you keep telling yourself you’re lazy and disgusting but — think about it — if you actually were lazy and disgusting, then you’d feel fine. You’d even be proud of it!

The very fact that your actions are bothering you shows what a mismatch it is for the person you actually are. The fact that you’re beating yourself up about it shows that this is not what you value.

If you define yourself as unfit, out of control, or having no willpower, then you’re setting yourself up for failure. So rather than labelling yourself as “a binge eater,” rather than telling yourself “I’m out of control,” realize that there is nothing wrong with you.

In fact, you’re actually trying take care of yourself.

There is nothing wrong with you. You’re not lazy, or disgusting, and you are not a “binge eater.” It’s just an action you’ve done in the past, and it won’t be forever.

It’s natural and normal to want to feel better. It makes sense that you want to feel better if you’re feeling lousy. So, even though binge eating might not be your ideal response to a tricky situation — or to difficult emotions — what you’re doing when you binge is actually valuing your existence by trying to make yourself feel better. And that is both normal and human.

Find the Good Amidst the Bad (Then Celebrate and Emulate)

No matter how bad it seems, there are always things that are going right. The trick is to find those good parts and clone them so that they take up more space in your life.

Maybe you only binge when you get home after work. Maybe there’s only actually two or three hours each evening where there’s a strong urge to binge. Right now you’re focused on that time, because it’s the behavior you want to change, but think about it: for 21 hours of the day, you don’t want to binge.

That’s awesome. Seriously. That. Is. Awesome. Fist-pump the air, and give yourself credit. I mean it. Celebrating every win, no matter how small, is going to be the quickest way to end binge eating. Once you’ve found a win and fist-pumped the air, ask yourself:

• What’s different about the times when I’m not binge eating or don’t want to binge eat?
• Where am I when I don’t want to binge?
• What activities am I doing?
• Is there some way I can emulate these conditions?

For me, it really helped to be around other people. So a way to emulate those conditions might be to invite people over for dinner more often, or go to their house.

I’d also go straight to the fridge the second I came home. So I started coming up with activities I could do to delay that action. Take a bath, talk to a friend, listen to loud music, take some deep breaths — do whatever it is that you enjoy that will help you interrupt the pattern when those binge urges would normally take over.

Maybe you notice that you feel more prone to binge after you’ve had a bad night’s sleep, or when you’re stressed, anxious, or worried. Is it possible to get more sleep? Can you plan to get more time in for your well-being in general?

Taking care of yourself is important. No one ever binged when they were feeling at ease and at peace.

Dedicating time just for yourself is going to be crucial to stop binge eating for good.

If you’re not sure where to even start, try making a tally chart of the number of times you catch yourself daydreaming about food. This will make you more aware of your thoughts, which means you’re more likely to be able to catch yourself and say:

• “OK, I’m thinking about food. Does this mean I need something else right now?”
• Or maybe just “OK, this isn’t helpful right now. Let’s focus on something else.”

It will also make you aware of how often your food thoughts aren’t occurring:

“OK, so today I caught myself fantasizing about food 37 times, but how many thoughts go through my mind throughout the day? I’m not thinking about food all of the time. So when am I not thinking about food? Can I do more of that?”

So, no matter how horrible and hopeless it feels, there are always good things to find amongst the bad. Once you find them:

1. Celebrate. You’re living with your values for the majority of the day. You didn’t binge yesterday. You got out of bed today. Booyah!
2. Emulate. How can you clone these wins so there are more of them in your life?

Watch Those Hunger Games

When you aren’t sure if it’s real hunger or fake hunger that’s calling you, that’s what I call “Hunger Games.”

Along with that tally chart I mentioned in the previous step, whenever a food thought popped into my head, I’d rate my hunger using this scale:

1. I’ve gone way past my initial hunger cues. (“Hangry” territory.)
2. Pleasantly hungry. (This is a great place to start eating.)
3. Not hungry, not full. Neutral.
4. Pleasantly satisfied.
5. Stuffed. I feel sick.

If a food thought pops into your head, try rating your hunger. This will give you a better idea of when you’re experiencing real hunger, or when it’s fake hunger that’s calling you.

Remember that fake hunger arises suddenly. There’s an urgency to eat, and eating never actually satisfies it. If you’re not sure what kind of hunger you’re experiencing, just set a timer for five or 10 minutes, then reassess.

I know the thought of being hungry can be scary, but if you’re reading this then it’s more than likely that you have plenty of food available around you, all the time.

Take a deep breath and try to tune into your real hunger. Once you do this, you’ll see for yourself that it’s not as scary as it seems. In fact, it’s a totally natural human experience: your body is gently letting you know that it needs some fuel. You might even find that food tastes better when you allow yourself to be slightly hungry.

If you eat when you’re not hungry, please don’t judge yourself for it. You’re getting used to being back in tune with your body, and that takes time.

Besides, no one eats only when they’re hungry. That’s just not realistic, so there is absolutely no need to feel bad about it.

Make a Plan for Your Kryptonite Foods

Kryptonite foods. We all have them. They’re the foods that drive you wild, make you weak at the knees. For me, it was peanut butter, brazil nuts and chocolate (and especially chocolate covered brazil nuts!)

While the effect these kryptonite foods have on you will lessen over time once you stop any restriction, it’s a good idea to lay out some boundaries for your relationship, until you can start seeing each other on equal terms again.

Here are some ideas for your kryptonite foods:

• Eat this food while other people are around or you’re out in public
• Order this food in a cafe or restaurant and eat there
• Buy a small, individual packet to take home with you. This will minimize the “eat me” effect, where you leave a packet of something in the cupboard and it keeps calling you, over and over, until you’ve finished the whole
• Rather than eating straight out of the packaging, or while standing up, put it on a plate or in a bowl, then sit down with it, and do your best to focus your attention, and savor it.

This is not an exhaustive list, so feel free to come up with ideas that are going to work exactly for your personal situation. The key here is to create a supportive environment for yourself.

There is no need to invite more struggle into your life.

Remind yourself that this is not forever, and that you can trust yourself. It’s just, for now, you’re choosing to not have those foods at home because it makes your life easier.

Feel Your Tongue

How many times have you inhaled an entire box of chocolates without even noticing? You almost black out and wake up later, having no real recollection of eating, apart from the pain in your stomach.

The way to minimize a food blackout is to focus your attention on the food. Bring awareness to your tongue. How does your tongue feel? How does the food feel, and taste?

It might be useful to rate the taste between 1 to 10, with 1 being “This is gross!” and 10 being “Best. Meal. Ever.” Maybe you notice that the first few bites are amazing (a nine or 10), but that the taste diminishes as you continue to eat.

If your first few bites aren’t at the high end of the scale, this might be an indication that you weren’t hungry, or you didn’t pick what you actually wanted to eat.

You can also ask the “Next Bite Question”: will this next bite make me feel better (emotionally, physically, and psychologically)? Will it move me in a direction towards health and wellbeing, or will it move me away from my goals?

When you bring awareness to your tongue, rate the taste and ask the next bite question, you not only minimize the chance of a food blackout, but you can end meals more easily, and walk away from food because you know you’re done.

Realize You Are Always in Control

I know it doesn’t feel like it, but unless someone is physically tying you down and forcing you, you are 100 percent in control of the food you’re putting into your body. In any moment, you have the power to decide whether to take a bite, or not.

For me, there was a great insight when I gave myself permission to binge. So rather than trying to fight this strong urge inside me, I’d say to myself:

“I’m having the thought that I want to binge.”

By labelling your thoughts you can reduce the effect they have on you. From here, you can ask yourself if this is something you actually want to do, or not. The conversation in my head would then go something like this:

“OK, I hear you. And I can totally binge if that’s what I want to do. But has this ever been a good idea in the past? Have I ever been glad after a binge?”

The answer was always no. But the fact that I acknowledged how I felt, and gave myself the freedom to do whatever I wanted, meant I could logically assess what I actually wanted to do. And from there, I could choose to nourish myself in a different way, or I could choose to binge eat.

If I decided to binge, I’d give myself full permission to do it, but I’d try to do it as mindfully as possible (feeling the food on my tongue, as discussed above).

No matter what I decided, I felt back in control of my actions. It made me realize that I always had a choice.

To Sum It Up

Try not to judge yourself for binge eating. I know you want to stop, but try to recognise that — in those moments — you are trying to make yourself feel better. To want to feel better is normal and human. It’s OK.

Realize, too, that you are not alone. Binge eating is a very common response to dieting (and other trauma) and lots of people go through this. That’s why it can be extremely helpful to reach out to others who are going through this, or have gone through this before. Seeking professional help can also be an incredibly valuable part of your journey.

The post 6 Essential Tips to Help You Stop Binge Eating appeared first on Girls Gone Strong.

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