How Does Your (Gut) Garden Grow?
Nutritionist Kathie Madonna Swift argues that drugs, stress, and poor food choices are causing obesity, and that nurturing your digestive bacteria is the fastest way to lose weight
By Rachael Combe September 26, 2014
Photo: Hans Gissinger/Truck Archives
For decades, farmers have been using antibiotics to fatten up their livestock—they don’t know exactly how it works, but it does. Want to build a bigger chicken? Mix some bacteria-killing drugs into its feed. Research has suggested that this principle might also apply to humans: Some scientists speculate that all the antibiotics we’re prescribed, beginning in infancy (American children are, on average, prescribed at least one course of antibiotics per year), may be playing a role—along with our overly processed diet—in the expansion of our waistlines.
Kathie Madonna Swift, a holistic nutritionist based in western Massachusetts, has gathered quite a following over the years through her work at various health centers in the Berkshires: Clinton-family health guru Mark Hyman’s UltraWellness Center, Canyon Ranch, and, now, the Kripalu Center. In The Swift Diet (cowritten with ELLE contributor Joseph Hooper), Swift hypothesizes that the onslaught of drugs and nutrient-free food has damaged our “microbiota”—the array of bacteria that live in our bellies—transforming what should be friendly flora into fat-harvesting frenemies that turn our digestive health upside down and make our thighs balloon. Fear not, there is a cure—but be warned: It does involve a whole lot of arugula.
You coined the term “irritable weight.” What does that mean?
Kathie Madonna Swift: Over the years, I’ve worked with so many women who have struggled with weight issues and who have also been trying to manage their problem digestion. I see irritable bowel syndrome (IBS) and being overweight as two faces of the same problem.
Your book is about weight loss and healing the microbiome of the stomach—and yet you begin by talking about the brain. Why?
It’s the big missing piece in most weight-loss approaches. I do these weeklong seminars, and it’s always an aha! moment when I tell people about research showing that chronic, unremitting stress affects the microbiota and that, in turn, the bacteria influence neurotransmitters in our brain, affecting not only our digestion but our emotions, too. There’s a lot of research with animals showing that changing their gut microbiota can radically change their behavior—making timid mice act more boldly, for example. And in humans, stress can alter the amount of mucus in the stomach, which affects the strains of bacteria that thrive there, which in turn can affect the chemical messengers that link the whole gut-brain connection.
How would bad gut bacteria cause weight gain?
What we think happens is that, all too often, beneficial microbiota are not fed, not tended to, not nourished with what they need, which is a plantcentric, fiber-rich diet. They’re getting too much sugar, too much unhealthy fat. They’re getting wiped out by overuse of antibiotics. There’s a decline in healthy bugs, and opportunistic bugs begin to flourish. When that happens, there’s a shift in intestinal permeability—some scientists have referred to it as the opening of the biological doorway. You want nutrients to get through the gut wall into the bloodstream, but you don’t want unfriendly organisms, pathogens, or big protein molecules to leak through.
Is that “leaky gut”?
Yes, but I’m still keeping watch on other mechanisms that might be at play. As with most anything in nutrition or science, you can’t put all your eggs in one basket. But when these bad things seep through, they cross-talk with your immune system and set up low-grade, chronic inflammation and a shift in energy balance. In some individuals, these bugs become energy harvesters and storers. There’s evidence, for example, that American kids, who get so many antibiotics and live in such a hygienic environment, are missing bacteria that keep the hunger hormone ghrelin in check. Lose the bacteria and you lose control of your appetite.
So what do we have to give up, and what should we eat to properly feed our microbiome?
You have to eliminate what I call the micromenaces—first, foods with high carbohydrate density. I use the example of a rice cake. It seems so virtuous, but its carb density is actually very high because there’s nothing to it—it’s all carbs, whereas foods that are often not allowed on low-carb diets, like fruit and sweet potatoes, contain a lot of fiber and water along with the carbs—so their carb density is lower. Cut out sugar, of course, and unhealthy fat: the mass-produced vegetable oils and trans fats. And then there are specific potential gut irritants: gluten, lactose, the additives and chemicals in processed foods that might be playing a role, alcohol….
You cut out all that forever?
No! Once you’re feeling better, you can experiment with adding foods back in. Don’t permanently eliminate a food until you’ve tested it three separate times. Because otherwise, people can really whittle their diet down to nothing.
And what are the top foods for nourishing the gut?
I really try not to pick favorites, but my son started calling me “Arugula” one year because we were eating so much of it. You want to increase the amount of prebiotic foods you eat—that’s the good, starchy vegetables and legumes, ancient grains, and lots of herbs and spices, lots of fruits and vegetables. And add in fermented foods, like yogurt, sauerkraut, tempeh, and raw apple-cider vinegar. I think a key element here is diversity. Try to eat seasonally, because that forces you to mix it up.
You also suggest people try a probiotic supplement. But is there a risk that in dosing yourself every day you’ll reduce the diversity of your microbiota, limiting it mostly to the one you’re taking in a pill?
Some scientists think there might be a risk. In fact, a lot of clinicians might switch it up a bit—I do this myself. For example, I have had some patients with IBS use Align supplements for a week or so, which have some actual data supporting their use with IBS, and then we might go to a different broad-spectrum probiotic, alternating the organisms. We’re still experimenting with probiotics. Some supplements do have research behind them, but we are not yet at a place where we can make definitive recommendations about which are best.
Putting aside weight gain for a moment, are there other conditions that might improve with a better microbiome?
Well, certainly two of our other epidemics—diabetes and heart disease—are affected. And so are autoimmune conditions—multiple sclerosis, rheumatoid arthritis, and others—because so much of our immune system resides in the gut. With the brain connection microbiota have, I think improving the gut can help maintain cognition and increase the neuroplasticity and resilience of our brains. There’s a lot that’s still uncharted territory, but I really believe there’s an opportunity at the plate.
The skeptic in me says that anyone eating such a healthy diet would lose weight, no matter what’s going on with the gut biome.
So true! I actually didn’t want the word diet in the title of the book. It should be a way of life. But I think knowing how your food affects your microbiome is motivating—that kind of understanding and awareness can really inspire. You can almost visualize this community of organisms multitasking to help us stay well. They are an ecological community, and all we need to do is nourish it.
This article originally appeared in the October 2014 issue of ELLE magazine.