“I Need a Drink!” Middle-aged women and alcohol

By Pam Salvadore with medical review by Shannon Sinsheimer, ND

So many things change as women age. Our bodies, our minds, our purpose, all appear to go through a major transition between the ages of forty-five and sixty. Perhaps the biggest of the female changes is that of menopause, the end of a woman’s reproductive ability. Currently, the average age for menopause is fifty-one. During peri-menopause, the years leading up to menopause, one of the primary goals of the female reproductive system is to drastically reduce estrogen levels. When a woman enters into full menopause, estrogen levels have fallen by 75-90%, resulting in the infamous menopausal symptoms we all dread – hot flashes, night sweats, and sleep interruptions, to name a few. 

New symptoms, such as “brain fog” – that muddled feeling that requires great effort just to concentrate – are also coming into focus as being decidedly related to reduced estrogen levels. Adding insult to injury, as menopause settles in, women also lose water from within their systems, one of the most important components of metabolization in the human body.

Given these sometimes harsh changes, it’s no surprise that a woman may crave a cocktail as a means of relief, which begs the question: How does alcohol consumption affect women as they go through peri-menopause and menopause? 

The simple answer is that alcohol changes the impact of our hormonal balance. First, alcohol cannot be stored in the body; therefore, it becomes a priority for metabolization. However, alcohol does not require digestion, as it is simply absorbed into our systems, meaning it moves through our bodies more rapidly than regular food.1 Our body reacts to alcohol similarly to how it reacts to sugar, and quick jolts of sugar to our system wreak havoc with our hormones, especially insulin. 

Insulin, a hormone released by the pancreas whenever blood sugar rises, is the hormone responsible for sugar metabolism. Insulin is like the traffic cop telling all the excess sugar created by alcohol in our blood to move straight to the nearest fat cell. Insulin then tells that fat cell not to open its doors and burn the fat as energy until all the other nutrients in our system have been metabolized. End result: you’re stuck with excess fat cells. 

So while a woman’s endocrine system is trying to drastically reduce estrogen levels in the years leading up to menopause, we tend to make it harder on our bodies by drinking alcohol and providing more places for estrogen to accumulate, creating mixed messages in our systems. On the one hand our bodies are going through these incredible symptoms of estrogen loss – night sweats, hot flashes, etc. – while on the other hand our fat cells are concentrating estrogen within their walls and releasing it when and if the body burns the fat. In the end, we have a state of confusion in the form of uncontrollable spikes and dips in estrogen levels that only stand to amplify menopausal symptoms. Of note is the fact that a woman’s metabolism also slows down in menopause. We do not burn the fuel provided by food as quickly or efficiently and that can lead to weight gain. 

How much you drink makes a big difference as well. It’s one thing to enjoy a glass of chardonnay on a warm summer evening, another to down the entire bottle. 

Studies have shown that moderate drinking (defined as one 5-ounce glass of wine per day) can actually have beneficial effects on women’s health including a lower risk of heart disease, type 2 diabetes, dementia, and stroke. However, increase the amount you imbibe and your risks also increase drastically. According to a recent Healthline article, heavy drinking during menopause can increase a woman’s risk of developing cancer, heart problems, liver disease, and osteoporosis. A more specific study by Jasmine Lew, a researcher at Howard Hughes Medical Institute, found that alcohol consumption did indeed increase the risk of breast cancer in post-menopausal women and the risk is dose dependent: one drink per day increases a postmenopausal woman’s risk of breast cancer by 7%, whereas three drinks per day up the risk to a whopping 51%.2

In the end, anecdotal reports find that some women feel happier having a drink at this stage in their lives; others find that alcohol immediately triggers hot flashes and sweating. Still more find that regular alcohol consumption impedes their ability to maintain healthy sleep habits. As with anything in nature, we are all unique. Find the right balance for your body and do your best to stay rested and comfortable during this physically tumultuous time.

Contributing writer Pam Salvadore of La Quinta is a nutrition journalist. For more from Pam visit her blog pamsalvadore.wordpress.com

References: 1) Byrd-Bredbenner, C., Moe, G., Beshgetoor, D., & Berning, J. (2013).   Wardlaw’s Perspectives in Nutrition (9th ed.). p 258-259 New York, NY: Mcgraw-Hill Education; 2) Barnes, Mary Ellen, PhD, and Ed Wilson, PdD,MAC. “Menopause and Alcohol Abuse.” GoodTherapy.org Therapy Blog. EdwardWilson Ph.D., MAC, 2008. Web. 18 Apr. 2016.

As published in Desert Health News

Natural Remedies for Dry Skin

By: Pam Salvadore

Traditional Chinese Medicine remedy of poached pear and honey

Skin is the largest organ in our bodies. It’s what holds our muscles, bones, and tissue intact and also provides a barrier, keeping the bad organisms out and absorbing the good. Skin helps regulate our body temperature by absorbing and releasing heat and helps flush out toxins. Amazingly, skin also regenerates and heals itself. So, it’s no surprise that the first signs of difficulty within the body appear on the skin in the form of dry skin, rashes, hives, and eczema. 

Desert dryness can lead to itchy skin.

Perhaps the most common skin problem is the tight, itchy feeling of dry skin. It sounds innocuous, but dry skin can drive you to distraction and, in some cases, become a serious problem. From chapped lips to cracks on your heels, here are a few things you can do to heal skin irritations of all kinds.

Every climate has an impact on our skin and our dry, hot environment contributes significantly to skin irritation. First, there is little moisture in the air for the skin to absorb. Secondly, as a cooling mechanism, hot weather causes us to sweat out any moisture we do have. Lastly, the moisture we imbibe gets distributed internally to our organs, intestines, and muscles first, leaving little left over to nourish our skin. Dry skin can be a sign of dehydration. Drinking more water, staying cool, and perhaps adding a humidifier to your indoor environment are all good ways to combat the environmental impact the desert has on your skin.

Hormones can also cause dry skin. Estrogen stimulates the formation of skin-smoothing collagen and oils. As we age and estrogen levels decline, dry, itchy skin becomes quite common. Unfortunately, skin changes caused by hormone depletion are permanent. It is up to us to treat this form of dry skin if we want to keep it healthy. Lotions and body oils are a great place to start. There are many formulas available, but those that contain only a small number of ingredients that are all natural are best.

Skin is a great medium for discovery when something doesn’t agree with you. If you’re allergic/intolerant to something, it often manifests on your skin in the form of an itchy, red rash or hives. Pay attention to these reactions and try to pinpoint their causes. If you can’t find the source, consult an allergist to have a skin test. If allergy skin tests appear negative, you may consider consulting a naturopathic doctor or nutritionist for food intolerance testing. Once you know the cause, avoidance can control or eliminate the breakouts.

Last but not least, our skin helps flush our system of toxins. This is most evident with acne, but can also manifest as little hives or bumps. According to Dr. Diane Sheppard of AcQpoint Wellness in La Quinta, such outbreaks are deemed “weeping” in traditional Chinese medicine, meaning that the skin is purging toxins from your system. These outbreaks are of little concern, but are a good sign that you’re on the right track to eliminating internal stressors. 

Of course, there are more serious skin problems, such as psoriasis and eczema. The jury is still out, but more and more researchers are looking to see if there’s a connection between these more pronounced skin reactions and allergies/intolerances. Then there’s the most concerning skin problem of all in the form of cancer. Most skin cancers are treatable with early intervention, so make sure you get in to see your doctor as soon as possible if you see something abnormal.

Indie Lee’s lavender and chamomile body oil contains natural ingredients that can help relieve problem skin.

It’s important that you take steps to heal irritated skin. Otherwise, your protective layer will only become more inflamed and fail to protect you when you need it most. The most simple cures often work the best. Apply moisturizing lotions or natural soothing oils (I found a good one with chamomile and lavender by Indie Lee), dial down the hot water when you bathe, use a gentle soap, and moisturize immediately after showering or washing your hands to help trap and retain any water on your skin. Limit your exposure to chlorine and use a humidifier to increase the moisture in your home. You can even try the traditional Chinese medicine cure of eating pears poached in water, with ginger and honey. Dr. Sheppard recommended this fix for me which works like a charm! Finally, if none of these home remedies is working, see your doctor to rule out any internal or autoimmune causes and inquire about prescription remedies. 

In the end, your skin is your friend. It will defend you when needed and can tell you if you have a more serious problem lurking beneath it. Take care of your skin and it will take care of you.

Click here to read this article in Desert Health News

Smart Fat


By Pam Salvadore

What do you get when you bring together a medical doctor and a Ph.D. in nutrition? You get a breakthrough diet based on the consumption of smart fats. That’s right, a diet based on eating fats that are actually good for you.

Originally, Steven Masley, M.D., and Jonny Bowden, Ph.D. disagreed on the most beneficial diet for the human body. However, after years of research and practice, often times using themselves as the guinea pigs, doctors Masley and Bowden have come to the same conclusion that eating a clean diet, based on the consistent inclusion of smart fats, is the most beneficial nutritional approach to overall health and longevity.

Let’s put this in perspective. Since the 1970s the standard American diet has recommended that we eliminate fat and rely primarily on protein and carbohydrates for the bulk of our nutritional intake. Unfortunately, this prescription is riddled with misinformation. Masley and Bowden propose that it is this government recommended “SAD” diet that has led Americans to forego clean, natural meats, fruits, and vegetables for the highly processed foods many of us grew up on. The doctors further posit that this is how the American public became increasingly subject to a myriad of health problems, such as heart disease, diabetes, and obesity. These problems all have one thing in common: they begin with high levels of inflammation in the body. Masley and Bowden propose that to eliminate this detrimental inflammation, we return to the clean, smart eating of earlier generations…a plan that includes a good portion of “smart fats.”

Mixed nuts are a perfect smart fat snack

Smart fats are the good fats that occur naturally in foods like avocados, nuts, and fatty fish. The authors believe that increasing these fats in the diet results in an increase in the intake of Omega 3 fatty acids. Research shows that Omega 3 fatty acids alter our hormonal balance (the key players in our metabolism) and lower inflammation, thus making our bodies better able to draw nutrients from our food and handle – or avoid – disease. Smart Fat explains this topic in depth with both scientific research and common sense analogies.

Determining the difference between smart and “dumb” fats is a key factor, and the authors go to great lengths to discern the differences and identify smart and dumb foods. Of particular importance, dumb fats are the trans fats found in processed foods, the fats from factory-farmed animal meat, poultry and fish, and the fats found in highly processed cooking oils, such as vegetable oil. Subsequently, while Masley and Bowden’s Smart Fat diet requires including an impressive amount of smart fat in your diet, they strictly prohibit any form of dumb fat and/or dumb food.

So what should you eat? Smart Fat recommends that you include four components in your daily intake: smart fat, clean protein, fiber, and flavor. Since this “diet” is actually a new approach to eating in general, they want to be sure that it is nutritious, enjoyable, and maintainable. After all, there’s no joy if there’s no flavor. The doctors set the goal of 5 servings of smart fat, 5 servings of clean protein, and 10 servings of fiber per day. It sounds like a lot, but they give you the tools to convert to this way of eating via meal plans and quite a few recipes.

Other smart fat foods include avocados, salmon, and olive oil

Smart Fat also includes a section discussing supplementation. The doctors do not outright say that you should be taking any one specific supplement, rather they outline the supplements that they take and the reasons why. Most importantly, they urge the reader to pursue only the highest quality supplements and point us to resources and screening tools to be sure we are getting the best. While the doctors do sell their own products, they do not push them on the reader in any way.

Finally, Masley and Bowden further agree that no diet or way of eating stands alone as the picture of perfect health. In order to attain optimal health, the pair recommends completing the picture by including reasonable amounts of exercise, sleep, stress reduction, and close relationships with key people in your life. Addressing the big picture, not just short-term weight loss, is their key to success and maintaining a healthy body, mind and soul for life.

In the end, we are what we eat. Like any performance automobile we need to put the best fuel in the tank in order to get the best performance on the track. Masley and Bowden have written an informed, approachable, and sustainable plan that will benefit most people. Smart Fat is a good resource for anyone looking to clean up, get healthy, and live their best life.

Click here to read this article in Desert Health News.

The Power of a Snarky Comment

salad mouth

Several days ago I posted a snarky comment on Facebook about cleansing in response to a cynical article posted by Cosmopolitan. Since then, I have gone about my way, like others, to renew my commitment to clean eating and general “healthiness,” it being a new year and all. As if the Gods had read that post, they have conspired to prove to me that cleansing and detoxing are very real occurrences in the human body! I have not engaged in any one prescribed program. No lemon/maple syrup/cayenne concoction for me. I am simply eating a whole, clean diet composed primarily of fruits, vegetables, and small amounts of lean protein. I am guzzling water and have declared the month “Juice Free January” in reference to my abstinence from alcohol. It’s been seven days. To date, I have experienced headaches, bloating, gas, runny noses, bloody noses, seemingly never-ending trips to the bathroom and incredibly itchy skin. Relenting to the concept, a quick Google search revealed that these are all symptoms of detoxifying your body. Apparently my return to a normal diet has thrown me into a full blown cleanse!

So how did that happen? Turns out that our bodies are built to cleanse all by themselves. Aided or burdened by the foods we put in, our major organs execute an intricate process to clean our blood, absorb nutrients, and purge toxins…every second of every single day.

Among a host of other internal organs, the single biggest “cleanser” in our bodies is our liver. The liver cleans our blood, detoxifies toxins, produces internal chemicals necessary for human life, creates cholesterol and bile, and stockpiles vitamins and minerals for future use. Keeping our livers happy is vital to our good health.

Also of note are our kidneys. Our kidneys further remove toxic waste from the blood and work to expel them in our urine. Kidneys also perform the vital task of maintaining blood concentrations and volume by dumping excessive water and other solutes. As if that weren’t enough, the kidneys further work to regulate the body’s acid/base balance. This is why doctors look to our urine for clues when searching for the cause of a physical problem. They want to know what concentration levels are present, what the pH is, and what toxins the kidney’s have discarded.

To me, the most surprising component of detoxification in our bodies is our single largest organ, the skin. The skin maintains our body’s “clean” state by acting as a barrier to environmental toxins such as free radicals, viruses and diseases. If you don’t keep this physical barrier in shape, you can expose your body to a world of pathogens that will work their way from the outside in.

Bottom line: you don’t need an $11 bottle of juice to initiate a cleanse of your system. Your body is keenly aware of your cleansing needs and constantly working to perform them! The best things you can do to support your body are to feed it unprocessed, nutritious foods and to not overburden it with junk food, alcohol, and unnecessary medications.

The question for me now becomes “what the hell am I purging?” What’s making my head ache every day and my skin itch so badly? How long is this going to last? What, if anything, can I do to speed it up? Who can fill me in on the process of detoxing? What on earth is going to happen when I down a glass of wine on February first?

I’ll share my findings as I progress.

Stay tuned!

A Simple and Nourishing Guide to Your New Year

Eat a rainbow of colors.

By Pam Salvadore

Around this time every year we all make resolutions to lose weight, get in shape, and take control of errant behaviors. This year, take advantage of that January mindset to do just one thing: get healthy. Commit to a fresh start by getting back to basics and all of those other goals will fall in line.

As you may expect, an essential first step is to look at what you’re eating. Make the decision to eat clean by eliminating all of the processed food in your life. Eat whole foods like fruits and vegetables. Choose lean, clean protein like free-range chicken and grass-fed beef. Opt for minimally processed whole grains. If this sounds familiar, it’s because it is. This is how we ate before food was made “convenient” and all but stripped of nutritious content. By eating clean, you are giving your body the fuel it needs to function at the top of its game. Your body will begin to purge unhealthy fats and additives, attack free radicals, drop unnecessary pounds, and restore balance to your system.

Now that you know what to eat, figure out how you’re going to eat it by adopting a reasonable eating plan. No weights and measures, just eat when you’re hungry and stop when you’re full. This basic approach usually translates to three meals and one or two snacks a day. Eat slowly and without distraction so you can feel when your body is full. After a week or two of eating this way you’ll notice that your body is satiated on a lot less food than what you’re used to, leading to natural weight loss.

Once your diet is clean and portions are appropriate, try adding in a few more healthy items to your plate. Consider your dinner. Can you scale back on protein a little? Perhaps make that piece of meat equivalent to the size of your palm? Can you increase your vegetables? Maybe add a fresh salad to your meal? By upping your vegetable content you are increasing your fiber, which works to eliminate toxins from your system and helps you feel full longer. Salad is also a way to increase your vegetable diversity and help you eat a rainbow at every meal. Not only is it tasty, but it’s a guaranteed way to be sure you get a broad spectrum of nutrients. Aim for one quarter of your plate filled with protein, one quarter with grain, and the other half full of vegetables. Add fruit for dessert, and you’ve just satisfied most of the nutrient needs in your body.

Get out and walk.

Now that you know what you’re putting into your body, focus on what you’re putting out. The word “exercise” can be intimidating, but it need not be. We’re not talking about challenging Rocky to a race up the stairs. We’re simply talking about moving your body more. This can mean going for a walk in the morning, playing with your kids in the park, or keeping your cart on the path during golf. Most of the things you do on a daily basis can be converted into exercise. At the market, grab a basket and carry it around instead of pushing a cart. The weight of your basket and lack of support provided by the cart will engage your muscles and challenge your balance. At the mall, park your car once and walk to all the stores you need to visit. Stop moving your car and move your feet instead. This all counts as exercise. Do more of it and your body will respond with healthy rewards.

Now indulge your lazy side. Sleep as much as you can. Let those droopy eyelids call the shots and go to bed when you’re tired. Aim for 7-9 hours a night. REM sleep is how your body restores and resets itself. It’s also how your memories are processed and retained in your brain. Turn in earlier than usual for one week. By the end of that week, if you don’t need your alarm clock to wake up on time, you’re getting the right amount of sleep for you.

Focus on your whole being - mind, body, spirit and soul.

Finally, and perhaps most importantly, laugh! Pay attention when the littlest one at the table has a silly joke to tell. Really hear your spouse when he/she describes their daily giggle. Laugh with others and enjoy the happy things that surround you. There will always be a list of the negatives in our lives. By taking the time to laugh, you prioritize happiness. Being happy is one of the most rewarding health benefits of all!

Hopefully these ideas provide some basis for a calm, rational, and healthy approach to your New Year. Whatever you do, don’t use the concept of resolutions to beat yourself up over your shortcomings. Use your resolutions to be kind to yourself, and the benefits you reap will become not only part of who you are but also who you want to be.


Click here to read this post in Desert Health News.

Trust the Trail

Trail Face

by Pam Salvadore

This summer did not go well. In July, I lost my mother to a brutal disease, and thus inherited her responsibilities: keeping her home, caring for my father, and the minutia of wrapping up her “paper existence.” At the same time, my own family expanded. Our grandson moved in for the summer and our son rebounded after college. The presence of the boys created a buoyant atmosphere at my house, a sharp contrast to the sadness at my Dad’s.

Feeling cornered by the demands of this hectic life, I put myself at the back of the line. I was so busy that I missed the husband with whom I live. I also missed the frenetic energy of the boys and their milestones. As I commuted back and forth between two homes and two lives, most of all I missed myself. I relinquished good nutrition in favor of comfort food. Water gave way to wine. Sleep became elusive. Exercise went out the window. By August, I was stiff from stress, bloated and swollen from poor nutrition, flushed with hormones, and craving solitary confinement. This was the toughest spot I in which I had ever found myself.

As women do in times of trouble, I found myself turning to a friend for guidance. Cheryl, that rare true friend, reminded me that in order to be a good wife, mother, and daughter I needed to start taking care of myself. She pulled out her calendar and pointed to the trip we had planned long ago, a 15-mile hike of the Pacific Crest Trail near Lake Tahoe. The hike was an effort to capture some of the empowerment and beauty in Cheryl Strayed’s inspiring book, Wild.

Having never hiked more than the trails surrounding my home, I inquired as to exactly what I needed to pull this off (secretly hoping to find a loophole that allowed me to bow out gracefully). Cheryl had everything arranged. I was to arrive wearing my most comfortable hiking shoes and sunscreen. Everything else was under control, including our gear and food. Committed, and thankful that my brother was going to join us, I swallowed my fear and wrote it on my calendar. The night before we departed, I felt a little puddle of fear swirling in my stomach and began to take inventory of what scared me the most. It didn’t take a degree in psychology to tell me that it was more than just hiking of which I was scared.

Primarily, I was riotously out of shape. Would I be able to breathe at altitude? Could my muscles recover sufficiently to descend on day two? Secondly, I am a notorious germaphobe. Would I be able to use the woods as my toilet? How could we eat a proper meal without washing up? What kinds of creatures went bump in the night when you slept on a bed of leaves? What does one do when confronted by an angry bear? This little control freak finally had to face her fear of the unknown. The next morning, I slapped a smile on my face, a 30-pound pack on my back, and we were off.

It began quite innocently. There was a designated trailhead with signage and a map. About 200 yards in, however, the trail turned into a narrow ribbon of dirt. This is what was supposed to lead us from Donner Pass to Squaw Valley? At points, the foliage was overgrown and in others there was no foliage at all. At the highest peaks, there appeared to be no trail, as it was either covered by rockslides or invisible over the surface of a boulder. It felt like more of the same: a lot of decisions being made for me with very little input from me. Frustrated, I placed my trust in Cheryl and Matt, looking to them to lead the way.

Our packs were heavy and mine dug into my shoulders and hips. A big part of the weight was water. I pondered that as we trucked through the endless dust and dirt enhanced by thedrought. It was incredibly dry at altitude, as evidenced by the creaks of dying trees and the crunching of leaves. The infamous Donkey’s Ear that lines this portion of trail was shriveled down to a crunchy cacophony of death. Reassured by the weight on my shoulders, I didn’t have to worry about water. We carried a gallon each, as well as a purifier to use at any water sources we found. In the entire 15 miles, we saw only one active stream and we certainly took advantage of it.

Just when I thought that I had a handle on my fears things got tricky.

We came upon a sheer cliff that obviously had fallen victim to a rockslide. The trail disappeared under a pile of broken rock. To the right of the rock, the cliff dropped off at a 90-degree angle. To the left a sheer wall went straight up and disappeared into the sky above. We had no choice but to traverse the rocks. One long, unsteady step at a time we concentrated on making it across. I almost blew out my ankle on several occasions, as the rocks shifted and pulverized beneath my feet. I think I held my breath for most of that test. From the other side, I looked back in awe of my accomplishment. I was sweating and breathing heavier than I did on any climb, but for the first time in the trip, the puddle of fear in my stomach was gone. I felt empowered and confident. I looked back upon those rocks as incidents that had befallen my family over the summer. Some were crumbling and unsteady. Some were solid. All required dedication and concentration to navigate. And I did it.

Eleven miles in, we found a flat spot to make camp. I was so tired, hungry, and sore that a squirrel could have bitten my nose while I slept and I wouldn’t care. We set up our tents and spread out for dinner. As the burgers cooked, I wound my way out to a nearby ledge to watch the sunset. The incredible colors of the fading light cast a striking profile of the peaks splayed out before me. As the air cooled, the wind died leaving complete silence. Between the sunset and the quiet, a sense of calm embraced me.

After dinner, we laid across a blanket and stared up at a clear, starry sky. The moon made an arc from east to west and stars appeared brighter than I had ever seen before. The air was crisp. The quiet was peaceful. The little voice in my head had finally shut up. All was right with my world again. As if in confirmation, a star shot across the sky.

We woke at first light. Packing up, we were giddy at the mere four miles left to go. Our plan was to hike to the Squaw Valley tram and ride it down, triumphantly. Unfortunately, life doesn’t always go according to plan.

We missed our turn and added a treacherous extension to our descent. Unstable stairways twisted around the sheer faces of rocks lining the mountainside. Our knees took a hit, but nobody twisted or broke anything. Covered in sweat, dust, and grime we slipped out of the woods into a parking lot at Squaw. No fanfare. Just three exhausted hikers with smiles of accomplishment. After all, life doesn’t hand you a trophy for making it. You need to acknowledge each victory yourself.

The things I learned about myself up on that trail resonate to this day. I can do anything I put my mind to doing. I am the captain of my ship and only I can determine its course. While I can rely on the support of people I love, I need to learn from them so I can be independent in the end. I learned to forgive myself for not being perfect. Most importantly, I learned to trust the trail. Just as it did up on that mountain, the trail will lead you where you need to go. I have recommitted to myself by eating healthy foods and exercising regularly. I’m drinking water again, but still enjoying some wine. I look at my family and feel the same sense of calm I felt watching the sunset on that ridge. I’m where I need to be, living how I need to live, with the people I love the most. Choosing, as I move forward on shaky legs, to trust the trail.

Bacteria That’s Good For You

Brain Maker

A Desert Health review of Perlmutter’s Brain Maker

By Pam Salvadore

It’s a fact that the brain controls the body, but what controls the brain? In his new book, Brain Maker, David Perlmutter, M.D., describes an emerging field of science that contends that the gut controls the health of the body, including the health of the brain.

As you may recall from Dr. Perlmutter’s first book on the subject, Grain Brain, the impact of grains in the diet was shown to influence the gut’s microbiota and, subsequently, the body’s health. While Grain Brain focused exclusively on the impact of grains, Brain Maker goes one step further by directly connecting all outside influences to the state of the gut’s microbiota, and showing the profound impact an unhealthy microbiome has – especially on the brain.

The gut, comprised of both the large and small intestines, is responsible for the metabolism of food and subsequent distribution of nutrients to the organs and cells of the human body. The gut is also home to our unique microbiome: a microbiome that consists of millions of flora (aka bacteria), each one with a specific job or function. According to Dr. Perlmutter, these bacteria perform vital functions: they provide the first line of defense in helping filter out toxins from our system; they control our immune response, especially that of inflammation; they create and influence hormones, telling our endocrine system how to react to stress; and they create neurotransmitters, such as GABA and glutamate, that are vital to brain function. Dr. Perlmutter believes that “what’s taking place in your intestines today is determining your risk for any number of neurological conditions.”

Given this information, it is important to know what a healthy microbiome is. A healthy microbiome contains a balance of both good and bad bacteria. Neither exists exclusive of the other, however, maintaining balance is the key. For example, one of the most important bacteria present are Firmicutes, whose job it is to extract energy from food and regulate fat absorption. If Firmicutes dominate the microbiome, they hoard calories and the weight packs on. An overwhelming population of Firmicutes can also hijack your body’s immune responses by keeping other vital bacteria from doing their jobs. Hence, keeping Firmicutes in balance is key.

Bacteria in the microbiome is also responsible for maintaining the permeability of the intestinal lining. In a healthy microbiome, the lining of the intestine is made up of tightly fitting cells that allow nutrients to pass, but are too tightly packed to allow disease or infection to get through. With the nutrients absorbed and infection passedalong, this normal balance tells the body that no immune response or hormonal adjustment is needed. Your health remains intact. Should the bacteria become unbalanced, infection and irritating particles leak through intestinal walls and into the bloodstream, causing your body to mount an immune response most notably marked by inflammation. Inflammation is a proven contributor to, not only brain disease, but many other diseases of the human body as well.

Perlmutter explains that we attained our initial microbiome at birth, as we passed through the birth canal. After this initial setting, Perlmutter believes that outside influences such as whether or not we are breast fed, the influence of antibiotics, the ingestion of hormone regulating medications, and even the food we are eating contribute to whether our microbiota thrive or shift to an unhealthy balance. He sites numerous studies that connect an unhealthy microbiome to diseases such as Alzheimer’s, depression, anxiety, obesity, autism, and diabetes, and also introduces studies that show a positive correlation between the restoration of healthy balance to the microbiome and the reduction and elimination of disease . Brain Maker is full of success stories from both Perlmutter’s patients and colleagues’ patients around the world.

Given all of these findings which establish a scientific link between gut health and the state of disease in our bodies, Perlmutter uses the remainder of the book to discuss resetting an unhealthy microbiome, and the tools it takes to maintain its health and reverse any damage already done. He gives concrete steps, such as repopulating the microbiome with the correct balance of good and bad bacteria, and includes instruction on how to feed these new found friends keeping the correct percentages flourishing while ushering out any negative intruders. Perlmutter details what supplementation to consider, which tests to take, significant signsfor which to look, and the type of exercise that works to help microbiota flourish.

The book concludes with a complete list of recipes, resources, and links to the studies quoted. Brain Maker provides a good resource for anyone looking to restore health to their own body. There are no radical ideas here, just proven scientific links and logical nutritional solutions.

David Perlmutter, MD, is a board-certified neurologist and Fellow of the American College of Nutrition. Brain Maker is available at national book retailers, online and in e-book. For more information visit www.drperlmutter.com.