Gut by Giulia Enders
I still have a small pile of other books to review I read last year, I’ve promoted this one, the last book I finished in 2015, to be the first reviewed in 2016, and will get back to the others soon.
I’m notoriously bad at persevering with projects – it’ll be interesting to see how I fare with the reading challenges I announced for myself the other day. There is one project I really ought to take in hand though – and that’s myself. Mid-50s, overweight, unfit, menopausal and moody – I do need to do something – but as I’ve seen before, to make it last I need to be a bit sneaky about it to make long-lasting changes.
I’m sure I’m not alone in feeling a little bloated after Christmas with all the extra food and drink (although I don’t drink so much these days). I usually start January with a few weeks of probiotic yoghurt drinks alongside trying to eat better. I think the probiotics do make a difference for me when my gut is stressed, and now having read Gut by the rather perky young German doctor Giulia Enders, I’m beginning to understand why that may be so.
The book is split into three sections. The first, Gut Feeling explores the physiology of the gut from mouth to rectum, how pooing works, all about faeces and also a section on allergies and intolerances. Yes, there’s necessarily a lot about the less savoury aspects of our digestive tracts here, but it’s all fascinating – such as this about … suppositories!
The final few centimetres of the large intestine, however, do not send their blood to the detoxifying liver; blood from their vessels goes straight into the main circulatory system. … everything useful has already been removed. But there is on important exception: … Suppositories are able to contain much less medication than pills, and still take effect more quickly. Tablets and fluid medication often have to contain large doses of the active agent because much of it is removed by the liver before it even reaches the area of the body it is meant to act on. That is, of course, less than ideal, since the substances recognised by the liver as ‘toxins’ are the reason we take the medicine in the first place. So if you want to do your liver a favour and still need to take fever-reducing or other medication, make use of the short cut via the rectum and use a suppository.
This, and I don’t think I’m generalising here, is a practical and efficacious European attitude towards medication – but we’re a bit squeamish about them here in the UK, aren’t we? I also learned that rumbling tummies aren’t due to hunger and empty stomachs, but are due to the small intestine sensing a break in digesting and getting down to doing some housework.
You may have heard that we all have a ‘gut brain’, the second section concentrates on the nervous system of the gut and the many ways in which it interfaces with the brain – most of the time unconsciously:
When you eat a piece of cake, you taste it while it is still in your mouth, and you are also conscious of the first few centimetres it passes through after you swallow it. But then, as if by magic, the cake is gone! From then on, what we eat disappears into the realm of what scientists call ‘smooth muscle’.
Of course we again become conscious of our guts when we overdo it – Enders discusses reflux and vomiting – and at the other end constipation. Another important part in this section introduces us to the theory that good gut health affects our minds – ‘95% of the serotonin we produce is manufactured in the cells of our gut, where it has an enormous effect on enabling the nerves to stimulate muscle movement, and acts as an important signalling molecule.’ This and the whole gut brain theory are areas of endocrinology in their infancy – and I’d love to find out more.
The final section of the book concentrates on gut flora. The good and bad bacteria that populate our gut. I learned the appendix is one of the places that many of the good bacteria like to hang out in. I had my appendix out when I was ten, so maybe that’s why the probiotic drinks help when my gut gets stressed…
Studies carried out on obese subjects show that they have less overall diversity in their gut flora, and that certain groups of bacteria prevail – primarily those that metabolise carbohydrates.
She acknowledges that this is far from the only factor – here was me being ready to blame my gut flora for being overweight.
Several studies have shown that our satiety-signal transmitters increase considerably when we eat the food that our bacteria prefer. And what our bacteria prefer is food that reaches the large intestine undigested, where they can then gobble it up. Surprisingly enough, those foods do not include pasta and white bread.
Surely, that should have been ‘Not surprisingly’? This is where prebiotic foods come into their own, primarily dietary fibre and foods such as onions, leeks and asparagus for example. If you eat enough fibre for it to get to the lower reaches of your large intestine before being eaten up, the theory also suggests (but is yet to be proven) that it can protect against cancer by making sure the good bacteria there have the right things to digest. Prebiotics require the presence of the right bacteria to do their job, so I may top up my own with capsules from the health food shop for a while.
Enders and her translator, David Shaw, have done a great job to make a complex subject comprehensible, it is informal in style and easy to read. Throughout the text are little cartoons and diagrams drawn by the author’s sister. I could have done without all of the cartoons frankly – I don’t need bacteria as little soldiers to get the point across. I like a good diagram though, and some of these were indeed useful.
It’s amazing to realise that Enders is only 25 and still studying for her medical doctorate. She wants to become a gastroenterologist – and this explains her bias towards our gut flora in this book. I would have been interested to read a little more about hormones, peptides, enzymes, stomach acid, low GI food benefits etc. – the more chemical side if you like. For instance, as in the BBC series last year, it has been suggested that people who tend to be ‘feasters’ have less GLP-1 hormone in their gut – which tells the brain when you’re full. The chemistry of the gut could probably fill another book on its own.
Of course, this is not a diet book either. It does give some good pointers on how to keep your gut happy though and that is enough to inspire me to make some gentle lifestyle changes. It’s a good thing I love asparagus! A fascinating read. (8/10)
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Source: Own Copy.
Gut by Giulia Enders, trans David Shaw. (Scribe Publications, May 2015). Paperback, 288 pages.