Elizabeth McMillan, CNS, LDN
The old saying, “You are what you eat.” is commonly thrown around to suggest that your dietary choices will reflect your waistline, which is partially true. The old saying should be, “You are what you digest.” Digestion is truly the beginning of every process in the body. Without digesting and absorbing the nutrients from the foods we eat, we are not able to sustain life.
The Webster’s Dictionary defines digestion as the process of making food absorbable by mechanically and enzymatically breaking it down into simpler chemical compounds within the digestive tract. This process starts with the mechanical action of breaking down food in the mouth. Then after the food bolus travels to the stomach via the esophagus, stomach acid breaks the food down further into more absorbable units. The food substances are absorbed as nutrients in the intestines. When this process does not happen efficiently, poor gut health symptoms arise like bloating, indigestion, heartburn, diarrhea or constipation.
Gastroesophageal reflux disease (GERD) is when feelings of indigestion and heartburn become daily instances, and not just after a night of pizza and wings. In fact, anti-acids and proton-pump-inhibitor medications (i.e., Prilosec) are among the top 10 most prescribed drugs in the U.S., with more than 53 million prescriptions written yearly.
GERD begins at the connection point of the esophagus and the stomach, called the lower esophageal sphincter. If this sphincter does not remain controlled, symptoms of acid reflux become apparent. In the last 25 years, Western medicine started to look beyond the sphincter control and started to decrease the amount of acid secreted in the stomach—therefore improving symptoms of acid reflux. In the short term, this is beneficial and drugs like Prilosec were only prescribed for no more than three months. Blocking acid production for a longer could lead to low stomach acid called achlorhydria and eventually stomach cancer.
Stomach acid is a crucial component of proper digestion and gut health, and there are two perspectives regarding acid reflux. The traditional model believes that too much acid secretion and poor lower esophageal sphincter control causes acid reflux symptoms—hence acid reducing medications will reduce the acid and improve symptoms. However, after much research, a new model is coming to light and offers the belief that GERD is caused by too little stomach acid. Large quantities of stomach acid are required to initiate the digestion and absorption process. Without acid, undigested food sits in the stomach and begins to ferment—causing symptoms of indigestion, gas, bloating and other altered gut motility symptoms.
Many things arise when there is too little stomach acid. First, any protein eaten will not be broken down into usable parts. This is especially important since diets high in protein are very popular. Further, pepsin, an enzyme used for protein digestion, also needs acid to be activated. With too little stomach acid, protein cannot be digested and absorbed at two stages. Thirdly, vitamin B-12 is not cleaved from proteins and not transported to the small intestine by intrinsic factor without stomach acid. Finally, the acidic juices in the stomach are required to be at a certain acidity to be secreted into the small intestine. To conclude, without sufficient stomach acid and chronic use of anti-acids, the body cannot break down and absorb food, plus the deficiency of protein, magnesium and vitamin B-12 is likely.
There are many holistic interventions for symptoms related to GERD. It is first important to discuss if it is too much or too little stomach acid, or it is lower esophageal sphincter weakness. Discussion with an integrative nutritionist or practitioner specializing in digestive health should provide insight to what the real problem is to your indigestion symptoms. Improving digestion starts with eating slower and completely chewing your food. Foods that are naturally bitter like arugula, parsley, kale, endive, radish, red wine, kale, broccoli, cranberry, citrus, among others, will help secrete proper stomach acid. Digestive enzymes and taking betaine HCL are lifesavers for those with poor digestion and low stomach acid.
Improving digestion is the first start to improving all physiological pathways, since without proper digestion, the food we eat does not get utilized but only adds to the waistline. Remember—we are what we digest!
Elizabeth McMillan, CNS, LDN is a clinical nutritionist at the Rose Wellness Center, specializing in gut health. For more information, visit RoseWellness.com.