A Thumbs Up Book Review
Breaking the Vicious Cycle: Intestinal Health through Diet
By Elaine Gottschall, B.A., M.Sc.
The Kirkton Press, 2004
Review by Jill Ebbott
Sometimes great misery and hardship bear unexpected fruit. When Elaine Gottschall and her husband struggled in 1958 to find answers for their eight-year-old daughter’s ulcerative colitis, I cannot imagine that they might have envisioned the day when Mrs. Gottschall would detail their path to success for others with gastrointestinal disorders in her book, Breaking the Vicious Cycle: Intestinal Health Through Diet, now in its twelfth printing.
The Gottschalls had endured three years of medical failures and their daughter’s steadily declining health, when specialists maintained that her condition was incurable, and surgery seemed imminent. With so little to lose, they turned to the Specific Carbohydrate Diet as outlined by Drs. Sidney V. and Merrill P. Haas.
Their first sign of the diet’s success was the disappearance of their daughter’s recurrent night terrors, and within two years she was free of all digestive difficulties. Most compelling for many to learn, however, is that she eventually returned to a more normal and unrestricted diet, and continues that way without difficulty today.
The central thesis of the book is that many digestive disorders arise from the fermentation of incompletely digested carbohydrates. While single sugar carbohydrates, or monosaccharides, require no further action on the part of the body to be fully absorbed and are therefore well tolerated, the more complex disaccharides (double sugars) and polysaccharides (starches) must be broken down by the fragile enzymes within the intestinal microvilli in order to pass into the bloodstream to be assimilated. When this process is incomplete and the sugars and starches remain in the intestine to ferment, the stage is set for intestinal disorders.
A host of conditions can compromise the function of the enzymes within the microvilli: a nutrient-poor diet; decreased stomach acid due to aging, antacids; iodine deficiency; antibiotic therapy; and a high consumption of sugars and starches. In fact, those with Crohn’s disease have been found to consume between 20 and 220 percent more carbohydrates than those without the disease.
Simply suffering from a folic acid or B12 deficiency will reduce the vitality and quantity of these enzymes, and I am reminded of yet another reason not to adopt a vegetarian regime: those who do not consume animal products find it difficult at best to maintain adequate levels of B12. Most vegetarians are advised to supplement with this nutrient.
Dr. Samuel Gee, a world-renowned specialist in pediatric digestive disorders, commented in his time that “what the patient takes beyond his power to digest does harm.” Gottschall details the damage that occurs within the intestine when sugars and starches are allowed to remain and ferment.
Just as the naturally alkaline rumen of cows is acidified by a grain-based diet, it is strongly suspected that when humans consume too many carbohydrates which cannot be fully digested, our intestinal pH is acidified as well. This sets in motion a chain of undesirable events.
The acidic environment facilitates mutation of harmless bacteria into pathogenic forms. Fermented byproducts nourish pathogenic bacteria, yeast and parasites, as well as encourage microbes from the colon to migrate up to the small intestine. As microbial overgrowth increases, the intestinal lining attempts to protect itself. Mucus-producing goblet cells grow in number and secrete a protective mucosal layer. As this barrier spreads, it forms a thick sludge, and the already compromised enzymes within the microvilli cannot make contact with sugars and starches. It is now impossible for digestion of these foods to occur. Fermentation increases, bacterial overgrowth and mutation f lourish, damage to the intestinal lining continues, and the vicious cycle is set in motion.
While modern medicine utilizes different criteria for diagnosing the various digestive maladies that are so common today, Gottschall maintains that Crohn’s and celiac disease, ulcerative colitis, diverticulitis, chronic diarrhea and some of the other digestive disorders usually have this proliferation in bacterial fermentation in common.
There are different manifestations and details, of course. With ulcerative colitis, the goblet cells may become exhausted, fail to produce the protective mucus, and ulcerations of the intestinal lining occur. Diverticulitis produces painfully inflamed pockets in the wall of the intestine. Celiac patients, the author asserts, are sensitive not only to starches and sugars, but also to the gluten which is bound to starch.
But Gottschall argues that by addressing the faulty digestion of sugars and starches, most of these disorders can be permanently resolved, regardless of their variable idiosyncrasies. This entails the elimination, for a period of at least one to two years, of every food containing disaccharides and polysaccharides. Of course, this constitutes a vast wedge of the typical American food pie chart: fluid sweet milk products; all soy; grains and sugars; potatoes, yams, corn, and most other starchy vegetables; and almost all other processed food. But the reward for eliminating these and other assorted components from the diet can be a return to robust health.
The story doesn’t end there, however. Because digestive malfunction often occurs with psychological disorders (as was the case with her daughter’s night terrors), Gottschall goes on to detail how these conditions can be causally related. She quotes the French scientist, Dr. H. Baruk, summarizing his fifty years of research on schizophrenia and other mental disorders: “. . . it is preferable to consider the majority of psychoses or neuroses as reactions to biological factors which are very often digestive in origin.”
Interesting connections between gut and psychology abound. Doctors have reported that when patients undergo surgical shortening of the small intestine, some experience accompanying neurological symptoms such as aggressiveness, disorientation, slurred speech, staggering gait and delirium. Some babies with chronic diarrhea have epileptic seizures which disappear when the diarrhea is resolved. Most schizophrenics have some form of intestinal disease. Celiac specialists have reported that patients sometimes present with degeneration of the brain, spinal cord,and other nervous tissue. Gastroenterologists acknowledge that neurological effects can arise from liver disease. And a high percentage of autistic children suffer from intestinal distress, many of whom can resolve autistic behaviors through a change of diet that includes the elimination of sugars and starches.
Gottschall explains the fact that bacterial fermentation of incompletely digested carbohydrates produces an excess of short-chain volatile organic acids such as lactic, acetic and others; a higher blood acidity; overgrowth of intestinal bacteria; the mutation of some bacteria such as E. coli; and toxic byproducts.
As reported in The Journal of Developmental Disorders in 1985, high blood levels of D-lactic acid can produce “bizarre behavioral symptoms.” Dr. H. Baruk found that a harmful strain of E. coli could produce a toxin that affects the nervous system. Research by E. R. Bolte shows how the toxin of Clostridium tetani can travel from the intestine to the central nervous system by way of the vagus nerve. Both research and anecdotal evidence support the gut-brain connection.
While half of Breaking the Vicious Cycle leads us through the science behind the Specific Carbohydrate Diet, the other half translates that science into a highly detailed picture of what can and cannot be eaten, how to time the reintroduction of formerly excluded foods, and many, many recipes to ease the diet transition. This section is indispensable to the implementation of the plan, but it’s also where I begin to have a few quarrels.
While explaining that the heart of her approach is to deprive intestinal pathogens of their energy source—fermented bacteria—Gottschall mentions nothing about the support of beneficial bacteria. Apart from yogurt, no information on fermented foods is forthcoming, and one is left to wonder how much more rapid the results might be if the diet incorporated both approaches. In the same vein, when discussing fats there is nothing about coconut oil, and this seems like another lost opportunity. Coconut oil is anti-bacterial, anti-viral, anti-parasitic, anti-fungal, and it nourishes the growth of good bacteria. In short, it’s everything you want to ease a dysbiotic gut.
Another curiosity is the inclusion of some very processed items in a diet that otherwise eschews such foods. Saccharin gets equal billing with raw honey, diet sodas with aspartame are limited to once per week (because they may contain lactose) and those with saccharin can be consumed two to three times weekly. Inflammatory corn and soybean oils are permitted, yogurt can be made with all forms of milk, including powdered, and although saturated fat supports gut health, the author allows the substitution of low-fat foods.
But these, as I said, are smaller quarrels with an otherwise very valuable addition to the understanding of gut health. Carbohydrates are the only macronutrient without which humans can still thrive, so it is therefore no surprise that when they comprise the largest part of any diet, trouble will certainly follow.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2009.