Why a Low Lectin Diet is the Evolution of the Gluten-Free Diet, with Dr. Steven Gundry

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Why a Low Lectin Diet is the Evolution of the Gluten-Free Diet, with Dr. Steven Gundry

Episode Intro

Dr. Michael Ruscio: Hey, everyone. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. Today, I am here with Dr. Steven Gundry, who I’m very excited to talk with. He wrote a book called The Plant Paradox, and he is quite well-versed on the issue of lectins, which I’m excited to discuss. So, doc, welcome to the show.

Dr. Steven Gundry: Thanks for having me. Looking forward to being here.

DrMR: Tell our audience just a little bit about your background before we launch into all the details on lectins.

DrSG: So I for many years was professor and chairman of cardiothoracic surgery in pediatrics at Loma Linda University in Southern California. And about 17 years ago, a gentleman who I call “Big Ed” changed my life, because he reversed most of the blockages in his coronary arteries, which were severe, with a diet and taking a bunch of supplements from the health food store. And I thought that was pretty impressive since I had an undergraduate special major at Yale in human evolutionary biology.

And what he did made a whole lot of sense to me, and it made a whole lot of sense to me because I was a big fat guy, eating a healthy vegetarian diet and running 30 miles a week and going to the gym one hour a day. So I put myself on the diet I described for my undergraduate thesis and I lost 50 pounds my first year and another 20 pounds subsequently. And I’ve kept it off for 17 years.

But I started treating my patients that I operated on at Loma Linda with this program. Not only did their high blood pressure went away, their arthritis went away, their diabetes went away. So after about a year of this, I resigned my position and set up an institute in Palm Springs where all I ask for people to do is every three months give me about 10 or 12 tubes of blood that we’d send around the United States to labs that insurance would pay for.

And we found some very interesting correlations, primarily to foods that I was taking away from people that weren’t part of our evolutionary diet. Most of those centered around modern lectin-containing foods. So that’s kind of where I’ve been looking really for the last 10 years since my first book came out, which was Dr. Gundry’s Diet Evolution. But it’s now resulted in The Plant Paradox, which is the hidden dangers in healthy foods.

DrMR: I love your entire story. First of all, from a credential perspective, it’s very impressive. But also, I love the angle of evolutionary biology, and I think that really will resonate with many people in our audience, because I think we oftentimes see the value in looking to an evolutionary framework to try to guide us in modern day when perhaps science doesn’t have all the answers or we only have partial answers via modern-day clinical trials or what have you. And we need some sort of guiding North Star. We look to our developmental past and aspects we can take from our evolutionary biology to guide us going forward.

Hidden Dangers in Healthy Foods

And one of the things that I think is coming up more and more often, at least in my mind, is this paradox, as you aptly titled your book, in what seem like healthy foods. And one diet that is I think most notable there would be the low FODMAP diet. And I bring that up a lot because we have a lot of interest, or at least I do, in gut health. And of course, the low FODMAP diet has some pretty impressive results in IBS, IBD, and just functional gastrointestinal disorders at large by removing foods that, at face value, are seemingly healthy.

And I think that’s a very important string to pull on, because I’ve certainly seen in the clinic patients that are trying to make their health better but inadvertently eating more “healthy foods” that are actually detracting from their health. And that’s why I’m excited to have this conversation about lectins.

The Problem with Lectins

So I guess before we get deeper into it, is there an evolutionary reason why lectins are a problem? I believe they’re a type of defense mechanism for plants, but can you tell us where the evolutionary piece ties in regarding lectins?

DrSG: Yeah. So plants are subject to evolutionary pressures exactly like animals. And plants, believe it or not, want to live. They don’t want to be eaten. And they absolutely don’t want their babies eaten. But when animals arrived, plants had a problem because they couldn’t run. They couldn’t hide, and they couldn’t fight. But they’re chemists of incredible ability. They can turn sunlight into matter, and we haven’t figured out how to do that yet.

So what they do is one of their main defense mechanisms is a protein called a lectin. And I’m not saying lecithin and I’m not saying leptin, the anti-hunger hormone, but lectin. And these things are designed—they’re proteins that are sometimes called sticky proteins because they stick to specific sugar molecules. They bind to the sugar molecules that line our mouth and our gut. In fact, just as a teaser, it’s been shown that within five minutes of eating a slice of raw tomato, the entire mucosal surface of your mouth will be bound from the lectin in tomatoes. Pretty interesting study.

So these things are designed to attach to sugar molecules and actually pry open the tight junctions in our enterocytes, the lining of our gut. And I think it’s useful for people to understand that the lining of our gut is really only one cell thick. And our gut surface area is about the same as a tennis court. And all of these cells are held together, locked arm-in-arm like the kids’ game “Red Rover, Red Rover.” And lectins actually flip a switch on these cells, releasing zonulin, which opens these tight junctions. And the idea from a plant strategy is to make the gut leaky and then lectins and pieces of bacteria, which are lipopolysaccharides, LPSs, then get through the wall of our gut. And our immune system senses them, our border patrol. And that starts the inflammatory process.

Inflammation makes things hurt, and one of the plant’s strategy is to make people who eat them or their babies hurt. And it’s actually an incredibly effective strategy. We, unfortunately, have lost sight of that.

Lectins and Evolution

And you’re right from an evolutionary perspective. Lectins are in everything. They’re in us, and they’re a communication system between cells. But the longer that we have been exposed to a lectin-containing plant in evolution, the longer not only has our gut bacteria evolved to actually eat lectins, but also the gut bacteria we know educate our immune system as to whether certain lectins are problematic or whether we’ve known these for millions of years and we shouldn’t get all bent out of shape when they appear.

We came from tree-dwelling apes, and we ate primarily leaves of trees and the fruits of trees. And then, 10,000 years ago, things dramatically shifted when we began to eat the lectins in grasses, the grains, and the lectins in beans. And we had never been exposed to these lectin-containing compounds until 10,000 years ago, which is a very short time in evolution. The other thing that I find fascinating is that all of us in America are not from America. We’re from Europe, Asia, or Africa.

DrMR: Sure.

DrSG: None of us were exposed to American lectin-containing plants until 500 years ago when Columbus started trying them. And quite frankly, getting to know and tolerant to a new lectin in 500 years I think is speed dating evolution. And really, some of our most popular foods, some of our most prized foods are actually American plants that I don’t think we have any business eating.

High-Lectin Foods

DrMR: That’s actually a very, very interesting point. Let’s go into a little more detail about some of the lectins that we are less evolved to deal with and what some of the food sources of those are so people can be aware of them.

DrSG: So, again, all of the grains are problematic just because they’re relatively new. Interestingly, everybody’s heard of gluten and gluten is a lectin. Surprisingly, it’s a fairly minor lectin. The more important lectin in wheat and barley and rye is actually called wheat germ agglutinin, which is in the hull of the grain. Gluten is in the endosperm, but it’s not out in the hull. So wheat germ agglutinin is actually one of the major causes of heart disease in experimental animal models.

And one of the things that’s fascinating about wheat germ agglutinin is that traditional cultures have for centuries tried to remove the hull from grains and eat, for instance, white bread. The French have white baguettes, not whole wheat baguettes. They have white croissants, not whole wheat croissants. The Italians have white pasta, not whole wheat pasta, although we’re seeing it now. Ridiculous.

And they’ve been throwing away the hulls of grains. Perhaps the most striking example is rice. Rice was started cultivating 8000 years ago, and traditional four billion people use rice as their staple. And those four billion people go to the trouble of taking the hull off of brown rice and eat their rice white. And I’ve always been struck that perhaps they’re a whole lot smarter than we thought.

DrMR: Right.

DrSG: Because they’ve been getting rid of the hull for centuries. So those are a couple of big ones. Now, there’s two American grains or pseudo-grains that are brand new, and that’s corn and quinoa. The Incas had actually three detoxification processes to get the lectins out of quinoa. The Southwest American Indians who started corn always treated their corn with lye because it would chemically degrade lectins and also keep niacin from being bound.

So you look at cultures, and they’ve always come up with a scheme. Now, the modern lectin-containing foods from the Americas are the nightshade families. Those are the potatoes, eggplant, peppers, tomatoes, and goji berries. It turns out goji berries are from America. They’re not from China. They were taken to China in trade, and they actually grew very well. Then there’s the American beans, which are peanuts and cashews. They’re not nuts at all. The peanut lectin is an amazing way to cause heart disease in rhesus monkeys, our cousin. And there’s some very good examples of the peanut lectin causing colon cancer changes.

And then there’s the American fruits such as squashes, zucchinis, pumpkins, and their seeds, like sunflower seeds and pumpkin seeds, and chia seeds. Loren Cordain sent me a paper years ago showing that chia seeds increase inflammation in humans, which shocked me.

Removing Lectins from Foods

DrMR: Quite a list there. So let me ask a couple follow-up questions. I’m sorry. Are you done?

DrSG: Well, one of the follow-up questions is, well, how do you get rid of lectins? Well, you can peel and de-seed tomatoes and peppers and even zucchinis and squashes and cucumbers. The lectins are primarily in the peels and seeds. Traditionally, Italians always peel and de-seed their tomatoes before they make pasta sauce. You’ll never open a can of Italian bell peppers and see peels and seeds. The Southwest American Indians always charred their chilis and peeled them and de-seeded them. That’s why you’ll never open a can of green chilis and see peels and seeds. They’re all gone. So, again, I study the evolution of cultures in handling lectins, and it’s fascinating what people do.

What to Avoid When Gluten-Free

DrMR: You could be gluten-free but still eating a diet containing a fair amount of lectins if you were still eating lots of grains, right?

DrSG: Correct. And in fact, you’re probably well aware of the literature that you can put celiac patients, biopsy-proven celiac patients, on a gluten-free diet for two years and about 73% of them will still be positive for celiac by repeat biopsy at the end of two years. And it’s not because they’re cheating. It’s because the gluten-free foods that they’re eating are full of other lectins.

And a good part of my practice involves people who have gone on a gluten-free diet for either celiac or autoimmune disease or IBS and have gotten better, but they haven’t gotten completely better. And it’s when we finally remove these other, what I think are more important, lectins, that they finally start turning around.

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Lectin and White Blood Cells

What are some of the most common symptoms? Of course, you mentioned heart disease. I’ve heard some discussion of joint problems, and I’ve also heard a couple of patients actually ask me about “Can chronically depressed white blood cells be caused by lectins?” So curious to get your thoughts on what the more common symptomatic manifestations may be of someone who is lectin-sensitive or over-consuming.

DrSG: That’s a great question. And one of the things that struck me early on when I started to play in this arena is these people would invariably have workups for low white blood cell counts. And they’d never find anything wrong, but they’d always have white blood cell counts of 2000-3000. And it was striking to me that after we took lectins out of their diet that their white blood cell counts returned to normal.

So I think actually what’s happened is that we know that in an infection that white blood cells will marginalize along the surface of blood vessels. And interestingly enough, the lectins, one of their targets are the sugar molecules on the surface of blood vessels. So I think what’s happening is that those white blood cells have been marginalized on blood vessels or even headed off into tissues, so we don’t see them in the traditional blood draw. So that’s very true.

Now, I can tell you lectin sensitivity, you can take animals and inject lectins into their belly. And they will become profoundly anxious and depressed, and they will retreat to a corner of their cage. And they will not go out, inquisitive, and do food-seeking behaviors. And if you think about it from a plant strategy, if you can make an animal depressed or anxious, that’s a pretty lousy predator.

Now, people always say, “Oh, come on now. Plants don’t think.” Well, they don’t think in the way you and I associate thinking. But again, evolutionary pressures are evolutionary pressures. And if you through chance or a mutation have a compound that keeps you from being eaten or your seeds from being eaten, then that compound will persist. And we do know that actually plants, as I talk about in The Plant Paradox, if you start insects chomping on one side of a tree, within 15 minutes, the other side of the tree will increase its lectin content by about four-fold.

Plants are so sensitive. I talk about—there’s an experiment with leaves which are normally eaten by caterpillars. And they will increase their lectin content if they feel the vibration of a caterpillar eating their leaves. And they produce the vibration of a caterpillar and the plants do not respond to the vibration of the caterpillar. The caterpillar actually has to be physically in contact with the leaf and produce the vibration. So these guys are a lot smarter than we think.

DrMR: Sure. If they’ve been around for as long as they’ve have, then you have to assume that they’re not dopes. And certainly, evolutionary pressures have a large impact on—perhaps there were strains of plants that were more efficient at secreting lectins and they were less eaten. And so, as you said, they may have benefited from the pressure there.

Common Symptoms of High-Lectin

So depression and fatigue seems like one. Now, of course, that’s challenging because there are many things that can manifest as depression and fatigue. And I’m asking this question with kind of two different people in mind. One, the layperson who is their own health advocate and they’re trying to piece this together. So they’re trying to figure out, “Okay, I can go on low FODMAP. I can go on low carb. I can go on low lectin.” So I always try to get people what are the most key items that a given problem may manifest as. And also, for a clinician trying to figure this out with their patients. So would you say there’s like a top tier of presentation or symptoms that really flag in your mind, “Okay, this person probably has a problem with lectins?”

DrSG: So certainly, joint pain and arthritis. Quite frankly, autoimmune disease; I’m now convinced and I’ve written papers that when you remove lectins from people with autoimmune disease, their autoimmune disease clears. It’s actually rather impressive. Last fall, I gave a paper at the big microbiota meeting in Paris at the Pasteur Institute of 78 people with marker proven autoimmune disease that became marker negative with removal of lectins from their diet.

So this is a thing that’s called molecular mimicry. And lectins—again, plants are pretty smart. And all proteins are identified by a molecular barcode. And they’re identified by what are called toll-like receptors, TLRs. And these toll-like receptors are basically barcode scanners. And they scan a protein to decide if that protein is foreign or if we recognize that protein.

And lectins, they make their barcode resemble the barcode of other organs in our body. For instance, they look remarkably like thyroid tissue, a pancreatic beta cell, a synovial membrane, the myelin sheath. And it’s actually fascinating to me from a plant standpoint of why they might want to do this, have us shoot ourselves in the foot. So joint pain, absolutely. Swelling for no good reason. Skin rashes. Psoriasis. Just got off the phone with a woman this morning from Virginia, who we embarked on this a year ago, with such severe psoriatic arthritis and plaque psoriasis. She had failed Enbrel, had some really bad reactions to it.

And she embarked on this program. And we do very sophisticated inflammatory cytokine markers. And over the past year, her joint pain now is almost completely gone. Her plaques are down to just a couple spots on her. For instance, her IL-6 went from 38.0 down to 6.0. Normal in my lab is less than 4.5, so we’re almost there. Her C-reactive protein went from over 31.0 down to 3.5. People notice her. Her docs told her that she’s going to be crippled for life unless she got on another immunosuppressant. And now, they’re fascinated that this is happening.

Interestingly, she said, “They don’t want to know what I’m doing. They’re just fascinated that this is happening.”

DrMR: Sad, but true. I believe it, totally.

DrSG: It’s really true.

Cardiovascular Effects

DrMR: Heart disease, that would also be one in there, correct? Are you seeing high cholesterol? Or how does that manifest from a cardiovascular perspective?

DrSG: It’s not so much high cholesterol. I’ll tell you, a very, very famous heart surgeon—one of the fathers of heart surgery was Michael DeBakey. I had the pleasure to know him. And Dr. DeBakey, even in the 1950s, said that cholesterol has nothing to do with heart disease and that it’s an innocent bystander that gets sucked into the blood vessel.

And I like to use the example if I was an alien observing the surface of Earth, I would say that every time that there’s a traffic accident, I see an ambulance. And I’m pretty certain, because I see an ambulance at every traffic accident, that the ambulance is the cause of the traffic accident. And that would be a correct observation from what data I had.

Well, suppose DeBakey is right and cholesterol happens to be an ambulance at the scene of an accident on the wall of the blood vessel. It turns out that lectins attach to the wall of blood vessels. And because they’re a foreign protein, our white blood cells attack it and set up inflammation. And there is this interesting theory that high cholesterol is merely a bunch of ambulances at a scene of inflammation, trying to patch that area.

As I’ve gone through and watched people reverse their coronary artery disease, I’ve become convinced that cholesterol, per se, is not the issue at all.

DrMR: So then, are there certain ways that lectin sensitivity, for lack of a better term, manifests from a cardiovascular perspective? Are these people that maybe their, what is it, cardiac Doppler scores are low? How would someone know from a cardiac perspective I should maybe start restricting lectins in my diet?

DrSG: Well, so I take care of a lot of people with known coronary artery disease. They’ve had stents or we’ve done bypasses or they’ve had strokes. And last year, at the European Atherosclerosis Society meeting, I gave a 12-year follow up of 1000 patients who had been on the program. And ordinarily, if you’re diagnosed with a heart attack or a stent or bypass, statistically within three years, you have a 50% chance of having a new event: a new heart attack, a new stent, a new bypass, and a stroke.

At the end of 12 years in the 1000 patients, we have a 2% incidence of a recurrence. Only about 20 patients out of 1000 had a new event.

DrMR: That’s terrific.

DrSG: Yeah. Our paradigm of what causes, how to prevent heart disease quite frankly is just all wrong.

Plant-Based Diets

DrMR: Well, I certainly agree with you in large part. And this is a great transition to the next question that I wanted to ask, which is what do you say to the plant-based diet, vegetarian advocate who just has their paradigm of plant-based diets are better for preventing heart disease? What is your typical retort to them?

DrSG: I consider myself a vegaquarian. I eat mostly plants. I supplement with some shellfish and an occasional fish, but I primarily am a plant predator. But I select my plants carefully. I eat the ones that I was designed to eat. And I came out of Loma Linda, which of course is a very famous vegetarian institution. And it’s a blue zone, and there are interesting similarities in blue zones that Dan Bruckner and I would disagree about. Dan thinks that blue zones are blue zones because they eat a highly vegetarian diet that includes lots of beans and pulses.

And I actually disagree with him, and I cite some sources in The Plant Paradox that show that grains and beans are actually a negative aspect of these diets that are, if you will, compensated for by the very high polyphenols in the diets of these people. The other thing that I think is the most common thread that we would both agree on is that all of these blue zones, animal protein is a very, very small part of all of their diets. And that, Dan and I would absolutely agree on, may be actually the biggest factor.

And I go into this a lot in The Plant Paradox. And I grew up in Omaha, NE, and Milwaukee, WI, and I can assure you that it makes me very sad when I tell people that animal protein may not be very good for us.

Ancestral Diets

DrMR: Let me ask you this question then, coming back to Cordain, who you mentioned earlier. He did a worldwide survey of hunter-gatherer populations. And I want to say that it was over 65% of hunter-gatherers worldwide consumed over 55% of their calories from animal sources. I guess the question I’m asking is, if there’s this change in macronutrient ratios as we go more toward the poles, how do you account for that in terms of your overall dietary recommendations?

DrSG: Well, as I talk about it in the book, my personal feeling is that the Paleo or ancestral diet was designed to make you an ancestor. You were designed to grow up rapidly, have babies, and then get out of the way. So I have—nothing wrong with that. In fact, there’s a brand-new study that was published last week, looking at simultaneous food stuffs of Neanderthal and modern humans, Cro-Magnon man, in Europe. And it turns out that their diets were actually identical. They [the diets] were mastodons and lots of raw vegetables and leaves.

There was a theory that Cro-Magnon man ate a lot of fish, and that’s why they were smarter than Neanderthals. But now, we know that they actually ate the same diet. And one of the things about mastodons is they’re nice and fatty. So we had to start eating grains and beans when the mastodons left, or we killed them all, one of two.

So I think, sadly, if you look at animal models, including two rhesus monkey studies, that it’s protein that’s actually the driver, or lack of protein is the driver of longevity. And in my office, our saying is 150 is the new 100. So that’s where we’re aiming for, and I’m sticking to it. I’ll let you know when I’m 150 how it went.

Dietary Lectin and Using Olive Oil

DrMR: That’s a lofty goal, but I certainly support longevity. And hopefully, it’s a good 150.

DrSG: Yeah, exactly.

DrMR: Right. So then, something else maybe to give people a little more crystallization in terms of it seems like there’s a lot of plants that they can’t eat. What are the plants that one should focus on? And maybe it’s as simple as eating many of those plants that you outlined, but peeling the skins and de-seeding and essentially doing that for vegetables and avoiding grains. And maybe from a broad-stroke perspective, it’s as easy as that. But what additional tips would you give people to start refining this?

DrSG: Right. So the broad stroke is you’re designed to eat what you’re designed to eat, and that was leaves. We ate tubers. There is pretty interesting evidence that once fire was harnessed about 150,000 years ago, we were able to eat tubers safely. And fire actually made us human because, as you and I know, we have no ability to digest the cellulose in a plant cell wall. And cooking actually breaks that down. So fire was great.

So leaves and tubers and, quite frankly, fats. We ate fatty animals, but I love the fats from the fruit of olives or avocados. I personally think the only purpose of food is to get olive oil into my mouth. There’s beautiful studies out of Crete and Spain, having people use a liter of olive oil per week for five weeks. For your listeners, that’s about 12 to 14 tablespoons of olive oil a day. That’s a lot of olive oil.

In the Spanish study, they took 65-year-old individuals and compared this olive oil Mediterranean diet to a low-fat Mediterranean diet. And at the end of five years, the olive oil group had improved memory. And the low-fat group had worse memory. But particularly interesting, the olive oil group had less heart disease, unlike what Dr. Ornish would want you to think or Dr. Esselstyn, compared to the low-fat group. And the women in the olive oil group had a 67% less breast cancer rate than the low-fat group.

So I’m a big fan of olive oil. I’m a big fan of avocado oil. I think MCT oil is very useful. I have a food pyramid that people can find on my website—GundryMD.com—that kind of stands the current food pyramid on its head. Leaves and tubers and fats are the base of the pyramid.

And then the second part of the pyramid is don’t eat. I think meal skipping is one of the most important things that people can do, particularly from an evolutionary perspective. People forget that we had no storage system. We did not crawl out of our cave and said, “What’s for breakfast?” Because there wasn’t any breakfast, and we had to find breakfast. And if we didn’t find breakfast until lunch, then that was breakfast at lunch. If we didn’t find it till dinner, that was breakfast at dinner. And we’re beginning to realize thanks to studies that I’ve done, that Dr. Dale Bredesen from UCLA and the Buck Institute have done, that the longer we go between meals, the better our brain functions and the longer our brain works properly.

Dr. Ruscio Resources

Hey, everyone, in case you’re someone who is in need of help or would like to learn more, I just wanted to take a moment to let you know what resources are available. For those who would like to become a patient, you can find all that information at drruscio.com/gethelp.

For those who are looking for more of a self-help approach and/or to learn more about the gut and the microbiota, you can request to be notified when my print book becomes available at drruscio.com/gutbook. You can also get a copy of my free 25-page gut health eBook there.

And finally, if you’re a healthcare practitioner looking to learn more about my functional medicine approach, you can visit drruscio.com/review. All of these pages are at the drruscio.com URL, which is D-R-R-U-S-C-I-O dot com, then slash either ‘gethelp,’ ‘gutbook,’ or ‘review.’ Okay, back to the show.

The Benefits of Intermittent Fasting

DrMR: We’ve talked, of course, about intermittent fasting on the podcast. And certainly, I think there’s some impressive research to back it up. There’s definitely very plausible evolutionary history to support that. Exactly like you said, it’s not like a caveman’s going to wake up and have breakfast waiting right then and there.

And also, personally, I’ve been experimenting with it lately. It’s been funny to me to make the transition, coming from a bit more of like a health and fitness, eat small frequent meals background that I came from, shifting to skipping meals. That, according to the dogma I used to be involved in way back in my early college years, was the devil. You can’t skip meals. Skipping meals will make you store fat. But really, when you look at some of the clinical trials, you see really no negative metabolic consequence and some actual metabolic benefit from intermittent fasting.

And then, personally, I feel well on it. But it is funny. Friends and family will often say, “Oh, do you want something to eat?” “No. I’m fine.” They think that you’re being unhealthy in doing that because our culture’s been so ingrained. But I am in complete agreement with you.

DrSG: Yeah, it’s interesting. Ten years ago, I started a program on myself that from January through June, six months during the “winter,” I didn’t eat breakfast or lunch during the week. And I ate all my calories in a two-hour window from six to eight o’clock at night, so that 22 out of 24 hours I was fasting. And then, on the weekends, I had lunch and dinner, but I still didn’t eat breakfast. And I did that, and when I was writing the first book, I had a whole chapter on intermittent fasting and its benefits. And my editor at Random House said, “This is absolutely crazy. You’re already crazy enough. This is going to throw people over the edge, and we’re going to cut it.” I said, “No, no, no. You can’t.” So he said, “All right. I’m going to give you a page and a half, and that’s all you’re going to get because this is nuts.” And of course, in retrospect, it’s pretty funny.

So I’ve been doing that for 10 years now, just eating two-hour window of time six months out of the year. And it’s fascinating. I’ve become good friends with Dale Bredesen, who’s probably the smartest man in the world in preventing Alzheimer’s and reversing Alzheimer’s. And he’s convinced that one of the keys as we age is to at least have a 14-hour window between meals. And if you carry the ApoE 4 gene, which is the Alzheimer’s gene, which I’m supposedly the world expert on treating with diet is how I know Dale, he and I both think you should bare minimum go 16 hours between two meals.

What that means realistically is that if you finish dinner at six o’clock at night, your next meal, next food that enters your stomach is 10 o’clock the following morning.

Fasting, Digestion, and Brain Health

DrMR: There’s a gut perspective… I’m just wondering from your own clinical observations, because I oftentimes notice that people who have more…And I’m making some assumptions here, but it seems that people who may be more prone to feeling mentally sluggish or brain fog, they often times notice that if they go longer between meals—this is my clinical observation—their gut and their brain feels better. And that’s not really much of a stretch, but have you noticed that same sort of connection?

DrSG: Oh, absolutely.

DrMR: Yeah.

DrSG: Number one, I’m old enough to remember that when we ate lunch my mother would say you can’t go in the water for an hour after eating because you’ll get cramps and die. And as you and I remember from school, the gut actually requires huge amounts of blood flow and energy during digestion. And the brain, of course, is the most energy needy organ. And what happens is that when we eat, we divert blood flow down into our gut.

And that’s why all of us, like myself and Dale Bredesen, think you really should not go to sleep for four hours after your last meal because we know now that there’s a period of time where your brain… It’s called deep sleep where you actually do a deep cleaning of the toxins in your brain. And there’s a lymphatic wash that requires huge amounts of blood flow to accomplish. And if that blood flow has been diverted to your gut, then your brain is not going to be able to clear its toxins.

So one of the really cool things about intermittent fasting is you do get this brain fog that lifts. And the other thing is digestion is expensive work. And so, giving your gut a rest not only takes less work, but one of the things that’s interesting is you go through a period of time where you cut back on the reproduction of bacteria in your gut. And the more bacteria that are dividing, the more of these lipopolysaccharides are released. So gut rest is a very, very useful thing.

Not Eating Before Sleep

DrMR: That’s actually a very poignant comment, because I’ve been meaning to look into if there’s any data showing how long you should wait from your last meal to when you go to bed. Because, of course, when you go into this intermittent fasting, for a lot of people it kind of pushes them to eat later in the day. And I’ve been wondering how close to bed is too close. And so you like the window of four hours from your last meal to when you go to bed.

DrSG: Yeah. Dale Bredesen has worked this out very nicely. And I’ll give him a plug. His book The End of Alzheimer’s will be released on August 22^nd. And the guy is just brilliant in the areas of dementia and Alzheimer’s.

DrMR: Yeah, we’ll have to get him on the show, because I’d be curious to pick his brain on that topic a little further. So I may ask you to connect me with him at some point.

DrSG: Yeah, we’ll do that. I’d be happy to.

Research on Low-Lectin Diets

DrMR: We’re getting your time here. I just want to ask you a couple final questions. One, it sounds like there’s some pretty compelling research to support this, because you’ve cited a few studies throughout the call. But I know we have clinicians who listen, and they really like to hear what the research says. So would you have any kind of high-level commentary in terms of where we are with clinical research in the regard of low-lectin diets?

DrSG: Yeah. It’s in its infancy. I am probably the only guy who’s written about the blood values and inflammatory cytokines and presented papers. Certainly, Dave Asprey has adopted the low-lectin diet and has had great results. I think it’s just a matter of time when more people start seeing this. I have, in my book, well over 300, 400 references on how lectins affect our gut, our brain, our immune system, our blood vessels. So people think I’m making this up, but it’s a very heavily referenced book.

And it’s real. I wouldn’t have believed any of this 15 years ago. I just wouldn’t have believed it.

DrMR: Sure.

DrSG: I can see it on blood work. Anecdotes are great, but when you have hundreds and thousands of patients who reverse all their inflammatory markers by lessening the lectins in their diet, there’s something there.

Tracking Inflammatory Markers

DrMR: Just briefly on the inflammatory markers. Are there a few that you…? I know you mentioned a couple earlier, but let’s say a clinician had a limited budget with their patient. Maybe they don’t have great insurance coverage. Are there a couple that you think are most impactful for tracking inflammation?

DrSG: Yeah. So hs-C-reactive protein, CRP, it’s a good generalized marker of inflammation. I really like TNF-alpha, tumor necrosis factor alpha. IL-6 is really good for tracking rheumatoid arthritis patients. I wrote a paper—gosh, it’s been probably three years ago now—that I gave at the American Heart Association, suggesting that people who have an adiponectin level above 16 are probably sensitive to lectins. Most people think of adiponectin as a good hormone, and yet we know that adiponectin is elevated in rheumatoid arthritis.

And the Nurses’ Health Study from New England actually showed that skinny women with high adiponectin levels had a much higher incidence of Alzheimer’s disease than the general population. I think an elevated adiponectin marker is a good way to look.

Also, here’s a tidbit for clinicians. If the patient had their tonsils out, there’s almost a guarantee that they’re sensitive to lectins. And the reason I say that is tonsils are the fortresses that guard our harbor, our GI tract. And they’re the first place that we actually encounter lectins. And so all that, what we thought was strep throat, I’m pretty convinced was just a battle between us and lectins at the mouth.

DrMR: That’s very interesting. Okay. Those are great markers for people.

DrSG: Yeah. You still have your tonsils. Also, if they have a low vitamin D level, get their vitamin D levels up to 70-100, and you may be shocked often with how much vitamin D you have to push. And it’s all in my book, The Plant Paradox.

Additional Information on Lectins

DrMR: This has been a fantastic dialogue. As we come to a close, is there anything else that you think people should know regarding this topic.

DrSG: Well, sadly, through no fault of your own, your doctor or nurse practitioner or PA are not savvy with this. And what I can tell particularly your women listeners is through the years, if you have complaints such as brain fog, such as IBS, such as joint pains, rashes, please ask for more sophisticated tests or find a practitioner who will actually listen to you. Because this is not in your head, this is actually happening.

If I have one word of advice, it is for women to really not accept that this is all in their head. It’s not.

DrMR: Sure. Sure. And I want to ask you where people can track down your book and learn more from you in a moment. But before I do, I want to ask you one question to help keep people grounded. And the quick background on this question is people hear more and more about what you shouldn’t eat and what you shouldn’t do. Sometimes it can create this kind of orthorexia and fear of food. So I like to ask guests, what is maybe the least healthy but most fun thing that you’ve done lately?

DrSG: Let’s see. What did I do that was the least healthy? I was in Italy, and I had some fresh melon for the first time in a year. And I only did it because I was in Italy, and it was completely de-seeded and peeled. So that was my really, really bad thing to do and I thoroughly enjoyed it because I wrapped it in prosciutto.

DrMR: That sounds pretty good.

DrSG: And poured olive oil all over it, seriously.

Episode Wrap-up

DrMR: All right. Where can people hear more from you? Please tell me about your book and your website and where they can kind of track you down.

DrSG: So they can get The Plant Paradox on Amazon, Barnes & Noble, any of your local booksellers. They can visit my website at GundryMD.com. G-u-n-d-r-y. And you can sign up for my daily newsletter and go from there.

DrMR: Awesome. Well, Steven, thank you so much for taking the time. This was a really educational call, and I think people will get a lot out of it.

DrSG: Well, thanks. I appreciate really being on your podcast. The book’s been on the New York Times bestseller list for 12 weeks now and really rolling.

DrMR: Awesome. Well, keep up the good work, and hopefully we’ll have you back on sometime in the near future to maybe do a part two to this call.

DrSG: That’d be great.

DrMR: Thank you again, Steven.

DrSG: Take care.

DrMR: Bye-bye.

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Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.