http://www.thekitchn.com/feedburnermain

There are a few websites that I check almost every morning, and one of them is Joanna Goddard’s blog, A Cup of Jo. She covers everything from family, to dating her husband, to travel, and she even includes great recipes from time to time. Her honesty and vulnerability make her feel like a close friend, even though I’ve never met her in person.

If you, like me, are a longtime reader of Joanna’s blog, it might not come as a surprise that her favorite pint of ice cream has a great sense of place and story behind it. Have you tried this delicious scoop?

READ MORE »

http://www.thekitchn.com/feedburnermain

The last time I came down with a cold, I curled up beneath a heap of blankets, propped myself up with pillows, and battled my brain fog with a mug of “golden milk.” Warm and velvety, spiced with turmeric, cinnamon, and ginger, it was the color of daffodils — and every bit as comforting. But I wasn’t just going for soothing; I was gunning for a record-breaking recovery. Would golden milk be my Seabiscuit?

READ MORE »

http://www.thealternativedaily.com/

[…]

http://www.thekitchn.com/feedburnermain

Have you jumped on the golden milk trend yet? If not, this is the perfect — and aruguably, most delicious — way to do so.

READ MORE »

http://www.thekitchn.com/feedburnermain

Bad habits are hard to break, but maybe that’s because we’re thinking about them all wrong. What if it’s less about breaking a bad habit than it is about making space for something better? Here are five ideas for small, simple changes you can make to help you feel better about yourself and your kitchen this summer.

READ MORE »

http://www.marksdailyapple.com/

The following guest post from Al Kavadlo & Danny Kavadlo is adapted from their book STREET WORKOUT and is published with permission from Dragon Door Publications. Enjoy!

In the beginning, we crawled. We hunted. We climbed. We played. We did a lot of things. Early man used his arms, legs and entire body every time he pulled himself up a tree to pick fruit or hoisted up a mammoth carcass for the weekly feast. He didn’t isolate body parts when he fought to survive. He didn’t jump or sprint because it was “leg day.” He did it because a saber-toothed tiger was gonna rip him apart if he didn’t.

Fast forward a few millennia and we find mankind erecting the Egyptian Sphinx, Stonehenge and the Great Wall of China. It takes a great deal of raw, physical strength to move mountain-sized boulders, but we had it. There was no isolation there, friends, just the full body working together in harmony. Trust me, these architects were not at the gym doing three sets of ten hammer curls.

The Acropolis. The Great Buddha of Kamakura. The Brooklyn Bridge. Our ancestors didn’t use any modern gym equipment to get in shape for masterfully designing and building these incredible structures. In fact, they built these amazing structures because they understood (from an architectural perspective) that leverage, one of the key principles of progressive bodyweight training, could help create something incredible, whether it’s a majestic pyramid or a sculpted human body.

Training the body without the use of external resistance equipment is known as calisthenics. It has been around since the dawn of humanity. Calisthenics, or bodyweight training, is the oldest and noblest form of exercise.

Pressing, pulling and squatting are hard-wired into our DNA. Way before the invention of the modern gym, using only our bodies for resistance was not just the best way to train…it was the only way. It’s no wonder so many of us get excited, inspired and motivated by this phenomenon! In fact, the modern gym (sometimes called “globo-gym”), with all its fancy, bi-angular lat pull-down machines, shiny cable crossovers and digitized, fake bicycles is a recent invention of the 20th century. Calisthenics is timeless.

That’s not to say that gyms did not previously exist. They did, but not in the modern sense. The very first gyms (or “gymnasia”) of ancient Greece consisted of exclusively bodyweight exercise. The minimalist equipment used, for example, were parallel bars, climbing ropes and running paths. In fact the word “calisthenics” has its roots in Greek and translates approximately to “beautiful strength.” It’s interesting to note that these gyms also taught wisdom, philosophy and linguistics.

In the era in which we grew up, the aforementioned globo-gyms had become the standard. Thank goodness that in the 1980’s New York of our youth, we were too young and too broke to visit them. I guess we were lucky in that when we were kids, minimalism wasn’t a trend; it was our only choice. Our fitness journey started out with push-up and pull-up contests. In fact, the only equipment we owned at the start of our odyssey was a doorframe pull-up bar. Man, we loved that thing!

For many years we’ve observed numerous big box fitness chains opening up all over the place. We even worked at a few of them. (Hey, hey, hey—everybody’s gotta make a living somehow.) But now on a global scale, it appears that fitness culture is returning to its roots. It’s nice to see. The Primal community is a big part of this resurgence, as is a subculture that has simply become known as Street Workout.

We’re born with an urge to be outside. We’re animals, not built to sit under florescent lights in a climate controlled, windowless room. It’s bad enough that so many good people have to do this at their jobs. Let’s not do it during our workouts.

Street Workout taps into so many elements you simply can’t find in the contemporary big box gym. These include the elegant minimalism of bodyweight training, the splendor of the great outdoors and the empowerment of owning a body that’s truly self-made. Not to mention the badass feats of strength associated with extreme calisthenics.

The improvisational element of Street Workout is equally appealing. When you use what the world has provided around you, rather than what you’ve been told to use by the corporate equipment manufacturers, you awaken a creative, even artistic, part of your mind. Whereas commercial gym members use multiple thousand-pound machines to train one muscle at a time, we can look at a pole, fence or street sign and come up with a dozen full-body exercises on the spot. We can even do entire workouts with nothing but the floor beneath our feet.

On a cultural level, Street Workout is revolutionary. The great anthropological equalizer if you will. Our community comes from different backgrounds and origins, assorted borders and parts of the world. We are united for a common cause: a love of fitness, form and function, a passion for self-improvement and a need to inspire others. Young and old, male and female, black and white, gay and straight: we are all represented.

But sociology aside, Street Workout is also the great equalizer of body types. Because calisthenics focuses on your pound-for-pound strength, the big guys and little guys have the same relative resistance: themselves. Allow us to elaborate; a muscular guy who’s 6’ 2” and weighs 250 lbs. will naturally have a higher bench press than an equally muscled individual of 5’6” and 150 lbs. Assuming the same body composition, it’s simply a matter
of physics. The heavier guy can lift more external weight. But if you put them both in a push-up contest, it’s an even playing field. Street Workout is an equal opportunity employer. If your body mass is going up and your reps in push-ups are going down, are you really getting stronger?

By utilizing basic principles of progression such as the manipulation of leverage, adding or removing points of contact and/or increasing the range of motion, you can continue to build new levels of strength without ever having to pick up a weight.

Some people will argue that the pull-up, for example, can only be progressed by adding weight to the body. Though that is one approach, there are many other methods to progress the pull-up. Here are three way ways to increase your pulling power without adding weight or using any equipment beyond the bar itself.

Archer Pull-up

This is an advanced variation that involves keeping one arm straight while relying primarily on the opposite side to do the bulk of the pulling. Begin like you’re performing a very wide pull-up, but bend only one of your arms as you pull your chin over the bar. This means your torso will shift toward that side while the opposite arm stays straight. You’ll need to reach your legs slightly to the side to counterbalance. The hand of your straight arm may need to open and roll over the bar at the top of the range of motion, depending on your wrist mobility.

If you are unable to perform a full archer pull-up, you can allow your secondary arm to bend slightly in order to make the exercise less difficult. Once you get to the top, you can extend the arm fully and attempt a negative archer pull-up. In time, you shouldn’t have to bend the secondary arm at all.

Muscle-up

The mighty muscle-up begins like a pull-up, but continues until your entire torso goes up and over the bar. Grip the bar slightly narrower than you would for a pull-up, then lean back and pull the bar down your body as low as possible. At the top of your pull, reach your chest over the bar and extend your arms.

It’s helpful to think about leaning away from the bar during the pulling phase before pitching forward at the top. This creates a movement pattern that’s more of an “S” shape than a straight line, allowing you to better maneuver your body around the bar.

One Arm Pull-up

The one arm pull-up is the ultimate in pound-for-pound pulling prowess. It is said that only 1 in 100,000 people will ever perform this exercise, but any able-bodied person who is willing to put in the time and effort can achieve a one arm pull-up in this lifetime.

Due to the lopsided nature of using just one arm to pull yourself, some trunk rotation may be unavoidable when working on the one arm pull-up. Your body will naturally twist as you go up. In the beginning, you should use this to your advantage, and practice turning in toward the bar as you pull. This will cause your grip to rotate from an overhand to an underhand position as you ascend.

Before you begin working toward a one-arm pull-up, make sure you spend plenty of time getting comfortable with the two arm variety. Focus on getting to the point where you can perform at least 15 clean overhand pull-ups in one set without using momentum. Ideally, you should do closer to 20. This is the foundation for your one arm pull-up. Getting comfortable with archer pull-ups is also very helpful before embarking on the quest for the one arm pull-up.

These examples are just the tip of the iceberg. You can train every muscle in your entire body without relying on external resistance, and every movement pattern in the Street Workout continuum can be progressed or regressed to suit any fitness level. The possibilities of what you can do with just your own bodyweight and your environment are greater than you might have imagined.

If you would like to know more, pick up a copy of our new ebook, Street Workout.

http://chriskresser.com/

PPIs have become one of the most commonly prescribed classes of drugs in the industrialized world, despite increasingly frequent warnings by researchers about potential risks and complications.

A 2010 study found that of 946 patients receiving PPI therapy in a hospital setting, only 35 percent were prescribed PPIs for an appropriate upper GI diagnosis (1). In 2014, Americans filled more than 170 million prescriptions for acid blockers, falling only behind statins in total cost expenditure worldwide (2). PPIs are the most common of the acid blockers. They go by a variety of names but typically end in the suffix “-prazole” (omeprazole, pantoprazole, esomeprazole, etc.).

The purpose of this article is to provide an update to these earlier articles on heartburn and antacids, focusing on a number of scientific studies published in just the last few years. If you haven’t already, be sure to check out these previous blog posts.

The many roles of proton pumps in the body

Before we get into the potential harmful effects associated with PPIs, it’s important to understand what they do in the body. PPIs are inhibitors of proton pumps, specifically the proton/potassium pump of parietal cells in the stomach. The theory is that heartburn is caused by excess production of stomach acid by these cells, so inhibiting this proton pump will reduce the acidity of the stomach and prevent the burning sensation of acid reflux or the formation of peptic ulcers.

But proton pumps aren’t limited to the stomach; they are present in just about every cell in your body. All of your cells, with the exception of red blood cells, have mitochondria that allow your body to metabolize carbohydrates and fat to produce energy. They do this by pumping protons across the membrane to generate a source of electric potential that can be harnessed to form ATP, the body’s main storage form of energy. Without an efficient proton-pumping system, the body must rely on anaerobic systems for energy production, leading to rapid fatigue.

Proton pumps are also important in the transport of various substances in the body, as we will see in detail in later sections. And while proton pump inhibitors are designed to interact specifically with the hydrogen/potassium pump in parietal cells of the stomach, research suggests that they likely have nonspecific binding capabilities (3). In other words, their chemical structure enables them to bind to other proton pumps as well. Though PPIs don’t stay in the blood for very long, their binding to proton pumps is essentially irreversible—they will continue to inhibit the proton pump until the master antioxidant glutathione is able to facilitate dissociation (4).

PPIs can harm your heart, brain, kidneys, and gut. There are other alternatives.

PPIs alter the gut

The composition of microbes that inhabit your gut is incredibly sensitive to changes in the local environment. pH, a measure of the acidity of an environment, is an important facet of gut health and a particularly potent regulator of microbial communities (5). PPI use reduces the amount of acid produced in the stomach, and ultimately the amount of stomach acid that reaches the gut. This causes a significant shift in the pH of the intestines.

Indeed, several recent studies have shown that PPI alters the gut microbiota by reducing its overall diversity (6,7). Opportunistic pathogens, including Enterococcus, Streptococcus, Staphylococcus, and E. coli, tended to be more prevalent in the guts of PPI users.

As stomach pH becomes less acidic, many ingested microorganisms that would normally be destroyed are able to make their way into the gut (8). Imhann and colleagues found that oral bacteria, such as the genus Rothia, were over-represented in the gut microbiota of PPI users (7). Those who used acid blockers also had an increased chance of acquiring Clostridium difficile, Campylobacter, Salmonella, Shigella, Listeria, and community-acquired pneumonia than those using other medications (9,10).

A 2013 study also found a significantly increased percentage of individuals with small intestinal bacterial overgrowth (SIBO) among PPI users (11). Together, these studies point to the vital importance of sufficient stomach acid for protecting against bacterial influx into the GI tract and maintaining an intestinal pH that supports GI health.

PPIs impair nutrient absorption

Another consequence of long-term PPI use is impaired nutrient absorption, which I discussed extensively in a previous article. Stomach acid is essential for the absorption of many macro- and micronutrients. PPI users have been shown to have an increased risk of vitamin and mineral deficiencies, including vitamin B12, vitamin C, calcium, iron, and magnesium (12,13). Achlorhydria (a lack of stomach acid) and atrophic gastritis (stomach inflammation) allow for the overgrowth of bacteria, which compete with the host for consumption of micronutrients like vitamin B12 (14).

These micronutrients are particularly important for bone health. Studies have found an association between PPI use and total bone fractures in the elderly (15). While the association was modest, the findings were significant enough that the FDA felt it necessary to issue a news release in 2010 warning of the possible increased fracture risk (16). Since then, a more recent study has shown a similar association in young adult PPI users (17).

The effects of PPIs on bone health may be more nuanced than simply causing nutrient deficiency. Osteoclasts, the bone cells responsible for the resorption of calcium, also possess proton pumps, and their activity is thought to be directly affected by PPIs (18,19).

PPIs increase the risk of cardiovascular events

Several recent studies have also shed light on PPIs and the cardiovascular system. PPI users have been shown to have a significantly greater risk of heart attack than those on other antacid medication (20, 21). PPIs also reduce production of nitric oxide, a natural substance that promotes the dilation of blood vessels and improves blood flow (22).

PPIs may also damage blood vessel cells, as shown by a study published in May 2016. When researchers exposed cultured human blood vessel endothelial cells to esomeprazole, the cells seemed to age much more quickly, losing their ability to split into new cells. PPIs, which are designed to work especially well in acidic environments, seemed to inhibit an acidic compartment of the cell called the lysosome, which can be thought of as the cell’s “garbage disposal.” Without the ability to break down old proteins and other waste products of metabolism in lysosomes, “garbage” built up in the cells and inhibited their function (23).

PPIs harm the kidneys

The kidneys are also affected by PPIs. A study published in 2016 compared patients using PPIs to patients using H2 blockers, another common antacid drug. They showed that over the course of five years, those in the PPI group were 28 percent more likely to develop chronic kidney disease and 96 percent more likely to develop end-stage renal disease (24).

While the mechanism by which this occurs is unclear, we do know that proton pumps are present in the intercalated cells of the kidney. These proton pumps are responsible for moving protons into the urine, creating a gradient that allows for bicarbonate reabsorption into the blood (25). Bicarbonate is vitally important to maintaining proper blood pH.

PPIs negatively affect cognitive function

PPIs also impair cognitive function. A 2016 study found that regular PPI users had a 44 percent increased risk of dementia compared with those not using the drugs (26). A different study published in 2015 that assessed cognitive function in PPI users versus controls found statistically significant impairment in visual memory, attention, executive function, and working and planning function among PPI users (27).

Several commonly prescribed PPIs, such as lansoprazole and omeprazole, have been reported to cross the blood-brain barrier. In mice, PPIs were observed to affect β- and γ-secretase enzymes, resulting in increased levels of amyloid β, a protein fragment that forms the plaques characteristic of Alzheimer’s disease (28).

Furthermore, communication between brain cells requires the action of proton pumps. Simplistically, neuron cells contain small vesicles, or pockets, of neurotransmitters. When a neuron is stimulated, the vesicle releases these neurotransmitters into the synaptic space, where they can then interact with receptors on other nearby neurons, transmitting the signal down the line. The neurotransmitters must then be taken back up by the neuron so that they can be released again in response to the next stimulus. The energy required for this reuptake process is driven by proton pumps (29). If PPIs bind to these proton pumps, cognitive abilities would certainly be impaired.

PPI withdrawal can lead to rebound reflux

Your body is acutely sensitive changes in your physiology and is constantly trying to maintain a stable equilibrium, often termed homeostasis. In the case of PPIs, when it senses reduced stomach acid production, your body produces the hormone gastrin to try to compensate. Gastrin normally stimulates gastric (stomach) acid production.

Excess gastrin has in turn been shown to lead to an expansion of enterochromaffin-like cells (ECLs) (30). ECLs are found in the mucosa of the stomach in close proximity to parietal cells. A greater number of ECLs results in a greater amount of ECL hormones released that can interact with parietal cells. Parietal cells, as you may recall, are the cells responsible for stomach acid production via proton pumps. These parietal cells undergo hypertrophy, or an expansion in the size of each cell (31).

Larger parietal cells have more proton pumps and can produce larger amounts of stomach acid. This is termed “rebound hypersecretion,” or an overproduction of stomach acid after taking PPIs (32). This is why getting off PPI therapy is so difficult, because long-term use fundamentally changes the physiology of stomach cells. It also points to yet another instance where simply treating the symptoms of a condition fails to recognize and treat the underlying root cause.

Luckily, parietal cells are constantly undergoing renewal, with an average lifespan of only 54 days (33). So just because you took PPIs does not necessarily mean you are destined to rebound hypersecretion forever, as after a few months your stomach cells should have largely turned over. However, the repair mechanisms after PPI discontinuation have not been widely studied, and it is entirely possible that there are lasting effects.

Alternatives to PPIs

Collectively, these and many other studies suggest that PPIs are not as safe as they are made out to be. Frankly, it’s bordering on criminal that the FDA continues to allow these drugs to be prescribed as frequently as they are, and for durations of years or even decades in some cases, given the overwhelmingly large body of evidence documenting the potential harms associated with long-term PPI use.

If you’re convinced you should avoid PPIs, there are some alternatives (see my previous article for a more detailed discussion of these). Always consult with your medical practitioner before discontinuing the use of PPIs and be sure to reduce your dose gradually to avoid any withdrawal symptoms.

1. Eat a low-carb Paleo diet
   Malabsorption of carbohydrates can lead to bacterial overgrowth, resulting in the bloating and increased abdominal pressure that drives acid reflux.
2. Resolve low stomach acid and treat bacterial overgrowth
   Contrary to conventional wisdom, acid reflux is often due to too little stomach acid, which results in bacterial overgrowth.

Now I’d like to hear from you. Have you taken PPIs? Did you know about the long-term dangers? Did you notice improvement in your acid reflux by switching to a Paleo diet or reducing your carbohydrate intake? Share your experience in the comments section!

http://chriskresser.com/

PPIs have become one of the most commonly prescribed classes of drugs in the industrialized world, despite increasingly frequent warnings by researchers about potential risks and complications.

A 2010 study found that of 946 patients receiving PPI therapy in a hospital setting, only 35 percent were prescribed PPIs for an appropriate upper GI diagnosis (1). In 2014, Americans filled more than 170 million prescriptions for acid blockers, falling only behind statins in total cost expenditure worldwide (2). PPIs are the most common of the acid blockers. They go by a variety of names but typically end in the suffix “-prazole” (omeprazole, pantoprazole, esomeprazole, etc.).

The purpose of this article is to provide an update to these earlier articles on heartburn and antacids, focusing on a number of scientific studies published in just the last few years. If you haven’t already, be sure to check out these previous blog posts.

The many roles of proton pumps in the body

Before we get into the potential harmful effects associated with PPIs, it’s important to understand what they do in the body. PPIs are inhibitors of proton pumps, specifically the proton/potassium pump of parietal cells in the stomach. The theory is that heartburn is caused by excess production of stomach acid by these cells, so inhibiting this proton pump will reduce the acidity of the stomach and prevent the burning sensation of acid reflux or the formation of peptic ulcers.

But proton pumps aren’t limited to the stomach; they are present in just about every cell in your body. All of your cells, with the exception of red blood cells, have mitochondria that allow your body to metabolize carbohydrates and fat to produce energy. They do this by pumping protons across the membrane to generate a source of electric potential that can be harnessed to form ATP, the body’s main storage form of energy. Without an efficient proton-pumping system, the body must rely on anaerobic systems for energy production, leading to rapid fatigue.

Proton pumps are also important in the transport of various substances in the body, as we will see in detail in later sections. And while proton pump inhibitors are designed to interact specifically with the hydrogen/potassium pump in parietal cells of the stomach, research suggests that they likely have nonspecific binding capabilities (3). In other words, their chemical structure enables them to bind to other proton pumps as well. Though PPIs don’t stay in the blood for very long, their binding to proton pumps is essentially irreversible—they will continue to inhibit the proton pump until the master antioxidant glutathione is able to facilitate dissociation (4).

PPIs can harm your heart, brain, kidneys, and gut. There are other alternatives.

PPIs alter the gut

The composition of microbes that inhabit your gut is incredibly sensitive to changes in the local environment. pH, a measure of the acidity of an environment, is an important facet of gut health and a particularly potent regulator of microbial communities (5). PPI use reduces the amount of acid produced in the stomach, and ultimately the amount of stomach acid that reaches the gut. This causes a significant shift in the pH of the intestines.

Indeed, several recent studies have shown that PPI alters the gut microbiota by reducing its overall diversity (6,7). Opportunistic pathogens, including Enterococcus, Streptococcus, Staphylococcus, and E. coli, tended to be more prevalent in the guts of PPI users.

As stomach pH becomes less acidic, many ingested microorganisms that would normally be destroyed are able to make their way into the gut (8). Imhann and colleagues found that oral bacteria, such as the genus Rothia, were over-represented in the gut microbiota of PPI users (7). Those who used acid blockers also had an increased chance of acquiring Clostridium difficile, Campylobacter, Salmonella, Shigella, Listeria, and community-acquired pneumonia than those using other medications (9,10).

A 2013 study also found a significantly increased percentage of individuals with small intestinal bacterial overgrowth (SIBO) among PPI users (11). Together, these studies point to the vital importance of sufficient stomach acid for protecting against bacterial influx into the GI tract and maintaining an intestinal pH that supports GI health.

PPIs impair nutrient absorption

Another consequence of long-term PPI use is impaired nutrient absorption, which I discussed extensively in a previous article. Stomach acid is essential for the absorption of many macro- and micronutrients. PPI users have been shown to have an increased risk of vitamin and mineral deficiencies, including vitamin B12, vitamin C, calcium, iron, and magnesium (12,13). Achlorhydria (a lack of stomach acid) and atrophic gastritis (stomach inflammation) allow for the overgrowth of bacteria, which compete with the host for consumption of micronutrients like vitamin B12 (14).

These micronutrients are particularly important for bone health. Studies have found an association between PPI use and total bone fractures in the elderly (15). While the association was modest, the findings were significant enough that the FDA felt it necessary to issue a news release in 2010 warning of the possible increased fracture risk (16). Since then, a more recent study has shown a similar association in young adult PPI users (17).

The effects of PPIs on bone health may be more nuanced than simply causing nutrient deficiency. Osteoclasts, the bone cells responsible for the resorption of calcium, also possess proton pumps, and their activity is thought to be directly affected by PPIs (18,19).

PPIs increase the risk of cardiovascular events

Several recent studies have also shed light on PPIs and the cardiovascular system. PPI users have been shown to have a significantly greater risk of heart attack than those on other antacid medication (20, 21). PPIs also reduce production of nitric oxide, a natural substance that promotes the dilation of blood vessels and improves blood flow (22).

PPIs may also damage blood vessel cells, as shown by a study published in May 2016. When researchers exposed cultured human blood vessel endothelial cells to esomeprazole, the cells seemed to age much more quickly, losing their ability to split into new cells. PPIs, which are designed to work especially well in acidic environments, seemed to inhibit an acidic compartment of the cell called the lysosome, which can be thought of as the cell’s “garbage disposal.” Without the ability to break down old proteins and other waste products of metabolism in lysosomes, “garbage” built up in the cells and inhibited their function (23).

PPIs harm the kidneys

The kidneys are also affected by PPIs. A study published in 2016 compared patients using PPIs to patients using H2 blockers, another common antacid drug. They showed that over the course of five years, those in the PPI group were 28 percent more likely to develop chronic kidney disease and 96 percent more likely to develop end-stage renal disease (24).

While the mechanism by which this occurs is unclear, we do know that proton pumps are present in the intercalated cells of the kidney. These proton pumps are responsible for moving protons into the urine, creating a gradient that allows for bicarbonate reabsorption into the blood (25). Bicarbonate is vitally important to maintaining proper blood pH.

PPIs negatively affect cognitive function

PPIs also impair cognitive function. A 2016 study found that regular PPI users had a 44 percent increased risk of dementia compared with those not using the drugs (26). A different study published in 2015 that assessed cognitive function in PPI users versus controls found statistically significant impairment in visual memory, attention, executive function, and working and planning function among PPI users (27).

Several commonly prescribed PPIs, such as lansoprazole and omeprazole, have been reported to cross the blood-brain barrier. In mice, PPIs were observed to affect β- and γ-secretase enzymes, resulting in increased levels of amyloid β, a protein fragment that forms the plaques characteristic of Alzheimer’s disease (28).

Furthermore, communication between brain cells requires the action of proton pumps. Simplistically, neuron cells contain small vesicles, or pockets, of neurotransmitters. When a neuron is stimulated, the vesicle releases these neurotransmitters into the synaptic space, where they can then interact with receptors on other nearby neurons, transmitting the signal down the line. The neurotransmitters must then be taken back up by the neuron so that they can be released again in response to the next stimulus. The energy required for this reuptake process is driven by proton pumps (29). If PPIs bind to these proton pumps, cognitive abilities would certainly be impaired.

PPI withdrawal can lead to rebound reflux

Your body is acutely sensitive changes in your physiology and is constantly trying to maintain a stable equilibrium, often termed homeostasis. In the case of PPIs, when it senses reduced stomach acid production, your body produces the hormone gastrin to try to compensate. Gastrin normally stimulates gastric (stomach) acid production.

Excess gastrin has in turn been shown to lead to an expansion of enterochromaffin-like cells (ECLs) (30). ECLs are found in the mucosa of the stomach in close proximity to parietal cells. A greater number of ECLs results in a greater amount of ECL hormones released that can interact with parietal cells. Parietal cells, as you may recall, are the cells responsible for stomach acid production via proton pumps. These parietal cells undergo hypertrophy, or an expansion in the size of each cell (31).

Larger parietal cells have more proton pumps and can produce larger amounts of stomach acid. This is termed “rebound hypersecretion,” or an overproduction of stomach acid after taking PPIs (32). This is why getting off PPI therapy is so difficult, because long-term use fundamentally changes the physiology of stomach cells. It also points to yet another instance where simply treating the symptoms of a condition fails to recognize and treat the underlying root cause.

Luckily, parietal cells are constantly undergoing renewal, with an average lifespan of only 54 days (33). So just because you took PPIs does not necessarily mean you are destined to rebound hypersecretion forever, as after a few months your stomach cells should have largely turned over. However, the repair mechanisms after PPI discontinuation have not been widely studied, and it is entirely possible that there are lasting effects.

Alternatives to PPIs

Collectively, these and many other studies suggest that PPIs are not as safe as they are made out to be. Frankly, it’s bordering on criminal that the FDA continues to allow these drugs to be prescribed as frequently as they are, and for durations of years or even decades in some cases, given the overwhelmingly large body of evidence documenting the potential harms associated with long-term PPI use.

If you’re convinced you should avoid PPIs, there are some alternatives (see my previous article for a more detailed discussion of these). Always consult with your medical practitioner before discontinuing the use of PPIs and be sure to reduce your dose gradually to avoid any withdrawal symptoms.

1. Eat a low-carb Paleo diet
   Malabsorption of carbohydrates can lead to bacterial overgrowth, resulting in the bloating and increased abdominal pressure that drives acid reflux.
2. Resolve low stomach acid and treat bacterial overgrowth
   Contrary to conventional wisdom, acid reflux is often due to too little stomach acid, which results in bacterial overgrowth.

Now I’d like to hear from you. Have you taken PPIs? Did you know about the long-term dangers? Did you notice improvement in your acid reflux by switching to a Paleo diet or reducing your carbohydrate intake? Share your experience in the comments section!

http://www.thekitchn.com/feedburnermain

It’s safe to assume we all look forward to vacation days, whether you’re planning to spend them on a beach with a frosty drink in hand or at home, sleeping in and catching up on Netflix. But did you know that taking time off has real benefits for our mental and physical well-being? “A great vacation changes up your routine, renews your energy, improves your outlook, and helps you re-engage with your life,” says Dr. Andrew Shatté, a psychologist and research professor at the University of Arizona.

Still, not all vacations are great, as many of us can attest to. Who hasn’t come back home feeling like you need a vacation to recover from your vacation? Step one is just to take the time off; only 25 percent of us are actually taking advantage of all our hard-earned vacation days. Next, follow these tips for getting the maximum relaxation and break for your brain.

READ MORE »

http://www.thekitchn.com/feedburnermain

Cakes, brownies, and other batter-based recipes aside, when a recipe calls for a separate bowl for whisking a dressing, making a sauce, or tossing together veggies and oil, I look the other way and head straight to the next step. Why? Because I am Team One Less Dish.

READ MORE »