Hello everyone! Welcome to another Friday blog. Today I’m delving into how EVOO is digested by the body and what it can do to prevent and treat gastrointestinal problems.

Haven’t we all had antibiotics at some time or another? Do you know what kind of repercussions can arise from this simple trip to the MD? It can result in a host of inflammatory reactions, allergies and immune response that we didn’t expect. It can literally lead to many of the health issues related to inflammation and can cause vitamin deficiencies and poor assimilation/absorption of nutrients. It can lead to poor tolerance to gluten, dairy and other food ‘allergies’ as well. Ever wonder why you used to be able to eat certain foods, but they give your gut problems now? This is likely the reason. 

So, what is the gastro-intestinal system? It is the largest endocrine organ in the body and consists of a series of hollow organs: mouth, esophagus, stomach, small intestine, large intestine and anus. It also includes solid organs: liver, pancreas and gall bladder. Let’s look at the digestive tract and what is actually happening. Digestion begins when we chew our food and swallow, signaling peristalsis. Peristalsis is an automatic process where your brain signals muscles in the esophagus to move food through the digestive tract with the upper part contracting and lower part relaxing to allow the food to be moved into the next section to be broken down further and absorbed by the body. The pH (power of hydrogen) changes as food moves through the digestive tract. The pH scale: 0-14, with 0-6 being on the acidic end, 7 being neutral, 8-14 being alkaline.

Mouth: Food is chewed, mixed with saliva containing enzymes that begin to break food down, increasing the surface area. In the oral cavity, saliva has a pH of 6.7-7.3, which is considered neutral. A study was done to determine changes in pH in saliva with respect to dental health. When pH was low (acidic) it resulted in chronic generalized periodontitis (6.85 +/- 0.11). When pH was high (alkaline) it resulted in chronic generalized gingivitis (7.24 +/- 0.10). The healthy gingiva group pH was 7.06 +/- 0.04. Approximately 750ml of saliva are secreted daily. WOW! That’s a lot. That’s the size of a large bottle of EVOO! Saliva flow eliminates carbohydrates that could be metabolized by bacteria as well as removing acids created by bacterial activity. It also neutralizes acidity from drinks and foods, helping to protect our teeth. When the pH is off, it can result in bad breath and dental disease. Amylase is a major enzyme that begins breaking down carbohydrates into smaller molecules like simple sugars. Salivary amylase also helps prevent starches from accumulating on the teeth, helping to prevent periodontal disease. Lingual lipase helps begin the breakdown of fats and salivary kallikrein helps produce a vasodilator to open blood vessels. Some enzymes in the mouth also protect us from bacteria, supporting the body’s immune system. Food passes the epiglottis (dangly at back of throat) and into the esophagus. 

Disorders of the mouth:  Oral cancer - affects the lining of the lips, mouth or upper throat and can start as a painless white patch that thickens and forms an ulcer or red patch and continues to grow. It is very important to get any persistent sores checked out. Cold sores (Herpes virus), Canker sores (painful sores caused by virus or bacteria), Thrush (yeast infection), Leukoplakia (white patches of excess cell growth on cheeks, gums or tongue and common in smokers), Dry mouth (lack of enough saliva), Halitosis (gum or tooth problems and bad breath).

Esophagus: There are no enzymes produced in the esophagus, but it does produce mucous for lubrication. Once in the esophagus, food is moved to the bottom where the lower esophageal sphincter opens (relaxes) to allow chewed food into the stomach. The esophageal sphincter then closes (contracts) to prevent food from backing up into the esophagus. 

Disorders of the esophagus: Esophageal cancer - smoking and poor control of acid reflux are risk factors. Symptoms: difficulty swallowing, chest pain, weight loss, coughing, worsening indigestion, heartburn, hoarseness. People with chronic acid reflux can have stenosing (hardening) of the lower esophageal sphincter. This can cause the sphincter to be unable to open or close completely, making the problem even worse. It can require surgery to stretch it to allow food to pass.

***There is a great natural way to combat indigestion and acid reflux. Most often indigestion happens when your stomach can’t handle the amount of food it receives and can’t produce enough acid to digest your food. If this happens, squeeze the juice of a lemon and take it like a shot, follow with water to rinse your esophagus. It has the same pH as your stomach. You’ll notice almost immediate relief. You can also use vinegar the same way. I’ve never understood why most doctors prescribe antacids for this problem. It makes no sense whatsoever to hinder your stomach’s function when you should be helping it along.***

Stomach: The pH of the stomach is 1.5-3.5. This is very acidic and necessary for the denaturing (modifying/unfolding) and digestion of proteins. The stomach lining contains glands and parietal cells that produce hydrochloric acid and enzymes that break down food. Pepsin is the major gastric enzyme produced by the stomach. Proteins are denatured and broken down into amino acids, fats into fatty acids and carbohydrates into simple sugars. Parietal cells also produce bicarbonate to aid in regulating the pH, causing a temporary rise in pH of the blood and produce mucous creating a viscous layer to protect the lining of the stomach. Digestion of EVOO begins in the stomach through a process called hydrolysis (breaking apart by water) catalyzed by gastric lipase (acid stable). EVOO actually suppresses gastric acid secretion, reducing risk of acid reflux and preventing gastric juices from backing up into the esophagus. Let’s consider this a minute. When you consume EVOO (fat), you are more satiated and consume less overall food. EVOO suppresses gastric acid secretion, decreases the ‘workload’ of the stomach and prevents gastric juices from  traveling back up to the esophagus. This can help prevent acid reflux disorders. EVOO “is a potent releasing factor of cholecystokinin peptide, which consistently indicates that the consumption of olive oil might be beneficial in digestive diseases.” Food mixed with gastric juices form into a substance called chyme that is dumped into the small intestine. Lingual and gastric lipases hydrolyze short, medium and long chain fatty acids. The accumulating FFAs (free fatty acids) at the droplet surface inhibits lipolysis (fat breaking) by gastric lipase. EVOO prevents surface particle formation, extending the effectiveness of gastric lipolytic activity. Disorders of the stomach include the following:

Peptic ulcer disease: break in the inner lining of the stomach (may worsen with eating), lower esophagus or duodenum (waking at night with upper abdominal pain, improves with eating). Cause: bacterium helicobacter pylori, NSAIDS (nonsteroidal anti-inflammatory drugs, tobacco smoking, Crohn’s disease

Stomach cancer: typically slow-growing with very few to no symptoms early on, but vague abdominal discomfort/pain or fullness above the navel with increased symptoms and pain during the later stages.

Small Intestine: Next, digestion continues in the duodenum (upper part of the small intestine) with gastric lipase breaking down 10-30% of triglycerides (TG) into diglycerides (DG) and free fatty acids (FFAs). The pH changes rapidly from a very acidic pH to about 6 in the duodenum and continues to increase to 7.4 in the terminal ileum. This stimulates pancreatic lipase to further hydrolyze TG by allowing fat emulsification. These lipid metabolites are rapidly absorbed by epithelial cells in the small intestine with EVOO supplying Oleic-acid-rich hydrocarbon skeletons for cellular synthesis of TG and phospholipids (important in creation of new cells). The smaller the droplets, the better to be exposed to pancreatic lipase, inducing the epithelial cells to secrete CCK (hormone), stimulating gall bladder contraction and delivering bile salts to the duodenum. The synergistic actions of gastric lipase and colipase-dependent pancreatic lipases complete the breakdown of proteins, carbohydrates and fats. Chemical digestion is completed in the small intestine before chyme has reached the large intestine. EVOO has a positive effect on the hepato-biliary system ensuring optimal bile drainage and full emptying of the gall bladder. It stimulates contraction of the gall bladder, preventing disorders of the bile ducts, while also stimulating synthesis of bile salts in the liver, increasing the amount of cholesterol excreted by the liver. Bile contains water, bile acids (derivatives of cholesterol), several other organic molecules and electrolytes. It has hydrophobic (water insoluble) and hydrophilic (water soluble) regions and functions sort of like detergent to break things apart into smaller molecules to enhance absorption of vitamins and nutrients. Adults produce anywhere between 400-800ml of bile/day. It is of note that 95% of this bile is resorbed by the blood in the ileum. 

Disorders of the small intestine include the following: bleeding, celiac disease, Crohn’s, infections, intestinal cancer, intestinal obstruction, irritable bowel and ulcers.

Large Intestine/Colon: Large Intestine/Colon: the ileum (lower part of small intestine) joins the cecum (upper part of the colon). The rest is divided into 4 parts: ascending colon, transverse colon, descending colon, sigmoid colon (just before the rectum). In the colon, the pH drops again to about 5.7 in the caecum. No digestive enzymes are produced here. The large intestine absorbs water and any left-over nutrients before sending the waste/indigestible matter to the rectum. Waste is stored here as feces. Billions of bacteria live here and are important in many functions. The colon absorbs vitamins created by our bacterial flora, such as vitamin K (this is very important because daily ingestion of vit K is normally not enough to maintain adequate blood coagulation), thiamine (vitamin B1) and riboflavin (vitamin B2). You think that seemingly innocuous antibiotic you took for a sinus infection didn’t get your gut out of whack? These good bacteria need to be replenished after you have finished the antibiotic.**Make sure you always completely finish your antibiotics to prevent the bad bacteria from developing resistance factors to that antibiotic!!!** This is how MRSA gets started. Then get a good pre/probiotic to help restore the good bacterial flora!

Diseases/disorders of the colon: Colitis: inflammation of colon, IBS: irritable bowl syndrome. Diverticulosis: tiny pouches called diverticuli are weak areas in the muscular wall allowing the lining to protrude through. They can bleed or become inflamed or infected. Diverticulitis: when these pouches become inflamed or infected resulting in abdominal pain, fever, constipation are common. Colon bleeding: hemorrhage. Inflammatory bowel disease: Crohn’s, ulcerative colitis. Crohn’s disease: inflammatory condition affecting the colon and intestines causing abdominal pain and diarrhea (sometimes bloody). Ulcerative colitis: inflammatory condition affecting the colon and rectum. Salmonellosis: salmonella bacteria cause an infection in the intestine causing stomach cramps and diarrhea. Shigellosis: bacteria shigella cause fever, stomach cramps, diarrhea that may be bloody. Traveler’s diarrhea: bacteria contaminating water and food in developing countries causing abdominal cramps, nausea, fever, diarrhea. Colon polyps: small growths that can develop into cancer. They are slow-growing and removal can prevent many colon cancers. Colon cancer: 100,000 Americans are affected/year. Most is preventable through regular screening. 

Rectum: pH reaches about 6.7. In active ulcerative colitis and in Crohn’s disease, low colonic pH have been observed, but implications are poorly understood.

Okay, once again, there’s a lot going on here. So...let’s talk poop. Can EVOO help us with digestion? The answer is an emphatic yes! EVOO “reinforces the mucus lining of the colon, which gets worn down from passing hard stools.” Are we surprised? Oleic acid is very active in the production of membranes/linings of multiple organs!!! (Check out my other organ system blogs) Here are a few other things it will do: EVOO lubricates your digestive system making it easier for movement of your food, carries fats that increase the speed of evacuation of bowel, is very rich in vitamins and antioxidants, stimulates the gallbladder and liver to promote the release of bile and stimulates muscle contractions in the intestine which soften stools to aid in evacuation. Let’s think about just how important this small thing can be. Who hasn’t taken antibiotics? They destroy all the good bacteria that help us to process our foods, along with the bad guys making us sick. This can lead to a whole myriad of problems with digestion and absorption. Think of it like having a problem with your car. If you don’t fix a small problem right away, it can cause a big problem if you just let it go. Your body is the same way. One system affects another and so on...

Liver: After intestinal absorption, A-tocopherol (vitamin E) is packaged into chylomicrons and secreted into systemic circulation through lymphatic vessels. Triglycerides in EVOO induce chylomicrons, whereas phospholipids (e.g. lecithin) induce very low density lipoproteins (VLDLs = bad cholesterol). Diets high in medium chain triglycerides (such as virgin coconut oil) slow re-synthesis of triglycerides and formation of lipoproteins, whereas long chain triglycerides (Oleic Acid) reduce synthesis of lipoproteins that inhibit activation of LXR (liver X receptor), further activating sterol regulation and glycerolipid synthesis. LXR is very sensitive to oxidized cholesterol derivatives, the oxysterols. A rise in oxysterol concentration triggers transcription of LXR target genes. LXR has emerged as a potent target to treat a large range of diseases related to cholesterol such as cardiovascular disease, cancer and Alzheimer’s disease. LXR is also a potent activator control of hepatic lipogenesis (fat creation) and beneficial to several organs involved in homeostasis, aiding to restore gut microbiota dysbiosis (microbial imbalance) induced by a poor high fat diet. Oleic acid in EVOO enhances the ability of LXR!

Disorders of the Liver: Nonalcoholic fatty liver disease - (NAFLD) Hepatic steatosis when 5-10% of a liver’s weight is fat. Most common problem with the liver affecting > 3 million people/year, typically asymptomatic, but can have pain in upper right side of abdomen, fatigue, enlarged liver or spleen, swelling in the belly, jaundice (yellowing of skin or eyes). Risk factors are obesity, high cholesterol, type 2 diabetes and gastric bypass. Unchecked can lead to cirrhosis.   Hepatitis C - infectious disease caused by the hep-C virus with mild to no symptoms. It spreads through blood and IV drug use. Occasional symptoms include abdominal pain, dark urine, fever, yellow-tinged skin. Typically, the virus persists for years and can lead to cirrhosis and liver failure. Hepatitis B - infectious disease caused by the hepatitis B virus. It can cause both acute and chronic infection. Acute symptoms include vomiting, mild jaundice, dark urine and abdominal pain. About 25% of chronic infected individuals experience cirrhosis and liver failure. Risk factors include IV drug use, sexual intercourse, living with an infected person, dialysis.  Hepatitis A - infectious disease caused by Hepatovirus A. Occurs in young people and initially is typically asymptomatic. Symptoms develop in 2-6 weeks following infection and include nausea, vomiting, diarrhea, jaundice, fever, abdominal pain and may last 8 weeks. 10-15% have a recurrence after 6 months.  Cirrhosis - long term damage characterized by scar tissue that has replaced liver tissue. Symptoms include weakness, tiredness, swelling in lower legs, jaundice, bruise easily, spider-like blood vessels on the skin and fluid build-up in the abdomen.  Alcoholic hepatitis - Inflammation of the liver due to decades of heavy alcohol consumption (8-10 drinks/day). It’s usually associated with fatty liver, progression of fibrosis leading to cirrhosis. Symptoms include jaundice of the skin and eyes, fatigue, hepatic encephalopathy (brain dysfunction) and fluid accumulation in the abdominal cavity.  Hemochromatosis - Rare. Affects mostly middle aged Caucasians. Genetic. Build-up of iron in the body causing several side effects.

Pancreas: Your pancreas makes about 8oz of digestive juices (containing enzymes) to help break down food. EVOO is very beneficial to the pancreas because it only requires it to produce a small amount of digestive enzymes, allowing it to focus on production of hormones. Hormones produced here include insulin, glucagon, gastrin and amylin. Beta cells (75% of pancreatic hormone cells) produce Insulin - which lowers blood sugar by assisting to transport sugar to cells for energy. Alpha cells (20% of pancreatic hormone cells) produce Glucagon - if blood sugar gets too low, it sends a message to the liver to release stored sugar. Gastrin stimulates your stomach to make gastric acid. Beta cells make Amylin - controls appetite and emptying of the stomach. Drinking EVOO signals the liver to open bile ducts, allowing anything previously stuck to move out much easier (very effective in weight loss).

Remember from the Liver/Pancreas Connection (Blog #2), EVOO with its long-chain fatty acid (OA) provides a signal to the brain of “nutrient abundance” resulting in switching fuel source from carbohydrate to lipid (fat). This depresses appetite and controls the amount of carbohydrates being released into the blood. In this way, it aids in controlling blood sugar levels and very important in prevention of diabetes. A study found “increased Oleic acid intake was associated with a decreased risk of developing pancreatic cancer.” 

Disorders of the pancreas: Acute pancreatitis - sudden onset causing inflammation. Symptoms include severe upper abdominal pain, nausea, vomiting, diarrhea, bloating and fever. Most common cause is gallstones, followed by chronic alcohol consumption, trauma, medications, electrolyte abnormalities, high lipid levels, hormonal abnormalities and hereditary conditions. Medications don’t do much, but most people recover completely.  Chronic pancreatitis - this is progressive with multiple ‘hits’ contributing to destruction of the pancreas. Most common in men 30-40 years of age. Symptoms are upper abdominal pain and diarrhea, with later symptoms of weight loss and malnutrition leading to diabetes. Most common cause is chronic alcohol consumption. Treatment includes enzyme supplementation, avoidance of alcohol and pain control. Hereditary pancreatitis - acute recurrent attacks under age of 30 lead to chronic pancreatitis. Cystic fibrosis leads to pancreatitis. Symptoms include chronic pain, diarrhea, malnutrition and/or diabetes. Treatment includes pain control and pancreatic enzyme supplementation.  Pancreatic cancer - 4th most common cancer deaths in men, 5th in women. This type of cancer is resistant to chemo and radiation therapies. It is insidious and is asymptomatic (no symptoms). Treatment is surgical resection, if caught early. However, due to the asymptomatic nature of pancreatic cancer, catching it early is rare. 

This is a brief overview of the gastrointestinal/digestive system and some of the problems that can arise. When you consume EVOO (particularly high polyphenol EVOO) it guarantees the intake of phenolic anti-oxidants: Oleocanthal, hydroxytyrosol, tyrosol, vanilic acid, vanillin, cafeic acid, cynamic acid, p-coumaric acid, o-coumaric acid, ferulic acid and phenylacetic acid, flavones, lignans, non-polar and polar phenolic compounds and their derivatives, carotenoids (leutin and B-carotene, lycopene) important in maintenance of eye tissue and reproduction and vitamin E (tocopherols, 4 tocotrienols). Alpha-tocopherol is the most abundant and has the highest biological activity against oxidants, B-sitosterol which decreases the absorption of cholesterol in mammals and squalene (major component in human skin). Remember from last week’s blog, EVOO has 200 times the amount of vit E and 80 times the amount of vitamin K when compared to virgin coconut oil. EVOO acts dually as a supplier and cofactor of B-carotene (converted to vit A in small intestine), increasing the absorption and bioavailability of carotenoids over that of eating fruits and vegetables! EVOO also increases levels of peptide YY and enteroglucagon. Transport proteins in the brush border membrane are highly expressed in diets rich in fats and found in jejunum (middle section), duodenum and ileum (lower section) in that order. The rate of absorption is related to chain length and number and place of double bonds. The degree of unsaturation facilitates solubilization and absorption of fatty acids. 

Okay! The takeaway is EVOO does amazing things for your entire digestive tract, protecting the lining and reducing inflammation preventing cancers, diabetes, fatty liver disease, weight-gain, acid reflux, ease of bowel movements, enhances absorption of vitamins and much more!! It also supplies a good bit of vitamins E and K! Remember, if your gut microbiome is out of whack (which it is in most of us), replenish with prebiotics (fiber or food for the bacteria) and probiotics (the actual bacteria)!! Fixing your digestion is key in preventing or fixing things that are going wrong in your body. It may be worth checking the pH of your saliva as well, since it will tell you if your blood is too acidic. 

Next week, we’ll take a look at popular diets of 2020 and how EVOO can help with weight-loss, appetite suppression and reaching your optimal health goals. Until then, drink/drizzle/digest EVOO, eat fatty fish, get lots of water and sleep, take some prebiotics and probiotics, exercise your body and mind!! #EVOO