Chris Kresser is a neighbor and my favorite savant when it comes to ancestral health and how it informs functional medicine. He generously answered my burning questions about how he got into functional medicine and Paleo, gut health, and his latest interests....
Q: Chris, you’re trained as an acupuncturist but you’re also one of the best functional medicine clinicians I know. How did your work evolve to where it is now?A: In my 20s and early 30s I struggled with a complex, debilitating illness. On my journey back to health it became clear to me that addressing the underlying causes of disease, rather than just suppressing symptoms, is the key to recovering and optimizing health. Unfortunately, the conventional medical system is focused on disease management— suppressing symptoms with drugs and surgery rather than getting to the root cause of the problem. I chose to study Chinese and integrative medicine in school because I believed it would better prepare me to do the kind of work I wanted to do with patients. While I was still a student, I discovered functional medicine and began to learn everything I could about that subject. I knew very quickly that functional medicine would be the focus of my work, and it has been from the first day I opened my practice.
Q: You talk about the central role of the gut in most of your work. I feel like gut problems are the #1 issue that most of my clients don’t know they have. Why is it tricky to identify the gut as the root cause of symptoms, and what is your most convincing argument to get people to connect the dots and ultimately heal their gut?
A: One reason why it’s tricky is that dysfunction in the gut doesn’t always lead to gut symptoms. For example, more than 30 percent of people with “leaky gut” (i.e. intestinal permeability) do not experience digestive distress. For them, leaky gut manifests in a different way— skin problems, brain fog, anxiety or depression, autoimmune disease, and joint pain are just a few examples. The same is true for gluten intolerance. I work with children as well as adults, and it’s not uncommon to see kids with severe behavioral issues (ADHD, autism spectrum disorders) that improve significantly or even disappear entirely after removing gluten from their diets. These kids (and their parents) may or may not have been aware of a gut problem, but it was fixing the gut that fixed their brain.2,500 years ago Hippocrates said “All disease begins in the gut.” We’re only now beginning to learn just how prescient he was. Another way of putting it is this: you’re only as healthy as your gut.
Q: You write on your blog about “grey-area” foods. What are they, from an ancestral perspective, and what approach to them do you advocate for your tribe?
A: Grey-area foods are foods that have only recently (on the evolutionary timescale) been introduced to the human diet, but that modern research suggests may be healthy when well-tolerated by the individual. They include dairy products, grains, legumes, chocolate, coffee, tea, white potatoes, and alcohol.These foods are the most likely to cause problems for people, but that doesn’t mean that they’re an issue for everyone, and I don’t believe that we should all avoid them as a rule simply because some react to them.In my book, I recommend that everyone avoid them for a 30-day period, and then add them back in one by one. If you tolerate them well, I believe that eating them in moderation within the context of a diet based on nutrient-dense, anti-inflammatory foods is fine for most people.
Q: What are your 3 best strategies for healing the gut?
A: Top three...
Remove inflammatory foods that irritate the gut. This will depend upon the person, of course, but in general a Paleo diet is a great place to start. Nightshade plants like eggplant, peppers, and tomatoes may also need to be removed, as they cause problems for some people.
Eat gut-friendly foods. These include fermented foods (such as sauerkraut and kefir/yogurt, assuming you tolerate dairy) as well as fermentable fibers that feed the beneficial gut flora, which are found in starchy plants like sweet potatoes and plantains, as well as many fruits and vegetables.
Take high quality probiotics and prebiotics. In a perfect world we wouldn’t need these, but due to the damage many of us have done to our guts over time, probiotics and prebiotics are often necessary. Prescript Assist is my favorite probiotic, and there are many good choices for prebiotics, including resistant starch (e.g. potato starch, plantain flour, etc.), non-starch polysaccharides (inulin, FOS, larch, etc.), and soluble fiber (acacia, glucomannan, psyllium, etc.).
Q: What is the most interesting scientific concept that you’ve met recently, and why it is compelling to you?
A: I’m fascinated by the field of epigenetics, which is the study of how environmental factors like diet, lifestyle, and exposure to toxins directly affect the expression our genes. And we’re learning that these effects are much more far-reaching than we had previously assumed. For example, recent research suggests that obese men’s sperm contains a “molecular signal” that can pass on obesity and metabolic problems to their children and even grandchildren!The other side of this, of course, is that if we take responsibility for our own health by making good choices, we can pass that legacy down to our children and grandchildren as well.