Is That Pulled Pork Sandwich Worth It?

By: Dr. Deedra Mason

Whether it is the spring temperatures opening up the patio at your favorite restaurant or the upcoming break with the kids, is your regular eating plan going to fall off track? Maybe you are one of the millions of people saying they love the winter temperatures because it gives them an excuse for comfort food winter style eating.  Either way, I want you to ask yourself, is it worth it?

Gut Health + Mental Well-Being

Twenty percent of Americans are diagnosed with acid reflux, and this number is growing!  According to the Institute of Diabetes and Digestive Kidney Diseases, it occurs with regularity across all age groups and ethnicities.(1)  A growing population of these OTC antacid users is seeking care from a physician for a stronger approach to their complaints raising hospitalizations by as much as 215% when compared to 2005 numbers. (2) Would you be surprised that the rates of prescription of antacids have increased 42% in infants with the diagnosis of reflux?  Whether these numbers are a surprise or you feel they are in line with the people that you know, I want you to ask if it is worth it.


A new study from the Journal of Psychotherapy and Psychosomatics reported an intimate link between the gut dysbiosis created by acid reflux remedies, prescription proton pump inhibitors, depression, and mental-emotional well-being. (3) According to WHO, roughly 42 million Americans report anxiety, that is 18 % of the adult US population.  Another 16 million people have been diagnosed with severe depression. That is 7% of American adults.  That 18% percent is conspicuously close to the number of people treated for acid reflux or GERD.  While the correlation is not a direct one, it is “food” for thought. (4)


The study in the Journal of Psychotherapy and Psychosomatics included 11,830 adult individuals that were current users of proton pump inhibitors demonstrated that compared with those who did not develop Major Depressive Disorder, “patients with major depression had a greater prevalence of higher cumulative defined daily dose” of proton pump inhibitors.” (3)


More and more literature is citing the importance of a healthy microbiome for a healthy mental outlook as well as healthy sleep and weight.  When you consider the importance of brain development in infants and the maintenance of brain volume in aging, perhaps the road to health IS paved with good intestines.


Importance of Gut Bacteria

Gut bacteria fall into 1 of 4 Phyla (Classification system for microbes). The relationship between some of our gut flora and our bodies is not simply a “cohabitation”, but instead a symbiotic or a mutually beneficial relationship.  The characteristics of gut bacteria can influence our hormones, cardiac function, and neurotransmitters essential to mental aging and well-being.

But, not so fast; the balance is a delicate one! Literature also shows how our mental outlook, mindful practice, and healthy self-talk can influence the vitality of these gut bugs, allowing them to compete with gut biota that are not beneficial. (5)

That is the good news.  Certain strains in the Lactobacillus and Bifidobacterium species can support the hormones, environment, and neurotransmitters for a healthy mental outlook and conversely a healthy mental outlook can help support the prolific nature of those particular strains.


What does this mean for me?

Yes! Certain strains of bacteria can be protective.  If sleep/insomnia are a chronic concern, you can look at the benefits of a particular strain of bacteria while speaking to your practitioner about alternatives to a medication.


Diet First

Your first line approach is to make sure you eat a diet that is hospitable to a robust and diverse microbiota

Consider a low to no sugar diet and plenty of soluble fiber such as legumes and beans. Look for foods that offer a healthy fermentable nourishment for the gut lining like broccoli, cabbage, garlic or inulin and mushroom beta glucans.  Look at medium chain triglycerides such as coconut oil, before overconsuming medium and long chain fatty acids such as dairy products.


Sleep Second

Second in line is to focus on healthy gut bacteria that may offer you a better response to daily stressors and an optimal night’s sleep.

Specifically, look for a probiotic solution with multiple strains and the correct strains to offset any physical or mental stressors to the body and mind. These strains, often referred to as “psychobiotics” are strains such as Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum to name just a few.  Studies show as little as two billion CFU’s can be supportive. (6)


Mindfulness Matters, Too

The third step towards a brain-gut axis is to be mindful in your self-talk and eating habits.

Start with positive affirmations to manage negative feelings or boost self-confidence while slowing down at the dinner table. Choose not to stand while eating, take a pause before your next bite, and truly savor the taste and satisfaction from your food.  By simply putting intention toward tasting, the blend of flavors in food can be the reward the brain seeks and the rest the gut needs.


It is important to note there are many different presentations for mental health concerns for all ages, as such there are a multitude of interventions including nutritional, botanical and lifestyle.  Keep steady in knowing there are a variety of nutritional methods clinically supported to help you, whatever you and your practitioner decide.





(1) El-Serag HB, Petersen NJ, Carter J, et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;126:1692–1699.

(2) Gastroesophageal Reflux Disease (GERD) Hospitalizations. Yafu Zhao, M.S. (Social & Scientific Systems), and William Encinosa, Ph.D. (AHRQ)

(3) Wei-Sheng Huang et al. Use of Proton Pump Inhibitors and Risk of Major Depressive Disorder: A Nationwide Population-Based Study, Psychotherapy and Psychosomatics (2018)

(4) Department of Maternal, Newborn, Child and Adolescent Health (MCA); Adolescents and mental health 4, 2017

(5) Sarkar A, Lehto SM, Harty S, Dinan TG, Cryan JF, Burnet PWJ. Psychobiotics and the Manipulation of Bacteria–Gut–Brain Signals. Trends in Neurosciences. 2016;39(11):763-781. doi:10.1016/j.tins.2016.09.002.

(6) Timothy G. Dinan, Catherine Stanton, John F. Cryan Biol Psychiatry. 2013 Nov 15;74(10):720-6. Psychobiotics: a novel class of psychotropic.