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Live Dirty, Eat Clean

By Sandy Levy


“Live Dirty, Eat Clean” is the mantra of Bethesda, MD gastroenterologist Dr. Robynne Chutkan. In The Microbiome Solution, subtitled: A Radical New Way to Heal Your Body from the Inside Out, Dr. Chutkan, who heads The Digestive Center for Women, writes not only from her experience as a physician but from her experience of her own health problems and those of her young daughter. These experiences led to her belief “that illness is often the result of a decreased, not increased, bacterial load, and that less is sometimes more when it comes to medical intervention.” The diseases she treats, such as irritable bowel, gluten intolerance, eczema, thyroid disorders–and the list goes on–are evidence of an “epidemic” of “‘missing microbes,’” as Martin Blaser, M.D., has called it. Her patients’ histories invariably include too much antibiotic usage, and, usually, a diet of highly processed foods.


Your microbiome is made up of all the organisms that live in and on you. Some of these organisms cause disease, but the overwhelming majority are integral to your health. Here are some of the things that gut bacteria do, according to Dr. Chutkan: “Crowd out pathogens,” “Digest food,” “Neutralize cancer-causing compounds,” and “Synthesize hormones.” Destruction of these bacteria has led to “a new breed of disease,” the auto-immune disease.


Dr. Chutkan believes that “we need interaction with dirt and germs to train our immune system,” hence her advice to “live dirty,” which means, for instance, using soap as little as possible, because our skin is part of our microbiome, too. She also believes we need to remove “medications, practices, and foods that are damaging” and replace these with practices and foods that support the microbiome. Her list of “Live Dirty Lifestyle Dos” includes “use a chlorine filter” for your bathing water; “use edible hair and skin products,” and “open your windows,” and the “Don’ts” include “Don’t use hand sanitizer” and “Don’t use mouthwash.” There is also a list of medications to avoid, and a list of ten things to do if you must take an antibiotic, including requesting a narrow-sprectrum version.


An important and simple and inexpensive way to support the gut is to eat fiber-rich foods, sometimes called “prebiotics.” I like Dr. Chutkan’s easy “1-2-3 rule”: one vegetable at breakfast, two at lunch, and three at dinner, and I appreciate her recipes, both for foods and cosmetic products. I was even glad to read Chapter 13: “Everything You Wanted to Know About Stool Transplants but Were Afraid to Ask,” but it’s okay, too, to skip it.


Does the doctor’s prescription seem too radical? Perhaps it does, but she makes a convincing argument that unless we take care of our microbiome, we are well on our way to ruining our health.

Helpful links:

Dr. Joseph Mercola on the influence of fiber on the microbiome: https://articles.mercola.com/sites/articles/archive/2016/01/25/low-fiber-diet-health-hazards

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