Dr. Kourosh Maddahi - October 2020

Balance Within the Body

Avoiding ‘Probiotic Die-Off ’

The microbiome is an important part of our body. While we talk a lot about the microbiome within the mouth and the good bacteria that work with our immune system, it’s also important to give care and attention to the good bacteria, also known as probiotics, which live further within our digestive system. These bacteria call our gut home. The average person has about 100 trillion good microorganisms working within their body. One issue that many people deal with is “probiotic die-off.” Even when we eat a diet rich in healthy foods, the good bacteria in our digestive tract are still susceptible to many negative influences that ultimately lead to the die-off. But what causes probiotic die-off? More often than not, die-offs are triggered by a disruption to the “balance” of our digestive tract (and, really, our bodies in general). Antibiotics can cause significant harm, which we’ve talked about in the past. Antibiotics are devastating to all forms of bacteria in your body, good or bad.

strive to avoid antibiotics when possible. When selecting food items, always be sure to read all labels and make sure you’re buying goods that are not treated with antibiotics. Another big threat to probiotics is medication in general. When you change a dosage, or start or stop a medication, probiotics in your body can be adversely affected. Taking new supplements or changing your supplement dosage can have a similar effect. Significantly changing your diet can also harm your gut flora. If you introduce new foods or alter your diet in a sudden, major way, your digestive system may be “shocked” by the change, resulting in a die-off. For most of us, simple and small changes to our medications or diet isn’t going to have much, if any, impact on our existing gut flora. While our microbiome is sensitive, incremental changes can go a long way in keeping it healthy as we work to keep ourselves healthy. The truly important part is avoiding foods and behaviors that have a negative impact on our microbiome, such as eating foods treated with pesticides or meats treated with antibiotics, as well as smoking and consuming alcohol. Refer a friend, get a brighter smile!

This includes antibiotics prescribed by your doctor and antibiotics present in food, such as certain meat and dairy products. In general, we should

Also known as Jerusalem artichokes, sunchokes will give your spinach salad a little something extra! Inspired by FoodAndWine.com. Warm Spinach and Sunchoke Salad

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INGREDIENTS •

DIRECTIONS 1. Preheat the oven to 400 F. 2. In a large cast-iron skillet, heat 2 tbsp olive oil until nearly smoking. 3. Add sunchokes, garlic, and crushed red pepper. Season with salt and pepper. 4. Move skillet into the oven and roast for 25–30 minutes, until sunchokes are just tender. 5. In a large bowl, add the prepared spinach. 6. Remove skillet from the oven and

1/4 cup extra-virgin olive oil, divided 1 lb sunchokes, scrubbed and cut into 1-inch pieces 15 garlic cloves, peeled Pinch of crushed red pepper Kosher salt and black pepper 1 lb leaf or curly spinach, stemmed and large leaves torn 1/4 cup apple cider vinegar 1 Honeycrisp apple, sliced

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add vinegar and remaining 2 tbsp olive oil, then pour mixture over the spinach.

7. Toss gently until spinach is wilted. 8. Add apple and half of the cheese and season with salt and pepper to taste. 9. Transfer to a serving bowl, toss, top with remaining cheese, and serve.

4 oz clothbound cheddar, crumbled (1 cup), divided

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