What is the endocannabinoid diet? and why might our bodies need it?

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​​In the late 1980's the Hollywood classic Twins, Arnold Schwarzenegger and Danny DeVito, star as fraternal twins Julius and Vincent Benedict. They result from a secret experiment carried out at a genetics laboratory to produce the perfect child. Separated at birth, one twin (played by Arnold Schwarzenegger) was born and raised in the Austrian countryside that lives a healthy and active life, with a nutritious diet of farm-to-table fruits and vegetables. Danny DeVito plays the role of the opposite twin who moves away to dwell in the sewers of Gotham City and pigs out on McDonald's while chugging beer. The idea of twins who have drastically different appearances like Schwarzenegger and DeVito is impossible and absurdly funny. But, in the modern-day field of epigenetics, the line between nature and nurture is blurred. Epigenetics is the study of changes in gene expression caused by mechanisms other than changes in the underlying DNA structure. In other words, environmental factors can alter the way our genes are expressed, making even identical twins look dramatically different.  Every biological response, disease or otherwise, originates directly or indirectly from the genes within our cells. These genes are, in essence, the blueprints of our biological existence.

Epigenetics has transformed the way we think about genomes. It explains how different biological and environmental signals affect gene expression. Rather than change DNA itself, epigenetic signals can, for example, prompt changes in the number of methyl chemical groups attached to a gene, turning it on or off like a switch. Genes are typically carried in long, continuous chains of DNA: one such chain can carry hundreds of thousands of genes. But a chain of DNA does not typically sit naked in animal cells; it is wrapped tightly around a core of proteins called histones. Years ago, we recognized that histones have some reparative role to play in DNA, but we now understand that histones—beyond repairing DNA—actually play a role in allowing DNA expression. Our DNA is wrapped around these histones, and the histones contain binding sites for various molecules, including methyl groups, acetyl groups, and others. When a histone is bound, it leads to changes in the conformation of the DNA, either tightening it up or opening it up; in other words, either making it unavailable or available for genetic transcription. By binding what is called the epigenome—the combination of the DNA wrapped around the histone protein—we regulate the action of our genes.

Thousands of genes are directly associated with some disease or other condition. Researchers are discovering more connections between genes and disease. According to these reports, there are more genes or hereditary units responsible for breast cancer, colon cancer, liver cancer, Alzheimer's disease, etc. The good news is that more than 70% of genes that code for health and longevity are under epigenetic control! 

According to Dr. Colin Campbell, a researcher at Cornell University, nutritional epigenetics holds the key to health and longevity. He believes, dietary and lifestyle conditions determine how and when these genes are expressed. Almost always, having a particular gene is not the only nor the final word. Before a gene can manifest in a disease or other condition, its "hidden" message must be expressed. Researchers found that the production of enzymes, which are the main products of gene expression, also could be markedly controlled by what we eat!  A person's diet is an essential source of epigenetic signals, and scientists are now investigating how eating habits modify gene expression in adults and their offspring. Understanding that relationship could help researchers identify nutritional elements that might help prevent or treat diseases such as obesity, diabetes, coronary artery disease, cancer, and Alzheimer's.

How can Diet Help Change Genetic Projections?
In traditional medicine, we are looking at health from a "disease-target-kill model." Allopathic medicine takes the reductive approach. We are separating disease into its parts, element by element, component, and subpart, and then use drugs to attack these separate targets. Epigenetics points to a better way. For instance, we have known that the foods we eat contain the macronutrients of proteins, carbohydrates, and fats and micronutrients, such as minerals and vitamins—all of which produce various types of physiologic activity. But the concept that food represents information is relatively new. The foods we eat and the lifestyle behaviors we choose are literally instructing our genomes. Nutritionists have long known that "you are what you eat" is not just an expression. Recent studies suggest that what you eat affects you and sometimes even your children and grandchildren! Epidemiological studies show how certain exposures have shaped the health of specific populations over time, particularly between mother and child. One famous example is the Dutch Hunger Winter. In 1944, a famine struck the western Netherlands, forcing inhabitants—including pregnant mothers—to live on between 400 and 800 calories a day. When scientists later studied the babies conceived, carried, or delivered during this period, they found elevated rates of obesity, altered lipid profiles, and cardiovascular disease in adulthood.

As an integrative cannabis physician, I treat a lot of cancer patients—as you can imagine.
One of the first questions patients ask me during the office visit is, “How can I change my diet so that I can be healthier? What foods can I eat to boost my immune system and fight this cancer?”.  A person's diet influences their immune system, like all other aspects of health. Nutrition can affect the gut microbiome, inflammatory processes, and even our mental health.

As a result of increased research on cancer survivors, we now know that diet and exercise play a vital role after a cancer diagnosis. According to researchers, both can have a significant impact on cancer as well as on overall health and survivorship. Following a healthy diet and getting regular exercise can reduce the risk for cancer recurrence (or a second primary cancer) and reduce the risk for other life-threatening chronic diseases, such as heart disease or diabetes.

A study looking at the eating habits of women after a breast cancer diagnosis showed that those who consumed a better-quality diet (rich in fruits, vegetables, whole grains, and healthy fats) had a 60% lower risk of dying from any cause and an 88% reduced risk of dying from breast cancer compared with those who had a poor-quality diet (heavy in saturated fats, refined grains, and sugars). In addition, those who had good-quality diets and got regular exercise had an 89% lower risk of dying from any cause and a 91% reduced risk of dying from breast cancer compared with sedentary women who had poor-quality diets.

As a chronic pain survivor, I always knew that my diet directly affected my back pain and inflammation. On the days I indulge in comfort foods filled with gluten and refined sugar,  I pay for it the next day— aching stiffness in my spine and swelling in my joints. The standard American diet is a recipe for inflammation. Inflammation is a driver of chronic illness. According to neurologist Dr. David Perlmutter, "The food we eat goes beyond its macronutrients of carbohydrates, fat, and protein. It's information. It interacts with and instructs our genome with every mouthful, changing genetic expression. People are getting to this place of understanding that their lifestyle choices do matter a whole lot as opposed to this notion that you live your life come what may and hope for a pill. "Nutrition matters. The brain, our mood, cognition are more responsive to diet and lifestyle than any other part of the body, and until now, it's been virtually ignored. We load up on medications when our mood is off, and we hope for a pain killer or an arthritis pill when we get older. The genes provide nature; nutrition and lifestyle factors provide nurture.

It's not just about nutrition. It's multiple factors. Along with diet, exercise, environment, and mood may affect gene expression. One complication is the sheer complexity of the epigenome.  

In his book, The Biology of Belief, and Spontaneous Evolution, cellular biologist Dr. Bruce Lipton explains how emotions regulate genetic expression. He says, "Each cell membrane has receptors that pick up various environmental signals such as thoughts, attitudes, and perceptions. Your cells can choose to read or not read specific genes depending on the signals being received from these environmental receptors.". We are the product of our genes AND of our environments. Our health is predicated on choosing how we interact with our genetic predispositions. 

We know that transcription factors occupy the top of the hierarchy of epigenetic information. Nutrients and bioactive food components can modify epigenetic phenomena and alter the expression of genes at the transcriptional level. Even emotional traumas can be transmitted to subsequent generations through epigenetic inheritance. A 2016 study conducted by New York's Mount Sinai hospital and published in Biological Psychiatry suggests that the genes of the children of Holocaust survivors showed evidence of an increased likelihood of stress disorders, for example. Nutrition, exercise, and other environmental factors are just part of the puzzle that affects an individual's risk of developing particular conditions or diseases. 

What is the Endocannabinoid System?
The endocannabinoid system (ECS) is the body’s largest, and most important neurotransmitter system in our body. It’s activated by both endocannabinoids and phytocannabinoids. The ECS strives to maintain constant homeostasis by breaking down cannabinoids based on your body’s current needs. The ECS has a series of receptors throughout the body that modulate responses to a variety of stimuli. Our endocannabinoid system is constantly in flux depending on the needs of the body. Many people are not making optimal amounts of endocannabinoids. Experts are exploring this in terms of deficiency in the ECS. Studies have shown that patients with chronic pain and inflammation including people with migraines, fibromyalgia,  depression, PTSD, ADHD, weight gain, and irritable bowel syndrome have lower levels of anandamide, an endocannabinoid in our body.

What causes low levels of endocannabinoids?
It’s not a simple answer. If you’re experiencing pain and inflammation, not sleeping well or having difficulty with mood, anxiety, and stress, or trouble concentrating, your ECS may be out of balance. According to Dr. Bruno, nutrition professor of Huntington University of Health Sciences, “Recent research suggests that, in some cases, the cause may have to do with genetic variants in the core endocannabinoid system genes. A diet low in phytocannabinoids—low in plant foods—may also play a role. The fact is, inadequate levels of endocannabinoids may be associated with their production, metabolism, or the state of cannabinoid receptors.”

​How do we optimize our ECS?
What is the Endocannabinoid Diet and why might our bodies need it?
Beyond cannabis, however, certain foods and activities can also help the ECS function optimally, improve your health, and enhance the effectiveness of medical cannabis. Essential fatty acids, chocolate, herbs, spices, and tea can naturally stimulate the ECS. A healthy ratio of omega-3 and omega-6 fatty acids can enhance the activity of the ECS. 
Consumption of these foods and herbs can all help to support the healthy function of the ECS:

• Hemp seeds and hemp oil
• Flax seeds (grind at home in a coffee grinder) and flax oil
• Chia seeds
• Walnuts
• Sardines and anchovies
• Eggs (pasture-fed or omega-3 enriched only)
• Chocolate:
• Cacao powder contains three compounds that are structurally very similar to endocannabinoids.
• Herbs and tea: Beta-caryophyllene is a terpene found in black pepper, lemon balm, hops, cloves, cannabis, oregano, cinnamon, and several other herbs. Echinacea, Camellia Sinensis, commonly known as “tea,”, turmeric, the yellow spice in curry powder, contains curcumin.

Things that impair the ECS:
Alcohol, pesticides, plastics, chronic use of corticosteroids.

Endocannabinoid-enhancing activities :

• Social interaction
• Meditation
• Yoga
• Massage
• Osteopathic Manipulation (OMT)
• Acupuncture
• Breathing exercises
• Sex

Nutritional Epigenetics is a model that creates key opportunities for early intervention. In my clinical practice, I see a tremendous shift in this mindset since the COVID crisis. Communities are more invested than ever with optimizing their health and wellness, preventative care, boosting their immune system.