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Your Brain & Your Gut and How They Are Connected: an interview with Britta Zimmer, ND, Medical Director of Pacific Quest

Full disclosure: Britta Zimmer and I went to a small Washington, DC high school together, played sports and she went on to become a naturopathic doctor. Our worlds reconnected when she began working at Pacific Quest (HI) on the big island of Hawaii and I noticed on their website they had hired her when I was making a referral. As you’ll see, Britta has an interesting perspective and adds a important lens to teens and young adults in treatment. Britta lives on the Big Island in Hawaii with her family.


AKoT: Thanks for talking with me, Britta. I promise this will not be like the 3 hour exams we had in high school. You have been working at PQ for 9 years. With this, you have seen a few things through your lens. What has been the largest surprise to what you are doing?

B.Z.: The biggest surprise is the potential for transformation in the adolescent’ physical, mental, and emotional health in a relatively very short period of time. I did part of my residency at an at-risk youth clinic in Portland, Oregon which morphed into specializing in adolescent health in private practice. Tending to the health issues of adolescents and adults is a process. This process is considerably more drawn out in outpatient practice due to compliance issues.

Now that I work in an inpatient setting, I am astounded at what naturopathic lifestyles changes can accomplish in a brief treatment period. Nutrition, sleep restoration, exercise, and stress management are the first line treatments for all of our students and from that base we use our different physical and therapeutic modalities. These modalities work considerably better and faster when the first line treatment is lifestyle changes and of course this beautiful setting with almost 100% compliance helps tremendously. Once I recognized this I dove into why.

I believe one of the main reasons we see a quick turnaround in our students’ physical, mental, and emotional health is a reduction in overall body inflammation which equates to better brain health. Simply put, the gut and brain communicate via the vagus nerve, this superhighway of information translates the state of health of the gut to the brain. Quelling the inflammation in the intestines has been found to lead to improved mental health outcomes due to the high percentage of neurotransmitter receptor sites in the gut. Note that there are more neurotransmitter receptor sites in the gut compared to the brain and we are talking about important neurotransmitters such as serotonin and dopamine. Gut neurotransmitters have been found to affect mood, the jury is still out on whether this is from a direct effect within the enteric nervous system (your gut-based nervous system) or via communication within the central nervous system or a combination of the two. Simply eating an anti-inflammatory diet accomplishes this but one also has to balance inflammatory hormones with better sleep and stress management.


AKoT: And for those of us who have no idea what anti-inflammatory diet is? Where do we start?

B.Z.: An anti-inflammatory diet is primarily composed of whole foods, meaning foods which appear as they do in nature, basically non-processed foods; whole protein sources such as organic meats, fish, eggs, tofu, beans and nuts with moderate amounts of complex carbohydrates and plenty of brightly colored vegetables. An anti-inflammatory diet is devoid of sugar, bad fats, and chemical additives. In addition, avoiding food sensitivities such as gluten, dairy, soy, or corn can lead to less inflammation in the intestines. Not everyone is sensitive to these foods but when you are, eating them on a daily basis sets up a cascade of inflammatory events which the body has to offset. The gold standard of determining food sensitivities is an elimination/reintroduction diet which can be difficult to pull off. One can also get a food sensitivity test for IgG delayed hypersensitivity markers, most NDs offer this test. In Hawaii, with the support of NDs, many dermatologists are offering the IgG food sensitivity test since they are seeing great results with food elimination and inflammatory skin conditions such as eczema and acne.


AKoT: What should a family do in a home setting? Is there a way to start help at home?

B.Z.: Get rid of or simply stop purchasing as many processed foods as possible.

  1. Cereals with more than 7 grams of sugar per serving should be considered dessert.
  2. Think simple compositions of meals such as a roasted chicken, steamed or sauteed vegetables, roasted potatoes or brown rice.
  3. Dessert should not be a nightly occurrence unless fruit is dessert.
  4. Try to eat at home as much as possible, restaurants put more sugar, fat, and salt in food than you can imagine because these ingredients make food taste better. Also eating at home as a family and cooking together is an important way to attune to your kids and bond.


AKoT: Ok, so I went home and checked the cereal that my husband (yes, I am throwing him in front of the bus) bought our children and spoke to him about his choice/our 3.5 YO choice. Is there anything else that you believe anyone can do to help themselves and their gut?

B.Z.: Eat fermented foods and / or plain yogurt daily or take a high quality probiotic supplement. Studies are conclusively showing that good bacteria in the gut affects mood positively. Unfortunately, we are great at killing our good gut bacteria by taking oral antibiotics for non-bacterial illnesses ( often, we doctors give unnecessary courses of antibiotics to cover our liability for those “what if” cases) and antibacterial household products.

Note that the flavored yogurt doesn’t count because of the high sugar content and other artificial ingredients, stick to plain yogurt and feel free to add a touch of honey or granola for flavor. It takes about 2 weeks to kill a sweet tooth, meaning if you cut out sugary foods for about 2 weeks this plain yogurt will actually start tasting good to you and your children. The trick is sticking with it so those taste buds do not get accustomed to sweet foods, it takes about 24 hours to get back on the sugar habit.



More about Dr. Britta Zimmer

Britta Zimmer is a licensed Naturopathic Physician, receiving her BA from the University of Virginia and ND from the National College of Naturopathic Medicine in Portland, Oregon. Dr. Zimmer completed a comprehensive Naturopathic Family Practice Residency in Portland Oregon which included extensive work at a community clinic providing health care for at risk youth. Before moving to Hawaii, Dr. Zimmer, was part of a group practice in Portland Oregon specializing in general family practice medicine, women’s health and adolescent health care. Dr. Zimmer has developed the integrative psychiatry program and the medical-wellness program at Pacific Quest, an outdoor behavioral health program located on the Big Island of Hawaii. She enjoys yoga and stand-up paddle boarding with her husband and two daughters, ages 7 and 11.