The Ketogenic diet has been gaining popularity among people struggling with autoimmunity over the past several years. This is mostly due to the diet’s high concentration of polyunsaturated fatty acids (when done right) and its ability to facilitate the production of anti-inflammatory ketones (also when done right). But do the benefits of the ketogenic diet really outweigh the risks? And if not, are there ways to secure the anti-inflammatory benefits that are coveted by people suffering with lupus, Crohn’s disease, ulcerative colitis, rheumatoid arthritis, Hashimoto’s thyroiditis, Grave’s disease, psoriasis, and other autoimmune diseases without taking on the additional health risks that are associated with following a classical Ketogenic diet long-term? In this article, I’ll discuss the basics of Keto, how it leads to its anti-inflammatory effects, what the research is saying about the long-term effects of this type of diet, and how you can secure the benefits of a Ketogenic diet without wrecking your gut microbiome (specifically your good gut bacteria) and while avoiding the other negative consequences associated with this diet.

What is the Ketogenic diet and does it actually help with autoimmune disease?

The Ketogenic diet is basically a way of eating that includes lots of fats and very few carbohydrates. People essentially replace carbohydrate-containing foods with fats in their diet. Here are some examples of foods that are permitted and foods that are typically avoided on the Keto diet:

Foods that people typically avoid on the Ketogenic diet:

1. Grains and starches, including breads, pastas, cereals, other grains
2. Beans and legumes, including black beans, garbanzos, lentils, kidney beans, peas, etc.
3. Sugary foods: fruit juices, candy, ice cream, sodas, smoothies, pastries, cakes, etc.
4. Fruit, except very small amounts of low-sugar berries like raspberries and blackberries
5. Most root vegetables, including potatoes, sweet potatoes, carrots, beets, etc.
6. Low-fat condiments, including low-fat mayonnaise, low-fat salad dressings, etc.
7. Artificially sweetened foods, including most “sugar-free” candies, syrups, pastries, sweeteners, and desserts
8. Sweetened condiments and sauces, including honey mustard, barbecue sauce, teriyaki sauce, ketchup, etc.
9. Unhealthy fats, including processed vegetable oils, mayonnaise, etc.
10. Alcohol, including wine, beer, liquor, and mixed drinks

Foods that people typically eat on the Ketogenic diet:

1. Fatty fish, including salmon, trout, tuna, and mackerel
2. Other types of meat, including turkey, chicken, red meat, etc.
3. Eggs, including pasture-raised eggs (which are a better choice than free-range, cage-free, and caged)
4. Butter and cream, including grass-fed butter (which is nutritionally a better choice than regular butter) and heavy cream
5. Cheese, including unprocessed cheeses like cheddar, blue, or mozzarella
6. Nuts and seeds, including almonds, flax seeds, chia seeds, walnuts, pistachios, etc.
7. Healthy oils, including avocado oil, extra virgin olive oil, and coconut oil
8. Avocados, including whole avocados or homemade guacamole
9. Low-carb vegetables, including green vegetables, peppers, zucchini, etc.
10. Condiments, including salt, pepper, herbs, and spices

So as you can see, this diet is actually pretty restrictive, and the reason for this is that the anti-inflammatory benefits associated with this diet depend on your body entering into a metabolic state called ketosis.

Here’s the breakdown on ketosis: basically, most of your body’s cells prefer to use carbohydrates as their main energy source; however, when you significantly limit carbohydrates (grains, sugars, and other starches) in your diet, your body begins to convert your stored fat into ketone bodies. These ketone bodies are then released into the bloodstream and your body uses them to produce energy. This, in a nutshell, is the process known as ketosis. This diet relies on this process.

Now, this article isn’t about trying to persuade you to go Keto; instead, it’s about educating you about the benefits, risks, and alternatives associated with using this diet to address your autoimmune symptoms. I want you to have the best outcome possible, so if you’re going to try a Ketogenic diet, I want you to do it correctly; I don’t want you to be uninformed and end up wasting your time on a diet that won’t help you reach your wellness goals.

That being said, it’s important to note that the benefits of the Ketogenic diet are highly dependent on the ketosis process, so if you’re sneaking carbohydrates or if your fat-to-protein ratio is not ideal, you will likely not enter into ketosis and you won’t experience the anti-inflammatory benefits associated with following a classical Ketogenic diet. In all honesty, you’ll probably experience pro-inflammatory effects and an increase in your autoimmune disease symptoms.

The truth is that this diet isn’t something you can “sort of do” and still get some of the benefits; it’s more of an all or nothing type of deal. There is a threshold of carbohydrate availability that your intake must be below and there are specific guidelines that you must follow regarding your ratio of fat to protein in order for you to actually enter into ketosis. Furthermore, if you’re eating, but you’re not consistently adhering to these narrow guidelines for at least 2 to at least 14 days, [1] it becomes less likely that you’ll begin to produce the ketones which lead to the anti-inflammatory effects that are associated with this diet. Every time you sneak carbs, you set yourself backwards and have to start all over until you get to the place (again, within that 2- to 14-day window, where your body begins to produce ketones).

To summarize, when done correctly, the Ketogenic diet can reduce the immune system dysregulation and symptoms that we see with various autoimmune diseases, but it is a diet that takes a lot of work and is very difficult to get right. Also, it isn’t without its risks and the potential for long-term complications.

What are some of the problems associated with the Ketogenic diet?

In light of the fact that the Ketogenic diet can help improve autoimmunity symptoms, it’s also important to consider the drawbacks associated with this diet. There are multiple problems associated with the long-term use of the Ketogenic diet, and these center around the diet being restrictive and acidic, as well as around the diet’s effect on your gut bacteria and vagus nerve function. I’ll discuss each of those in this section.

The Ketogenic diet is restrictive

In order to properly follow a classical Ketogenic diet, you would need to completely eliminate multiple food groups. This results in a diet that is low in fiber (which is typically found in a wide array of fruits and vegetables) and oftentimes low in micronutrients (which are also plentiful in appropriate quantities in a variety of fruits and veggies).

The fact that the Ketogenic diet is low in fiber is the main reason why people who adhere to this diet oftentimes report gastrointestinal concerns like bloating and extreme constipation, and it’s also been cited as the main reason why people have a difficult time staying on the diet long-term.

As far as micronutrient status is concerned, there are a few nutrients that those who adhere to high-fat, minimal-carbohydrate-containing diets are significantly more likely to be deficient in. These include potassium, magnesium, vitamin C, and folate. Some researchers have argued that people adhering to a true high-fat, low-carb diet need less of these nutrients; however, this remains to be seen in the scientific research.

In fact, nutrient deficiencies are the main reason why children who have to be on a Ketogenic diet to manage their seizures need to be seen by their providers within one month of starting the diet and every three months thereafter for evaluation. [2] If they aren’t supplementing appropriately, the micronutrient deficiencies can significantly impair their health and lead to problems with their growth. Of note is the fact that children who were placed on this diet for 3-15 months to address their seizures saw a decline in their growth and tended to be shorter than their healthy peers who were on a more standard diet. [3]

The Ketogenic diet is acidic, which can negatively affect bone health

Research suggests that low-carbohydrate, high-fat diets are highly acidic, especially when compared to diets that contain more plant-based foods. [4-5] In fact, it’s a well-known fact that the Ketogenic diet leads to metabolic abnormalities that increase our risk for kidney stone formation. These metabolic abnormalities may also contribute to increased risk for osteoporosis and poor bone health in both the short- and long-term. [6-9]

The Ketogenic diet wrecks your gut bacteria, endangers gastrointestinal health, and impairs your vagus nerve’s ability to sense and modulate inflammation levels

The title of this section is a mouthful, but these characteristics of the diet are all related. I’ll share some background physiology to catch you up to speed and then I’ll explain why each of these negative consequences of the Ketogenic diet is relevant to you as a person diagnosed with an autoimmune disease.

OK, we all have bacteria in our gastrointestinal tracts and these bacteria serve multiple functions. Through a mechanism known as the gut-brain axis, our gut bacteria can communicate with and influence our brains. This mainly happens through the bacteria’s effects on a nerve called the vagus nerve.

The vagus nerve plays a critical role in inflammation control, autoimmunity, and even mood control, but it’s hampered by the Ketogenic diet

The vagus nerve is the longest nerve in your body; it’s a cranial nerve, meaning that it originates in our brains, and it descends all the way down to our gastrointestinal tracts. It serves various functions, but its roles in modulating inflammation levels, mood regulation, and controlling the parasympathetic (“rest and digest,” so the opposite of “fight or flight”) nervous system are the most relevant to our discussion here.

The vagus nerve controls inflammation through what’s known as the inflammatory reflex. Basically, the vagus nerve senses where our bodies’ inflammation levels are, it communicates that information to the brain, and then it receives feedback from the brain and makes changes in our internal environments based on that feedback. [10]

But there are multiple factors that can impair our vagus nerves’ ability to sense what’s going on in the environment. When this happens, the vagus isn’t able to provide the brain with the necessary feedback (at least not as efficiently), and our inflammation levels may be permitted to rise outside of the normal range.

One of the factors that can impair the vagus nerve’s ability to sense the inflammation levels in the environment is chronic stress, not only stress in adulthood but also childhood stress. This is because when we experience chronic stress during childhood, it changes our brains and bodies, alters how our bodies respond to chronic stress, and leads to alterations in our vagus nerve function as well. [11] These changes then increase our risk for a host of chronic conditions, including increasing our risk of being diagnosed with and hospitalized with symptoms due to multiple autoimmune diseases. [12] But, this is another topic for another day. If you haven’t yet and you’re intrigued by this topic, I recommend checking out my article on childhood stress and autoimmune disease risk.

To stay on topic, animal research demonstrates that in the short-term, high-fat diets may actually help the vagus afferents to do their job of controlling inflammation more efficiently. [13] But in the long-term, and by long-term I mean after 24 hours or more, the effect is the exact opposite. After as little as one day, high-fat diets impair important functions of the sensing portion of the vagus nerve.

Remember, if our vagus nerve has a harder time sensing our inflammation levels, it can’t relate that info to the brain, and the result is that the inflammatory reflex is interrupted and our inflammation levels are more likely to go beyond what the brain considers to be normal. This, of course, would be associated with an increase in autoimmune disease symptom severity.

Furthermore, there’s actually an overwhelming amount of research that demonstrates that high-fat diets lead to significant changes in our gut bacteria. [14-15] In fact, after fewer than 5 days on a high-fat diet, we see a significant increase in inflammatory, gram-negative bacteria like Bilophila wadsworthia and Desulfovibrio spp.  [16-18]

Now here’s why you don’t want these guys in your gut. These bacteria are composed of something called lipopolysaccharides or LPSs, and if they’re in your gut, they can release LPSs there. The LPSs interact with your vagus nerve and the result is an increase in inflammation. [19] To make matters worse, high-fat diets are known to facilitate intestinal permeability. [20]

This basically means that whereas the barrier in your gut was solid like a bowl, after being on a high-fat diet, it becomes more like a colander or a sieve. The LPSs can then go through the little holes in your gut barrier and they can enter your bloodstream where they cause your body to have low-grade, chronic inflammation. [21] In addition to worsening your autoimmune disease symptoms, these LPSs can also negatively impact your mood and contribute to depression and other mental health concerns.[22-24]

If the Ketogenic diet destroys your good bacteria, why would anyone even recommend it to treat autoimmune disease?

Now, you may be saying, “Wait a minute, Dr. Janelle. I thought you said the Ketogenic diet was anti-inflammatory; what’s all this? And if it really can destroy my microbiome, hamper my vagus nerve function, and negatively affect my mood, why on earth would I, or anyone for that matter, even try it?!”

Here’s my explanation: All of what I’ve just described does take place in the body on a Ketogenic diet, but in spite of that, the diet still has a net anti-inflammatory effect. In other words, as I mentioned in my introduction, the anti-inflammatory effects of the ketones and the polyunsaturated fatty acids that typically comprise the diet are so powerful that they can overcome the inflammatory effects, to a certain degree. So to summarize, the anti-inflammatory effects outweigh the pro-inflammatory effects in this case, but that doesn’t mean the diet is devoid of negative potential long-term complications.

So if you’re actively thinking as you’re reading, then you’re probably wondering “Is there a way then to secure the anti-inflammatory benefits of ketosis without the bone-depleting, gut-wrecking, and mood-destroying effects of a high-fat diet?”

And if this is your question, then boy do I have an answer for you!

Enter time-restricted eating.

How does time-restricted eating help with autoimmunity and help my body produce anti-inflammatory ketones without the negative effects associated with the Ketogenic diet?

Time-restricted eating is a manner of eating that supports optimal circadian rhythm function [25] (which, by the way, is a critical part of wellness for people diagnosed with autoimmune disease). It essentially limits your daily eating times to 6-12 hours per day and allows for a period of fasting every day. Research demonstrates that this type of time-restricted eating has powerful anti-inflammatory effects on the body, as well as other benefits.

These benefits are partially due to the fact that this type of fasting has been shown to actually lead to the production and metabolism of ketone bodies. [26] In other words, by implementing this type of time-restricted eating, we can produce ketones on a daily basis, while enjoying a much less restrictive diet than the Ketogenic diet (and not to mention avoiding the unwanted potential complications and the increased all-cause mortality—or likelihood of death—that is associated with high-fat, low-carbohydrate-containing diets). [27-28]

In order to help the high-performing women I work with who’ve been diagnosed with autoimmune disease to improve their symptoms while simultaneously addressing the underlying causes of their conditions, I typically recommend a much more sustainable diet that is centered around whole foods and that includes complex carbohydrates, moderate protein, and healthy fats. I make these recommendations in the context of time-restricted eating in order to support optimal vagus nerve and circadian rhythm function. I have them have their last meal by 6pm for the latest and fast overnight until 12-16 hours later, so if they finish eating by 6pm, they have breakfast between 6 and 10 a.m. To further support circadian function, I recommend that they follow a schedule and have their meals at the same time each day.

Because stress is a significant contributor to both autoimmune disease risk and symptom severity, I also work with my clients to help normalize their chronic stress response (which is controlled in the body by the hypothalamic-pituitary-adrenal or HPA axis, and which can get out of whack and increase our risk for autoimmune disease and many other chronic disorders if we experience high stress in adulthood or even comparatively small amounts of stress in childhood).

I’ve found that this three-pronged approach to addressing autoimmune disease—an approach that emphasizes optimal HPA axis function, vagus nerve health, and circadian rhythm function—leads to amazing results in helping my clients significantly reduce their autoimmunity so that they can truly thrive.

If you’d like to learn more about my unique and comprehensive approach to addressing autoimmunity, you can click here to watch the replay of a webclass I did for my audience a while back.

I wish you nothing but the best as you progress along your wellness journey!

To see a list of references associated with this blog post (and any of my other posts where I reference an extensive list of scientific sources), click here.

Unfortunately, there has been a lot of misinformation passed around regarding how likely a person who was abused is to become an abuser and abuse their own (or other people’s) children. This post is my attempt to clear things up. In this post, we’ll take a look at how the effects of abuse and other traumatic experiences are passed down across generations, we’ll look at exactly what the evidence shows regarding how likely adults who were abused are to become abusers, and we’ll explore the two key differences that exist between people who perpetuate the cycle of abuse and those who break it.

Abuse runs in my family. How are the effects of abuse passed down from previous generations to me?

If abuse has been perpetuated in your family, I want to take a moment to congratulate you. The fact that you’re even reading this post tells me that you are likely a person who is seeking to understand their past experiences and to be proactive about their future, and for that, I commend you. I can already tell that you have the qualities of a cycle-breaker.

Now, because abuse has been perpetuated in your family, there are a few things you need to know. The first thing is that, while the research is still relatively new, it does suggest that the epigenetic effects of trauma can be passed down from generation to generation. Does this necessarily mean that if we’ve experienced traumatic events like abuse, it’s inevitable that we also repeat these habits with our children? No, it doesn’t. The reason behind this lies in the difference between genetically and epigenetically transferred risk. If you’re not familiar with these concepts, I break it all down in my post on ancestral or intergenerational trauma. For the full explanation, you’ll want to check that out.

Essentially, traumatic events like abuse are marked by epigenetic changes (and not changes to our actual genes). While we can’t currently change our genes, epigenetics can change depending on our internal (mindset, hormones, nutritional status, etc.) and external (physical environment, social support, etc.) environments. Because we can all control multiple (if not all) aspects of our environments, we don’t have to be defined by the choices of our ancestors.

How reliable is the available data about the abused becoming abusers?

In 2019, a scientific review of the then available research reported that anywhere from 7% to 88% of people who were abused went on to abuse their own children. That very wide (and utterly useless) range exists because the methods that many of the researchers used to gather their data weren’t as reliable as they could’ve been. Instead of looking at Child Protective Services’ involvement or another more reliable metric, the majority of these researchers used subjective means of gathering data. This means they simply asked participants whether they were abused or not and, as you can imagine, this leaves great room for recall bias (e.g. people’s memories may be skewed) and other forms of human error.

To further highlight the problems with the available data, one researcher who conducted another review found that all but one of studies he examined that tried to answer the question of whether or not abused individuals become abusers were of questionable quality.

To summarize, the quality of the majority of research in this area is dishearteningly low, and this contributes in a major way to the lack of consistency that we see across studies.

As an abuse survivor, am I going to abuse my own children?

That being said, several researchers have concluded that there’s absolutely no reason for people to accept the false claim that abused people are doomed to abuse their own children. These researchers have made it clear that this idea is a myth at best (and dramatically damaging at worst). Regarding the myth that the majority of people who are abused grow up to become abusers, researchers have agreed that “its unqualified acceptance is unfounded.”

In fact, more reliable studies have concluded that the majority of individuals who endured abuse do not go on to mistreat their own children. In all actuality, many people who’ve suffered abuse avoid having children altogether because of their own fears of becoming parents like their own parents. Others become so determined to protect their children from what they experiences that they become overly protective. And still others go out of their way to avoid repeating their parents’ mistakes and they become model parents.

The anatomy of a cycle breaker

Researchers in England set out to better understand what made the difference between individuals who were abused and went on to perpetuate the cycle of abuse and those who broke the cycle.

They separated the study participants into four groups:

1. Group 1: parents who were abused and also abused their children. They called this group Maintainers.
2. Group 2: parents who were abused but did not abuse their children. These were the Cycle Breakers.
3. Group 3: parents who were not abused but who abused their children. This group was called the Initiators.
4. Group 4: parents who were not abused and did not abuse their children. This was the control group (Controls).

What qualities do abused children who become abusive parents have?

The results of this study were fascinating. These researchers found that individuals who were abused were more likely to abuse their own children when there were other risk factors for abuse at play in the home. These factors included those that are also recognized as adverse childhood experiences (ACEs), such as the parent being depressed or having another mental health concern, there being substance abuse in the home, and violence between caregivers.

Abuse survivors were also more likely to perpetuate the cycle if they were young parents (under age 21) and if they struggled with feelings of isolation or a lack of support and if they had poor parenting skills.

We can think of these risk factors as part of the environment that sets the stage for abuse and other ACEs and therefore for the epigenetic changes that come along with them.

What qualities do abused people who break the cycle of abuse have? How is this different from those who perpetuate the cycle?

Now here’s what I believe is the most interesting part of this study: When they compared the Maintainers with the Cycle Breakers, researchers found that these groups had very similar risk factors—both had a high prevalence of other ACEs in the home, both had higher prevalence of young parents, and both had poor parenting skills.

But what appeared to make the difference was the fact that the Cycle Breakers had stronger social support and they were also more likely to be financially solvent.

Maintainers had more feelings of isolation. They felt their lack of perceived support more keenly, and they were less likely to be financially solvent. The Maintainers in this study tended to isolate themselves and their families, which led to them not having access to the social and financial support that they needed.

Researchers further described social integration and support as well as financial solvency as key protective factors against breaking the cycle of abuse. These protective factors played a significant role in whether or not the cycle of abuse was perpetuated.

Summary

In closing, I want to reiterate the fact that although the physiological effects of our parents’ and grandparents’ traumatic experiences can be passed down to us, these changes are passed down epigenetically. This means that we do not have to be defined by their choices or subject to their experiences. By being proactive about maintaining optimal internal and external environments, we can carve out our own futures.

I also want to reiterate that higher-quality research demonstrates that the majority of individuals who are abused as children do not grow up to abuse their own or other children. By comparing and contrasting those who maintain the cycle of abuse and those who break it, researchers have found that while the risk factors among these groups are similar, Cycle Breakers have two factors that set them apart from the Maintainers. These two factors—sufficient social support and financial solvency—have a protective effect against the perpetuation of the cycle of abuse.

That being said, if you are a person who has experienced abuse of any kind, I highly recommend the following things:

1. Take control of your environment so that you can address the epigenetic changes that have taken place in your body as a result of your difficult past. To learn more about this, click here.
2. Connect and reconnect with like-minded others to ramp up your social support and increase your likelihood of becoming or remaining a Cycle Breaker.
3. Take a financial literacy course, further your education, or do whatever you need to do to be able to pay off your existing debts and remain financially independent in the future.

There’s been a lot of talk lately about “ancestral trauma,” which is the notion that the effects of traumatic events are passed down from generation to generation. It’s the idea that you can be negatively affected by the choices and experiences of your parents, grandparents, and even your great grandparents and further back. While this may sound like it makes sense on the surface, there are a few problems with the way this narrative is presented. In this post, I’ll explain why the ancestral trauma narrative may be causing more harm than good, what the science really shows regarding the intergenerational transmission of trauma, and what this means for you if you or your ancestors are survivors of adverse childhood experiences (ACEs).

How do traumatic experiences affect health and life?

We know from the Adverse Childhood Experiences study (also known as the ACE study), which was conducted by Kaiser Permanente and the CDC, that traumatic events during childhood, including household dysfunction (parental divorce or separation, incarceration, substance abuse, mental illness in the home, or domestic violence), abuse (physical, sexual, or emotional), and neglect (physical or emotional) can have negative effects on health. In this study, they gave everyone a score based on how many categories of these stressful events they had experienced before age 18, and they found out that those with higher ACE scores had greater risk for chronic disease. If you don’t know your ACE score, you can take the ACE questionnaire here.

The ACE study and studies based on it revealed that when we experience traumatic events in childhood, these experiences actually lead to changes within our brains and bodies that increase our risk for various chronic conditions, including mental health concerns, autoimmune diseases, hormonal disorders, and metabolic syndrome-related concerns (e.g. diabetes, hypertension, heart disease, etc.). These traumatic events can also affect our personalities, our relationships, and our underlying thoughts and beliefs about ourselves, the people we interact closely with, and the world in general.

Is “ancestral trauma” really a thing?

Ancestral trauma or the intergenerational transmission of trauma—which again is this notion that the health effects and other effects of traumatic experiences are passed on from generation to generation—is absolutely valid, but there is a major problem with the way this concept is explained, and this is what makes the idea so harmful.

Here’s what I mean: I was spending some time recently in a Facebook group when I came across a heated debate. In this post, hundreds of people were going back and forth arguing about the validity of the original poster’s claim. Essentially, the original poster had recently learned about ancestral trauma and, as you can imagine, she felt incredibly validated by this concept.

In case you haven’t yet had the chance to experience it, you should know that coming to the realization that you’re not fully at fault for many of the things that have happened in your childhood and the effects these things have had on your life (especially in a society that emphasizes personal responsibility so heavily) can be incredibly freeing. I know from personal experience that coming to this realization can help people to be more patient with themselves and to extend more grace to themselves. And this is exactly where the original poster was. She had heard about the concept, and she took to social media to share what she had learned.

Unfortunately, however, the people in the Facebook group didn’t take too kindly to what she was sharing, and I’ll tell you exactly why. Her post went something like this: “…Ancestral trauma explains so much about who we are. Our ancestors’ traumatic experiences are passed down through our DNA, and this shapes our personalities, our relationships, and our risk for disease.”

Now, why would such a docile post stir up so much commotion? It’s because of those three letters: DNA. The original poster’s interpretation of the ancestral trauma narrative was controversial because she was claiming that these effects are passed down genetically. People didn’t like that because many of them had put forth concerted efforts to escape the effects of their own ancestral trauma. Even though their parents were alcoholics, they had never abused any harmful substances, so they couldn’t get behind the idea that these effects were permanently etched in their DNA. This idea was incredibly disempowering, and they couldn’t support an idea that made them a permanent victim to anyone else’s experiences.

Why is the ancestral trauma narrative harmful?

The narrative that the effects of trauma is passed down genetically—through our DNA—from generation to generation is harmful and damaging because it takes control out of the hands of the individual and puts it in fate, luck, or chance. I side with the people on this one, and fortunately, so does the actual science. Science does NOT support the idea that the effects of trauma are passed down genetically.

Are the effects of trauma passed down genetically or epigenetically? And why does it matter?

As I’ve stated, science does NOT support the idea that the effects of trauma are passed down genetically; it does, however, support the idea that the effects of trauma are passed down EPIgenetically.

What’s the difference? For something to be passed down genetically, it would need to be written in the actual DNA. If you remember high school biology, this would mean it’s written in those base pairs, adenine, thymine, guanine, and cytosine. You can think of our genetics as a wooden table. No amount of effort will change the table from wood to stone. No matter how hard we try, we can’t change the makeup of our genes. It’ll always be the same.

If something is passed down epigenetically, however, it isn’t written in the base pair themselves, Instead, it would actually be documented via methylation and other less permanent etchings on our genes. The term epi- means upon. You can think of epigenetics as an overlay, or a decorative piece. If we’re going back to the table analogy, I’d even say think of it as a tablecloth that we lay upon the table. It’s an integral piece of our dinner setup, but with some effort, we can always switch the tablecloth out for another one.

And that’s exactly it. Research on the children of Holocaust survivors has shown that the effects of our ancestors’ traumatic experiences are etched in our epigenome, but because epigenetics are actually a combination of genetics and environment, by changing our internal (e.g. by changing our diets and thought patterns, through nutritional supplementation, etc.) and external environments (e.g. by having ample social support, engaging in physical activity, etc.), research demonstrates that we can actually change our epigenetics and “undo” or counteract the negative physical and mental health effects that our ancestors’ (and even our own) traumatic experiences have had on our lives.

In closing

And this is why we need to be careful about the way we talk about the intergenerational transmission of trauma. Instead of being a disempowering message, it’s actually a hope-filled, empowering message, if it’s told in the right way.

The effects of your ancestors’ traumatic experiences are passed down to you epigenetically, but the fact remains that you have the power to choose whether you’ll succumb to those predispositions. Yes, their experiences may have conferred an increased risk for mental health concerns, autoimmune disease, hormonal disorders, and even metabolic syndrome upon you, but that doesn’t in any way mean that you HAVE to experience these diagnoses or, if you’ve already been diagnosed, it doesn’t mean that these diagnoses have to limit your life.

If you want to take the first step toward decreasing your risk for or addressing these ACE-related chronic concerns and join a community of women like us who are committed to living their healthiest and most fulfilling lives now, in spite of our past experiences, click here to learn more about my ACE Defying Wellness Program.

The ACE study, conducted by the CDC and Kaiser Permanente, found that adverse childhood experiences (ACEs) significantly increase our risk for multiple chronic health concerns. These chronic health concerns include metabolic syndrome-related concerns, such as insulin resistance, type-2 diabetes, high cholesterol, overweight and obesity, hypertension, heart attack, stroke, and other cardiovascular concerns. But how could this be? How exactly does something that we experience in early childhood impact our risk for chronic disease twenty or more years later? Let’s find out.

First of All, What are Adverse Childhood Experience or ACEs Anyway?

Throughout this article, I’ll use the terms “early life stress,” “childhood trauma,” and “adverse childhood experiences” interchangeably. Before we get into the details of how this type of trauma increases our risk for metabolic syndrome-related health concerns, I want you to understand exactly what I mean when I use these terms.

When I use these terms, I’m referring to any experience that chronically activates the stress response during childhood. This could be a stressful condition that recurs multiple times or it could be a stressful event that occurred once but led to activation of your stress response every time you thought about or remembered it.

Here is a list of the most commonly studied adverse childhood experiences:

• your parents being separated or divorced;
• living with someone who is experiencing depression or another mental health concern;
• living with someone who struggles with addiction;
• seeing your mother or another household member treated violently;
• having someone in your household go to jail or prison;
• experiencing sexual, physical, or emotional abuse;
• feeling like you’re not loved or protected at home;
• and not having enough clothing, food, shelter, or means to obtain necessities during childhood.

I’ve listed the most commonly studied forms of adverse childhood experiences above, but there has also been research done that looked at connections between chronic health concerns and other forms of trauma, such as:

• having a parent or sibling die,
• being in foster care,
• being chronically ill during childhood,
• and more.

Take the ACE assessment to find out your ACE Score and what you can do to reduce your health risk!

How Do Adverse Childhood Experiences Affect Our Risk For Insulin Resistance, High Blood Sugar, & Type 2 Diabetes?

If you’ve experienced early life stress, also referred to as adverse childhood experiences or ACEs, and you’ve been diagnosed with diabetes, the two could very well be related. Research suggests that when we experience trauma during childhood, it changes our brains and bodies in such a way that it negatively impacts our diabetes risk. Trauma during childhood increases our diabetes risk by its effects on our stress responses and our lifestyle habits.

So how exactly does trauma impact our stress responses and increase our risk for high blood sugar, insulin resistance, and diabetes? When we experience ACEs, the chronic arm of our stress response (which is controlled by what’s known as the hypothalamus-pituitary-adrenal axis or HPA axis) becomes hyperactive. In other words, our bodies become so used to releasing stress hormones in response to stressful situations that they begin to overreact to things that are only slightly stressful. Hyperactivity of the stress response explains why levels of stress-related hormones like corticotropin-releasing hormone and cortisol tend to be higher in ACE survivors than in non-ACE survivors.

When the stress response becomes hyperactive, the high blood levels of cortisol and other stress hormones lead to disruption of our endocrine, immune, and autonomic nervous systems. These physiological changes and the unhealthy lifestyle behaviors that can come about as a result work together to increase our risk for insulin resistance, high blood sugar, and diabetes. These unhealthy lifestyle behaviors include overweight and obesity, living a sedentary lifestyle, and using alcohol and/or recreational drugs, all of which we as ACE survivors are at increased risk for as a result of our trauma.

Is childhood stress really connected to chronic disease? There is definitely a distinct connection between the mind and the body. Ongoing research continues to validate this fact. Some of the most interesting research about this topic, in my opinion, revolves around the connection between childhood trauma and the immune response, specifically the risk for autoimmune conditions like rheumatoid arthritis, lupus, Hashimoto’s thyroiditis, Grave’s disease, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, and more.

Do you remember a time when you were under so much psychological or even physical stress that it altered your normal menstrual cycle? Maybe your period came early or late, or maybe it didn’t come at all that month. We’ve known for many years that high levels of acute stress can negatively affect reproductive function, but a growing body of research is now demonstrating that chronic stress, and particularly chronic childhood stress also referred to as adverse childhood experiences or ACEs, can also lead to reproductive concerns. This includes conditions like pre-menstrual syndrome (PMS), polycystic ovarian syndrome (PCOS), fibroids, endometriosis, and infertility or otherwise impaired fertility.

You’ve likely heard about the mind-body connection—it’s the idea that the mind and the body are intimately connected, with each affecting the other, despite the fact that we frequently try to separate them. In reality, our minds are more intimately connected to our bodies than many of us realize. I’m not just making this up; research continues to support this fact. Some of the most fascinating research that demonstrates how intimately connected the brain and body truly are is the research that describes the link between the risk for mental health concerns like anxiety, depression, and post-traumatic stress disorder (PTSD) and childhood trauma, which is commonly referred to as adverse childhood experiences or ACEs.

If you’re wondering what types of events constitute traumatic occurrences or ACEs, the most frequently researched forms of trauma as it pertains to increased mental health and other chronic disease risk include:

• parental separation or divorce;
• seeing your mother or another caregiver treated violently;
• having a household member with depression or another mental health concern;
• having an incarcerated household member;
• having a household member who struggles with addiction;
• physical, sexual, or verbal abuse;
• and physical or emotional neglect.

Despite the fact that these are the most commonly studied forms of trauma, there has been research done that has demonstrated links between chronic health concerns and other forms of trauma, such as:

• experiencing the death of a parent or sibling,
• growing up in foster care,
• experiencing chronic illness during childhood,
• and more.

Take the ACE assessment to find out your ACE Score and what you can do to reduce your health risk!

What Mental Health Concerns Does Trauma Increase Our Risk For?

Before I explain what childhood trauma has to do with mental health in adulthood and with the mind-body connection, let’s get clear on a few more things. First of all, I want you to understand which health concerns I’m talking about when I say ACEs increase our risk for mental health concerns. So far, a growing body of research has been able to confirm a link between early-life stress or trauma and the following mental health concerns:

• Difficulty adapting
• Anxiety
• Depression
• Bipolar disorder
• Schizophrenia and other forms of psychosis
• Post-traumatic Stress Disorder (PTSD)
• Addiction and substance abuse
• Attempted suicide

An astounding 45% of children in the United States have experienced one or more adverse childhood experiences. For most of the health concerns that have been linked to childhood trauma, the risk increases as the number or type of trauma increases. In other words, a person who has experienced both severe physical abuse and severe physical neglect would be at increased risk for these mental health concerns compared to a person who has only experienced severe physical abuse, all other things being equal.

Why Does This Even Matter?

All of this is crucial to know because if you’ve experienced at least one type of adverse childhood experience, you carry an increased risk for not only mental health concerns like anxiety, depression, and PTSD, but a host of other physical health concerns as well, such as autoimmune diseases, cardiovascular disease, reproductive concerns, and more. But here’s the good news: although you’ve experienced trauma during childhood that has changed your brain and body and predisposed you for many different health concerns, the good news is that there are things we can do to support our HPA axes and to support our bodies so that we are able to reduce the risk that we’ve accumulated over the years and live our healthiest and best lives now; we no longer have to be controlled by our past.

This is one of the top reasons why I advocate for knowing your risk, understanding how the trauma you’ve experienced affects your health in adulthood, and being proactive about your health in order to reduce the risk that you’ve accumulated in your life so far and break the cycle in your own life and for the sake of your children.

If you’ve read this article and you’ve experienced adversity during childhood, I encourage you to be proactive about your health. Take the ACE Assessment to find out your ACE score. I’ll also send you my Adverse Childhood Experiences and Overall Health Risk Report, which contains important information about how your ACE score can affect your risk for mental health concerns, autoimmune conditions, cardiovascular disease, reproductive concerns, and other health concerns, and important tips you can implement right away to help you minimize your risk for these types of concerns.

If you already know your ACE score, check out my book, Set On Edge to learn how ACE survivors like us are kicking ACEs to the curb and finally living our healthiest and best lives now, in spite of our difficult pasts. ACEs no longer have to define you.