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The nutrition-cannabis connection

Can good nutrition help the use of cannabis medicine be more effective? Early research suggests it might. Here’s what we know about the interplay between cannabis compounds and dietary fats, caffeine, and bacteria in the GI tract—a.k.a. the gut microbiome.

Cannabis medicine from centuries ago was often a mixture of cannabinoid-rich flowers or resins with food ingredients. This wasn’t just to make the medicine more palatable—ancient practitioners placed high value on spices, fats, sweeteners, and other ingredients they thought had their own potential medical benefits.

Fast-forward to today, and scientists are beginning to understand how the relationship between cannabis compounds, such as CBD and THC, and everyday dietary nutrients have a combined effect on the human body. Here are some of the early clinical findings on cannabis and nutrition:

Omega-3s and the endocannabinoid system

Omega-3-fatty-acids, the same ones found in salmon and olive oil, are thought to keep the human endocannabinoid system functioning at optimal levels. Our endocannabinoid systems are made up of a vast network of receptors found throughout the body and regulate our “relax, eat, sleep, forget and protect” bodily states.

These receptors respond to cannabinoids, such as CBD and THC, which enables a cascade of bodily reactions—both physical and mental—that can be beneficial for managing many health conditions. With adequate omega-3s in the diet, patients may get even more from their medical cannabis.

Here’s how: 

“Tones” the endocannabinoid system:

Studies in mice have shown sufficient omega-3s in the diet correlates to enhanced endocannabinoid receptor signaling, meaning these receptors are better at sending and receiving messages. Further studies demonstrated when mice were lacking omega-3s in their diet, CB1 receptors become desensitized. In a separate study, after six weeks of omega-3-rich oil added to mouse diets, CB1 receptors were strengthened. 

For optimal endocannabinoid system functioning, the ratio of omega-6s to omega-3s is 4:1. The highly-processed, high-fat Western diet, however, is closer to 16:1.

How do I get enough omega-3s?

Most adults can consume enough omega-3-fatty-acids through foods, especially with a balanced diet. Omega-3-rich foods include:

● Fish and seafood (especially fatty fish such as salmon, trout, herring, mackerel, anchovies, sardines)

● Walnuts, chia seeds, ground flaxseeds, hemp hearts

● Plant oils (such as flaxseed oil, hemp oil, olive oil)

Nutritional guidelines for adults focus on just one kind of omega-3-fatty-acid: alpha-linolenic acid (ALA). Recommended intake of ALA for non-pregnant, non-breastfeeding adults is 1.6 g for men and 1.1 g for women.

Dietitian’s tip: Hemp hearts are so versatile—try sprinkling them onto salads, yogurt, and even avocado toast in the morning. They also add a nice nutty flavour to smoothies, or a great nut-free substitute for pine nuts in homemade pesto.

Omega-3s and omega-6s make cannabinoids more bioavailable

Patients may have heard about taking their cannabis medicine with foods high in fat for better felt effects. That’s because animal studies have shown orally administered cannabinoids (i.e., edibles, oils or softgels) combined with dietary fats activate the intestinal lymphatic system. This means cannabinoids hitch a ride via the lymphatic transport, increasing exposure throughout the body. These study animals were fed sesame oil, which is very high in omega-6-fatty-acids with some omega-3s, although researchers did not indicate which type—omega-6 or omega-3— was optimal.

With cannabis, omega-3s may regulate body mass

As mentioned above, researchers are finding a lack of omega-3s leads to desensitized endocannabinoid receptors. In response, the body generates more of its own “homemade” endocannabinoids to compensate (namely, anandamide and 2-AG, which have similar structures to THC and CBD).

An overabundance of these naturally occurring cannabinoids are connected to inflammation and obesity. Emerging evidence suggests cannabis can calm overactive, overstimulated endocannabinoid receptors, a process called down-regulation. Early results for managing obesity with cannabis are showing reduced food intake, less body fat, and more balanced blood glucose levels. 

 Limiting processed food intake made with refined oils, and increasing omega-3 rich foods, is a great way to balance omega-6 to omega-3 ratio for improved overall health. Got questions?  Our in-store dietitians can help with recommended  foods or supplements. We offer free, 15-minute phone consultations with our dietitian team.

Cannabis and caffeine

Anecdotal reports of combining medical cannabis with morning coffee have mixed results: some find the pairing enjoyable—others not so much. Research is suggesting the entire endocannabinoid system may change in response to caffeine, while early studies point to the combined effect of cannabis and caffeine on memory.

May slow the endocannabinoid system

A recent clinical study asked coffee drinkers to abstain from coffee for one month, then steadily increased consumption. Results showed these decreased levels of endocannabinoid metabolites; in other words, fewer and fewer body-made cannabinoids and related chemicals were present in the body. Researchers speculate that because coffee solicits a stress response, the body stopped making its own stress-reducing chemicals via the endocannabinoid system.

More coffee = more cannabis? One study on squirrel monkeys showed the more caffeine-like substance the animals were given, the more cannabis they self-administered. And the reverse was true, too—less caffeine chemical, the fewer times they self-administered cannabis.


Memory loss and memory retention

There are two notable animal studies on the effects of caffeine and cannabis may have on memory. In one study on rats, caffeine combined with THC was found to worsen memory response. In a different study on zebrafish, whose memory systems are impaired by CBD, caffeine appeared to counteract the effects of CBD and improve memory retention.

Dietitian’s tip: More research is needed in this area. If you’re looking for ways to decrease your caffeine intake but still enjoy the taste of coffee, opt for decaffeinated coffee, or even chicory root coffee.  And if you’re just looking for a hot beverage to warm yourself up in the morning, try herbal tea.

Patient awareness caution: Both caffeine and cannabis are metabolized by the liver. Patients with impaired liver function should speak with their healthcare providers about combining the two.

Cannabis and the gut microbiome

Good nutrition has a positive effect on the gut microbiome—the delicate balance of bacteria that live in the gastrointestinal (GI) system and contributes to overall health. Research is showing the gut microbiome has an effect on the endocannabinoid system, and vice-versa.


Endocannabinoid system and microbiome connections

There are cannabinoid receptors found throughout the GI system which appear to regulate symptoms such as nausea, pain, and inflammation through a similar process as probiotics. This may be why conditions such as IBS, for instance, have the potential to be better managed with medical cannabis.

While this shows the effect the endocannabinoid system has on gut health, another mouse study showed that gut health may have an effect on the endocannabinoid system, too: gut bacteria of depressed mice were given to recipient mice. Later, the recipient mice showed a reduction in bodily chemicals needed to manufacture their own endocannabinoids.

Dietitian’s tip: To help encourage  gut health, introduce probiotic food to your diet every day. Opt for a plain probiotic yogurt or plain kefir—try blending kefir into morning smoothies for a thick, creamy mouthfeel.

Many chemicals in cannabis may have prebiotic properties

While cannabinoids such as CBD and THC may help stimulate receptors in the GI system, research suggests other chemicals within cannabis may also have prebiotic properties—i.e., supporting players for healthy bacteria in the body. Cannabis flavonoids, lignans, terpenoids, and polysaccharides may all help improve overall gut microbiome.

By influencing the gut, cannabinoids could mitigate brain inflammation

One early study on mice with inflammation of the brain and spinal cord (encephalomyelitis) were given both THC and CBD. Results showed changes in mouse microbiomes as well as reduced brain inflammation compared to the control group.


May improve overall health of microbiome

One clinical review of people with alcohol-use disorders highlights the positive effects of cannabis on the microbiome. With cannabis, people with alcohol-use disorders had reduced inflammation, more balanced gut bacteria, and lowered intestinal permeability, showing the effect cannabinoids may have on compromised GI systems. There were also decreased cravings for alcohol in the study, pointing to cannabis having a potentially beneficial effect across the gut-brain axis.

There is an endocannabinoidome

(Say that five times fast!) Because of the growing evidence connecting the endocannabinoid system and the microbiome, new research is exploring the concept of the endocannabinoidome as a whole entity.

It’s never too late to be proactive about eating better, which not only help promoted good health, but just might influence how well medical cannabis can help with symptom management. While the clinical research is still early, there seems to be a connection between the foods we eat and how they interact with medical cannabis—and vice versa.

One focused area of research is in managing obesity with cannabis. This may sound counterintuitive for patients who experience “the munchies”, not to mention medical cannabis is an approved prescription for stimulating appetite among cancer patients and AIDS patients. We explore this concept more fully in a separate blog—visit our library to learn more.