Exercise as Medicine

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For many chronic health problems, regular exercise is more effective than any drug.

Exercise as Medicine is a major movement at John’s Hopkins School of Medicine.

You can visit this website for links to many topics on the benefits of exercise.

You can find the top 10 things you need to know about exercise here. They include the following evidence based recommendations from the Physical Activity Guidelines for Americans.

any amount of physical activity has some health benefits. Americans can benefit from small amounts of moderate-to-vigorous physical activity throughout the day.

The benefits of exercise are cumulative, walk 10 minutes 3 times per day and you get the same benefit as a 30 minute walk. Walk  5 minutes 6 times and the benefit equals that of 30 minutes continuous walking. So you can break up your exercise in little pieces throughout the day. No requirement for a specific long period devoted to exercise.

New evidence shows that physical activity has immediate health benefits. For example, physical activity can reduce anxiety and blood pressure and improve quality of sleep and insulin sensitivity.

Exercise improves cognition, decreases cancer risk, decreases risk of depression, hypertension, diabetes, stroke and heart disease. It lowers risk of falls and injuries from falls. It decreases pain and helps a variety of conditions. Exercise reduces all cause mortality (death rates from all causes)

Here are some direct quotes from the second edition of the  Physical Activity Guidelines.

  • For youth, physical activity can help improve cognition,* bone health, fitness, and heart health. It can also reduce the risk of depression.
  • For adults, physical activity helps prevent 8 types of cancer (bladder,* breast, colon, endometrium,* esophagus,* kidney,* stomach,* and lung*); reduces the risk of dementia* (includingAlzheimer’s disease*), all-cause mortality, heart disease, stroke, high blood pressure, type 2 diabetes, and depression; and improves bone health, physical function, and quality of life.
  • For older adults, physical activity also lowers the risk of falls and injuries from falls.*
  • For pregnant women, physical activity reduces the risk of postpartum depression.*
  • New evidence shows that physical activity can help manage more health conditions that Americans already have. For example, physical activity can decrease pain for those with osteoarthritis, reduce disease progression for hypertension and type 2 diabetes, reduce symptoms of anxiety and depression, and improve cognition for those with dementia, multiple sclerosis, ADHD, and Parkinson’s disease.

You can choose from a variety of TEDtalks on exercise here.

I particularly enjoyed my friend Darryl Edwards talk here.

 

So sleep well, exercise often, eat clean, filter your water, avoid environmental toxins, get plenty of sunshine, and most important of all, stay connected with friends and family.

Doctor Bob

 

Can LED light bulbs, computer screens and TV make your pain worse?

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The answer is probably yes.

The mechanism(s) go like this:

Exposure to full spectrum light in the evening > reduces quantity and quality of restorative sleep which in turn > increases chronic inflammation and contributes to depression both of which make pain worse.

Exposure to full spectrum light in the evening also > reduces nitric oxide production > which increases blood pressure and risk of cardiovascular disease and metabolic disorders.

In animal studies interruption of circadian rhythm with artificial light exposure when the animal would typically be sleeping decreases memory capacity.

And fat tissue has specific receptors for light which alters fat storage. Increased visceral fat produces more inflammatory cytokines and chemokines which sensitize pain fibers and increase inflammation throughout the body.

Exposure to artificial light in the evening even worsens the grades of children in school.

Adequate restorative sleep is so important that I prescribe all patients with chronic pain 2 pages of  sleep hygiene recommendations.

To optimize your circadian rhythm get some early morning light exposure (without sunglasses) before 12 noon and at sundown reduce your ambient light exposure to mimic the natural light outdoors. Sleep in absolute darkness and wear blue light blocking glasses in the evening.

You can learn more about this topic by listening to a 12 minute TEDtalk by Dan Pardi who does research in the Circadian LAB at Stanford.

Hat tip to Tommy Wood for bringing this TEDtalk to my attention.

Sleep well.

Doctor Bob.

My Autoimmune Disease: remission with the AIP (and one medication)

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In September of 2018 I awakened with swollen, red and painful hands. I could not make a fist. I could not grip a steering wheel without extreme pain. I left dropped items on the floor because it was too painful to pick them up. All of my joints were painful and stiff. My legs were swollen. My wife had to help dress me so I could go to work. The simplest hand techniques to perform nerve blocks were painful. Just putting on sterile gloves caused severe pain. This happened just a few days after a week of camping. I felt weak all over and had trouble sleeping, unable to find a comfortable position.

(My camping vacation included digressions from my typical paleo/ancestral diet. I drank wine, ate some gluten containing foods and some dairy. I ate some wheat and sugar containing deserts.)

As a physician I ordered a variety of blood tests for tick born illness (such as Lyme’s Disease), rheumatoid arthritis, and other disorders that could cause my symptoms. All tests were negative except for an inflammatory marker (hsCRP) which was very high.

I queried physician friends about something I may have overlooked. No suggestions were forthcoming above and beyond what I had already done.

I prescribed myself a non-steroidal anti-inflammatory drug  NSAID. That provided modest relief but I was still suffering severe symptoms.

After 6 stubborn weeks I consulted a rheumatologist and he diagnosed me as having  “sero-negative” rheumatoid arthritis. Given the choice of several pharmaceutical interventions I chose the least toxic and started a drug called hydroxychloroquine. I was told it would take about 3 months to produce results, and in the meantime should continue the NSAID.

I immediately started to follow the Autoimmune Protocol AIP

Within one week of the AIP the redness in the joints of my hands was gone.

Within 2 weeks the pain in my joints was significantly reduced.

Within 3 weeks the swelling in my hands/fingers was completely gone and I stopped the NSAID. I no longer had pain in my hands and fingers while doing every day tasks.

Within 4 weeks I was able to resume my daily yoga and Pilates routine.

Within six weeks I felt in complete remission.

My rheumatologist agreed that I appeared to be in remission at follow up visit (no signs of inflammation, synovitis, etc., on examination with resolution of presenting symptoms) but he was and remains skeptical about the auto-immune protocol.

My clinical response was clearly way ahead of the expected time sequence for hydroxychloroquine. I concluded that the AIP was a major factor in my recovery.

All X-rays and MRI scans of my joints (which have suffered from osteoarthritis) were negative for the typical findings associated with rheumatoid arthritis.

The autoimmune protocol is a combination of lifestyle modifications involving diet, sleep, exercise, and stress reduction. It goes beyond the paleo diet. The paleo (ancestral) diet  eliminates processed/refined foods,  grains, legumes, dairy, added sugar, and refined vegetable oils. It stresses the consumption of a variety of organic vegetables and organic fruit, grass-fed meats, organ meats, free range poultry and eggs, wild seafood. The auto-immune protocol adds further restrictions: no nuts, eggs, nightshades, seeds, spices from seeds, and absolutely no alcohol.

There are many reasons for the added restrictions under the AIP. The added dietary restrictions are important for what they avoid but also important for the resulting increase in other beneficial foods that are allowed. The foods are omitted because they can cause or contribute to: gut irritation, dysbiosis, act as carrier molecules across the gut barrier, increase gut permeability, and/or cause inflammation. In theory, by eliminating those foods (hopefully on a temporary basis) and substituting nutrient dense less potentially harmful foods, we reduce some of the contributing factors to autoimmunity and inflammation.

For a detailed discussion of the AIP I suggest you visit Sarah Ballantyne’s  website and read her book: The Paleo Approach, Reverse Autoimmune disease and Heal Your Body.

Avoiding potentially harmful foods and beverages while increasing healthy nutrient dense foods represents the major focus of many individuals following the AIP. But equally important are the other lifestyle components. These include obtaining adequate  restorative sleep, reducing/managing stress (Stress Reduction and Health), getting reasonable amounts of playful exercise (this should be fun and occur in a green space as much as possible), sunshine, eliminating exposure to  environmental toxins, drinking filtered water, and frequent contact with supportive family and friends. Without addressing all of these areas one is not likely to succeed in achieving remission from an auto-immune disease.

In addition to Sarah’s Ballantyne’s book and website, if you have an auto-immune disease I recommend Dr. Terry Wahl’s website and book. Dr. Wahl’s, a medical school faculty physician, teacher and researcher,  was wheelchair bound with Multiple Sclerosis and facing death having failed all available medical treatments as well as some experimental drug protocols. She read about functional medicine, paleo nutrition and evolutionary biology in order to create her own treatment plan. One year latter she was in remission and riding her bike 20 miles. She subsequently raised money to do clinical research using her version of the AIP and has published a successful clinical trial.

There have been few controlled clinical trials of the AIP for auto-immune disease, largely because it does not involve drug research (no profits to be made) and because the NIH does not like to fund studies that alter multiple parameters at one time. Unfortunately, NIH funding has followed a drug and surgery model of medical treatment and does not look favorably on lifestyle interventions (one exception being the Mediterranean diet). I hope that bias changes in the future. In the meantime, physicians and scientists like Terry Wahls MD and Dale Bredesen MD, PhD (neurologist/researcher/author, The End of Alzheimer’s) remain pioneers in functional medicine and lifestyle interventions, being left to start their own foundations and raise money to fund medical research.

Both of these physicians have conducted clinical trials of lifestyle interventions (see below) that have produced revolutionary results, largely ignored by major medical societies and medical organizations. Progress occurs slowly, today’s iconoclasts are often tomorrows Nobel laureates.

Sometimes, despite significant clinical improvement with the AIP, some medication remains necessary with an auto-immune disease. If the auto-immune disease has been present for a long time, permanent damage may be present. That does not represent failure. If one can reduce drug doses, eliminate one or more drugs from a complicated medical regimen, and improve symptoms beyond what drugs alone achieve, I would call that success. Anecdotal reports from many patients (including my own) with auto-immune disease, suggest that it is not a cure-all, and those that show significant clinical improvement demonstrate various time responses ranging from weeks to several months in order to see results. But there are no down-sides to the AIP, no bad side-effects, no dangerous drugs, and only potential for clinical improvement. That seems like a no-brainer to me.

After eight weeks of strict dietary adherence, having achieved remission and appearing to be stable, I slowly added back small amounts of eggs, nuts and some nightshades (one at a time, observing for negative responses). I have been successful with that approach. I have not suffered any symptoms of rheumatoid arthritis since my initial remission. I remain on a paleo/ancestral diet and remain very cautions with regards to sleep habits, exercise, stress reduction, and social support. I try to laugh frequently and continue to engage in meaningful work. All of these components are essential to the AIP and to healthy living in general.

The following are links to published studies on the auto-immune protocol as well as links to a similar lifestyle intervention for Alzheimer’s disease. Another link is an editorial on inflammatory bowel disease and diet. The Autoimmune Protocol has been studied for Inflammatory Bowel Disease. In a peer reviewed published clinical trial it improved symptoms and inflammation seen on endoscopy, even producing remission in some patients. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/) It has also been studied for Hashimoto’s Thyroiditis and found to be effective .(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592837/)

Efficacy of the Autoimmune Protocol for Hashimoto’s Thyroiditis

Efficacy of the Autoimmune Protocol for Inflammatory Bowel Disease

Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study.

Multimodal intervention improves fatigue and quality of life in subjects with progressive multiple sclerosis: a pilot study.

Diet and Inflammatory Bowel Disease

A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis.

Reversal of cognitive decline in Alzheimer’s disease.

Inhalational Alzheimer’s disease: an unrecognized – and treatable – epidemic.

A colleague and scientist (Pedro Bastos), after reading my post, sent the following links to related articles (two by Loren Cordain, and a Master’s Thesis by one of his graduate students). For those interested in understanding the theories of molecular mimicry as triggers and mechanisms in autoimmune disease, Cordain’s work is outstanding.

Cereal grains, double-edged sword, Loren Cordain, 1999, Evolutionary Aspects of Nutrition and Health.

Rheumatoid Arthritis, molecular mimicry, dietary lectins, Loren Cordain, 2000, British Journal of Nutrition

Master’s Thesis, auto-immune disease and Paleo Diet, Trevor Connor

Eat clean, sleep well, exercise out-doors, get sunshine, love and laugh.

Bob Hansen MD

Sleep! You can’t live without it.

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Circadian rhythm refers to the cycling of hormones according to the time of day. Every hormone cycles with daylight and darkness, each in it’s own way. Our brain has a master clock, called the circadian clock, controlled by specialized cells deep in the brain. There is a direct connection from our retina (in the back of the eyes) to the circadian clock in the brain. Blue light (part of the normal outdoor spectrum of light) stimulates very specific receptor cells in the retina which in turn communicates directly with the circadian clock telling the brain whether it is day or night. To synchronize our hormones and achieve restorative sleep, we must get outdoor light exposure to our eyes (without sunglasses, early in the day) and limit light exposure in the evening.

Artificial light, especially from cell phones and other devices that emit intense blue light, shift work, late night social activity, poor eating habits, sedentary lifestyle and at the opposite extreme, late evening workouts,  can all disrupt our circadian rhythm preventing adequate restorative sleep. A rare genetic illness called fatal insomnia that strikes adults at middle age prevents sleep and results in death within a few months, highlighting the importance of sleep. Sleep deprivation can kill a human quicker than starvation! Adequate amounts of deep non-REM sleep are required for tissue regeneration, healing, DNA repair and immune function. REM sleep with dreaming provides great benefit by organizing our memory, discharging the emotional content of traumatic events, and facilitating creative brain activity. One night of short-sleep produces a state of inattention and slow reflexes as dangerous as driving under the influence of alcohol intoxication. Chronic  short sleep and disrupted circadian rhythm results in increased risk of depression, cancer, hypertension, diabetes, dementia, obesity, metabolic syndrome, insulin resistance, heart attack and stroke, to name a few. Sleep interruption immediately halts weight loss during a calorie restricted diet (likely the result of hormonal disruption). So getting an adequate amount of restorative sleep every night is essential to good health. Here a few tips to help achieve a good night’s sleep each and every night.

  1. GET OUTDOOR LIGHT EXPOSURE ON YOUR EYES WITHOUT SUNGLASSES EVERY DAY, EARLY IN THE DAY. This helps set your biologic/circadian clock. Even on a cloudy day, outdoor light is much stronger and natural than indoor light. It is essential for setting your biologic/circadian clock. If you cannot get outside, stand or sit in front of a large window for 20-30 minutes in the morning, looking outside. Take a lunch break outside without sunglasses. Wear a shade hat instead of sunglasses. Your brain needs to experience natural outdoor light during the day.
  2. Avoid bright light in the evening, especially the light from TV, computer screens, cell phones, which all emit intense blue light and trick your brain into thinking it is daytime. Wear blue light blocking glasses/goggles for 2-3 hours before bed. (Amber tinted glasses which block blue light can be purchased on-line and can be worn over reading glasses) There is also software available that will decrease the blue light intensity of computer screens and cell phones in the evening.
  3. Practice time restricted eating. Limit all eating to an eight hour period, thus providing for an over-night fast of 16 hours. If that does not seem possible try to limit eating to a 10-hour period which provides a 14-hour overnight fast. This improves sleep, circadian rhythm, blood pressure, blood sugar and reduces stress hormones. NO SNACKS BETWEEN MEALS. NO FOOD FOR 2 HOURS BEFORE BED. For every hour decrease in eating time period from 12 hours to 8 hours you get health benefit.
  4. Eat an anti-inflammatory diet.
  5. If you snore, are overweight/obese, fall asleep during the day, or do not feel refreshed in the morning ask your doctor to order a sleep study. Obstructive Sleep Apnea makes restorative sleep impossible and increases risk of heart attack, stroke and most chronic diseases.
  6. Avoid alcohol altogether and avoid caffeine after late morning.  Alcohol in the evening may help you fall asleep but it results in a withdrawal from alcohol during the night. This disrupts normal sleep patterns.
  7. Sleep in a cold, dark, quiet room. Use black-out curtains, no night lights, no phone charger lights, no lights of any kind should be on in the room. Any amount of light in the room impairs the production of melatonin which facilitates sleep onset.
  8. Have a wind–down time every evening. Develop habits of non-stressful activities, soft music, dim light, casual conversation, enjoyable reading. Do not spend evening time dealing with finances, conflict, or emotional activity.
  9. Try a magnesium supplement before bedtime. Magnesium glycinate, magnesium citrate, magnesium gluconate, are absorbed much better than cheaper supplements such as magnesium oxide. Magnesium L-Threonate is expensive, but it crosses the blood brain barrier into the brain with the greatest brain penetration of all magnesium supplements.
  10. Manage stress with yoga, meditation, regular exercise (but no intense exercise in the evening.) Perform most of your exercise outdoors in a green space. This provides much more health benefit than the equivalent exercise indoors.
  11. Regular contact with supportive family and friends is essential to health and reduces stress. The greatest predictor of health vs disease is the amount of social connectedness an individual experiences.
  12. Establish regular wake-up times and go-to-bed times. Regular sleep habits are essential. If you must rely on alarm clocks you do not have good sleep habits.

A few words about alcohol, caffeine and sleeping pills.

A drink or two in the evening may help you relax but it disrupts your sleep by causing a mild episode of alcohol withdrawal as your liver metabolizes the alcohol and your blood levels drop. Even this slight degree of alcohol withdrawal will impair a good night’s sleep.

Caffeine impairs sleep by blocking adenosine receptors in the brain. Adenosine is the neurotransmitter that increases gradually during the day creating a sate referred to as sleep pressure. Some people metabolize caffeine quickly, others slowly. The slower you metabolize caffeine the longer it takes to clear it from your adenosine receptors. Without adequate sleep pressure (adenosine receptors filled with adenosine in the brain) you cannot fall asleep. Many sleep experts recommend complete abstinence from caffeine and suggest that if you need caffeine to get started in the morning you are regularly sleep deprived.

Sleeping pills of all kinds interfere with normal sleep architecture. While they facilitate falling asleep, they impair your ability to achieve deep restorative stages of sleep and can produce many undesirable side effects including addiction, withdrawal symptoms, sleep walking, sleep driving, worsening of asthma and COPD, constipation, diarrhea, daytime drowsiness, burning and tingling sensations, unusual dreams, weakness, heartburn, etc…. Most importantly they all interfere with cycling through the various stages of sleep in a normal, restorative pattern!

If you want to explore these concepts in depth here are two excellent books that discuss sleep and circadian rhythm.

Why We Sleep, by Matthew Walker Ph.D.

The Circadian Code, by Satchin Panda Ph.D.

Eat clean, sleep well, spend time exercising out of doors, love one another.

Bob Hansen MD

Roundup (Glyphosate) Cancer and Monsanto

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I just received this notification from EWG.org.

“Hundreds of cancer victims and their families have filed lawsuits alleging that Monsanto’s signature pesticide Roundup causes cancer.

Now a U.S. judge has denied Monsanto’s attempts to throw out these claims and will allow the case to move forward including expert testimony that links glyphosate, the key ingredient in Roundup, to cancer. These suits allege that Monsanto knew about glyphosate’s cancer risk and failed to warn consumers.

Now hundreds of Americans are seeking to hold Monsanto responsible.

Monsanto has been waging a war on science for years. Just last year, Monsanto colluded with the Environmental Protection Agency to cover up glyphosate’s cancer risk and attacked EWG’s pesticide work, calling it “propaganda.””

I have discussed the risks of glyphosate before. You can read about it here

Glyphosate is a dangerous toxic substance. Most Americans will test positive for glyphosate in the urine. No levels in your body are safe.

It can cause cancer, disrupt your endocrine system, and interfere with brain development in children. There are many other problems with glyphosate. I encourage your to read about the hazards of glyphosate and protect your family. Support the efforts of the environmental working group. (EWG.org.)

Be safe, live clean, shower love on those you love.

Dr. Bob

Agent Orange AND glyphosate in our food? Scott Pruitt Strikes again

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Scott Pruitt and the EPA has approved wider use of Dow Chemical’s new pesticide “Enlist Duo”.

The following is taken from the Center for Food Safety’s recent notification.

“Enlist Duo is a combination of glyphosate (the main ingredient in Roundup) and 2,4-D (one of the active ingredients in “Agent Orange”). This is the first time this novel pesticide cocktail will be sprayed directly over-the-top of corn, cotton, and soybeans that are genetically engineered (GE) by Dow specifically to be sprayed with both.

National Cancer Institute scientists highlighted 2,4-D specifically as associated with two- to eight-fold increases in non-Hodgkin’s lymphoma. The International Agency for Research on Cancer of the World Health Organization classified 2,4-D as a possible carcinogen to humans and glyphosate as a probable carcinogen to humans.

Despite these harms, EPA dramatically expanded its approval of Enlist Duo for use on more crops and over more acres in 2017. In fact the U.S. Department of Agriculture conservatively estimates that use of Enlist Duo on just corn and soybeans will increase 2,4-D use by 200 to 600%.”

I have discussed the dangers of glyphosate many times before.

Now the toxicity of glyphosate has been combined with an active ingredient from agent orange which was used during the VietNam war. Many VietNam veterans attribute various chronic illnesses to agent orange exposure. I have frequently heard complaints about nerve damage, chronic pain, memory problems, cognitive impairment, etc., during my consultation visits with Vietnam veterans exposed to agent orange.

“The government of Vietnam says as many as 3 million people have suffered illnesses because of Agent Orange.[3]”

“The aftermath of the use of Agent Orange in Vietnam resulted in massive legal consequences. The United Nations ratified United Nations General Assembly Resolution 31/72 and the Environmental Modification Convention. Lawsuits filed on behalf of both US and Vietnamese veterans sought compensation for damages.”

Scott Pruitt has been busy turning the EPA upside down and reversing the recommendations made by the EPA’s own scientists.

EPA scientists recently re-evaluated the harmful effects of organophosphate pesticides on children’s brain health and behavior. They concluded that  Chlorpyrifos (an organophosphate pesticide) is unsafe and the EPA scheduled a ban on the use of this toxic agent. Scott Pruitt stepped in and canceled the ban! The EPA then announced that it would not finish it’s safety analysis for chlorpyrifos until 2022. Even Dr. Oz and his journalistic partner Dr. Mike Rosen  (Director of the Health and Wellness Center at Cleveland Clinic) have commented on the danger of that decision in their “Health and Spirit” newspaper column.

From Wikipedia:

“Chlorpyrifos is considered moderately hazardous to humans by the World Health Organization.[7] Exposure surpassing recommended levels has been linked to neurological effects, persistent developmental disorders and autoimmune disorders. Exposure during pregnancy may harm the mental development of children, and most home use was banned in 2001 in the U.S.[8] In agriculture, it is “one of the most widely used organophosphate insecticides” in the United States, and before being phased out for residential use was one of the most used residential insecticides”

“Chlorpyrifos exposure may lead to acute toxicity at higher doses. Persistent health effects follow acute poisoning or from long-term exposure to low doses, and developmental effects appear in fetuses and children even at very small doses. [16]”

Organophosphates are used as pesticides and in chemical warfare. Organophosphate pesticide use in agriculture causes an estimated 3 million poisonings per year resulting in 200,000 deaths per year.

Be  careful out there. Make wise choices. Eat organic vegetables and fruits whenever possible and pay attention to the EWG’s list of the Dirty Dozen.

Doctor Bob

Western Diet (high sugar, refined carbs, unhealthy fats) alters genes and causes inflammation

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New study (in mice) shows fast food makes the immune system more aggressive in a detrimental way.

Major points:

  1. The immune system reacts similarly to a high sugar, high (unhealthy) fat and high calorie diet as to a bacterial infection.
  2. Unhealthy food seems to make the body’s defenses (innate immune system) more aggressive in the long term. Even long after switching to a healthy diet, inflammation towards innate immune stimulation is more pronounced.
  3. These changes may be involved in the development of arteriosclerosis and diabetes.
  4. These changes are due to alterations in gene transcription (up-regulation of genes associated with inflammation)
  5. This up regulation of pro-inflammatory genes persists even after converting to a healthier diet.

Read more at News from IRT

Here: Fast food makes the immune system more aggressive in the long term: Study shows that even after a change to a healthy diet, the body’s defenses remain hyperactive — ScienceDaily

And here Western Diet Triggers NLRP3-Dependent Innate Immune Reprogramming: Cell

This study is an example of epigenetics, where an environmental factor (diet) alters the expression of genes. We know that regular consumption of a variety of colorful vegetables mediates many beneficial effects and part of that process involves altering the transcription of many genes related to health and our ability to defend against Oxidative Stress .

The epigenetic effect of nutrition can be transmitted to the next generation.

The epigenetic effects of diet include many aspects of health including  cancer risk.

And epigenetic changes in humans can begin  before birth in response to maternal nutrition and maternal exposure to environmental toxins .

Diet also effects the gut microbiome, which in turn affects health .

So avoid fast food and other forms of processed-refined foods. Eat a whole foods-ancestral diet that includes a variety of organic colorful vegetables and fruits, grass fed/finished meats and wild seafood. This will not only provide important micro and macro nutrients but will also turn up and turn on genes that prevent disease.

Live clean, sleep well, laugh and love.

Doctor Bob