Category Archives: gut flora

AHS 2022 Lecture, Acute and Long Covid, Nutritional and Lifestyle Immunology

Leave a reply

I recently gave a talk at the AHS 2022 meeting held at UCLA. You can view the video here:

This first slide gives a good overview.

The presentation covers a quick review of my presentations given last year at the PAH 2021 annual meeting (virtual) with additional information on long Covid.

Multiple nutrients acting synergistically support a balanced response to viral infections, including SARS CoV-2. Here is a picture.

The take home message is that no single nutritional intervention is likely to have significant impact with an acute infection unless all but one nutritional component is optimal. Nevertheless, there is compelling evidence that Vitamin D deficiency is rampant in the developed world and if one nutritional intervention is likely to be of benefit, Vitamin D supplementation, particularly in high risk populations, presents the most likely candidate. As usual, preventive supplementation would be preferable to rescue high dose intervention.

In a study of frail elderly hospitalized patients, regular vitamin D supplementation was associated with decreased mortality as demonstrated here. Compared to no supplementation, regular supplementation was associated with a 93% reduction in risk of death.

A study from Spain with very high dose Vitamin D in the form of Calcifediol showed significant benefit in hospitalized patients, suggesting that Vitamin D deficiency was prevalent in that population and that such a treatment intervention should be widely considered.

Calcifediol Treatment and COVID-19-Related Outcomes

Click to access dgab405.pdf

The following graphic from another nutrition review article, with red additions added by myself, demonstrates the complex interaction between nutrition and the two main components of our immune system, innate immunity (immediate response) and adaptive immunity (based on immune memory). Again red highlights added by yours truely.

And here is a slide from my lecture with quotes from that article.

Yet most Americans are deficient in many of these essential nutrients as depicted here. The percentages represent the % of Americans that fall below the estimated amount required to prevent deficiency in HALF of adults (a very low standard).

The EAR is a very low bar to meet, yet many Americans fall below even that low standard.

The SARS CoV2 virus interferes with a crucial component of the the initial (innate) immune response, the production of interferon 1 and the signaling of interferon one to immune cell mediators as depicted in this graphic.

SARS CoV2 on the left is compared to Virus X on the right. On the left interferon 1 (IFN) production and signaling is blocked by the virus, interfering with an effective and controlled immune response, on the right IFN is not blocked. A cascade of events results in TOO LITTLE, TOO LATE, AND THEN TOO MUCH of an immune response, producing a cytokine storm.

Obesity, insulin and leptin resistance, also interfere with the production and signaling of interferon. The result is that people with insulin and leptin resistance (pre-diabetes, Type 2 Diabetes as well as sarcopenia) experience a double hit. First the virus itself disrupts the immune response and superimposed upon the viral effect is the effect of insulin and leptin resistance on the immune response.

SOCS: suppressor of cytokine signaling. Several recent viral studies have shown that viral genes can hijack SOCS1 to inhibit host antiviral pathways, as a strategy to evade host immunity
On the left Interferon production and signaling are normal and a successful immune response is mounted. On the right the presence of insulin and leptin resistance, associated with obesity results in an initial inadequate response and a late excessive response. TOO LITTLE, TOO LATE, THEN TOO MUCH.

Factors that can quickly impact insulin and leptin resistance include all the components of an ancestral lifestyle depicted in my website graphic. A paleolithic or ancestral diet that eliminates sugar added foods and beverages, replacing those empty calories with nutrient dense foods, exercise, adequate restorative sleep, stress reduction, avoidance of environmental toxins, social connection. All of these affect health in general, mitigate insulin and leptin resistance, and support a balanced immune response to viral infection. The circle of health depicted below is surrounded by the many deleterious aspects of modern living. Thus, a mismatch between our evolutionary biology and present day life.

Here is a slide from my lecture that lists many lifestyle factors that can impact infection with any virus, including SARS CoV-2

My lecture also included discussion of Long COVID, theories of etiology and pathophysiology which will be discussed in my next post.

For the full lecture which is about 34 minutes long, please follow the link above.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Nutrition and Lifestyle vs Pandemic

Leave a reply

Earlier this year I gave 2 presentations on this topic at the (virtual) annual meeting of Physicians and Ancestral Health, a physician organization dedicated to incorporating evolutionary biology and lifestyle recommendations into the practice of medicine. Here is the first slide:

And here are some very important references:

Please note that this lecture was given before the delta variant arrived so the data applies to the pre-delta period.

MI= Myocardial Infarction (heart attack with loss of muscle), PE=Pulmonary Embolus, DVT= Blood Clots in legs, SIRS= Systemic Inflammatory Response Syndrome

I will skip several of the slides and get to the nutritional immunology and other lifestyle factors.

This slide shows many lifestyle factors that interact with the immune system. The “12% metabolic health” refers to a study demonstrating that only 12% of American adults are metabolically healthy, which will be explained later. Dysbiosis refers to an imbalance in gut bacteria favoring inflammation and immune compromise. The rest should be self explanatory but discussed in detail later in this series.

Here is the very busy slide that summarizes nutritional immunology:

w3/w6 refers to the omega 3 to omega 6 ratio in the diet, ROS= Reactive oxygen species (oxidative stress), CH: carbohydrates; GALT: gut-associated lymphoid
tissue; GPRs: G-protein-coupled receptors; FA: fatty acids; GI/GL: glycemic index/load; RAR/RXR:
retinoic acid receptor/retinoid X receptor; SCFA: short-chain fatty acids; TF: transcription factors; VDR:
vitamin D receptor.

Key points in this slide:

  1. Omega 3 fats from fatty fish fight inflammation, excess omega 6 fats from refined “vegetable oils” (corn, soy, cotton seed, sunflower seed, safflower, etc.) contribute to inflammation and blood clots, contributing to cytokine storm and bradykinin storm.
  2. Vitamin D interferes with the virus at multiple points.
  3. Adequate iron (Fe) from meat and seafood is essential for immune function (Iron from plant sources is much less bioavailable compared to meat and seafood.)
  4. Adequate complete protein (not available from vegan diets) is essential for immune function.
  5. Zinc and selenium (both found in seafood and meat) are essential for multiple protective pathways in the immune system (enhancing response to infection and mitigating excessive inflammatory response as cofactors for antioxidant enzymes)
  6. Sugar and high glycemic foods cause inflammation, high blood sugars suppress the immune system
  7. Dietary fiber supports a healthy gut microbiome which in turn suppresses inflammation and provides the gut lining with SFAs (gut epithelium requires SFAs for energy and function, gut barrier function needs SFAs)
  8. Phenolic compounds in colorful vegetables and berries modulate multiple essential immune pathways that can inhibit viral replication.
  9. Carotenoids, phenolics support several vital immune pathways.
  10. Omega 3 fats are the building blocks of chemicals that help resolve inflammation and mitigate against cytokine storm and bradykinin storm.
  11. Multiple vitamins and phenolics support our internal anti-oxidant system.
  12. To get a balanced protein intake we should eat “nose to tail”. Include connective tissue (home made bone broth is a great source) and organ meats (from grass fed/finished ruminants) in addition to muscle meat.

Here is another busy slide that presents more detail, note the reference at the bottom of the slide to read more.

Sorry for the small print but you can see the blow up on line by going here.

http://A Review of Micronutrients and the Immune System-Working …

So does the “Standard American Diet” meet these nutritional needs to support a healthy immune system?

The % above represent the % of American adults with intakes BELOW the EAR (Estimated Average Requirement) for various vitamins and minerals. But note the definition of EAR:

“nutrient intake value that is estimated to meet the requirement of half the healthy individuals to avoid symptoms of a clinical or subclinical deficiency” (NOT OPTIMAL LEVELS for immune function)


Note also that this study did not consider omega-3s, phytonutrients, flavonoids, polyphenols, fiber, etc., all of which are essential to a robust immune response to any virus including SARS CoV-2.

With regards to omega 3 vs omega 6 fats:

Omega 3 fats (EPA and DHA) found in seafood fights inflammation, blood clots. DHA and EPA are the building blocks of SPMs which help RESOLVE INFLAMMATION (MITIGATE CYTOKINE STORM)

We will return to this topic in my next post. We are just scratching the surface of a complex system.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
  11. If you are over age 12 and eligible for vaccination, consider protecting yourself and your neighbor with vaccination.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Chronic Inflammation, the silent killer

1 Reply

I was recently interviewed by a health blogger for his podcast. The topic was chronic inflammation. Here it is.

I prepared some notes for the interview. Here are the questions and answers.

What made you so interested in the topic of chronic inflammation?

Interest in chronic inflammation:

  • Emerging evidence, source of most chronic disease including mental health (depression, etc.) is inflammation
  • family health issues experience personally
  • health care policy interest since graduate school
  •  First started to question USDA dietary advice after reading GOOD CALORIES, BAD CALORIES, by Gary Taubes,
  • Experienced Statin myopathy, researched statin drugs, bad data, financial conflicts of interest. Sought alternative approaches to Coronary Artery Disease prevention.
  • In USA, Profit driven health care system evolved from more benign not-for-profit earlier system in medical insurance and hospital system. Drug and surgery oriented. Corporate ownership of multiple hospitals, concentration of wealth and power in the industry and in society in general
  • Saw this every day: growing obesity, Metabolic Syndrome, DMII, auto-immune disease. Root causes NOT ADDRESSED.
  • While recovering from surgery attended on line functional medicine conference on auto-immune disease, covering diet, sleep, exercise, sunshine, Vitamin D, environmental toxins, gut dysbiosis, intestinal permeability (THE GATEWAY TO AUTOIMMUNITY IS THROUGH THE GUT).
  • Introduced to EVOLUTIONARY BIOLOGY and Paleo Diet by my son

What diseases does chronic inflammation typically lead to? 

  • Cancer
  • Diabetes
  • Obesity epidemic, DIABESITY
  • Hypertension
  • Metabolic Syndrome (3/5: HTN, insulin resistance/high blood sugar, abdominal obesity, high TGs, low HDL),
  • Autoimmune diseases
  • Degenerative arthritis
  • Neurodegenerative disorders (dementia, Parkinson’s, neuropathy, multiple sclerosis)
  • Works of Dale Bredesen (dementia, “The End of Alzheimer’s”), Ron Perlmutter (Grain Brain), Terry Wahls (The Wahls protocol for MS), all FUNCTIONAL MEDICINE looking at root cause of illness, common-overlapping threads.
  • Interplay between sleep, circadian rhythm, exercise, sunlight, stress, environmental toxins, diet, processed foods, nutritional deficiency, gut microbiome, endocrine disruptors, intestinal permeability, oral and skin microbiome, social disruptors, GUT BRAIN AXIS. These are all part of one large ECOSYSTEM.
  • Positive and negative feedback systems requiring a SYSTEMS ENGINEERING approach to understanding root causes.
  • Butyrate is the preferred substrate for colonocytes, providing 60-70% of the energy requirements for colonic epithelial cells1,2. Butyrate suppresses colonic inflammation,3 is immunoregulatory in the gut,4 and improves gut barrier permeability by accelerating assembly of tight junction proteins.5,6
  • Improves insulin sensitivity, increase energy expenditure, reduce adiposity, increases satiety hormones,
  • HDAC activity inhibitor, PROTECTS GENES from removal of necessary acetyl groups.
  • Butyrate also influences the mucus layer. A healthy colonic epithelium is coated in a double layer of mucus. The thick, inner layer is dense and largely devoid of microbes, protecting the epithelium from contact with commensals and pathogens alike. The loose, outer layer of mucus is home to many bacteria, some of which feed on the glycoproteins of the outer mucus layer itself. Both of these mucus layers are organized by the MUC2 mucin protein, which is secreted by goblet cells in the epithelium. Supplementation of physiological concentrations of butyrate has been shown to increase MUC2 gene expression and MUC2 secretion in a human goblet cell line.7,8

What are the population groups which have higher risk of chronic inflammation? 

  • Obese
  • Sedentary
  • Poor-urban-polluted environment dwelling (air, water, noise, crowding, violence, racism, oppression)
  • Divergence from ancestral evolutionary biology
  • Working environment: indoors, polluted, oppressive supervisors, no sunlight, noise pollution, air pollution, toxic social situations, repetitive motion, bad ergonomics,
  • night shift, disruption of circadian rhythm
  • both parents working, no time for real food and family interaction, supervision of children.
  • screen time- sedentary behavior, lack of outdoor activity
  • Stress of social inequality, food insecurity, violent neighborhoods, nutritional deserts

What are the “danger signs” or typical symptoms which may signal a chronic inflammation? 

DANGER SIGNS:

  • Waistline (waist to height ratio, BMI)
  • Sarcopenia (muscle as an endocrine organ)
  • Sleep disturbance
  • Pain
  • Headaches
  • Depression
  • Lack of joy.
  • Brain fog, fatigue

What are the typical biomarkers of chronic inflammation?

  • METABOLIC SYNDROME (3 or more of the following: high blood pressure, elevated blood sugar, elevated Triglycerides, low HDL, obesity)
  • CRP predictive of cardiovascular events,
  • ESR associated with arthritis
  • Stress hormones (morning cortisol levels)
  • Resting Heart Rate and Heart Rate Variability

What are the typical sources of systemic chronic inflammation?

Sources of Chronic Inflammation:

Diet

  • N6/N3 FA ratio determined by too much Refined Easily Oxidized Vegetable Oils, not enough marine sources of N3 FA,  grain fed vs grass fed/finished ruminant meat. Loren Cordain research wild game FA composition = grass fed. Margarine vs Butter. Fried foods using Vegetable oils. Oxidized fats/oils, oxy-sterols in diet.
  • Sugar excess leading to insulin resistance
  • Refined carbs leading to insulin resistance (dense acellular….)
  • Disturbance of gut  microbiome from poor nutrition (sugar, refined carbs and vegetable oils all disrupt the microbiome)
  • Gut brain axis.
  • Food ADDITIVES AND PRESERVATIVES
  • Trans Fats (finally banned)

Endocrine disruptors/ BIOACCUMULATION

  • Plastics (microparticles in our fish, food and bottled water)
  • Plastic breakdown products
  • Phthalates added to plastics to increase flexibility ( also pill coatings, binders, dispersants, film formers, personal care products, perfumes, detergents, surfactants, packaging, children’s toys, shower curtains, floor tiles, vinyl upholstery, it is everywhere) 8.4 million tons of plasticizers produced annually. EWG.org
  • Pesticides, herbicides, glyphosate (Monsanto), DIRTY DOZEN, CLEAN FIFTEEN EWG.org
  • Medications
  • ABSORBED skin, eat, drink, breath,
  • BPS is as bad as the BPA it replaced
  • Polychlorinated biphenyls used in INDUSTRIAL COOLANTS AND LUBRICANTS
  • Flame retardants (PBDEs, polybrominated dipheyl ethers) are ubiquitous in furniture and children’s clothing. Also linked to autoimmune disease
  • Dioxins
  • PAHs (polycyclic aromatic hydrocarbons
  • Sunblock
  • CUMULATIVE BURDEN, INTERACTIONS, SYNERGY?

SLEEP DEPRIVATION CHRONIC IN OUR SOCIETY

Eating late vs time restricted eating

Gut Microbiome disrupted by

  • 1/3 of prescribed medications disrupt the microbiome AND increase intestinal permeability
  • Stress
  • Sleep deprivation
  • Sugar
  • Refined carbs
  • Refined veg oils
  • Over exercise and Under exercise, both are bad.
  • Environmental toxins

Gut dysbiosis and infections include (often chronic, low grade, not diagnosed)

  • Pathogenic bacteria, infection or overgrowth/imbalance
  • SIBO
  • Parasites
  • Viruses
  • BAD bugs > good bugs
  • Good bugs make vitamins and SCFAs required for colonocyte energy
  • Gut-Brain axis huge topic, VAGUS NERVE COMMUNICATION both ways, SCFA in gut and in CIRCULATION (butyrate, propionate, acetate), NEUROTRANSMITTER PRODUCTION (SEROTONIN, OTHERS), enterochromaffin cells producing > 30 peptides.
  • Overuse of antibiotics in medicine
  • AND use of antibiotics in raising our food.
  • Vaginal delivery vs C-section
  • Breast feeding vs bottle feeding

INCREASED INTESTINAL PERMEABILITY:

  • Caused by all factors above
  • Leads to higher levels of circulating LPS-endotoxin, bacterial products that create an immune-inflammatory response.
  • Incompletely digested proteins with AA sequences overlapping our own tissue causing autoimmunity/inflammation through molecular mimicry

Heavy Metal toxicity

  • Lead
  • Mercury
  • Cadmium
  • Arsenic

MOLD TOXICITY (> 400 identified mycotoxins, can cause dementia, asthma, allergies, auto-immunity)

  • At home
  • At work

What are the most efficient natural (non-medication) ways to address chronic inflammation?

  • Anti-inflammatory Diet, real whole food that our ancestors ate through evolutionary history (grass fed/finished ruminant meat, free range poultry, antibiotic free, and pesticide free food, wild seafood (low mercury varieties), organic vegetables and fruit, nuts, fermented foods, eggs)
  • Low mercury fish and seafood for omega three fatty acids
  • Sleep hygiene
  • Exercise, not too much, not too little, rest days, out of doors, resistance training, walking, yoga, Pilates, tai chi, chi gong, dancing, PLAYING!!!!!!!!!!!!!
  • Stress reduction: meditation, mindful living, forest bathing, sunlight, Playing, music, praying, SOCIAL CONNECTION, laughter, comedy, quit the toxic job, quit the toxic relationship, SAUNA/SWEAT, heat shock proteins, exercise
  • Vitamin D, sunshine, check levels
  • PLAY, PLAY, PLAY, LAUGH, DANCE, ENJOY, LOVE
  • Be aware of potential dangers of EMF, WiFi, hand held devices, blue tooth headphones.
  • Address environmental justice
  • Address social inequality, food insecurity
  • Tobacco addiction
  • Ethanol
  • Other substance abuse
  • Agricultural subsidies in US distort the food supply
  • Loss of soil threatens food supply
  • Suppression of science (global warming, environment, etc.,) worsens environmental degradation, creating an EXISTENTIAL THREAT.
  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Depression, Food, Sunshine, Gut Microbiome

Leave a reply

A family member was admitted to a psychiatric hospital this year with a major depressive episode. For the sake of anonymity lets call her Margie. I investigated the hospital and found that the medical director, chief nursing officer and CEO had excellent credentials. I asked Margie about her food choices, opportunity for exercise and time outdoors. All of these were deplorable. The only opportunity to spend time outdoors was to go outside with the smoking group for 20 minutes twice per day (cigarette breaks). There was no exercise program or exercise opportunity other than walking the halls and walking up and down the stairs with the smoking group going to/from a smoking session. The only green leafy vegetable available was iceberg lettuce (minimal nutritional value). Food options included high sugar and high starch content items, with very few vegetables and fresh fruits. Sugar and refined carbohydrates contribute to inflammation and gut dysbiosis, both of which contribute to psychiatric illness.

Margie had insomnia and depression. These two problems travel together and feed on each other. The lack of outdoor light in the morning and presence of artificial light in the evening all contribute to disruption of  circadian rhythm, worsening depression and insomnia. Lack of exercise also contributes to both.

Here is an excerpt of a letter I sent to her treating psychiatrist with copies to the CEO, medical director and chief nursing officer.

I do have concerns about the lack of availability at XXXXXXXXX Hospital of two essential components to mental health, specifically nutritional support and exercise.

So far the dietician has not yet consulted with XXXXX. I called the dietary department to discuss my concerns that she has been served primarily nutritionally deplete starch and sugar laden foods with a minimum of vegetables, fruit, healthy fat and protein. I was told that the only green leafy vegetable available is lettuce and when I inquired about other vegetables the response was very limited. Bob in the dietary department was great and very receptive to my concerns but seems somewhat limited in the availability of appropriate nutrient dense food at XXXXXXXX.

In addition, Margie tells me that XXXXXXX has no exercise program or exercise facility for patients. The importance of exercise and nutrition has been discussed extensively in the psychiatry literature.

Enclosed are a few review articles and abstracts relevant to nutrition and exercise for in-patient psychiatry. I hope you find these useful and would consider making efforts along the lines of the author’s recommendations in these studies and review articles.

I found the review by Dr LaChance and Dr. Ramsey “Antidepressant foods: An evidence-based nutrient profiling system for depression” to be most informative. You are probably aware that Dr. Ramsey has presented many lectures at the annual meeting of the American Psychiatric Association. The authors of the other studies enclosed have also been well represented at that meeting.

Despite requesting a response from the Medical Director, Chief Nursing Officer, and CEO, I never received any communication in response to my concerns.

The concept of “NUTRITIONAL PSYCHIATRY” has received much attention in the psychiatry literature. This article was published in the World Journal of Psychiatry. Antidepressant foods: An evidence-based nutrient profiling system for depression.

The article discusses nutrients that are “related to the prevention and treatment of depressive disorders”

Here is a summary:

Twelve Antidepressant Nutrients relate to the prevention and treatment of depressive disorders: Folate, iron, long-chain omega-3 fatty acids (EPA and DHA), magnesium, potassium, selenium, thiamine, vitamin A, vitamin B6, vitamin B12, vitamin C, and zinc.

The highest scoring foods were bivalves such as oysters and mussels, various seafoods, and organ meats for animal foods. The highest scoring plant foods were leafy greens, lettuces, peppers, and cruciferous vegetables.

This description aligns with the anti-inflammatory diet that I recommend to patients.

This dietary approach provides essential nutrients for brain health but also provides for healthy diversity in the gut microbiome,.

The relationship between psychiatric illness and the gut microbiome has been extensively reviewed in the medical literature.

Source of image:

Frontiers in Integrative Neuroscience, 11 September 2018 | https://doi.org/10.3389/fnint.2018.00033

This complicated picture depicts the interaction between food, gut microbiome, immune system, inflammation, endocrine system (stress response mediated by the hypothalamic pituitary adrenal axis), nervous system, neuro-transmitters including serotonin (the purported target of many anti-depressant medications). BBB is the blood brain barrier. ENS is the enteric nervous system. SCFAs are short chain fatty acids, very important for health, produced by “good” gut bacteria by using dietary fiber.

SCFAs serve several useful purposes including nourishment for the cells that line the gut, protection of the tight junctions between those cells (prevent leaky gut), direct anti-inflammatory actions and more. Leaky gut leads to an increase in pro-inflammatory substances crossing the gut barrier and entering the body (instead of staying in the gut and leaving with stool) with a cascade of undesirable consequences. LPS (lipopolysaccharides) are bacterial wall toxins that stimulate the immune system and create inflammation. This inflammatory response is a major contributor to death in the setting of systemic infections (sepsis).

If you are interested in understanding this picture you can read the entire article here.

It is clear from this picture that the authors recommend beans and whole grains. I advise  against the consumption of grains and legumes in favor of colorful vegetables which provide for 5-7 times the amount of fiber per calorie compared to grains. Many reasons to avoid grains and legumes have been discussed on the website many times.

Fiber-rich diets are the main fermentable sources for SCFAs which contribute to the attenuation of systemic inflammation by inducing regulatory T cells. (Lucas et al., 2018) and through multiple other mechanisms.

SCFAs are one of many metabolites produced by gut bacteria that contribute to the prevention of depression

The mechanisms of action include direct communication to the brain through the Vagus nerve, absorption of SCFAs into the blood where it can reach the brain and have beneficial effects, dampening of the inflammatory immune response, protecting the gut lining as mentioned above. These are depicted below.

SCFAs and depression

Image Source : Microb Cell 2019 Oct 7,; 6(10): 451-481, PMID 31646148

Exercise protects against depression and is useful as therapy for depression.

In her discussion of depression as a brain inflammatory disorder Psychiatrist Emily Dean describes well some of these interactions.

This is not the first time I have observed  very limited access to nutritious foods, exercise and sunlight in the setting of a psychiatric hospital. Unfortunately, it will likely not be the last despite multiple studies and articles in the medical literature pointing to the importance of these three ingredients for general and psychiatric health.

To prevent and treat depression and other psychiatric illnesses, nutrition, exercise, sunshine are all important. Lack of these basic treatment modalities hampers recovery and health.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose.

Doctor Bob

Anti-inflammatory diet, are 9 servings of vegetables per day possible?

Leave a reply

I often recommend a specific diet to decrease inflammation, decrease pain, and improve healing of tissue. I have been asked by patients to post this nutritional plan on my website so here it is (see below). In addition to this post, I will place the diet on a separate page along with recipes for vegetable soup and bone broth.

The recipes (vegetable soup and bone broth) meet the anti-inflammatory diet guidelines and also follow the more restrictive “Autoimmune Protocol”. This nutritional approach provides an array of micro nutrients that fight inflammation, support tissue repair, decrease the risk of chronic disease, and help maintain  a healthy gut flora (good bacteria in the intestines).

When I recommend 9 servings per day of vegetables patients often tell me it is impossible to achieve.  But it is not impossible, nor is it impractical. Every Sunday afternoon I make a large pot of vegetable soup that will keep all week in the refrigerator. I bring  generous servings to work every day for breakfast, brunch, and/or lunch and add some meat or seafood prepared the evening before (left-overs) on the side. The key to eating 9 servings per day is to have a variety of vegetables at every meal. The vegetable soup makes that goal not just achievable but convenient.

The anti-inflammatory diet described below provides ample fiber to feed your healthy gut bacteria and avoids the sugar and refined starches that can produce gut dysbiosis (unhealthy balance of bacteria in the intestines). Vegetables provide five times the amount of fiber per calorie compared to grains. You do not need to eat bread or cereal to get fiber.

So here is the anti-inflammatory diet. it is consistent with the Mediterranean diet as well as an Ancestral-Paleo diet.

Caution: if you have diabetes and are taking medications, this diet reduces carbohydrates and eliminates added sugar so adjustments in diabetes medications are necessary to avoid potentially dangerous low blood sugars. So consult your physician or primary care practitioner.

9 SERVINGS  OF NON-STARCHY VEGETABLES PER DAY, 3 SERVINGS FROM EACH OF THREE CATEGORIES. Organic as much as possible. (Read about the Dirty Dozen here: Dirty Dozen | EWG’s 2017 Shopper’s Guide to Pesticides in Produce )

  1. DARK GREEN LEAFY VEGETABLES, 3 SERVINGS PER DAY EQUALS 3 CUPS MEASURED COOKED OR 6 CUPS MEASURED RAW
  • Arugula, Beet Greens, Bok Choy, Chard all colors, Chicory, Cilantro
  •  Dandelion Greens, Endive, Escarole, Kale-all kinds, Parsley, Radicchio
  • Radish leaves, Spinach, Turnip Greens, Watercress
  1. Colored vegetables, 3 cups daily:
  • GREEN: Artichoke, Asparagus, Avocado (FRUIT), Cabbage (red and green) Celery, Cucumber with skin, Okra, Olives, Peppers, Zucchini with skin
  • RED: Beets, red cabbage, red peppers, cooked tomatoes (fruit)
  • YELLOW: Carrots, Pumpkin, Squash-summer and winter, Sweet potato,
  1. SULFUR RICH VEGETABLES, 3 CUPS DAILY: Some leafy greens are also sulfur rich so there is overlap in these categories
  • Arugula, Asparagus, Bok Choy, Broccoli, Brussel sprouts, Cabbage, Cauliflower, Collard Greens, Garlic, Kale, Kohlrabi, Leeks, Mushrooms, Onions red-yellow-white, Radishes, Scallions, Shallots, Turnip Greens, Watercress.

Berries (any kind) ½ cup per day. This can be substituted for one serving of vegetables.

OMEGA-3 rich fish-seafood (at least 16 ounces per week)

  • Anchovies, clams, herring, mackerel, mussels, oysters, salmon, sardines, trout, calamari (squid), saltwater fish should be wild, shellfish farmed OK, farmed trout OK.

Meat ideally grass fed and grass finished, hormone and antibiotic free.

Poultry and eggs free range, any wild game meat or poultry.

Drink only filtered water, coffee, tea, bone broth (homemade is best) and kombucha.

No grains, cereal, bread, pasta, no food made from flour, no oats, wheat, barley, corn etc.

No legumes (beans), no peanuts

No dairy except Ghee for cooking (optional)

No processed food made with added sugar or hydrogenated oils (which contain trans-fats)

No “vegetable oils” (soy oil, corn oil, etc.)

Use only extra-virgin olive oil, coconut oil, avocado oil and ghee. Limit EVOO to low heat cooking or add after food is cooked. The other oils on this list have higher smoke points.

Do not use store-bought salad dressing which usually has added sugar and inflammatory vegetable oils. Make your own salad dressing with EVOO and vinegar or lemon juice.

For more information about the AIP (Autoimmune protocol)  I suggest you visit these websites:

Autoimmune gut-repair diet – Autoimmune protocol | Dr. K. News

The Autoimmune Protocol – The Paleo Mom

The Autoimmune protocol is more restrictive than the anti-inflammatory diet and is beneficial for individuals with autoimmune disease.

Live clean, sleep well, exercise outside in the sunshine, love and laugh.

Dr. Bob

GMOs are dangerous, no doubt. Roundup and glyphosate are bad players.

1 Reply

 

I have discussed the dangers of GMO foods and Roundup before.

The evidence continues to mount.

“A peer-reviewed article, published  November 7, 2017, in the International Journal of Human Nutrition and Functional Medicine, demonstrates that GMOs are likely taking a heavy toll on our health. And a survey of 3,256 people who avoided them reported astonishing improvements in 28 health conditions.”

You can find a summary of the salient points from this scientific article here.

But I suggest you read the first few pages of the full article here.

The first few pages of this article describe the history of GMOs and how the warnings of  FDA scientists were silenced by regulatory executives who were shills for the likes of Monsanto and other dangerous players in this sad history.

11 genetically modified food crops are currently grown for commercial consumption. The six major crops are soy, corn, cotton, canola, sugar beets and alfalfa which are used to feed humans and animals. Cottonseed and canola are also processed into “food-grade” oils and sugar beets are refined to make sugar.

  • All six major GMOs are engineered to be herbicide tolerant, to survive spray of weed killer (such as Roundup)
  • 89% of GMOs grown in the US are herbicide tolerant
  • The most common herbicide involved is Roundup
  • 94% of soybeans grown in the US are Roundup Resistant (RR)
  • Some varieties of corn and cotton have genes inserted that produce a toxic insecticide called Bt toxin.
  • 76% of corn grown in the US is both Bt-producing and herbicide tolerant, 80% of cotton are both Bt and herbicide tolerant.

Roundup is not only used to kill weeds, but it is now sprayed heavily on crops immediately before harvest as a desiccant (drying agent) and large measurable amounts are found in the foods that you purchase in the supermarket.

In 1998 the FDA was sued by the Alliance for Bio-integrity and forced to turn over tens of thousands of pages of internal memos related to GMOs. FDA scientists repeatedly warned their superiors that GMO foods could create serious health risks such as allergies, toxins, antibiotic resistant diseases and nutritional problems. Michael Taylor, the former outside attorney for Monsanto and subsequent vice president of government and regulatory affairs for Monsanto was the political appointee in the FDA charged with overseeing GMOs!

On May 8, 2009,, the American Academy of Environmental Medicine published their policy paper on GMOs citing animal studies that revealed:

  • infertility,
  • immune dysregulation,
  • accelerated aging,
  • dysregulation of genes associated with cholesterol synthesis,
  • faulty insulin regulation, cell signaling and protein formation,
  • changes in the liver, kidney, spleen and gastrointestinal system

The AAEM recommended that the US government implement a moratorium on all GM foods and urged physicians to prescribe non-GMO diets.

But Monsanto prevailed and FDA officials ignored the warnings of their own scientists.

The three general categories of GMO danger include:

  1. consequences of the GMO transformation process
  2. the Bt toxin found in GMO corn and cotton
  3. the herbicides-particularly Roundup, that are sprayed on most GMO foods and consumed by those who eat GMO food.

A study of Monsanto’s RR corn revealed 117 proteins and 91 small molecule biochemicals significantly different from natural corn. Some of those differences “enhance the effects of histamine, thus heightening allergic reactions” and two of the polyamines in the GMO corn have been implicated in the formation of carcinogens (nitrosamines).

The GMO process can produce a host of unintended changes in RNA, DNA,  proteins and genes. And these changes can migrate and hybridize with non-GMO foods when the wind blows seeds from GMO plants into fields planted with non-GMO plants.

Altered Genes (transgenes) from GMO foods may “horizontally transfer” to humans or other organisms including the gut bacteria in humans that control much of our physiology.

Studies of rats fed GMO potatoes demonstrated adverse effects on every organ in young rats. Most changes occurred within 10 days. Disruption of organ growth, immune suppression and damage to organs of the immune system, thickening of the stomach and intestinal lining were noted.

Monsanto’s own data show that GM soybeans contain up to seven times the level of a natural allergen (trypsin inhibitor which also impairs protein digestion) and a doubling of soy lectin which impairs nutrient absorption. These were unintended consequences of the GMO process.

Monsanto’s MON810 Bt corn has 43 genes significantly altered in levels of expression. One of these genes which is normally switched off in non-GMO corn is switched on in the GMO version and it produces an allergenic protein.

Glyphosate is the major antibiotic in Roundup (yes Roundup is classified as an antibiotic). I have discussed the great hazards of glyphosate before. On October 24, 2017 JAMA published a study of the increase in measurable levels of glyphosate in humans.

The researchers compared urine excretion levels of glyphosate and aminomethylphosphonic acid (AMPA) in 100 people living in a Southern California community who provided samples during five clinic visits that took place between 1993 to 1996 and 2014 to 2016.

“What we saw was that prior to the introduction of genetically modified foods, very few people had detectable levels of glyphosate,” . “As of 2016, 70 percent of the study cohort had detectable levels.”

In July 2017, glyphosate was listed as a carcinogen by California.

A 2014 review concluded that:

Evidence is mounting that glyphosate interferes with many
metabolic processes in plants and animals and glyphosate residues have been detected in both.
Glyphosate disrupts the endocrine system and the balance of gut bacteria, it damages DNA and is a driver of mutations that lead to cancer.

There are many reasons to follow an organic, GMO-free, whole foods ancestral diet. Contamination with Roundup presents yet another compelling reason to choose your food wisely.

Some folks prefer videos to research articles, so below you will find both.

 

Here are a few links that will take you to articles related to this topic and quoted above.

Survey Reports Improved Health After Avoiding Genetically Modified Food

Genetically engineered crops, glyphosate and the deterioration of health in the United States of America

Environmental and health effects of the herbicide glyphosate. – PubMed – NCBI

Glyphosate: environmental contamination, toxicity and potential risks to human health via food contamination. – PubMed – NCBI

Aluminum and glyphosate can synergistically induce pineal gland pathology: connection to gut dysbiosis and neurological disease

GMO crops increase pesticide use

The high cost of pesticides: human and animal diseases

Is roundup the toxic chemical that’s making us all sick

Scientists Back Up WHO’s Classification of Glyphosate as “Probably Carcinogenic”

Food for thought: Are Herbicides a Factor for the Increase in Allergies and Autism?

Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance

Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies

Glyphosate, pathways to modern diseases IV: cancer and related pathologies

Glyphosate pathways to modern diseases V: Amino acid analogue of glycine in diverse proteins

GMOs, herbicides, and public health

Glyphosate induces human breast cancer cells growth via estrogen receptors

Glyphosate‐based pesticides affect cell cycle regulation

Glyphosate-based herbicides are toxic and endocrine disruptors in human cell lines

Environmental and human health impacts of growing genetically modified herbicide‐tolerant sugar beet: a life‐cycle assessment

Unidentified inert ingredients in pesticides: implications for human and environmental health

The possible link between autism and glyphosate acting as glycine mimetic—A review of evidence from the literature with analysis

Eat organic fruits and vegetables, avoid GMOs, enjoy better health.

Dr. Bob

The Broken Brain Docuseries is now re-running

Leave a reply

Due to popular demand the producers of this terrific series are making it available again  on line this weekend. If you have not taken advantage of this information you can do it here:

Replay (YouTube) | Broken Brain

Enjoy

Bob Hansen MD

The Broken Brain on-line “docuseries” is running now.

2 Replies

I would encourage everyone to watch this series of daily interviews and discussions on lifestyle and brain health. This was organized and produced by Mark Hyman MD, director of the Functional Medicine Clinic at Cleveland Clinic, well known author, speaker and physician, Discussions cover many topics including environmental toxins (such as heavy metals and Roundup), nutrition, exercise, sleep, stress reduction, gut bacteria, and more with specific reference to the effects on your brain and risk for dreaded conditions such as Alzheimer’s and other forms of dementia, Parkinson’s disease, multiple sclerosis, etc. These conditions can be prevented and when present, they can be treated with interventions not usually employed by modern medicine, unless you are fortunate enough to be working with a Functional Medicine practitioner.

You can sign up to receive a daily email with a link to the on-line video. Each video in the series is available for 24 hours starting at 3 PM PST, 6 PM EST.

Here is the link to get started with the third episode in this series.

Episode 3: Dementia and Alzheimer’s [LIVE] | Broken Brain

To Your Health,

Bob Hansen MD

Functional Medicine: Getting to the Root Causes of Illness, A cure for Alzheimer’s

Leave a reply

Today I watched a great TED talk by Dr. Rangan Chaterjee discussing his own journey in the discovery and implementation of a functional medicine approach to caring for his patients. The concept of using basic science and clinical science to diagnose and treat the root causes of illness, rather than treating symptoms, has been around for more than two decades.  This approach has recently started to attract more attention, especially within the community of younger physicians who have become more dissatisfied with the frustrations of traditional allopathic medicine.

Here is the talk. Dr. Chatterjee covers lots of ground in a passionate and informative talk.

Enjoy this talk. If you would like to learn about how a functional medicine approach can CURE ALZHEIMER’S DISEASE then watch this video of Dr. Bredesen who gave this lecture at a meeting of the American College of Nutrition.

Doctor Bredesen, an acclaimed neuroscientist, researcher, and more recently a brilliant clinician, has been criticized by the academic research community for implementing a clinical research protocol that addresses more than one variable at a time! Unfortunately, medical science has been handcuffed by the drug-model of clinical research wherein only one variable (drug vs. placebo for example) is studied. But if an illness has many potential contributing root causes, changing only one variable is doomed to failure, as Dr. Bredesen explains in this lecture.

Sleep well, eat clean, get outdoors every morning to help keep your circadian rhythm and biological clock in order.

Bob Hansen MD