Best wishes for this New Year. I hope you resolve to work on the 90% of factors (diet, environment, relationships) that affect your health, most of which are not covered by the Affordable Care Act or by our present Health Care system.1 This is one of the reasons why some of you, along with the majority of uninsured people, disapprove of the ACA.2 Another reason may be its over-reliance on symptomatic treatment. For instance, cholesterol problems are treated with statin drugs while often ignoring the root of the problem: diet and liver issues. See below.
This problem became more acute in my mind with news from the UK; doctors there are contemplating putting all patients over 50 years of age on Statin drugs on the strength of a study showing that statins prevent ~9,000 deaths every 5 years. The tile of the study is quite telling: “A statin a day keeps the doctor away: comparative proverb assessment modelling study.”3 It alludes to the refrain “an apple a day keeps the doctor away” because of its remarkable finding that an apple a day also prevents about the same number of deaths. Yet, nothing was said about improving our diet when this research was covered by the media. Instead, the emphasis was on putting people over 50 on a drug.
To make this selective type of reporting worse, two studies in the Journal Annals of Internal Medicine in December were trotted out to prove that multivitamins do not work. The studies in question showed that multivitamins do not prevent a second heart attack nor Alzheimer’s Disease. On the one hand we are told that antioxidants in our diet reduce mortality and on the other that they are not beneficial.
It is true that synthetic multivitamins are not as good as real food. It is also true that most multivitamins have too little of too many micronutrients. Most multivitamins in the market are not pharmaceutically or biologically worth our while since they are poorly absorbed in the gut. It is doubtful that those studies considered these points. More doubtful still that they took into account the microbiome’s or our gut flora’s health as a key factor in not only absorption of micronutrients, but as important players at the cellular level. “Postbiotics” is the new name for any substance, chemical or food, modified and processed by our glut flora. In other words, if a study subject had a poor diet and consequently a poor microbiome, anything he/she ingested was not properly absorbed nor processed in the gut, including a poorly absorbed multivitamin.
Another problem with those two studies is that they involved very ill patients whose advance diseases of the heart and brain often do not respond to any treatment modalities. Do you seriously expect a multivitamin, as flawed as they are, to prevent a second heart attack, and Alzheimer’s, the latter even untreatable by the most modern of drugs?
Oh, BTW, multivitamins lower the risk of cataracts…4
Hugo Rodier, MD
Leftovers from 2013 (articles too good to leave unreported)
“Taste receptors of the gut: emerging roles in health and disease.”5
Take a look at my last blog; it’s about our taste buds being so addicted to refined sugars that we cannot taste the sweetness of natural foods. It turns out that we have “taste buds” in the gut as well. This is a dramatic confirmation of “the second brain,” which is influenced by the gut flora therein. Eating poorly selects out bad organisms who will not be content until you satisfy their sweet tooth. Here are some quotes from this study:“These receptors ‘taste’ the luminal content and transmit signals that regulate nutrient transporter expression and nutrient uptake, and also the release of gut hormones and neurotransmitters involved in the regulation of energy and glucose homeostasis…
“… They play a prominent role in the communication between the lumen, epithelium, smooth muscle cells, afferent nerve fibers and the brain to trigger adaptive responses that affect gastrointestinal function, food intake and glucose metabolism…
“…[They] contribute to the induction or resolution of a number of pathological conditions related to diabetes, obesity, or diet-induced symptom generation in irritable bowel syndrome.”
“A new you coming every day”6
Our gut flora’s quality and very nature depend on the food we eat and on the chemicals we ingest. It is constantly adapting to its environment as we all should be. This is why we now know that it changes and mutates on a daily basis. I first learned about this crucial fact in 2000 from a terrific article in the J. Science, “Close Encounters: Good, Bad, and the Ugly.”7 A toxic environment can cause the intestinal organisms to mutate and become harmful:
“A logical approach to the situations that alter our gut microbial environment (eg, diet, environmental changes and antibiotic use) would be to deliberately increase our association with specific non pathogenic (friendly) organisms to counter such an environmental alteration.”8
Interestingly, this concept was discussed a hundred years ago in the Journal of the American Medical Association in 1906.9 Yet, it still does not get the attention it deserves, even after it was revisited in another JAMA issue in 2006….10
“An ALTer Ego of Serum ALT: Is It More Than a Marker of Liver Inflammation?”11
Helping the liver detoxify better is not often addressed in our Health Care system. Specifically, Fatty Liver is often left untreated, despite its epidemic status. The main thing to do for your liver is to stop eating refined foods, and avoid chemicals as much as possible. This may include some prescription drugs. In my opinion, the most practical way to assess liver function is to check a serum ALT, which is easily done in any clinic. Liver function impacts all aspects of our health, including cardiovascular health. This article is yet another confirmation that cholesterol problems stem from poor liver processing of fats:“In conclusion, [this] work … makes an important contribution to the increasing body of knowledge about the relationship between NAFLD (fatty Liver), liver inflammation, dyslipidemia, and cardiovascular risk. It suggests that ALT may be useful as a biomarker of an elevated risk of early atherosclerosis and cardiovascular disease in individuals without commonly recognized lipid and metabolic abnormalities. It also highlights a distinction that serum ALT within normal limits may not necessarily translate to a healthy heart. .. We advocate viewing ALT as a quantitative test with which degrees of liver inflammation and excess cardiovascular risk may be gauged on a continuous scale, rather than as a simple tool to make a dichotomous judgment between health and disease.”If you wish to supplement liver function I recommend Alpha Lipoic Acid (broccoli), N-Acetyl Cysteine (amino acid), and/or Milk thistle. The first two are pharmaceutical products. All three are glutathione precursors. Of, course, the best way to increase the latter is plant based foods.
“Cancer Therapies Use a Little Help From Microbial Friends.”12
The immune system is mostly in the gut in the form of friendly bacteria. This article and the ones after emphasize the critical need to eat good foods to keep the happy and thereby prevent 2/3 of cancers:“Outnumbering our own cells more than 10 to one, the microbes thriving peacefully in the human body help keep us healthy. New research shows they also aid in the treatment of cancer. The two studies find in mice that gut bacteria bolster the effects of three antitumor regimens by priming the immune system. In each case, when a mouse’s microbial residents are missing—as when antibiotics are given—the treatments are far less effective.”
“Commensal Bacteria Control Cancer Response to Therapy by Modulating the Tumor Microenvironment.”13“The gut microbiota influences both local and systemic inflammation. Inflammation contributes to development, progression, and treatment of cancer… Optimal responses to cancer therapy require an intact commensal microbiota that mediates its effects by modulating myeloid-derived cell functions in the tumor microenvironment. These findings underscore the importance of the microbiota in the outcome of disease treatment.”
1. “Bridging the divide between health and health care,” J. of the American Medical Association 2013;309:1121
2. Salt Lake Tribune, December 19th 2013
3. British Medical J. Epub December 2013
4. “A Multivitamin Supplement and Cataract and Age-Related Macular Degeneration in a Randomized Trial of Male Physicians,” Epub J. Ophthalmology November 26th 2013
5. J. Gut 2013;63:179
6. Epub J. Nature December 17th 2013
7. J. Science 2000;290:1491
8. American J Clinical Nutrition 2001;73:1147s
9. “The transmutation of species in bacteriology,” J. of the American Medical Association 1906;46:122
10. JAMA 2006;295:226
11. J. Gastroenterology 2013;145: 1191
12. J. Science 22nd November 2013;342: 6161
13. J. Science 22nd November 2013: 967