The affordable Care Act is upon us. In my opinion it is the wrong answer: lipstick on a pig. True, it does provide basic care for many people who otherwise would have no access to health care. But, as a “hole” ACA will contribute to a staggering waste of resources and money ($750+ billion a year.) We are throwing more money into a system that should be overhauled to emphasize education, nutrition, environmental and emotional issues so that people assume more responsibility for their own health.
These comments no doubt upset Democrats and delight Republicans. So, now, let’s upset the Republicans: we should have a Single Payer System, easily covered if we were to stop subsiding insurance companies and big corporations. Then, destitute people and all of us would have catastrophic coverage. Those who wish even more coverage may do so on their own. Some would argue that prevention would be poorly funded under such a system No, not when we call mammograms prevention; they have not been shown to reduce mortality at all. Besides, most screening today constitutes secondary and tertiary prevention- they screen for diseases that are already well in progress. Primary prevention seeks to avoid the onset of disease altogether. This is only done by nutrition, environmental and emotional care. In short, Public Health initiatives.
With these thoughts in mind ponder the 6 articles listed below. Ask yourself as you read them, what is the common denominator? Addressing the common thread that also runs through practically all diseases is the single most important way to restore health to our society. Unfortunately, politics, ideologies and mental/spiritual issues in our society and in each of us may stand in our way.
Hugo Rodier, MD
Striking at the roots of disease
- “Meal size and frequency influences metabolic endotoxaemia and inflammatory risk but has no effect on diet induced thermogenesis in either lean or obese subjects.”[1]
- “Gut Microbiota Metabolites of Dietary Lignans and Risk of Type 2 Diabetes: A Prospective Investigation in Two Cohorts of U.S. Women.[2]
- “Consequences of antibiotics and infections in infancy: bugs, drugs, and wheezing.”[3]
- “Cesarean Delivery and Risk of Childhood Obesity.”[4]
- “Decreased gut microbiota diversity, delayed Bacteroidetes colonisation and reduced Th1 responses in infants delivered by Caesarean section.”[5]
- “Gut Reaction-intestinal bacteria may help determine whether we are lean or obese.”[6]
The common denominator in the above 6 articles is our gut micro-organisms or Microbiome. They cannot optimally work for you if you eat poorly, that is, not enough fiber (fruits and veggies,) and too much sugar. Incidentally, there are sugar receptors in the gut that act much like taste buds.[7] Taking antibiotics and acid blocking drugs also compromise the microbiome. C-sections have been shown to diminish a mother’s transfer of healthy bacteria to the newborn. When the Microbiome is not healthy it triggers inflammation among other problems. Said inflammation can reach every cell of your body. Your metabolism or handling of energy at the cellular level is then compromised. This leads not only to obesity, but to practically all illnesses. These simple concepts are now repeatedly highlighted in the best medical journals. The last to do so on its cover is the Journal Gastroenterology May 2014. Below you will find the titles of articles contained therein.
The Gut Microbiome in Health and Disease
The Intestinal Metabolome: An Intersection Between Microbiota and Host
Regulation of the Immune System by the Resident Intestinal Bacteria
The Microbiome in Inflammatory Bowel Disease: Current Status and the Future Ahead
Brain–Gut Microbiome Interactions and Functional Bowel Disorders
Interactions Between the Intestinal Microbiome and Liver Diseases
Role of the Microbiome in Energy Regulation and Metabolism
Gastrointestinal Malignancy and the Microbiome
Role of the Intestinal Microbiota in Resistance to Colonization by Clostridium difficile
Manipulation of the Microbiota for Treatment of IBS and IBD—Challenges and Controversies
Diet and the Intestinal Microbiome: Associations, Functions, and Implications for Health and Disease
From Stool Transplants to Next-Generation Microbiota Therapeutics
Toxins in the environment
The microbiome has the same capacity to detoxify as the liver. Poor function in both causes toxins in the environment to have an impact on your health. For example, Autism is likely to become more of an environmental issue as we learn more. Right now Autism is considered half genetics, half environment.[8] As noted in previous issues, some chemicals have a neurologic and endocrine effect; they are called endocrine disruptors, or xenoestrogens. They have been associated with Autism.[9] Other endocrine disruptors, like phthalates[10] and BPA in plastics also have a negative effect on the brain, particularly in early development. The latter have also been shown to have metabolic problems and affect the quality of sperm in young men.[11]
Obviously, avoiding said chemicals is the best approach. Strengthening your liver and Microbiome through good nutrition is another. Here are other things to consider:
- “Coffee and Non-alcoholic Fatty Liver Disease: Brewing Evidence for Hepatoprotection?[12]
- “Increasing consumption of coffee is associated with reduced risk of type 2 diabetes.”[13]
- “Resveratrol ameliorates hepatic metaflammation and inhibits NLRP3 inflammasome activation.”[14]
Redeeming vitamins
From time to time we see the media highlighting a negative study on vitamin supplementation. Even though such studies tend to be flawed, biased and often financed by parties whose income is threatened by vitamins and natural products, i.e. Big Pharma, many patients and, sadly, supposedly scientists like MDs, unquestioningly buy into those reports. No amount of discussion will persuade them to look at the hundreds of studies saying the opposite (sampler below.) Why? Their own ossified beliefs often based on unscientific “facts.” So much for objectivity in science…
- “Genetic Variants Reflecting Higher Vitamin E Status in Men Are Associated with Reduced Risk of Prostate Cancer.”[15]
- “Vitamin B-12 Supplementation during Pregnancy and Early Lactation Increases Maternal, Breast Milk, and Infant Measures of Vitamin B-12 Status.”[16]
- “Dietary Intake of Vitamin K Is Inversely Associated with Mortality Risk.”[17]
- “Evidence for Threshold Effects of 25-Hydroxyvitamin D on Glucose Tolerance and Insulin Resistance in Black and White Obese Postmenopausal Women.”[18]
“Vitamin D Deficiency Is Associated With Inflammation in Older Irish Adults.”[19]
“Vitamin D Supplementation for Depressive Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.”[20]
“Vitamin D Increases Serum Levels of the Soluble Receptor for Advanced Glycation End Products in Women With PCOS.”[21]
Speaking of PCOS
“Are Young Adult Women With Polycystic Ovary Syndrome Slipping Through the Healthcare Cracks?”[22]
“Polycystic ovary syndrome (PCOS) is a common endocrine disorder often diagnosed in adolescence or early adulthood. In adolescence, the many similarities between normal features of puberty and symptoms of PCOS make it challenging to confirm the diagnosis. Even among adult women, the changing definitions of PCOS may lead to inaccurate diagnoses. Women may present with a variety of symptoms to different healthcare providers and may be treated only for the presenting symptoms without evaluation of the syndrome and its associated morbidities. Timely evaluations, accurate diagnosis, appropriate interventions, and multidisciplinary healthcare teams can be valuable because women with PCOS have an increased risk for obesity, impaired glucose tolerance, diabetes, dyslipidemia, metabolic syndrome,[my emphasis-it means they are not getting good nutrition advise…] infertility, endometrial cancer, and anxiety and mood disorders. Appropriate transition of care for the adolescent from pediatric to adult healthcare providers should include education of the patient and her parents regarding the chronic nature of the syndrome and the need for continued follow-up. Girls with symptoms suggestive of PCOS who fail to fulfill diagnostic criteria should undergo prolonged observation. Early identification of PCOS at different entry points in the healthcare system will require physician education and improved access.”
[1] J. Endocrine Abstracts (2014) 34 P226. DOI:10.1530/endoabs.34.P226. “Researchers also tested the effects of eating frequency on the release of gut-derived bacteria into the blood. These bacteria, or endotoxin, cause systemic inflammation, which may increase risk of metabolic disease. Researchers wrote that “in metabolically healthy lean and obese subjects, increased meal frequency may pose an inflammatory risk posed by circulating endotoxin and triglyceride leading to peak levels at bedtime. As such, small frequent meals may not influence diet induced thermogenesis, but may increase metabolic disease risk.”
[2] J. Diabetes Care May 2014;37:1287
[3] J. Annals Allergy Asthma Immunology p441–445.e1 Published online: March 13, 2014. Recurrent wheezing in 22% of children who took abx < 6 mo of age. Only 14% in those who did not.
[4] The Journal of Pediatrics Volume 164, Issue 5 , Pages 1068-1073.e2, May 2014
[5] J. Gut 2014;63:559
[6] J. Scientific American June 2014, page 30
[7] J. Scientific American June 2014, page 21
[8] “The familial risk of autism,” JAMA 2014;311:1770
[9] “Clues to Autistic Behaviors: Exploring the Role of Endocrine Disruptors,”
J. Environ Health Perspect 2014 May DOI:10.1289/ehp.122-A137
[10] “Prenatal Phthalate Exposures and Neurobehavioral Development Scores in Boys and Girls at 6–10 Years of Age,”
J. Environ Health Perspect May 2014 DOI:10.1289/ehp.1307063.
[11] “Urinary Bisphenol A Levels in Young Men: Association with Reproductive Hormones and Semen Quality,”
J. Environ Health Perspect May 2014 DOI:10.1289/ehp.1307309
[12] J. Gastroenterol Hepatol. 2014;29(3):435
[13] J. Diabetologia Epub April 24 2014
[14] J. Metabolism – Clinical and Experimental Volume 63, Issue 5, Pages 693-701, May 2014
[15] J. Nutr. 2014;144:729
[16] J. Nutr. 2014;144:758
[17] J. Nutr. 2014;144:743
[18] J. Nutr. 2014;144:734
[19] Journal Clinical Endocrinology Metabolism 2014;99 (5) , pp. 1807–1815
[20] Psychosomatic Medicine: April 2014 – Volume 76 – Issue 3 – p 190–196
[21] Journal Clinical Endocrinology Metabolism 2014;99 (5) , pp. E886. In women with PCOS, vit D3 might exert a protective effect against the inflammatory action of AGEs by increasing circulating sRAGE.
[22] Journal Clinical Endocrinology Metabolism 2014;99 (5) , pp. 1583–1585
