Volume 17 • Number 2 • February 2016

Doctor Nestle wrote the book FOOD POLITICS^[1] a while back. She recently published an article that, sadly, but, understandably got very little exposure. Its contents are much better than any editorial I could write. It strikes at the root of the health care issues bedeviling our society:

“This Viewpoint emphasizes that nutrition researchers and professional societies need to recognize the influence of food-industry sponsorship, take steps to control its effects, and ensure that sponsored studies promote public health. The longstanding influence of food industry funding on nutrition research, researchers, and professional societies threatens the credibility of nutrition science. So much research is sponsored by industry that health professionals and the public may lose confidence in basic dietary advice. Although most journals now require authors to disclose who pays for their work, disclosure—even done diligently—is not sufficient to alert readers to the extent to which industry funding influences research results and professional opinion. As is well established from experimental and observational research, drug company gifts and grants can have substantial effects. To recipients, however, these effects are almost always unconscious, unintentional, and unrecognized, making them especially difficult to prevent.”^[2]

Hugo Rodier, MD

POLLUTION AND BAD DIETS: a synergistic effect in obesity

I have suspected this problem from the beginning of my career when I taught myself what was missing in my Medical School education: nutrition and environmental issues. It seemed common sense to me that each would make the other’s impact on our health worse. And that the best protection from environmental toxins, other than avoidance, is nutrition. With proper nutrition we optimize our liver’s and intestines’ detoxification functions, both of which depend on our Microbiome, or gut flora. Take a look:

“Interactions Between Diet and Exposure to Secondhand Smoke (SHS) on Metabolic Syndrome Among Children: NHANES 2007–2010.”

“The joint effect between high exposure to SHS and low levels of certain nutrients (vitamin E and omega-3 polyunsaturated fatty acids) on metabolic syndrome risk was greater than would be expected from the effects of the individual exposures alone. Conclusions: Prevention strategies for metabolic syndrome aimed at reducing SHS exposures and improving diet quality may exceed the expected benefits based on targeting these risk factors separately.”^[3]

This article also associates obesity issues with Second Hand Smoking: remember the word OBESOGENS, or toxins like BPA:^[4]

“Relating Phthalate and BPA Exposure to Metabolism in Peripubescence: The Role of Exposure Timing, Sex, and Puberty.”

Phthalates are used to soften plastic products. BPA is used to make them more transparent. Too bad that does not involve transparency of its risks and side effects. BPA is also used as dental sealant and to keep aluminum from contaminating canned foods.

“Phthalate metabolites and BPA were associated with metabolism biomarkers at age 8–14 years in patterns that varied by sex, pubertal status, and exposure timing. For example, in utero monoethyl phthalate was associated with lower insulin secretion among pubertal boys (P = .02) and higher leptin among girls (P = .04). Conclusions: Considering the long-term health effects related to metabolic syndrome, additional research on exposure and metabolic outcomes across developmental periods and early adulthood is needed.”^[5]

Given the above articles and many others already covered in past issues it should not be surprising that manipulating our gut flora can help us with weight loss:^[6]

“Two Healthy Diets Modulate Gut Microbial Community Improving Insulin Sensitivity in a Human Obese Population.”

“Long-term consumption of the Mediterranean Diet and Low Fat High Carbs diets exerts a protective effect on the development of type 2 diabetes by different specific changes in the gut microbiota, increasing the abundance of the Roseburia genus and F. prausnitzii, respectively.”^[7]

FATTY LIVER AND GUT FLORA

As you know Fatty Liver (NAFLD) is an epidemic in our country. It is associated with an imbalance of gut flora; the above articles discussing “toxicity,” and metabolic issues” infer a liver problem. Consequently, the best way to treat Fatty Liver is by maximizing our Microbiome’s health through diet and probiotics. Medscape had a terrific overview of this concept on January 19^th 2016:

• Gut microbiota and non-alcoholic fatty liver disease. Hepatobiliary Pancreat Dis Int. 2015;14:572-581.
• The severity of NAFLD is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota. Hepatology. 2015 Nov 24. [Epub ahead of print]
• Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease. Hepatology. 2009;49:1877-1887.
• Intestinal permeability is increased in children with non-alcoholic fatty liver disease, and correlates with liver disease severity. Dig Liver Dis. 2014;46:556-560
• Non-alcoholic fatty liver disease in children: focus on nutritional interventions. Nutrients. 2014;6:4691-4705.
• Docosahexaenoic acid supplementation decreases liver fat content in children with non-alcoholic fatty liver disease: double-blind randomised controlled clinical trial. Arch Dis Child. 2011;96:350-353.
• Role of docosahexaenoic acid treatment in improving liver histology in pediatric nonalcoholic fatty liver disease. PLoS One. 2014;9:e88005.
• Gut-liver axis and microbiota in NAFLD: insight pathophysiology for novel therapeutic target. Curr Pharm Des. 2013;19:5314-5324.
• Randomised clinical trial: the beneficial effects of VSL#3 in obese children with non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2014;39:1276-1285.
• Probiotics and nonalcoholic fatty liver disease. Middle East J Dig Dis. 2013;5:129-136.
• Probiotics for non-alcoholic fatty liver disease and/or steatohepatitis. Cochrane Database Syst Rev. 2007;CD005165.

SUGAR AND THE BRAIN—and aging poorly

Despite clear evidence linking depression to our diets most patients remain unaware of this problem.^[8] Taking an antidepressant seems to be the main way of addressing depression with no further discussion. A better approach would teach patients about insulin resistance in neurons, which compromises the Energy and Information our brain cells need to do their job. Not surprisingly, the same cellular problems involved in arterial disease, that is, insulin resistance and Nitric Oxide dysfunction, are at play in the brain.^[9] Why should it be any different?

Translation: all the sugar you eat to temporarily assuage your depression is perpetuating the problem, much the same as an alcoholic drinking to temporarily forget his problems. Think on this: what is alcohol, after all?

Not impressed? Maybe this will get your attention: the same mechanisms of disease noted above are closely intertwined with OXIDATION. They also cause MORE WRINKLES. Yes, think of your brain, heart and skin cells relentlessly aging, and more precipitously so if you don’t eat your veggies. And here is the good news: cocoa, an antioxidant, decreases the tendency to get wrinkles.^[10] The problem is most people get a little bit of cocoa laced with a lot of sugar. Yes, you love M&Ms, right? Wrinkles get our attention, perhaps as much as sex hormones dwindling. They do so much faster when we eat diets bereft of antioxidants.^[11]

1. University of California Press, 2002 ↑
2. “Corporate Funding of Food and Nutrition ResearchScience or Marketing?” JAMA Intern Med. 2016;176(1):13 ↑
3. Journal Clinical Endocrinology Metabolism 2016;101(1), pp. 52–58 ↑
4. “Diabetes Genetic Risk Score Modifies Effect of Bisphenol A Exposure on Deterioration in Glucose Metabolism,” J. Clinical Endocrinology Metabolism 2016;101(1), pp. 143–150 ↑
5. J. Clinical Endocrinology Metabolism 2016;101(1), pp. 79 ↑
6. J. Cell Metabolism Volume 22, Issue 6 , p971–982, 1 December 2015 ↑
7. J. Clinical Endocrinology Metabolism 2016;101(1), pp. 233–242 ↑
8. “Glycemic index, glycemic load, and common psychological disorders,” Am J Clin Nutr 2016 103: 201 ↑
9. “The Role of Nitric Oxide in the Antidepressant Actions of 5-Aminoimidazole-4-Carboxamide-1-β-D-Ribofuranoside in Insulin-Resistant Mice,” J. Psychosomatic Medicine: January 2016 – Volume 78 – Issue 1 – p 102 ↑
10. “Cocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled Trial,” J. Nutr. 2016 146: 46 ↑
11. “Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women,” J. Nutr. 2016 146: 98↑