EDITOR’S NOTE
Does anyone still think that science is immune to biases, money, ideologies, and politics? As much as we would like to believe so, we are often reminded that we must follow the money to interpret any fact or statement. Take for instance Dr. Paul A. Offit who has gone on a rampage against nutritional supplements. CBS has denounced him as “Dr. Vaccine” for his close association with Merck Pharmaceuticals. Then, there is the G.O.P. demanding that the EPA release the raw data from studies that have linked air pollution and ozone depletion with health problems. A significant number of people feel that EPA regulations are crippling industry and the economy. They want the science behind these regulations to be reevaluated. The EPA has refused to release such data arguing that doing so would violate “privacy issues.” The EPA should release the research so that we put this issue to rest. Or, will we ever? Hugo Rodier, MD
A Gut Feeling
Since science has been king, subjective feelings, the unseen, even spiritual issues have been discounted, especially by left-brain people who cannot conceive of “things not seen.” The results? Ask yourself how we are doing as a society, especially in health care. Moi, I will always cherish The Little Prince’s advice: “it is only with the heart that one can see clearly; what is important is invisible to the eye.” This attitude has helped me in my profession. Often, research, such as what you see in this newsletter, is anticipated by a “feeling” that we need a new way of looking at a problem. We cannot solve them with the very tools that created said problem. This is why I enjoyed a recent study validating doctors’ gut feelings. [1]
But, all the above was to prepare you for an eye-popping report that has linked Autism (my home state Utah leads the nation, 1/57 children) with missing healthy strains of gut flora,
specifically, prevotella, coprococcus, and veillonellaceae. [2] I have felt, with fairly good evidence, that this is a major factor in the roots of Autism. The so called brain-gut connection has lately been featured in several studies. The mechanisms involved in a lack of friendly bacteria are likely complicated, and not yet fully elucidated. But, let me give it a try:
1. Poor energy or food processing in the gut. Remember that the brain is the organ that consumes the most energy.
2. Food allergies, some of which directly affect the brain. For instance, we now know that gluten sensitivity is linked to autism. [3]
3. Less than optimal processing of any substance we ingest: food, chemicals, drugs, etc. This is the concept of “postbiotics.” [4]
4. Poor detoxification of pollutants that may affect the brain. [5]
5. Compromised immune system in the gut, which may increase inflammation throughout the body, including the brain.
6. Vaccines that meddle with the immune system have been implicated, despite the CDC pronouncements to the contrary. [6]
7. I am sure I am missing more factors associated with autism and the gut.
So, what can we do? Improve their diets, as difficult as that is. Supplement the missing bacteria and other available strains. Soon, we will have more information on what other species may be missing in this and practically all medical problems. Supplement prebiotics or fiber. Avoid toxins as much as possible as we often discuss in this newsletter. Consider liver helpers, like Alpha Lipoic Acid and N-Acetyl Cysteine, both of which increase glutathione, a very important antioxidant in liver detoxification. Read Temple Gradin’s book. She suffers from Autism. Or, watch the movie about her.
Apps and Health Care
When X-rays first came out people were fascinated by the new technology. Many entrepreneurs cashed in by providing them in their businesses. Shoe stores used to x ray customers’ feet claiming they could then find you a better fitting shoe. Human nature: any new technology will get overused when first marketed. So it is with text messaging and other cell phone tricks. No doubt a whole lot of them have made our lives easier, but, as amply documented, some aspects of the wireless and internet revolution have unnecessarily complicated our lives and have isolated us further from our fellowman.
I am not the only one who thinks that apps in health care may fall in the same category. While some of them no doubt will be helpful, many of them will add and unwarranted micromanaging of symptoms and parameters that don’t add much to our health. [7]
We have seen this with the glucometer, a devise to check your blood sugar. In my opinion, a whole lot of patients have been saddled with it unnecessarily. Only Diabetics on insulin should be using it. If you are pre diabetic or type II diabetic, you are not going to change anything by checking your own blood sugar. If you argue that you may change your diet by checking, well, you were hopefully told to do that anyway, with a simple discussion on the glycemic index of foods and avoiding processed foods.
I guess it is OK if people get an app to monitor a specific disease. Just be ready to spend a lot of time with questionable results. BTW, how many of the cool apps you have downloaded in the past do you still use?
Omega Oils and the Prostate
You probably heard that the National Cancer Institute published a study associating prostate cancer with omega oils supplementation. [8] With all due respect to the NCI I recommend that we hold off before concluding the association is valid. Why? Because omega oils have been studied for decades and their benefits are amply demonstrated. It is not prudent to throw out that voluminous body of evidence on the strength of one study.
Also, prostate cancer is seen in ½ of men. When a condition is so prevalent, it is not difficult to associate it with practically anything. For example, a study may show that shaving twice a day is associated with prostate cancer. Sure, I am being facetious, but you get the point.
Pharmaceutical companies have come up with their own versions of omega oils, which they claim are stronger and more effective. They are also more expensive. If we are going to condemn omega oils now, why don’t we start with their products, instead of the “ineffective” oils over the counter? Can you say “Codex?”
Another interesting point is that Alpha Linoleic acid in flaxseed is not metabolized to omega oils well in some people, which has been associated with prostate cancer. [9] Did the NCI researchers try to isolate these patients in their study? I doubt it.
My Books
The new one on “Gut Health” is already available at www.hugorodier.com . Next month it comes out in book form. The old one (2010) “Licking Sweet Death,” wherein I showed the early evidence that processed sweet are addicting, continues to be validated. I include below an interview with a doctor who agrees: [10]
“In June 2013, the American Medical Association (AMA) declared obesity a disease , a move championed by many clinicians and derided by others. Debate aside, the announcement reinforced that the understanding and appreciation of obesity is evolving, and that in this era of soda bans and school lunch reform, obesity is high in the consciousness of both the public and the medical community.
One area of obesity research receiving a great deal of attention lately is the considerable neurobiological overlap between addiction and some forms of obesity. Nora D. Volkow, MD, Director of the National Institute on Drug Abuse (NIDA), has studied this association extensively. Medscape recently spoke to Dr. Volkow about her ongoing research into the relationship between weight and addiction.
Medscape: Hi, Dr. Volkow. Before we get to the relationship between obesity and addiction, how does human appetite control normally work?
Dr. Volkow: Eating behaviors are obviously necessary for survival, and we’ve evolved complex and redundant systems to ensure that the behaviors necessary to eat occur. The brain receives peripheral signals that relate to the body’s nutritional status: for example, the concentration of glucose, lipids, and certain nutrients. These signals are conveyed to the brain via the plasma and peripheral nerves in the gastrointestinal tract — a process known as “homeostatic regulation” of feeding — and help indicate whether the body needs to consume more food or not and whether there is a need for a specific nutrient. Parallel reward systems in the brain respond to the pleasantness of food and motivate our behaviors to consume them, a process described as “hedonic regulation” of food intake.
It was believed for many years that these peripheral signals were predominantly received by the hypothalamus, and it was initially thought that there were only a few signals (eg, glucose, insulin, leptin). However, in the past 10 years, many other signals (eg, hormones, peptides) have been identified that work in part by acting on and altering the sensitivity of reward systems in the brain to food.
For example, normally the hormone leptin is secreted from adipose cells to tell the brain that enough energy is stored; this decreases appetite and increases energy expenditure. There is a very rare genetic condition where individuals are born without the gene that encodes for leptin, and these individuals overeat and become obese from childhood. In these individuals, brain imaging studies have shown that reward systems in the brain are hypersensitive to the rewarding properties of food. Leptin treatment in these individuals decreases the sensitivity of the reward system, resulting in a decrease in the motivation to eat and a marked reduction in weight.
When peripheral signals — such as leptin or insulin — are not released, or your brain becomes tolerant to them, you don’t have a mechanism to counter the drive to eat. It’s like driving a car without brakes.
Medscape: Which brain regions make up our reward centers?
Dr. Volkow: We describe them as a reward circuit, because there are multiple connected regions involved. A central node in the circuit is the nucleus accumbens (NAc), a region regulated by dopamine, which we always hear about being responsible for the rewarding and addictive effects of drugs. The rewarding effects of drugs result from their ability to activate the NAc through increased dopamine release. Similarly, rewarding effects of food are linked to dopamine release in theNAc.
Before we get to food addiction, I should say that how effective food is at activating these dopamine pathways, and the NAc, is modulated by homeostatic peripheral signals. If you don’t have insulin and leptin, which decrease dopamine signaling in the NAc, the reward circuit will go into overdrive when you eat or are exposed to food; this is because signaling in the reward pathway triggers the motivation to eat. This can result in obesity. As people become obese, they become insulin- andleptin-resistant, thus removing the normal peripheral signals that help inhibit the rewarding effects of food; the more severe the obesity, the worse the brain becomes at preventing excess food intake.”
More on sugar addiction: quotes from recent study
“The negative impact of consuming sugar-sweetened beverages on weight and other health outcomes has been increasingly recognized; therefore, many people have turned to high-intensity sweeteners like aspartame, sucralose, and saccharin as a way to reduce the risk of these consequences. However, accumulating evidence suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease. This paper discusses these findings and considers the hypothesis that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis.” [11]
[1] “Family Physicians’ Diagnostic Gut Feelings Are Measurable,” J. BMC Family Practice 2013;14(1)
[2] J. PLoS One Epub July 3 2013
[3] J. PLoS One Epub June 18 2013
[4] “Probiotic and postbiotic activity in health and disease: comparison on a novel polarized ex-vivo organ culture model,” J. Gut 2012;61:1007
[5] “Residential Proximity to Freeways and Autism in the CHARGE study,” J. Environ Health Perspectives December 2010 ahead of print:-. doi:10.1289/ehp.1002835
[6] ” Autism After Infection, Febrile Episodes, and Antibiotic Use During Pregnancy: An Exploratory Study, ”
J. Pediatrics Epub November 12 2012
[7] “How apps are changing family medicine,” J. Family Practice 2013:62:362
[8] “Plasma Phospholipid Fatty Acids and Prostate Cancer Risk in the SELECT Trial,”
J. National cancer Institute djt174 first Epub July 10 2013
[9] J. Current Opinion Clinical Metabolism Care 2004;7:137 & J. Nutrition 2004;134:919
[10] Medscape Psychiatry , “Can Obesity Be an Addiction?” Bret S. Stetka, MD, Nora D. Volkow, MD
[11] “Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements,”
J. Trends in Endocrinology and Metabolism Epub July 10,2013 http://download.cell.com/images/edimages/Trends/EndoMetabolism/tem_888.pdf
