Most people my age worry about getting “All-Timer’s Disease.” Forgetting where we place our keys can be deeply troubling. Understandable. But, are we doing enough to prevent cognitive decline? Don’t forget that once we get AD, it cannot be successfully treated. Prevention is the way to go. And what is the best way to lower the risk of AD? Maintaining good circulation, especially to the brain. And this is mostly achieved, if not entirely, by good nutrition.
Eat your veggies and quit refined sugars! (And if you are really scared, become vegan.)
Hugo Rodier, MD
Impact of dietary protein on risk of death from CVD, cancer, and dementia
“Healio (2/24, Buzby) reports researchers found “dietary protein from different sources was associated with varying risk for CVD mortality and death from dementia or cancer among older women.” The researchers also found that “the partial substitution of plant protein for animal protein was associated with lower risk for all-cause, CVD and dementia mortality among postmenopausal women.” The findings were published in the Journal of the American Heart Association. HealthDay (2/24, Preidt) reports the researchers also found “that older women who ate the most plant protein were 21% less likely to suffer a dementia-related death and 12% less likely to die from heart disease, compared with women who ate little to no plant protein.”
Comment: it’s the same for men.
Prediabetes may pose threat to brain health
“HealthDay (2/17, Preidt, Mundell) reports researchers found in an observational study that prediabetes “may pose a threat to brain health.” In the study, “people with prediabetes had a 42% higher risk of mental decline over an average of four years, and were 54% more likely to develop vascular dementia…over an average of eight years.” The findings were published in Diabetes, Obesity, and Metabolism.”
Comment: our brain is the organ that needs the most energy. Anything that curtails its energy needs, especially circulation compromises its function and structure. Sugar and transfats, especially when full of pesticides, are particularly damaging.
Exercising in the afternoon may confer greater metabolic health benefits for men at risk for Diabetes Type 2
“The New York Times (1/27, Reynolds) reports research indicates that for men at high risk for type 2 diabetes (T2D) “who completed afternoon workouts upped their metabolic health far more than those who performed the same exercise earlier in the day.” Those at-risk men “had greater blood sugar control and lost more belly fat when they exercised in the afternoon than in the morning,” the 32-man study found. The findings were published online in the journal Physiological Reports.”
Comment: this is true for everyone. Exercise also lowers the risk for AD
Afternoon naps may help improve cognitive abilities in older adults
“CNN (1/28, Marples) reports, “Adults ages 60 and older who took afternoon naps showed signs of better mental agility compared to those who didn’t nap,” investigators concluded after analyzing “napping habits in 2,214 older Chinese people,” then measuring “their cognitive abilities using several cognitive tests.” The findings were published online in the journal General Psychiatry.”
Comment: It has been upsetting to see rare and misguided negative articles on napping. I hope you have snoozed them.
Disinfection spreads antimicrobial resistance
J. Science 2021:371:474
“During the COVID-19 pandemic, the use of disinfectants, alcohol-based hand sanitizers, and antiseptic hand wash has surged. As a precaution, many authorities have also increased chlorine dosage in wastewater disinfection to achieve a free chlorine residual concentration greater than 6.5 mg/liter, despite evidence that a free chlorine residual of just above 0.5 mg/liter can completely inactivate human coronavirus. These chemicals can reach aquatic and terrestrial environments through direct discharge of wastewater into receiving waters. Disinfection protocols put in place to prevent COVID-19 should be limited to the minimum required to kill severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and weighed against their potential to increase antimicrobial resistance (AMR).
Disinfectants facilitate the bacterial acquisition of AMR, potentially the biggest global health challenge next to the COVID-19 pandemic. For example, antiseptic ingredients quaternary ammonium compounds, triclosan, chlorhexidine, and ethanol; chlorine-based disinfectants; and disinfection by-products can promote the spread of AMR through mutation or horizontal gene transfer. Thus, current increases in disinfection practices may pose an environmental and public health risk by accelerating the spread of AMR.
Unlike human viruses, which cannot independently reproduce and rarely survive in the environment, bacteria can proliferate and persist, conceivably inheriting AMR over generations. The health of humans and animals is inextricably connected to the environment, potentially creating a cycle of AMR dissemination. Indeed, humans and animals can acquire AMR from the environment through food, water, and air.
From the One Health perspective, a robust risk assessment is necessary to evaluate the environmental and public health risks of increased disinfection and its role in mediating the spread of AMR, particularly in the long term. To reduce the release of disinfectants into the environment, policies should be enacted to reduce unnecessary fomite disinfection, reduce the chlorine load to maintain a free chlorine residual of just above 0.5 mg/liter, and dechlorinate treated effluent before discharge. These approaches may be critical to protecting the public from future health threats by slowing down the dissemination of AMR.”
Story Time: I was the President of the SLC Alliance Française in the 90s. It meant I had to do most of the work, like procuring baguettes, wine and cheese for our soirées. Once, I dropped a baguette. Worried that visiting Americans would notice, a Madame quickly ordered me in rapid-fire French to “pick it up before the Americans see it!”
Effects of diet-modulated autologous fecal microbiota transplantation on weight regain (Poop transplant for weight loss!)
J. Gastroenterology 2021;160:158
“Obesity is one of the greatest health epidemics of the twenty-first century. With rates of obesity rapidly increasing around the globe, the management of obesity and its accompanying metabolic disorders is at the forefront of modern research. Although dietary restriction and other lifestyle modifications can induce weight loss, unfortunately most individuals who lose weight are prone to weight regain even while maintaining lifestyle changes. The concept that the gut microbiota may be involved with obesity and the metabolic syndrome has arisen due to evidence from human studies of distinct differences in gut microbial composition between lean and obese participants, along with the findings that transfer of fecal content from obese or lean humans into germ-free rodents can transfer the phenotype.
In recent years, there has been an emergence of fecal microbial transplantation (FMT) as a highly effective medically accepted treatment for recurrent Clostridioides difficile infections. FMT is also being investigated as a therapeutic treatment in several other human conditions, including inflammatory bowel disease, irritable bowel syndrome, liver and kidney disease, and obesity/metabolic syndrome.
Most FMT clinical trials use allogenic transplants, that is, fecal material obtained from a healthy donor and transplanted into a recipient either by enema, endoscopy, or in an encapsulated form. Conversely, autologous transplants, which are prepared from the patient’s own fecal material, are frequently used as placebo therapy. However, the use of autologous FMT has been explored as a method of restoring microbial communities that are destroyed by disease or treatments such as antibiotic therapy by using the individual’s own banked fecal material. Indeed, in patients undergoing hematopoietic stem cell transplantation, the use of autologous FMT after antibiotic therapy using the patient’s own feces banked before the initiation of antibiotic therapy was shown to be highly effective in restoring microbial diversity and composition.
In this issue of Gastroenterology, Rinott et al take the concept of autologous FMT one step further by investigating synergistic effects of combining autologous FMT with dietary and exercise interventions in obese participants. In this randomized controlled trial, 90 obese participants were randomized into 3 different dietary interventions combined with an exercise regimen to induce weight loss over a 6-month period. Participants who lost weight in each of the 3 dietary groups provided a stool sample at the 6-month time point for preparation of autologous FMT. Participants remained on their initial diets, but included encapsulated autologous FMT or placebo on a weekly basis for a further 8 months. The primary outcome was a regain of the lost weight over the following 8 months. The concept underlying the study design was that weight loss induced by dietary intervention would be accompanied by a change in microbial composition that, if maintained through autologous FMT, would prevent weight regain. Results demonstrated that participants on a Mediterranean diet plus green tea and Wolfia-globose (Mankai) green plant supplementation who received the autologous FMT had a significantly attenuated weight regain during months 6–14, whereas patients receiving a placebo gained back a significant amount of weight. Participants receiving the autologous FMT also maintained improvements in metabolic parameters and this result was associated with a preservation of gut microbial changes that were seen at 6 months after weight loss.
These findings add support to the current body of evidence that the gut microbiota have a role in weight gain and metabolism. However, many questions remain. Indeed, although studies have shown varying degrees of effectiveness of FMT in the improvement of metabolic parameters in human participants, there has been no evidence yet that FMT can induce weight loss in obese patients.
Nonetheless, results from this small study support the intriguing concept that, if weight loss can be obtained through dietary or exercise intervention, it could possibly be maintained through the conservation of specific gut microbial profiles. Further, the finding that maintenance of weight loss was only seen in the one dietary group consuming the Mediterranean diet plus green tea and Mankai supplement who received autologous FMT, would suggest that specific microbial profiles may be involved and that weight loss per se may not result in the required microbial profiles. This finding then raises the question of whether weight loss or metabolic control could be achieved or alternatively maintained with either a select bacterial consortium or indeed only a single microbial species. Although earlier trials using probiotic bacterial strains had limited success in obese participants, more recent studies using different bacterial species (Anaerobutricum soehngenii; Akkermansia muciniphila) have shown some effectiveness in improving metabolic parameters in obese patients.
Going forward, for FMT or other forms of microbial manipulation to be successful in the treatment of obesity and/or the metabolic syndrome, an initial assessment of the recipient’s baseline microbiota may be required to adjust or provide selected keystone strains that are required for microbiome recovery and may be depleted in the recipients.
This concept is supported by studies showing that the response of individuals to FMT depends on the baseline microbial composition of the recipient.
Unfortunately, differences in microbial composition between obese and lean individuals are not consistent across studies, so it is difficult at this point to know which species are required or responsible for beneficial metabolic effects. Further, the role of other constituents found in feces such as viruses, fungi, archaea, bacteriophages, and metabolites in the beneficial effects of FMT are currently relatively unknown and require more intensive study.
Nevertheless, manipulation of the microbiome in obesity and other metabolic diseases has the potential to become a new treatment modality.”
Comment: patients may also do poop transplants for many other health issues. Best to do it under a knowledgeable doctor’s supervision.
