stigbengmark.com · increased life expectancy: 47 78 years but an tzunami of chronic diseases soon...
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Falköpings Radio, Hälsofrämjandet, Riksförbundet Pensionärsgemenskap (RPG), Pingstkyrkan
Falköping arrangerar i Pingstkyrkan Falköping 2017–09-09
VÄLJ HÄLSA”Hedra Din Moder till hälsa (Dina tarmbakterier) på det att det må gå Dig väl
och Du må länge leva på jorden” 2 Mosebok 2:12
Stig Bengmark MD PhD UCL, London University, UK
DIFFERENT LIFESTYLE – DIFFERENT DISEASE PATTERNClayton P, Rowbotham J Int. J. Environ. Res. Public Health 2009;6:1235-1253
INCREASED LIFE EXPECTANCY: 47 ➔ 78 YEARS but an TZUNAMI OF CHRONIC DISEASES SOON TO COME
Fontana L Biochimica et Biophysica Acta 2009;1790:1133–1138☹ Cardiovascular disease (CVD), cancer, and diabetes account for about 70% of deaths in the US and Europe. ☹ About 80% of adults > 65 yrs have at least one chronic
disease. ☹ & 50% have two or more chronic diseases. ☹ IMPORTANT TO REMEMBER:40% of cancer & up to 80% of all heart disease, stroke and type 2 diabetes are preventable with elimination of unhealthy diets, physical inactivity, and use of
b
PROGNOSIS DIABETES USA – 2050Boyle et al. Population Health Metrics 2010, 8:29
PROGNOSIS ALZHEIMER USA – 2050Hebert LE et al Arch Neurol 2003;60:1119-1122
FORCEFULLY ”HITTING BACK”ANTIBIOTIC-RESISTANT MICROORGANISMS
– a great threat to global healthA UK government commission estimates 700,000 deaths linked to drug-resistant infections & premature deaths in 2017 & forecasted to increase to 10 mill. by 2050 An increase of app 15 X
Predicting the World’s GDP to be: ☹ 0.5% smaller already by 2020 ☹ 1.4% smaller already by 2030
2050: Forcasted to reduce GDP to half- a loss each year of $ 100.2 trillion
2017 World GDP = $ 78 trillion
ANTIBIOTIC-RESISTANT MICROORGANISMS
☹ “one course of antibiotics now, within three months the risk is three times higher to get a resistant infection” Paul Cosford, medical director at Public Health England☹ “If you’re a child you’re 12 times more likely to get a resistant infection in the three months.” Paul Cosford, medical director at Public Health England☹ About 80 percent of the antibiotics sold in the United States are given to healthy animals in meat and poultry production to promote growth, or prevent disease in crowded or unsanitary conditions.Congresswoman Louise M. Slaughter - the only microbiologist in Congress
LEADING BURDENS TO GLOBAL ECONOMY – 2012 - WHO Add by 2050: Antibiotic resistance ($ 100 trillion)
OBESITY
$ 2.1 trillion
$ 2.1 trillion
$ 2.0 trillion
ALCOHOLISM $ 1.4 trillion
CLIMATE CHANGE
Global GDP 2017: $ 78 trillion
☹ Annual Costs Antibiotic Resistance = 128 % of 2017 World GDP ($ 78 trillion) ☹ 45 % of projected World GDP in 2050 (221 $ trillion)
61 % ($ 60 trillion of $ 134 trillion): China, India Indonesia, Brazil & Mexico☹ Annual Costs of the 3 Specific Burdens: Obesity, Smoking, Armed violence =
the 2050 GDP of India
☺Projected World GDP 2050 - $ 221 trillion ☺
Affecting all countries but especially developing countries
ANTIBIOTICS DYSBIOSIS DISEASESHighest number of
PRESCRIPTIONS
Louisiana Mississippi, Alabama, Arkansas, Tennessee, Indiana, West Virginia
OBESITY - THE GLOBAL TZUNAMI- strongly associated to modern agriculture & mass-produced cheap processed foods
EPICENTRE: Louisiana Mississippi, Alabama, Arkansas, Tennessee, Indiana, West Virginia
Soon to lead ”the league of unhealth”
GLOBAL STROKE INCIDENCE
Thrift AG et al Int J Stroke 2014;9:6-18
NEGATIVE EFFECTS ON HEALTH – a result of industrial
revolution?
PLANT BREEDING including GMOANIMAL BREEDINGARTIFICIAL INSEMINATIONSUPPLEMENTING CHEMICALS:
herbicides (to kill weeds), insecticides(to kill bugs), fungicides (to eliminate funguses), soil fumigants (to disinfect), desiccants (drying agent), harvest aids (to speed up hardening), and plant growth regulators (also called plant hormones, aimed to increase growth of plants: cells, tissues and organs)
INDUSTRIAL PROCESSING: separation, condensation, drying, freezing, irradiation, burning, roasting, curing, microvawing, emulsifying, toasting , supplementing salt & other food additivesHOME PROCESSING: baking, cooking,
microvawing, frying, wooking, grilling etc. FOOD ADDITIVES – commonly used:
antibiotics, acidity regulators, thickeners, stabilizers, emulsifiers, acidity regulators, anti-caking agents, glazing agents, flavour enhancers, gases, sweeteners
Modern techniques aimed to increase food productivity are increasingly associated with UNHEALTH:
☹ STRONGLY ASSOCIATED WITH USE POTENT CHEMICALS
GUIDE TO PESTICIDES
PLANT BREEDING – NEGATIVE EFFECTShttp://www.nutritionsecurity.org/PDF/Food%20Nutrition%20Decline.pdf
FRUCTOSE IN FRUITS Dr Mercola 2010 http://articles.mercola.com/sites/articles/archive/2010/06/19/richard-johnson-interview-may-18-2010.aspx
Agrawal R, Gomez-Pinilla F J Physiol 2012;590:2485–2499
FRUCTOSE & MEMORY LOSS
FOOD INTAKE & INFLAMMATION ☹ Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES ☹ High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc.☹ High intake of heat- and storage-induced proteotoxins: glycated (AGEs), lipoxidated molecules (ALEs),processed carbohydrates induces: ☹ Dysbiosis: reduced numbers & diversity ☹Leakage of various body membranes; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood-b i b i t
Louis Camille Maillard 1878 – 1936Undertook studies suggesting association between development of chronic disease, especially chronic renal disease induced bychemical reaction between amino acids and sugars. This work was considered a major contribution, and the reaction was named after him – Maillard reaction & He was awarded several prices, including the French Academy of Medicine award in 1914.
☹ HEAT-INDUCED TOXINS (AGEs & ALEs) IN FOODS“smoking with the stomach”
Dys-functioning, glycated PROTEINS (AGEs) and lipoxidated fats/oils (ALEs) induce about 50 times more inflammation in the body compared to non-heated proteins and fats/oils ☹ accumulate in tissues (amyloid) ☹ weakens immune system☹ impairs DNA repair mechanisms ☹ reduce antioxidant defense☹ induce inflammation & infection ☹ accelerate development of various diseases.
Bengmark S. Modified Amino Acid-Based Molecules; Accumulation and Health Implications. In Amino Acids in Human Nutrition and Health. Ed Mello JFD, CABI Alli f d UK 2011
AGEs & INFLAMMATION-INDUCTIONBohlender JM Am J Physiol Renal Physiol 2005;289:F645-659
FOOD & HEAT-INDUCED TOXINS (AGEs & ALEs)☹ MEAT, POULTRY, FISH: AGE content increases with
exposure to higher temperatures:comp: Boiling 1000 vs Frying 9000 kU/serving
Goldberg T et al. J Am Diet Assoc 2004;104:1287-1291☹DAIRY:CHEESE, espec. hard cheeses ☹POWDERED MILK (espec. ice cream, baby & clinical
nutrition formulas) ☹GRAIN PRODUCTS: Toasted bread, bread crusts &
crisp breads ☹VEGETABLE OILS:ex.heated olive oil ca 8000 kU☹☹ OTHERS: Egg yolk powder, lecithin powder, coffee, espec dark
roasted, hard-cured teas, roasted and salted peanuts, dark and sugar-rich alcoholic beverages - high in i.g. broth, Chinese soy, balsamic vinegar, Cola drinks etc
UNHEALTH
Das AB, Srivastav BB Toxicol Mech Methods 2012;22:163-169
Acrylamide has been studied extensively for more than 40 years, but the first detection of acrylamide in carbohydrate-rich foods was made as late as 2002Acrylamide has a number of adverse effects on the human body - two major effects being ☹ NEUROTOXICITY & ☹ CARCINOGENICITY
☹ HEAT-INDUCED ACRYLAMIDE SYNTHESISTareke C et al J. Agric. Food Chem. 2002;50:4998-5006
☹ Toasted bread contains several-fold more of acrylamide than untoasted ☹Wheat: 11–161 vs < 5 mg/kg . Rye: 27–205 vs 7–23 mg/kg Granby K et al Food Additiv Contamin 2008; 25:921–929
DIETSmoking with the
stomach”
☹ AGEs IN VARIOUS MILK PRODUCTSBaptista J, Carvalho R Food Res Int 2004;37:739-747
Fresh milk
2 years storage in room temperature
STORAGE IN ROOM TEMPERATURE 1-2 YEARS
1 year storage in room temperature
☹ DISEASES WITH ELEVATED AGEs/ALEs• ADHD• Aging• Allergy• Autoimmune diseases• Alzheimer´s disease• Amyotrophic lateral sclerosis • Atherosclerosis• Cardiovacular diseases• Cataract• Chronic liver diseases• Chronic pulmonary disorders• Creutsfeldt-Jakob disease• Diabetes
• Familial amyloidotic polyneuropathy• Fibromyalgia• Glaucoma• Hormone deficiencies• Macula degeneration• Nephropathies• Obesity• Osteoporosis• Paradontosis• Parkinson´s disease • Polycystic Ovary Syndrome• Rheumatoid diseases• Ruptured Achilles tendon• Sepsis• Stroke
AGE & PREMATURE AGINGNagai R et al J Clin Biochem 2014;2014:55:1-6
AGE/ALE & PREMATURE AGINGNagai R et al J Clin Biochem 2014;2014:55:1-6
AGE – ALE & OPHTALMIC DISEASES Smuda M et al Biochemistry 2015;54:2500-2507
GLYCATED PROTEIN & DIABETESJurascheck SP et al BMJ Open Res Care 2016;4:e000276.
GLYCATED PROTEIN & DIABETESJurascheck SP et al BMJ Open Res Care 2016;4:e000276.
HEALTH ON LOW AGE & EXERCISEMarcias-Cervantes et al Nutrition 2015;31:446-451
Improvment on Low AGE diet + exercise
SPICES – EFFECTS ON HB-GLYCATIONwild caraway = vild kummin Naderi Gh et al Indian J Pharm Sci. 2014; 76: 553–557.
☹ HEATING OF FOODS – NEGATIVE EFFECTSBenlloch-Tinoco M et al. Food Chem 2015;187:254–262
PHa: pheophytin APhb: Pheophytin BCHLOROFYLL:Microg/cupParsley 380Spinach 240Cress, garden 160Green beans 80Arugula 80Leeks 80Endive 50Sugar peas 50Chinese cabbage 40
BETACAROTENE:PeppersLettuceKaleCarrotsSpinachMustard GreensTurnip GreensChinese Cabbage
LUTEIN:SpinachKaleCarrotsBroccoliPeppersSweetcornTomatoes
Fresh Microvawed Conventionally heated
Lutein/Zeaxanthin micrg/100 gKale 21.9Collard greens 16.3Spinach 12.6Cress leaf 12.5Swiss chard 11.0Chicory leaf 10.3Parsley 10.2Mustard greens 9.0Beat greens 7.7Okra 6.8Red pepper 6.8Endive 4.0Avocado 4.0 Celery 3.6
HEATING & LEAKAGE OF PHTALATESMoreira MA et al. Int J Environ Res Public Health 2014;11: 507–526.
TRADITIONAL CONTAINERS NEWLY INTRODUCED CONTAINERS
Phtalates associated with Health problems:
infertility, allergies, asthma, obesity,
leiomyomas & breast cancer
COOKING & IODINE LOSSRana R, Raghuvanski RS J Food Sci Technol. 2013;50:1212-1216.
%loss
Cooking in
water
SIX DANGEROUS METABOLIC MANIFESTATIONS 0FTEN OCCURING IN THE SAME CHRONICALLY ILL PERSONS
☹ Abdominal obesity☹ High blood pressure☹ Elevated blood sugar ☹ Elevated blood triglycerides☹ Low blood HDL cholesterols☹ Fatty liver & fat-infiltrated skeletal muscles☹ High blood uric acid
Suggested in 1923 by Eskil Kylin, Swedish Physician, Eksjö, Jönköping and Stockholm.
Today strongly associated with consumption of ”Western-type” foods
Waist circumference men: < 102 cm women: <88 cm Fasting glucose 3,9 - 5,9 mmol/LTriglycerides: < 1,7 mmol/LLow-density lipoprotein cholesterol(LDL), men: < 2,5 – 3,0 mmol/LSystolic blood pressure: (SBP) < 130 mmDiastolic blood pressure: (DBP) < 85 mm
NORMAL VALUES
METABOLIC SYNDROMERe-described around 1980 as Insulin Resistance Syndrome – IRSrecoined to METABOLIC SYNDROME - MS.☹ Affects 20 – 25 % of the world’s
adults☹Was in 2000 about 32% of U.S. adults
& is:☹ 10 years later 34 % &☹ C ti t i
☹ FORECAST FOR USA + UK (375 mill) – 5 % OF GLOBAL POPULATION
Wang YC et al Lancet 2011;378:815-825
Chronic Diseases are further increased by 2030:☹ 76 mill more obese adults ☹ 6–8.5 mill additional cases of diabetes ☹ 6-7 mill additional cases of cardiovascular disease☹ 492 000 – 669 000 additional cases of cancer☹ Loss of 26–55 mill quality-adjusted life years ☹ Increased costs of preventable diseases by $ 50–68 bill/year
DISCRETE PERSISTANT CHRONIC INFLAMMATION - A MOTHER OF DISEASE
Bengmark S. J Clin Nutr 2004;23:1256-1266
CALORIE-CONDENSED FOODS & UNHEALTHCani PD, Delzenne NM Curr Pharm Des. 2009;15:1546-1558
CALORIE-CONDENSED & PRO-INFLAMMATORY FOODS
☹ Alcohol☹ Bread & Pasta, Pastries☹ Butter☹ Cheese☹ Chips☹ Fast food & t k
☹ Fried food☹ Jam and marmalade☹Milk & Latte☹ Potatoes & other tubers – EATEN WARM – NOT COLD☹ Red meat ☹ Tomato ketchup☹ Soft drinks
Jon Brower Minnoch, USA, 1941 -1983, 635 kgThe world´s heaviest person
Celebratingbirthday
THE QUARTET OF DEATHBengmark S. Hepatobiliary Surg Nutr 2015;4:278-288 - www.bengmark.com
☹ Excessive body weight ☹ Hypertension ☹ Impaired glucose homeostasis ☹ Atherogenic dyslipidemia
☹ LIFE STYLE CAUSES OF DEATH ☹Danaei G Plos Med 2009,6(4),e
2017: ”Obesity replacing smoking as leading cause of global death”
DISEASE, GENES ENVIRONMENTexample cancer Anand P et al Pharm Res 2008;25:2097-2116
☹ Environment 90-95 %
DIET app 1/3
Genes 5 %
PALEOLITHIC LIFESTYLE & HEALTHless fat, less protein, less sugar, less calories
Robbins J: Healthy at 100: The Scientifically Proven Secrets of the World's Healthiest and Longest-Lived Peoples
Read: http://thepdi.com/hunza_health_secrets.htm
17 % fat intake
10 % protein
1800 calories per day
0 % processed –99 % plant foods
THE TZUNAMI OF PROSTATE CANCER JAPAN
The age-adjusted death rate in ChDs such as prostatic cancer rose in Japan during the period 1948 - 98
25-foldparallel to increases in intake of :
egg 7 Xmeat 9 X dairy 20 X
Ganmaa D et al Medical Hypotheses 2003;60:724-730
”WARNING SIGNALS” - CHRONIC INFLAMMATIONUnexplained fatigue, sleep problems, frequent headache, hair loss, gray hair, dandruff, acne, skin rashes, dry eyes, frail nails, dry mouth or increased salivation, reduced sex functions, irregular menstruations, obstipation or diarrhea, osteoporosis, overweight, frequent infections, mental depression, easy breathless, sweaty feet, sweaty hand palms
Sweden 2017: Individuals with low education and low income have ☹ 60 % more disease ☹minus 9-10 years life span☹ affects also their children
USA: Garbutt JM et al. Clin Pediatr. 2012;51:840-847
CHRONIC DISEASES - Classrelated!
SOCIOECONOMIC STATUS & OUTCOME, – USAShea S et al. Plos One 2016; 11: e0165651.
EARN MORE – LIVE LONGER Chetty R et al JAMA 2016;315:1750-1766
”No elec t ion is won by pok ing
one's nose into people's f r idges”
Citat ion f r om Swedish conser vat ive gover nment
"Health is not a polit ic al is sue
– only healt hc ar e is .“
Citat ion f r om Swedish soc ialist gover nment minister .
HIGH BLOOD GLUC0SE PEAKS & POSTPRANDIAL INFLAMMATION
Freckmann G et al J Diabetes Sci Technol. 2007; 1:695–703 Erridge C et al Am J Clin Nutr 2007;86:1286 –1292
Minutes after meal
POSTPRANDIAL HYPERLIPIDEMIA IN METABOLIC SYNDROME
Alcala-Diaz JF et al. Plos One 2014;9:e96297
POSTPRANDIAL HYPERGLYCEMIA & HYPERLIPIDEMIA – THE INDUCER OF CHRONIC DISEASES
Ceriello A, Genovese S. Rev Endocr Metab Disord 2016;17:111–116
ENDOTOXIN - THE VILLAIN & ASSOCIATED DISEASES:
• Alzheimer Jaeger LB et al. Brain Behav Immun. 2009; 23: 507–17 • Cognitive impairment Lee JW et al. J Neuroinflammation 2008; 5: 37• Arterio-/Coronary Diseases Heo SK et al Immunol Lett 2008;120:57-64• Diabetes type 1 Nymark M et al Diabetes Care 2009 32(9): 1689–1693• Diabetes type 2 Andreasen AS Intensive Care Med. 2010;36:1548-1555• Cancer Hsu RY et al Cancer Res. 2011;71(5):1989-1998• Chronic Liver diesases Nolan JP Hepatology 2010;52:1829-1835.
ADHD, allergy, ALS, autism, autoimmune diseases, bipolar disease, cataracts, chronic fatigue syndrome, COPD, fibromyalgia, glaucoma, gulf war syndrome, HIV, iritis, macular degeneration, minimal encephalopathy, multiple sclerosis, nephropathies, obesity, osteoporosis, paradontosis, Parkinson, polycystic ovary syndrome, rheumatoid disease, stress, schizophrenia, stroke, uveitis, etc
Brix S et al J Allergy Clin Immunol 2015;135:277-280
Endotoxin in lungs
DYSBIOSIS-INDUCED METABOLIC DISORDERS Cani PD et al Diabetes 2008;57:1470-1481
LPS concentration 10 to 50 X higher than those obtained during septic shockMitaka C. Clin Chim Acta 2005; 351:17-29
Bifidobacterimspp.
LPS = ENDOTOXIN – THE VILLAIN
MINIMIZE POSTPRANDIAL INFLAMMATION1. Avoid long-chain fatty acids including olive oil. 2. Avoid highly processed foods and drinks containing sugar, high-fructose corn
syrup, white flour3. Keep servings modest & reduce the numbers of meals. 4. Avoid being overweight. 5. Eat daily salads of leafy greens dressed with vinegar + drink vinegar mixed with
water at your meals.6. Consume daily nuts, & eat vegetables, berries & fruits.7. Choose high-fiber, low GI foods - whole grains, legumes & vegetables & fruits.8. Eat lean protein at all meals – peas, beans, nuts, almonds or lean meat or fish.9. Obtain 30 min or more of daily physical activity of at least moderate intensity.10. Consider 1 red wine drink with some evening meals every week.
SKIPPING MEALS – INCREASING FAT BURNING/OXIDATION Nas A et al Am J Clin Nutr 2017;105:1351-1361
Skipping Breakfast Skipping Dinner Control 18 hours for burning of fat & detox
6 hours for supply of food
, Prof Martin Grootveld, Leicester, UK
Best - Number 1
Worst
THE MICR0BIOTA-OBESITY CONNECTION
Moran CP, Shanahan F Best Pract Res Clin Gastroenterol 2014;28:585–597
PLANT FOOD & MICROBIOTA & HEALTHDuranti S et al Genes & Nutrition 2017;1218:18
TREATMENT
”THE BATTLE FIELD”☹ POSTPRANDIAL INFLAMMATION
☹ GENERAL INFLAMMATION☹ CHRONIC DISEASES
Myles IA Nutrition Journal 2014;13:61”Ever ything in excess is opposed to Natur e. All disease begins in the gut ” HippocratesHi t
You ar e what you
eat ”
METABOLIC SYNDROME & DYSBIOSISTremellen K, Pearce K Med Hypotheses 2012;79:104-112
DIFFERENT MICROBIOTA IN OBESE vs LEANAngelakis E et al Future Microbiol. 2012;7: 91–109
GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606-613
☹ ↓ FFA oxidation☹ ↑ Endotoxin/s☹ ↓ SCFA production☹ ↓ Incretin secretion *☹ ↓ Butyrate production
☺↑FFA oxidation☺↓ Endotoxin/s☺↑ SCFA production☺↑ Incretin secretion☺↑ Butyrate production
* Incretin = hormone downregulating blood glucose
MICROORGANISMS:Yellow = beneficialGreen = pathogenic
BREAKING THE VICIOUS CIRCLEINFLAMMATION
INFECTION &DISEASE
Treatment alternatives: Antibiotics: Reduces infections but Deranges Microbiota & Creates Dysbiosis Intestinal Intestinal Reconditioning: Pro/Synbiotics restores Microbiota & REDUCES DEGREE OF CHRONIC INFLAMMATION
SYSTEMIC INFLAMMATIONFinch CE, Crimmins EM Science 2004; 305:1736–1739
Individuals with higher levels of inflammatory markers/s: C-reactive protein, fibrinogen, factor VIII activity, interleukin-6, TNF-α etc. but yet no obvious signs of disease, are candidates to develop ☹CHRONIC DISEASES &☹COMPLICATIONS TO DISEASE & TREATMENTS
☹ CLUSTERING & RISK PROFILE ☹Qvarnstrom M et al J Clin Periodontol 2010; 37: 805–811
ANTI - OBESITY FOODS ☺ Omega-3: inhibiting lipid synthesis & increasing thermogenesis (krill oil, flax seed)☺ Conjugated Linoleic Acid: increasing oxidation (mushrooms)☺ Phenolic compounds & Other Antioxidants; Catechin (blackberries, dark chocolat), Saponins (beans & legumes), Anthocyanins (eggplant/brainfood, black current, green bananas, cranberries, blueberries, asparagus) Isoflavones (soy beans)☺ Dietary minerals: Increasing adipocyte metabolism, reducing storage of fat & fecal fat excretion. (Soy/tofu, spring greens, spinach, watercress, broccoli, kale, chickpeas, almonds, sesame seeds, dried figs, currents).☺ Dietary fibres; promoting secretion of anorexigenic/appetite reducing
peptides (pectin, resistant starch, inulin, betaglucan)☺ Pro- and Synbiotics
PLANT FOOD PREVENTS CHRONIC DISEASESAune D. et al Int J Epidemiol 2017 E-pub Feb 22.
RECOMMENDATION for optimal health 1 – 1 ½kg/person/day
Eating 800 g fruit and vegetables a day –or 10 portions – is associated with:☺ 28 % reduced risk of cardiovascular disease☺ 24 % reduced risk of heart disease☺ 33 % reduced risk of stroke☺ 13 per cent reduced risk of total cancer☺ 31 % reduction in premature death
ADVANTAGES OF RAW FOOD VEGAN DIET Fontana L et al . Rejuvenation Res. 2007;10:225–234
Consuming a low-calorie low-protein vegan diet, composed of unprocessed and uncooked plant derived foods
Recruited from The St. Louis Vegetarian Society and a Raw Food online magazine (Raw Food News, www.rawfoods.newsmagazine.com).
SBP=Systolic blood pressure, DBP=Diastolic blood pressure, HOMO-IR=homeostatic model assessment - a method used to quantify insulin resistance and beta-cell function, hsCRP=high sensitive c-reactive protein –indicator of inflammation
”Couch potatoes”
“HARMONY
LIFESTYLE&
HEALTH
EXERCISE FOOD
REGULAR EXERCISE REDUCES MORBIDITY & MORTALITYGebel K et al JAMA Intern Med 2015;175:1863-1864
WHO’s guidelines suggest that “significant health benefits can accrue
through accumulation of at least 150 minutes of moderate activity per week”
661 000 persons followed during 14 years:No exercise – the highest mortality150 min/w moderate exercise, low speed - 20 %150 min/w moderate exercise, more speed - 31 %
450 min/w moderate exercise, more speed - 39 % ☺1500 min/w moderate exercise, high speed - 20 %
“GOOD FOR MICROBIOTA - GOOD FOR HEALTH
Avoid toxic substances: Alcohol, tobacco, pesticides, drugs, AGE & ALEs, casein, gluten, zein, refined sugars, flour etc
☺Avoid processed foods Eat fresh greens
☺ TRANSITION FROM AGRICULTUREAQVA- & HORTICULTURE-BASED
DIETAfter experiencing long-term health problems, including quadruple bypass surgery 2004, the former President & “junk food lover” was advised by his doctors to become a vegan. He radically changed diet ☺ shunning meat, eggs, dairy and almost all oils &☺ lost 20 lbs. in weight & improved his health.saying: "I like the vegetables, the fruits, the beans, the stuff I eat now“ "I feel good, and I also have … more energy."
HEALTHY FOODS – NEW TREND
ANTI-INFLAMMATION FOODS -examplesArtichokesAvocadoBerries:blackberries, blueberries, raspberries, strawberriesFermented, microb-enriched vegetablesGarlicGreen teaGreens: Kale, spinach, broccoli
Maitake mushroomNutmegParsleyPRE-, PRO- & SYNBIOTICSRed grapesSpices; cloves, Ceylon cinnamon, oregano, turmeric, chili pepperTomato
ISOFLAVONES IN SOY FOODS Food product
Total isoflavones
Daidzein Genistein
Soy flour, full-fat 177,89 71,19 96,83Soy flour, textured 148,61 59,62 78,90Soy flour, defatted 131,19 57,47 71,21Soybeans 128,34 46,46 73,76Soy protein concentrate 102,07 43,04 55,59Soy protein isolate 97,43 33,59 59,62Natto 58,93 21,85 29,04Soybean chips 54,16 26,71 27,45Tofu, fried 48,35 17,83 28,00Tempeh 43,52 17,59 24,85Miso 42,55 16,13 24,56Soybean sprouts 40,71 19,12 21,60Tofu, soft 29,24 8,59 20,65Tofu, silken 27,91 11,13 15,58
MICROBIOTA OF HUNTERER-GATHERERS – HADZAsSchnorr SL et al Nat Commun. 2014,5,3654
Paleolithic lifestyle (Hadza, Tanzania) leads to compared to European (Italians):☺Much greater Microbial Richness ☺Much Richer Biodiversity ☺ Absence of Bifidobacterium (no dairy?)☺ Enrichment: in Prevotella, Treponema & unclassified Bacteroidetes☺Most likely reflecting enhanced ability the Hadzas
to digest and extract valuable nutrition from fibrous plant foods.
MICROBIOTA FUNCTIONS: Amino acid biosynthesis for phenylalanine, tyrosine, tryptophan, & lysine is highly represented by multiple genes but also in precursor to amino acids such as glutamate, alanine, aspartate, pyruvate, glycine, serine, and threonine. Also rich in genes involved in branched-chain amino acid (BCAA) catabolic pathways. Rampelli S et al Curr Biol 2015;25:1682-1693
MICROBIOTA - AFRICAN & EUROPEANDe Filippo C et al Proc Natl Acad Sci USA 2010; 107:14691–14696
AMERINDIANS
MICROBIOTA DIVERSITY – ANCIENT CULTURESClemente JC et al Science Advances 2015 3;1
Yanomami
MALAWIANSGUAHIBO
HIGH FODMAP CONTENT: recommending avoiding:Lactose/milk sugar; milk, yogurt and ice creamFructose/fruit sugar; fruit, high-fructose corn syrup, honey and agave syrupSorbitol, mannitol, and other “-ol” sweeteners/sugar alcohols);certain fruits and vegetables & some sugar-free gums and candiesFOS/fructo-oligosaccharides, Fructans; bananas, onion, chicory root, garlic, asparagus, leeks GOS (galacto-oligosaccharides); artichoke, lentils, soy
Fruktos - Undvik: Äpple, päron, vattenmelon, fruktjuice, torkad frukt, honung. Välj i stället: Apelsin, kiwi, bär, honungsmelon, banan, druvor, ananas, jordgubbar.Laktos - Undvik: Mjölk från ko, get, får, glass, mjölkchoklad. Välj i stället: Laktosfria produkter, havre- och risbaserade produkter.Oligosackarider - Undvik: Ärtor, bönor, linser, lök, vitlök, vete, råg, korn. Välj i stället: Tomat, palsternacka, morot, squash, paprika, ris, potatis.Sockeralkoholer - Undvik: Tuggummi och halstabletter med xylitol och sorbitol, blomkål, sockerärtor, avokado. Välj i stället: Drycker sötade med sackaros, glukos, syntetiska sötningsmedel eller stevia.
Maccaferri S et al Dig Dis 2011;29:525–530
LEAKY BARRIERS• Gastrointestinal tract• Airways• Skin• Oral cavity• Vagina• Nose• Eye cavity • Placenta• Blood brain barriers
INFLAMMATION IN OBESE PREGNANT WOMENBasu S et al Obesity 2011;19:476-482
MCP1 IL-8 IL-6 TNFα Leptin CD14 TLR4 TRAM2
LEAKY PLACENTAA shocking 9/20 (43 %) of umbilical cord blood, cultivated from healthy neonates, born by cesarean section, demonstrate positive growth: Enterococcus faecium, Propionibacterium acnes, Staphylococcus epidermidis & Streptococcus sanguinis Jiménez E et al. Curr Microbiol 2005;51:270–274.
DEBRIS
Nicolaou G et al J Atheroscler Thromb 2012;19:137-1498
Bacteria & bacterial debris in human atheroma, in the past considered harmless, seems to contribute to disease progression via TLR- dependent lipid body formation in
h
THE MARCH from AGRICULTURE AQVA- & HORTICULTURE-based dietPresident Bill Clinton – now a veganradically changed diet, lost 20 lbs. in weight& improved his health, Clinton tells CNN.After experiencing periodic heart problems leading up to the 2004 surgery, the former junk food lover now calls himself a vegan, shunning meat, eggs, dairy and almost all oil saying: "I like the vegetables, the fruits, the beans, the stuff I eat now“ ☺"I feel good, and I also have … more energy."☺
PLANT-BASED DIET & CORONARY ARTERY DISEASEEsselstyn CB Prev Cardiol. 2001;4:171–177
• Safe: grains?, legumes, lentils, vegetables, fruits, nuts and seeds• Unsafe: oils, dairy foods, meat, poultry, & fish (frequently containing unacceptable levels of PCBs, dioxin, and mercury)
VITAMIN K IN FOODS micrg/100 grThyme, dried 1715Sage, dried 1700Parsley raw 1640Amaranth leaves 1160Kale raw 817Mustard greens, raw 497Spinach, raw 483Basil, fresh 413Beat greens, raw 400 Turnip greens, raw 251Lettuce, raw 174Broccoli raw 102
IGF-1, INFLAMMATION &☹ CHRONIC DISEASECarrera-Bastos P et al. Res Rep Clin Cardiol 2011;2:15-35
☹ The Neolithic Revolution, provided increasing access food to insulinotropic & IGF-1-raising foods; ☹ dairy products are rich in IGF1 ☹ grains & sugars induce synthesis of IGF-1. The human genome has not, and will not, adapt to the high levels of insulin/IGF-1 signaling. ☺ Modern man should attempt to develop a more Paleolithic type diet
IGF & TOLL-STIMULATORY FOODSExcess in refined, processed foods e.g. foods rich in IGF-1, and/or IGF-1 promoting & Toll-stimulatory (inflammation-inducing) foods:
☹ increase expression of inflammatory messengers ☹ reduce microbiota ☹ increase membrane leakages ☹ destabilize the immune system Contributory are: Lack of physical activity, mental and physical stress, Vitamin D deficiency, lack of anti-inflammatory minerals; Mg, Zn, Se, lack of omega-3 fatty acids etc. www.bengmark.com
DAIRY CONSUMPTION & IGF-1
The Endogenous Hormones and Breast Cancer Collaborative Group Lancet Oncol 2010; 11: 530–42☹ a positive association between intake of dairy
products or milk and IGF-I conc. reported in several cross-sectional studies☹ increase in IGF-I in response to a higher intake of milk and dairy products observed in both younger and older participants☺ IGF-I conc. found significantly lower in vegans compared with lacto-ovo-vegetarians and omnivores in the EPIC-Oxford cohort
Dennis Burkitt 1911 - 1993Suggested that Western diseases, rare in Africa are primarily the result of diet and lifestyle. ☹ Reported an association between low fibre in diet higher risk of colorectal cancer as well as other diseases such as CHD and diabetes
GI PERISTALSIS – UK vs UGANDAAppr GI transit time:
UK: 100 hrs vs Uganda: 20 hours Appr stool weight: UK 60 g/day vs Uganda 600 g/day Burkitt DP et al Lancet 1972;300 (7792):1408-11
British geriatric patients: ☹ GI transit time: >14 days in > half of the patientsBrocklehurst JC, Khan MY. Gerontol Clin 1969;11:293-300
DAVID JP BARKER 1838 – 2016The thrifty epigenotype hypothesis -Barker, D.J.P. Maternal Nutrition, Fetal Nutrition, and Disease in Later Life".
Nutrition, 1992;13: 807-813Curr Opin Nephrol Hypertens 1997; 6:106-110
We know that “disorders of adult life, including coronary heart disease, stroke and diabetes, arise through interaction between influences in our adult lifestyle and genetically determined susceptibility.”
☹ “Recent research, however, suggest that growth in utero may also play an important role” “Even brief periods of … may permanently change/`reprogramming´ the body…and lead to persistent changes in blood pressure, cholesterol metabolism, insulin response to glucose, and in a range of other metabolic, endocrine
d i t ”
Bygren LO et al Acta Biotheor 2001 ;49:53-59
FOOD INTAKE & INFLAMMATION ☹ Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES ☹ High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc.☹ High intake of heat- and storage-induced proteotoxins: glycated (AGEs), lipoxidated molecules (ALEs),processed carbohydrates induces: ☹ Dysbiosis: reduced numbers & diversity ☹Leakage of Various body membranes; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood-b i b i t
PROCESSED MEAT & RISK OF CANCEROesophageal cancer Salehi M et al Nutr Rev 2013;71:257-267, Huang W et al Cancer Causes Control 2013;24:193-201
Stomach cancer Larsson SC J Natl Cancer Inst 2006;98:1078-1087
Pancreatic cancer Larsson SC, Wolk A Br J Cancer 2012;31;106:603-607
Colorectal cancer Chan DS et al Plos One 2011;6:e20456
Bladder cancer Wang C, Jiang H Med Oncol 2012;29:848-855
Lung cancer Yang WS et al Ann Oncol 2012;23:3163-3170
Ovarian cancer Kolahdooz F et al Am J Clin Nutr 2010;91:1752-1763, Wallin A et al Br J Cancer 2011;104:1196-1201
PROCESSED MEAT AND HEART DISEASEMicha R et al. Circulation 2010;121(21):2271-2283
USA: Metaanalysis of 20/1598 totally including 1218380 individuals with 23889 cases of CHD, 10797 cases of diabetes mellitus and 2280 cases of stroke.Conclusion: Processed, but not unprocessed, meat is associated with 42% higher risk of CHD and 19% higher risk of diabetes mellitus (P<0.001). No association with stroke observed. Processing promotes ☹ vascular dysfunction and atherosclerosis, ☹ reduce insulin secretion, ☹ impair glucose tolerance.
USA: 37 698 men and 83 644 women (2.96 million person- years) followed for > 28 years. ☹ 20 % by eating processed meat: cured, bacon, sausages, paté meatballs, hamburgers etc Pan A et al Arch Intern Med 2012;172:555-563
EU: 448,568 men and women, age 35-69 studied during 13 years: ☹ A daily piece of steak is associated with a 13 % greater chance of dying during the study (13 years)☹ An extra daily serving of processed red meat linked to a 20 % higher risk of death during the study.☹ 72 % increased risk of dying in heart disease & ☹ 11 % increased risk of dying in cancer Rohrmann S et al BMC Medicine 2013;11:63
FISH INTAKE & HEALTH
☺ Vegetarians have a 22 % lower risk to get colorectal cancers; in the colon 19 %, in the rectum 29 % comp to non-vegetariansOrlich MJ Frazer GE et al JAMA Intern Med. 2015; 175:1727
☺ Meta-analysis shows that fish consumption is associated with a 63 % reduction in mortality such as prostate cancerSzymanski KM et al Am J Clin Nutr 2010;92:1223-1233.
LINKING DIETARY CHOLINE-RICH FOODS
(MEAT, FISH, MILK, EGG,) & PRODUCTION OF
TRIMETHYLAMINE(TMAO)
- a risk factor for
atherosclerosis Wilson Tang WH et al
l d
DAIRY-INDUCED INFLAMMATIONDietary proteins of cow´s milk induce inflammation:☹ release inflammatory mediators☹ increase intestinal permeability & ☹ induce leakage of large molecules; albumin, hyaluronan etc Jalonen T J Allerg Clin Immunol 1991;88:737, Isolauri E Gastroenterology 1993;105:1643, Bengtsson U et al. J Clin Exp Allerg 1996;26:197, Allerg Clin Immunol 1997;100:216
ESTROGENS IN MILK Malekinejad H et al J Agric Food Chem 2006;54: 9785-9791
Background: The dramatic increase in testicular, breast, prostate, ovarian, and corpus uteri, and large bowel cancers. 60-80% of the intake of estrogens originates in the Western world from milk and other dairy foods.The daily intake of total estrogens through milk is 372 ng/L
☹ “which is dramatically more than currently recognized.” ☹☹☹The content is twice as high in 3.5 % fat milk than in non-fat milk & extremely high in butter!
DIET AND BREAST CANCERCarroll KK Cancer Res 1975;35:3374-3383
THE JAPANESE EXPERIENCEThe age-adjusted death rate in ChDs
such as prostatic cancer rose in Japan during the period 1948 - 98
25-foldParallel to increases in intake of :
egg 7 X☹meat 9 X ☹ dairy 20 X
Ganmaa D et al Medical Hypotheses 2003;60:724-730
PROSTATIC CANCER
&MILK
CONSUMPTION
Ganmaa D et al Int. J. Cancer 2002,98,262–267
BOVINE MILK &
CORONARY HEART DISEASE
Artaud-Wild SM et al. Circulation 1993;88:2771-2779
PROSTATIC CANCER DEVELOPMENT IN EASTASIA Zho Y et al Asian J Androl 2015;17:48–57
BREAST CANCER: INCIDENCE & MORTALITY - 2030 Chajès V, Romieu I Maturitas 2014;77:7– 11
EARLY MILK CONSUMPTION & RISK OF PROSTATIC CANCERTorfadottir JE et al Am J Epidemiol 2012; 175:144-53
Iceland: 8,894 men born 1907 to1935 followed a mean 24.3 years & 1123 diagnosed with prostatic cancer 2,268 participants reported their milk intake in early, mid-, and current life. ☹Daily milk intake in adolescence associated
with a 3.2-fold risk of advanced prostate cancer (95% CI: 1.25, 8.28) suggesting that
☹frequent milk intake in adolescence increases risk of advanced prostate cancer later in life.
DAIRY & RISK FACTORS IN PROSTATIC CANCERAune D et al Am J Clin Nutr 2015;101:87-117
USA: In a Physicians Health Study, 21,660 men were followed for 28 years. 2806 men developed prostatic cancer & 305 died. ☹Total intake of dairy products was associated with
increased incidence of prostatic cancer (HR = 1.12)☹Larger intake of skim/low-fat milk was associated
with greater risk of nonaggressive prostatic cancer &
☹Larger intake of whole milk with fatal prostatic cancer & progression to fatal disease after
DAIRY INTAKE AND RISK OF CANCERLu W et al. Nutrition Journal 2016;15:91
Studies of 11 population-based cohort studies involving 778,929 individuals demonstrated that ☺ low total dairy intake reduced
relative risk of all cancers &☹ increase of whole milk significantly elevated risk of increased prostate cancer mortality with the RR of 1.43 (95 % CI 1.13–1.81, p = 0.003).
BOVINE MILK & CHRONIC DISEASESAllergy Rautava S, Isolauri EJ Pediatr Gastroenterol Nutr. 2004 Nov;39:529-535
Breast cancer Outwater JL et al Med Hypotheses 1997;48:453-461, Hjartåker A et al Int J Cancer 2001;93:888-893Colorectal cancer Manousos O et al Int J Cancer 1999;83:15-17, Ma et al J Nat Cancer Inst;2001:93:1330-1336
Chronic constipation Iacono G et al N Engl J Med 1998;339:1100-1104Coronary heart disease Briggs RD et al. Circulation 1960;21:538-542, Marshall T BMJ 2000;320:301-305
Diabetes type 1 Gimeno SGA, De Souza JMP Diabetes Care 1997;20:1256-1260, Virtanen SM et al Diabet Med 1998;15:730-738
Malabsorption O´Keefe SJD et al Am J Clin Nutr 1991;54:130-135
Ovarian cancer Larsson SC et al Am J Clin Nutr. 2004;80:1353-1357, Ganmaa D, Sato A Med Hypotheses. 2005;65:1028-1837
Parkinson disease Park M et al. Neurology 2005;64:1047-1051
Testicular and prostate cancerGanmaa D et al. Med Hypotheses 2003;60:724-730, Qin LQ et al Nutrition and Cancer 2004;48:22-27
CALCIUM I FOOD mg/100 g food - Daily need: 1000-1300 mg
Baking powder 11300Herb salt 3180 Parmesan cheese 1380Sesami seeds 980CHEESE 28 % 750Agar 600Nettles 490Persil 340Dill 343Peas 300 Beans 300Almonds 265Sunflower seeds 265Flax seeds 198
Sardines 190Brazil nuts 180CREAM135 MILK 120Digestive biscuits 110Fish 100Spinach 90Black current 90BREAD, wheat whole 48BUTTER 18HAMBURGERS10FRENCH FRIES 9
MAGNESIUM IN FOODS mg/100 grPumpkin &Squash seeds 540Cacao 20-22 % 520WHEAT bran 355Sesami seeds 350WHEAT germs 290Almonds 280Soya beans 265Cashew nuts 260Rosehip, dry 240Oat bran 235Peanuts 190Beans 190Peanuts 188
Lentils 80Spinach 79Prunes 52Avocado 41Banana 35CHEESE 35Broccoli 23FRENCH FRIES 35BREAD, whole wheat 24HAMBURGERS 20KETCHUP 18MILK 15CREAM 14BUTTER 3
MAGNESIUM DEFICIENCY – DANGEROUS MANIFESTATIONSMg involved in > 300 biochemical processes
Left untreated Mg deficiency will lead to more life-threatening conditions: hypertension, heart disease, stroke, type 2 diabetes, osteoporosis.
Mg known to prevent;☺ Obesity☺ Body aches, Muscle twitches ☺ Leg cramps, headaches and migraines ☺ Fatigue or low energy ☺ Restless sleep, Restless legs☺ Premenstrual syndrome ☺ Chronic bowel problems☺ Insulin resistance
HORMONAL ENVIRONMENTAL ”DISRUPTORS”
Up to 80 % of milk come from pregnant cows & contains significant amounts of: ☹ Pituitary hormones: PRL, GH, TSH, FSH, LH, ACTH ☹Steroid hormones: estrogen, progesterone, testosterone ☹ Hypothalamic hormones: TRH, LHRH, GnRH, GRH ☹ Gastrointestinal peptides ☹ Halogenated aromatic hydrocarbones ☹ Advanced glycation & lipoxidation end products
FREE ESTROGENS IN DAIRY pg/gWolford ST, Argoudelis CJ J Dairy Science 1979;62:1458-1463
E1 2 - 17β E3Whole milk 3.7 6.4 9.0 Skimmed milk 20.2 3.4 8.2 Whey 3.6 1.5 3.0
Cottage cheese 34.9 10.8 6.1 Butter 539.4 82.3 86.8
Compare 1266 322 51 Malekinejad H et al J Agric Food Chem 2006;54: 9785-9791
METABOLIC SYNDROME IN COWSHostettler-Allen RL et al J Anim Sci 1994;72:160-173
☹Modern feeds of dairy cows, less forage-based and rich in starch & carbohydrates (corn, maize grains, barley, molasses & dextrose)
☹ are likely to induce, also in cows ☹ Insulin resistance, observed in calves
fed on intensive milk- and lactose diet
ENTERAL NUTRITION INDUCES DYSBIOSISHaskel Y et al. Crit Care Med 1994;22:108-113
Synthetic clinical nutrition solutions induce:☹ loss of mucosal protein content☹ Leaky gut & intestinal microbial overgrowth☹ Criticare (Mead-Johnson) 67 %☹ Ensure (Ross Lab) 60 % ☹ Vivonex (Nestle) 53 %
"Cow's milk in the past has been oversold as the perfect food, but we are now seeing that it isn't the perfect food at all and the government really shouldn't be behind any efforts to promote it as such.“ Benjamin Spock, M.D., Los Angeles Times, November 18, 1992
“I would call milk perhaps the most unhealthful vehicle for calcium that one could possibly imagine, which is the only thing people really drink it for, but whenever you challenge existing dogma...people are resistant.“ Neal Barnard, M.D., Director of the Physician's Committee for R ibl M di i
BENEFITS OF PRE & PROBIOTICSDruarte C et al Adv Nutr 2014;5:S624-S633
1. JORDÄRTSKOCKETESTET. Jordärtskocka är liksom lök, vitlök, purjolök, sparris, kronärtskockor och banan rika på de mycket nyttiga men svårsmälta fiber som kallas fruktaner. Om Du kan äta en rå medelstor jordärtskocka utan att få tarmbesvär då kan man vara ganska säker att Du har en hyggligt fungerande tarmflora.
2. MOUNT EVEREST-testet. Om man har en bra fungerande tarmflora så är normalt att två gånger om dagen fylla toaletten med en större avföring. Moderna toalettstolar är inte byggda för ”paleolitisk” avföringen. Om man producerar tillräckligt med avföring så kommer toaletten bli lätt överbelastad –en liten ”alptopp” skall sticka upp över vattenytan och vattnet ”resa sig” något vid spolning.
3. MAJS/BLÅBÄRSTESTET. ”Paleolitisk” avföring tar cirka 20 timmar att ta sig från mun till anus. Lunchen ”kommer ut” mellan 8 och 9 nästa morgon och kvällsmålet mellan 12 och 13 nästa dag. Det kan man mäta genom att se när majs eller blåbär kommer ut igen.
FECAL TRANSPLANTATION Rao K, Safdar N J Hosp Med 2016;11:56-61
FLORA IN WESTERNERS☹ Lb plantarum, a dominating LAB, observed in only 25 % of omnivorous Americans & in 65 % of vegetarian Americans Finegold SM et al. Human intestinal microflora in health and disease Academic Press, London, UK, 1983. pp 3-31
☹ Benefial & common colonic LACROBACILLI present inonly in about 50 % or less of healthy Scandinavians:☹ Lb plantarum 52 % ☹ Lb rhamnosus 26 % ☹ Lb paracasei ssp paracasei 17 %
Ahrné S et al. J Appl Microbiol 1998;85:88-94
MICROBIOTA & OBESITYMillion M et al. Int J Obesity 2012;36:817-825
L. plantarum 0 (0%) 8 (18.2%) 0.0004 ☹L. paracasei 10 (14.7%) 17 (38.6%) 0.004 ☹L. reuteri 6 (8.8%) 1 (2.3%) 0.16 ☹L. rhamnosus 3 (4.4%) 4 (9.1%) 0.27L. ruminis 3 (4.4%) 4 (9.1%) 0.27L. salivarius 5 (7.4%) 2 (4.5%) 0.43
Obese (n=68) Controls (n=44) P-value
☹
Fei N, Zhao L. ISME J. 2013;7:880-884A Chinese man weighing 175 kg lost 51.4 kg after 23 weeks on VEGAN TYPE FOOD & recovered from hyperglycemia and hypertension. The endotoxin-producing Enterobacter cloacae B29 -found to constitute 35% of the gut bacteria -decreased to non-detectable.The Enterobacter cloacae inoculated in germfree mice induced obesity & insulin resistance.
THE GREAT Pswww.bengmark.com
☺ Lb Plantarum☺ Lb Paracasei ☺ Pediococcus pentosaceus
Lb paracasei – the master?☺ the strongest inducer of Th1 & repressor of Th2 cytokines when more than 100 strains are compared Fujiwara D et al. Int Arch Allergy Immunol 2004;135:205–215
CONTROL OF PATHOGENSThe ability of 50 different LAB to control 23 different pathogenic Clostridium difficiletested:
☹ 27 were totally ineffective☺18 antagonistic to some ☺ 5 effective against all:☺ 2 strains - Lb paracasei s. paracasei☺ 3 strains - Lb plantarum
Naaber P et al Med Microbiol 2004;53:551-554
FERMENTATION ABILITYThe ability of 712 different LAB to ferment oligofructans (inulin, phleins) studied: ☺ 16/712 able to ferment the phleins &☺ 8/712 able to ferment the inulin type fibre. ☺☺☺ Only four species had the ability to ferment both fructans : Lactobacillus plantarum (several),Lactobacillus paracasei subsp. paracasei, Pediococcus pentosaceus & Lactobacillus brevis☺☺☺Müller M, Lier D. J Appl Bact 1994;76:406-411
CHOICE OF LACTIC ACID BACTERIA (LAB) for SYNBIOTICS 2000
We harvested and studied the abilities of 536 LAB to control inflammation and infection 355 strains from humans180 strains from plants & CHOOSE☺ 3 strains from plants & 1 strain from humans www.bengmark.com
UNIQUE PROPERTIES OF LABs IN SYNBIOTIC 2000 ☺ All induce several Bioactive Proteins – five cross-react with stress proteins ☺ All transcribe NF-κB – to the largest extent L plantarum and L paracasei☺ All produce pro-inflammatory (IL-1β, IL-8) and anti-inflammatory (IL-10) cytokines, to a large extent L plantarum, and to somewhat less extent Leuconostoc mesenteroidesLjungh Å, Microb Ecol Health Dis 2002;3, Suppl 4:4 Kruszewska D et al Microecol. Ther. 2002;29:37
SYNBIOTIC 2000 & BETA-DEFENSINSWehkamp J et al Infect Immun. 2004;72:5750-5758
☺☺☺ SYNBIOTIC 2000☺☺☺Synbiotics AB, Sweden: www.synbiotics.se, [email protected]
➢ 400 billion Lactic acid bacteria:➢ 1010 of Pediococcus pentosaceus 5-33:3➢ 1010 of Leuconostoc mesenteroides 32-77:1➢ 1010 of Lactobacillus paracasei sbsp. paracasei➢ 1010 of Lactobacillus plantarum 2362➢ 10 gram bioactive fibers:➢ 2.5 g of betaglucan➢ 2.5 g of inulin➢ 2.5 g of pectin➢ 2.5 g of resistant starch
SYNBIOTIC 2000 INHIBITS GROWTH OF MULTIRESISTANT BACTERIAProfessor Val Edwards-Jones, Manchester, UK
Multi-resistant Acinetobacter baumanii Multi-resistant Klebsiella
SYNBIOTIC 2000 IN LUNG INJURYIlkgul O et al Br J Int Care. 2005;15:52-57
Placebo Only fibres ☺ Synbiotic 2000☺
SYNBIOTIC 2000 IN LIVER TRANSPLANTATIONRayes N et al. Am J Transplant 2005;5:125-131
50 to 85 % of transplant patients develop nosocomial infections within 30 days.Synbiotic 2000 or Only fibres daily from the day before surgery +during 14 postop days
30 day-infection rate: Synbiotic 2000 1/33 3 %
/
☺☺☺ SYNBIOTIC 2000 IN LIVER TRANSPLANTATION ☺☺☺ Rayes N et al. Am J Transplant
2005;5:125-131Isolated bacteria: Synbiotic 2000 Fibres onlyEnterococcus faecalis 1 11Escherichia coli 0 3Enterobacter cloacae 0 2Pseudomonas aeruginosa 0 2Staphylococcus aureus 0 1 Total 1 18
☺☺☺ SYNBIOTIC 2000 IN PANCREATECTOMY ☺☺☺
INFECTIONS: Control (Only fibers) 16/40 - 40 % Synbiotics 2000 5/40 - 13 % p< 0.05
Synbiotic 2000 Control Wound infections 4 6Peritonitis 0 5Pneumonia 0 4Urinary infections 1 1Sepsis 0 2Cholangitis 0 1
Empyema 0 1Total 5 20
R N t l A S 2007 246 36 41
☺
ISOLATED BACTERIA: Synbiotic 2000 FibresEnterobacter cloacae 2 8Enterococcus faecalis/faecium 1 7Escherichia coli 0 7Klebsiella pneumoniae 2 2Proteus mirabilis 1 1Staphylococcus aureus 0 2Total 6 27
Rayes N et al. Ann Surg 2007;246:36-41
☺
Oláh A et al Hepato-gastroenterology 2007;54:36-41Synbiotic 2000 Fibres Only
Total infections 9/33 ( 27 %) 15/29 ( 52 %) ☺Pancreatic abscesses 2 2Infected necrosis 2 6Chest infections 2 4Urinary infections 3 3SIRS 3 5MOF 5 9SIRS + MOF 8 14 p<0.05Late (>48h) MOF 1 5Complications 9/33 15/29 p<0.05Surgical drainage 4/33 ( 12 %) 7/29 ( 24 %)Mean hospital stay 14.9 ±6.5 19.7±9.3Dead 2/33 ( 6 %) 6/29 ( 18 %)
☺☺☺ SYNBIOTICS IN ACUTE PANCREATITIS ☺☺☺Oláh A et al Hepato-gastroenterology 2007;54:36-41
Isolated Microorganisms: SYNBIOTIC 2000 Fibres OnlyPseudomonas aeruginosa 1 4 Enterococcus faecalis 1 2Enterobacter spp 1 1Streptococcus spp 2 -Staphylococcus aureus 1 1Enterococcus faecium 1 -Candida spp - 2Staphylococcus haemolyticus - 1Serratia spp - 2Klebsiella spp - 1Escherichia coli - 1Stenotrophomonas maltophilia - 1Citrobacter freundii - 1Total 7 17
☺☺☺ SYNBIOTIC 2000 IN MULTIPLE TRAUMA ☺☺☺Kotzampassi K et al. World J Surgery 2006;30:1848-1855
102 patients supplied 15 days with either Synbiotic 2000 Forte or placebo The treated patients demonstrated reduced ☺ Mortality ☺ Rate of infection (P = 0.01)☺ Rate of SIRS & severe sepsis (P = 0.02) ☺ Numbers of days on mechanical ventilation (P= 0.001) ☺ ICU stay (P = 0.01)
☺
Spindler-Vesel A et al. JPEN 2007;31:119-126 TOTAL NUMBER OF INFECTIONS:Alitraq Abbott-Ross (glutamin + arginine) 16/32 50 % Nova Source Novartis (+guargum) 17/29 58 %Nutricomp peptide Braun (+peptide) 13/26 50 %Nutricomp standard ( + Synbiotic 2000) 4/26 15 %
NUMBER OF CHEST INFECTIONS: Alitraq Abbott-Ross (glutamin + arginine) 11/32 34 %Nova Source Novartis (+guargum) 12/29 41 %Nutricomp Braun (peptide) 11/26 42 %Nutricomp standard ( + Synbiotic 2000) 5/26 19 %
REDUCTIONS: INFECTIONS/POSITIVE BLOOD CULTURESLiver transplantation, 66 patients1
Patients with postop. infections 16 => 1 = 94 per cent Patients with pos. blood cultures 11 => 1 = 91 per centPancreatdoudenectomy for cancer, 80 patients2
Patients with postop. infections 16 => 5 = 69 per cent Patients with pos. blood cultures 27 => 5 = 82 per cent Severe pancreatitis – 62 patient3
Patients with infections 15 => 9 = 40 per cent Patients with pos. blood cultures 17 => 7 = 59 per cent Severe trauma, treated with Synbiotic 2000 Standard – 52 patients4
Patients with infections 3/30 (77 %) => 17/35 = 49 % per cent Severe trauma, treated with Synbiotic 2000 Forte – 72 patients5
Patients with post-trauma infections 13 => 5 = 62 per cent Patients with pos. blood cultures 13 => 5 = 62 per cent
REDUCTIONS: USE OF ANTIBIOTICS, ARTIFICAL RESPIRATION, TIME IN INTENSIVE CARE UNITS & IN HOSPITAL
Liver transplantation – 66 patients1
Days on Antibiotics 3.8 => 0.1 = 3.7 = 97 per centDays in ICUs 10.2 => 8.8 = 1.4 = 14 per cent Days in Hospital 27.9 => 27.8 = 0.1 = 3 per centPancreatdoudenectomy for cancer - 80 patients2
Days on Antibiotics 10 => 2 = 8 = 80 per centDays in ICUs 6 => 2 = 4 = 67 per centDays in Hospital 22 => 17 = 5 = 23 per centSevere acute pancreatitis – 62 patients3
Days in Hospital 19.7 => 14.9 = 4.8 = 24 per centSevere trama treated with Synbiotic 2000 Forte – 65 patients5
Days on Artificial Respiration 24 => 19 = 5 = 21 per centDays in ICUs 41.3 => 27.7 = 13.6 = 33 per cent
MULTI-STRAIN SYNBIOTICS IN DISTAL COLITISRectal application, 10 patients, studied before (D0) & 7 (D7), 14 (D14) and 21 (D21) days after treatment:
D0 D7 D14 D21Urgency 1.9 ⇒ 1.2 ⇒ 1.0 ⇒ 1.0Episodes of diarrhoea 2.4 ⇒ 1.3 ⇒ 0.9 ⇒ 0.8Nightly diarrhoea 0.5 ⇒ 0.1 ⇒ 0 ⇒ 0Visible blood 2.2 ⇒ 1.2 ⇒ 0.8 ⇒ 0.8Consistency of stool 1.1 ⇒ 0.9 ⇒ 0.7 ⇒ 0.8Pathmakanthan S, et al, Gut 2002; 51(Supp lIII) A307
ALLERGY, ADHD & GUT RECONDITIONINGErika Isolauri & Seppo Salminen
☺ 2001 – Mothers from families with high burden of allergies received during the last 2-4 weeks of pregnancy and the baby during first 6 mo Lactobacillus GGKalliomäki M et al. Lancet 2001;357(9262):1076-1079.☺ 2003 – 14/53(26 %) in the probiotic group and 25/54 (46 %) in the placebo group developed atopic eczemaKalliomäki M et al Lancet 2003;361(9372):1869-1871☺ 2015 - Probiotic-treated individuals showed no ADHD or Asperger syndrome - 0/40 = 0 %
☹ in contrast to placebo group - 6/35 17.1%) - about every 6th childPärtty A et al Pediatr Res. 2015;77:823-828.
COMMUNICATION BETWEEN THE GUT, GUT
MICROBIOTA & THE BRAIN
endocrine, neurocrine &
inflammation-related communications
Mayer et al J Neurosci2014;34:15490-15496
PSYCHO-NEUROLOGICAL DISORDERS & GUT CONNECTION
• ADHD Pärtty A et al Pediatr Res 2015;77:823-828.
• Autism Kraneveld AD et al. Int Rev Neurobiol 2016;131:263-287
• Alzheimer Alam MZ et al CNS Neurol Disord Drug 2013 E-pub
• Anxiety Luna RA, Foster JA Curr Opin Biotechnol 2015,32:35–41
• Chronic fatigue syndrome Frémont M et al Anaerobe 2013;22:50-56
• Encephalopathy Liu Q et al l
• Mental Depression Dinan TG, Cryan JF Neurogastroenterol Motil2013;25:713-719
• Myalgic encefalomyelitis Frémont M et al Anaerobe 2013;22:50-56
• Multiple sclerosis Ochoa-Repáraz J et al Gut Microbes 2010;1:103–108
• Parkinsons Disease Cersosimo MG et al J Neurol 2013;260:1332-1338
• Schizophrenia Severance EG Schizophren Res 2013;148:130-137
DIET, MICROBIOTA ANXIETY &
DEPRESSION
Luna RA, Foster JA Current Opinion in Biotechnology
2015, 32:35–41
DIET, MICROBIOTA
ANXIETY & DEPRESSION
Luna RA, Foster JA Curr Opin Biotechnol
2015,32:35–41
DYSBIOSIS IN EPILEPSIAErasistratus linked epilepsy to bowel dysfunction in the 3rd century BC.Ketogenic diet observed to be effective in seizures. Peterman MG. JAMA 1925;84:1979–83.Ketogenic antiepileptic effects
likely due to diet-induced NPY Mainardi P, Albano C. Med Hypotheses 2008;70:536-539
NPY release stimulated by nutrients in the gut. Fu-Cheng X et al. Pflugers Arch 1995;431:66–75Neuropeptide Y (NPY) is a potent & selectively inhibitor of excitatory synaptic transmission in the hippocampus Schwarzer et al Neuroscience 1995;69:831–45Fats - potent activators of NPY release in distal gut. Lin HC et al Peptides 2000;21:1561–1563
SonnenburgJustin & Erica
The Good Gut- Your weight- Your mood- Your health
Gut microbiota, immune
development and function
Bengmark S.Pharmacological
Research 2013 March;69:87-113
”Ever y man is the ar chitec t
of Her / His own health”
HEALTH: TWELVE COMMANDMENTS1. Limit/eliminate sugars, especially fructose, and sugar-like foods: bread, pizza, pasta, polished rice, warm cooked potato
& tubers. Cool before eating.2. Limit/eliminate diary products. 3. Limit red meat to 300 g/week. Avoid processed meat, pig meat, beef from supplement-fed animals and farmed fish.
Focus on wild fish, game meat and beef from grass-fed animals.4. Limit/eliminate intake of long-chain fatty acids and processed oils. Focus on plant fats such as cocos and avocado.5. Eliminate foods containing inflammation-inducing proteins: casein (diary), gluten (wheet, rye, barley) och zein (corn).6. Limit/eliminate heat-induced inflammation-inducing proteins – glycated and lipoxidated products - foods heated above
120-130 degree C. 7. Avoid exposure to microbial toxins such as endotoxin, pesticides and other poisons. 8. Limit your sodium & chloride salt intake - increase the intake of iodine. Avoid fluoride, bromide and reduce chloride.9. Limit/eliminate as much as possible exposure to chemicals including pharmaceutical drugs. 10. Focus on plant foods rich in proteins, fibres, antioxidants. Use grains such as amaranth, durrah, teff, quinoa, various
seeds, peas, beans, lentils, almonds and nuts. Germinate/sprout seeds,peas, beans, lentils, almonds and nuts for 12-24 hours.
11. Let the majority of your food (about 80 %) be fresh raw vegetables and fruits with low glycemic index, and anti-inflammatory spices and teas such as puerh, yerba & oliveteas. Supplement Vitamin D, omega3, turmeric and probiotics – the four corner stones of anti-inflammation. Supplement also iodine as KJ or Kelp.
12. Practise daily fasting as Peak fasting (intake of calories 6/24 hours) either as SKIPPING BREAKFAST (no food before noon) or SKIPPING DINNER (no food after 14 pm)
SYNBIOTIC 200040 billion Lactic acid bacteria:Pediococcus pentosaceus 5-33:3
Leuconostoc mesenteroides 32-77:1
Lactobacillus paracasei sbsp. Paracasei F19
Lactobacillus plantarum 2362
10 gram bioactive fibers:2.5 g of betaglucan
2.5 g of inulin
2.5 g of pectin
2.5 g of resistant starch
Price per dose: SEK 50,00Discounts:
More than 15 doses 10 per cent
More than 30 doses 20 per cent
http://synbiotics.se
SYNBIOTIC 1515 billion Lactic acid bacteria:Pediococcus pentosaceus 5-33:3Leuconostoc mesenteroides 32-77:1Lactobacillus paracasei sbsp. ParacaseiLactobacillus plantarum 2362
10 gram bioactive fibers:1.5 g of betaglucan1.5 g of inulin1.5 g of pectin1.5 g of resistant starch
Price per dose: SEK 18,50Discounts:More than 90 doses 10 per cent More than 180 doses 12.5 per cent
https://supersynbiotics.se/produkt/synbiotic15/
SYNBIOTIC 2000 FORTE400 billion Lactic acid bacteria:Pediococcus pentosaceus 5-33:3
Leuconostoc mesenteroides 32-77:1
Lactobacillus paracasei sbsp. Paracasei F19
Lactobacillus plantarum 2362
10 gram bioactive fibers:2.5 g of betaglucan
2.5 g of inulin
2.5 g of pectin
2.5 g of resistant starch
Price per dose: SEK 500,00Discounts:
More than 10 doses 10 per cent
More than 20 doses 20 per cent
http://synbiotics.se
PALEOLITHIC DIET“Much support that our genes, adapted during million of years to the lifestyle of our prehistoric ancestors badly tolerate the dramatic changes, especially in food habits, which have occurred”.
Eaton BS, Konner M. Paleotlithic nutrition: a consideration of its nature and current implications. N Engl J Med 1985;312:283-289
Contained more of: (X = times more) Minerals 2 X Fibers 4 to 10 XAntioxidants 10 XOmega-3 FA 50 X Lactic acid bacteria >1010 X
Contained less of:(X = times less)Protein 2 XSaturated FA 4 XSodium 10 X
DIET & LONGEVITYRobbins J: Healthy at 100: The Scientifically Proven Secrets of the
World's Healthiest and Longest-Lived Peoples
Read: http://thepdi.com/hunza_health_secrets.htm
80/10/10 DIET80 % raw greens
10 % vegetable fats (Medium-chain fatty acids as coconut fat & avocado)
10 % vegetable proteins(beans, peas, lentils, almonds, nuts, whole grains)
STORAGE & UTILIZATION OF ENERGYEASY ACCESS 1 – GLYCOGEN
Skeletal muscles 500 gr (2500 cal)Liver 100 gr (500 cal)
EASY ACCESS 2 – TRIGLYCERIDES Visceral fats up to 6 kg = app 55000 cal
DEPOT FAT – TRIGLYCERIDES Subcutaneous, slow release, examples: App 30 % fat (app 70 kg) = 190 000 calApp 50 % fat (90-100 kg) = 315 000 cal
App 90 % fat (635 kg) = 540 000 cal
PRESENT POOR EATING – POOR IMMUNITY PALEO
THE FRONT DOOR – SHORTCUT 1app 60 % are Sugar and Suger-like substances which
enters the body in upper jejunum via mainly the arterial system < 15 %
THE BACK DOOR – THE DANGEROUS ROUTEapp 30 % animal fats & vegetable oil enters via the the body via the lymphatic system and remains in circulation for hours > 10 %
THE MAIN DOOR< 20 % raw greens, vegetables, fruits are Foods for
Microbiota and reaches the large intestine after 2-3 hours, enhancing immune system &
preventing inflammation app 80 %
PREVENTING DYSBIOSIS IS KEY TO DISEASE & INFECTION CONTROLBrandtzaeg P et al Gastroenterology 1989;97:1562-84
☺A striking local preponderence (70-90 %) of IgA immunocytes in the gut: plasma cells, plasma blasts ☺The gut content is constantly tested by
recognition cells such as dentritic cells (DC) & ☺ Programming/tuning the immune
system ☺ Each DC commands about 1200 T-cells☹ If deranged microbiota - DYSBIOSIS & LEAKY GUT will induce INFLAMMATION
Per Brandzaeg 1936 -2016
DENDRITIC CELL & IMMUNE REGULATIONVan Baarlen P et al PNAS 2009;106:2371–2376
THE DENDRITIC CELL IN ACTION Kraehenbuhl JP, Corbett M. Science 2004;303:1624-1625
HIGH FAT DIET & MICROBIAL TRANSLOCATIONAmar J et al EMBO Mol Med 2011;13:559-572
Live intestinal bacteria found in large numbers in blood, adipose tissue (MAT) & mesenteric lymph nodes (MLN) after only one week on high fat diet (HFD)
CASEIN & GLUTEN IMPAIRS LACTOBACILLUS GROWTHWithout casein and gluten With casein and gluten
Dubos RJ, Schaedler RW J Exp Med 1962;115:1161-1172
GLUTEN & SURFACE MOLECULE EXPRESSIONSClass II, CD86, CD40, CD54 Nikulina M et al J Immunol 2004;173:1925-1933
100 µg/ml gluten matches the effects of 10 ng/ml LPS = ENDOTOXIN
GLUTEN-RELATED DISORDERSBiesiekierski JR, Iven J. Unit Eur J Gastroenterol . 2015;3:160
NCGS = ‘non-coeliac gluten sensitive’
A NEW ENTITY – NONCELIAC GLUTEN SENSITIVITY (NCGS) Sapone A et al. BMC Medicine 2011, 9:23
Often seen in diffuse often ignored distresses: lack of energy, mental depression, encephalopathy/‘foggy mind’, abdominal pain, bloating, diarrhea, eczema and/or rash, various headaches, numbness in the legs, arms or fingers, joint pain, fatigue etc.Gluten-free diet ☺ Increases energy, enthusiasm, well-being & ☺ Improves clinical signs. ☺Prevents & improve chronic diseases ☺Freedom of symptoms of several chronic diseases including a few
with THERAPY-RESISTANT EPILEPSY & NON-ALZHEIMER DEMENTIA
GLUTEN SENSITIVITY & CHRONIC DISEASESRuuskanen A et al. Scand J Gastroenterol. 2010;45:1197-1202Glutenoids affects genetic markers: HLA-B8, HLA DQ2, HLA DQ8, increase systemic inflammation
ADHD arthritis Addison´s disease allergyAutoimmune disordersAutismBipolar diseaseDermatitis herpetiformisDiabetes mellitus
EpilepsiaGraves´disease, infectionsInflammatory bowel diseases – IBDIrritable bowel syndrome – IBS
Mental depressionMyasthenia gravis
Obesity OsteoporosisPernicious anemia Polymyalgia rheumaticaPsoriasis Schizophrenia Scleroderma Sepsis Sjögren’s syndrome Thyreotoxicosis Vitiligo
NON-CELIACS & DYSFUNCTIONAL FLORATiellström B et al Scand J Gastroenterol. 2007;42:1204-1208
Children with celiac disease (CD) known to have an aberrant gut microflora. Non-CD relatives have compared to healthy controls impaired intestinal microbial metabolism significantly lower level of: ☹ acetic acid & ☹ total SCFAs ☹ increased level of i-butyric acid ☹ free tryptic activity (FTA)
Healthy controls
Relatives to individuals with celiac disease
GLUTEN-FREE DIET in TYPE 1 DIABETESMatteo-Rocco P et al. J Clin Endocrinol Metab 2003;88: 162–165
Gluten-free diet tried in 15 patients with diabetes type 1 but no gluten intolerance ☺ Insulin sensitivity increased significantly in 12/14 subjects after six months on gluten-free diet (P 0.04) & ☹ Decreased again in 10/13 subjects after another 6 months on “normal” diet (P=0.07)
GLUTEN-FREE DIET in IRRITABLE BOWEL SYNDROME Biesiekierski Jr et al. Am J Gastroenterol 2011;106: 508-514
EXCLUSION DIET (wheat + 15 other foods) IN ADHDPelsser LMJ et al Lancet 2011;377:494-503
Crossover study 100 children, aged 4-8 yrs, 9 weeks treatment + 4 weeks ”return” to previous diet
Total Inattention
Hyperactivity Connor scale
WHEAT: NEW & ANCIENT & IBSSofi F et al. Br J. Nutr. 2014;111:1992-1999
Abdominal pain Bloating
Stool consistancy Tiredness
Nausea
PROTEIN – ATIs (amylase-trypsin inhibitors) TRIGGERS INFLAMMATION
http://medicalxpress.com/news/2016-10-links-protein-wheat-inflammation-chronic.html ATIs – a non-gluten protein - app 4 % of wheat proteins –have strong inflammation-inducing abilities. ☺ A potent microflora should have ability de break down ATIs. ATIs known to induce:☹ Coeliac disease☹ Asthma☹ Multiple Sclerosis ☹ Rheumatoid arthritis ☹ Inflammatory bowel disease ☹ Non-coeliac sensitivity ☹ Systemic lupus erythematosus ☹ Autoimmune encephalomyelitis etc
ATIs – THE REAL VILLAINS Schuppan D, Zevallos V. Dig Dis. 2015;33:260-263
AMYLASE INHIBITORS INDUCE INFLAMMATIONJunker Y et al J Exp Med. 2012;209:2395-2408
LPS = Endotoxin
PROLAMINS & TRYPTOPHAN/CORTEX
Choi S et al Physiol Behov 2009;98:156-162
☹ An up to 8-fold decrease in cortex tryptophan & similar decrease in serotonin observed after feeding: ☹ Marked reductions; Zein (corn) ☹ Significant reductions: Casein (dairy) & Gluten (wheat, rye, barley)
Small reductions: Lactalbumin (dairy) ☺ Small increases: Vegetable protein (soy)
☺☺☺ ANCIENT GRAINS ☺☺☺
Amaranth – Aztec culture, high protein & mineral contentQuinoa – Inca culture, high protein & mineral contentSorghum (durrah, jowari, milo) - 5th in world, versatile, low energy, most cost-effectiveMillet – 6th highest in world, versatile, mild flavorTeff – staple in Ethiopia, tiny seed, high mineral content
SORGHUM (durrah, jowari, milo) – A SUPER GRAIN!Dykes L, Rooney LW Cereal Foods World 2007;52:105-111
Many thousend top athletes agree, among them the two best tennis players of the world –Novak Djokovic & Andy Murray -abstaining from gluten, lactose and processed carbohydrates, insisting that this gives them much greater energy.
VITAMIN D – FUNCTIONSHolick MF Mol Asp Med 2008;29:361–368
VITAMIN D – IMMUNE EFFECTS ☺ decrease T-cell activation & proliferation☺ inhibit dendritic cell maturation/
differentiation☺ induce tolerogenic dendritic cells Supplementing vitamin D reported to: ☺prevent acute and chronic diseases ☺improve allograft survival ☺decelerate loss of allograft function ☺ prevent acute rejection in transplantation
VITAMIN D & TELOMERIC AGINGVitamin D - a potent inhibitor of inflammation The difference in telomere length between the highest and lowest tertiles of vitamin D was 107 base pairs (P = 0.0009), equivalent to 5.0 years of telomeric agingRichards JB et al Am J Clin Nutr 2007;86:1420-1425
VITAMIN D DEFICIENCY & DISEASEAgingAllergyAlzheimer’s diseaseAsthmaAthletic performanceAutismCancerCavitiesColdsCrohn´s diseaseCystic fibrosis
Depression
Diabetes 1 and 2EczemaHeart diseaseHearing lossHypertensionInfertilityInfluenzaInsomniaMacular degenerationMigrainesMultiple Sclerosis
Muscle painMyopia
ObesityPeriodontal diseasePre-eclampsiaPsoriasisRheumatoid diseases SchizophreniaSeizuresSepticemiaTuberculosisVaginosis/fluor
VITAMIN D DEFICIENCY IN SURGERY85 % of patients undergoing hip or knee replacement Breijawi N et al Eur Surg Res 2009;42:1–1077 % of chronic pancreatitis patients Dujsikova H et al Pancreatology 2008;8:583–58657 % obesity surgery patients (79 % in black and Hispanic) Gemmel K et al Surg Obes Rel Dis 2009,5, 54–5967 % of renal transplantation patients Ducloux D et al Transplantation 2008;85: 1755–175995% of Afro-Americans undergoing renal transplantation Tripathy SS et al Transplantation 2008;85: 767–770
VITAMIN D IN BABIESArnberg K et al Acta Paediatr 2011;100:1244-1248
A cross-sectional study in 255 infants aged 9 months. 97 % received vitamin D supplementation. Mean plasma 25-hydroxyvitamin D: 77.2 ± 22.7 nM Association between vitamin D & low HDL (p = 0.003), low cholesterol (p = 0.002) and low triglycerides (p = 0.010), low body mass index (p = 0.005) and low waist circumference (p
0 002)
VITAMIN D & BREAST CANCERMohr SB et al Breast J 2008;14:255-60
AUTISM & LATITUDE Grant WB, Soles CM (latitude)Dermatoendocrinol. 2009;1:223-228
VITAMIN D & CANCER GROWTHSwami S et al Endocrinology 2012;153:2576-2587
.Mouse models of breast cancer and prostate cancer: vitamin D₃ and 1,25-dihydroxyvitamin D₃ (calcitriol) in large doses. (5000 IU/kg) & compared with a control diet (1000 IU/kg).
VITAMIN D & CHRONIC LYMPHOCYTIC LEUKEMIA PROGNOSISShanafelt TD et al Blood 2011;117:1492-1498
VITAMIN D & ALLERGY Sharief S et al J Allergy Clin Immunol 2011;127:1195-1202
VITAMIN D & ASTHMA IN CHILDREN Chinellato I et al J Pediatr 2011;158:437-441
☹ Only 9.4% of children with asthma have a sufficient vitamin/s (> 30 ng/mL). ☹ Children with well-controlled asthma have higher Vitamin D/s than children with un-controlled or partially controlled asthma (P = .023) ☺ A significant positive correlation exists between forced vital capacity & vitamin D/s (P = .040) ☺ A positive correlation exists between vitamin D/s and Childhood Asthma Control Test (P = .011)
VITAMIN D & CYSTIC FIBROSISRovner AJ et al Am J Clin Nutr 2007;86:1694 –1699
VITAMIN D & MATERNAL VAGINOSISBodnar LM et al J Nutr. 2009;139:1157-1161
VITAMIN D IN DEPRESSIONHögberg G et al Acta Paediatrica 2012;101:779-783
54 Swedish depressed adolescents. Mean serum 25OHD was 41 at baseline and 91 nmol/L (p<0.001) after oral supply of vitamin D during 3 months (4000 IU/d during 1 month and 2000 IU/d 2 months)
☺ Significant increases observed: Well-being (p<0.001) Depressed feeling (p<0.001)Irritability (p<0.05) (p<0.001) Tiredness (p<0.001) Mood swings (p<0.01)
Sleep difficulties (p<0.01) Weakness (p<0.05) Ability to concentrate (p<0.05) Pain (p<0.05) &Significant amelioration of depression according to the MFQ-S (p<0.05)
VITAMIN D PREVENTS INFECTIONS - INFLUENZA
TRAINING, VITAMIN D & MUSCLE POWERCarillo AE et al Clinical Nutrition 2012 E-pub
VITAMIN D DEFICIENCY – COSTSGant WB et al Prog Biophys Mol Biol 2009;99:104-113
36 % of direct and 28 % of indirect Health Costs associated with vitamin D deficience:☹ Cardiovascular 13.5 and 7.5 % resp☹ Infections incl influenza 7 and 6.5 % resp☹ Type 2 diabetes 7 and 2.4 % resp☹ Cancer 6.4 and 9.6 % resp☹ Osteoporosis 1.5 and 0.5 % resp☹Multiple sclerosis 1 and 0.2 % resp
SUBSTITUTING VITAMIN DGant WB et al Prog Biophys Mol Biol 2009, 99:104-113
to all European to 40 ng/mL would reduce ☺ the direct economic burden of disease by 11.4%, or EUR 105,000 000 000☺ the indirect economic burden of disease by 6.4 % or EUR 82,000 000 000 ☺ the total reduction in economic burden of disease by 17.7%, or ☺ EUR 187,000 000 000
PORTAL VEIN, THORACIC DUCT, HEPATIC ARTERYPORTÅDERN, STORA LYMFGÅNGEN, LEVERARTÄREN
Increase of chronic diseases 1850 – 2005 parallel to:100 % increase in consumption of animal fats 1500 % production of milk/cow -2 l/d => 30 l/d & intake of milk products 10000 % increase in intake of refined sugar ( 0,5 kg =>48 kg/p/y)
OMEGA-6/OMEGA-3 RATIO Simopoulos AP Mol Neurobiol 2011;44:203-215
• Reduces inflammation Lowers cholesterol
• Lowers triglyceride levels• Promotes weight loss• Promotes healing• Reduces pain• Improves skin• Increases joint mobility• Improves vision• Reduces soreness after training• Reduces risk of heart disease• Provides relief inflammatory
bowel diseases• May slow tumor growth• Eases the effects of Alzheimer’s
disease• Improves brain function • Stabilizes mood• Eases depression
Så här tyckte man på Bibelns tid.“Inget fett av fäkreatur, får och getter skall ni äta” 3 Mos 7.23”Man skall offra till Herren ..det fett som sitter på inälvorna liksom leverfetter och båda njurarna.” 3 Mos 7.3 resp 8.16
MAJSOLJA
RAPSOLJA
TISTELOLJA
SOLROSOLJA
LINFRÖOLJA
REDUCE/AVOID!EXCELLENT SOURCES!
SATURATED FATTY ACID METABOLISMMCFA: Coconut Oil 85,2, Palm kernel oil 81,5, Palm Oil 45,3, Olive Oil 14.5 (70 %
monosaturated) LCFA: Animal fats
POSTPRANDIAL LIPIDEMIA & INFLAMMATIONKhor A et al Nutr Res. 2014;34:391-400
☹ Postprandial inflammatory activity is a strong risk factors for atherosclerosis (& other chronic diseases) Ebenbichler CF Curr Opin Lipidol 1995;6:286–290
☹ Increased content of endotoxin in blood (eqv to smoking 3 cigarettes) & Erridge C et al Am J Clin Nutr 2007;86:1286 –1292 &
☹ Cascades of inflammatory and oxidative stress Ceriello A et al. Diabetes 2004;53:701–710 &
☹ Release of tumor necrosis factor-α, a key proinflammatory cytokine Erridge C et al Am J Clin Nutr 2007;86:1286 –1292 &☹ Increased numbers of & activates leukocytes Alipour A et al Arterioscler Thromb Vasc Biol 2008;28:792–797 &
☹ Inflammatory reaction potentiated by simultaneous intake of sugar Ceriello A et al. Diabetes 2004;53:701–710
POSTPRANDIAL METABOLISM – EFFECT OF VINEGARMitrou P et al Eur J Clin Nutr 2015;69:734-739
INSULIN TRIGLYCERIDES
POSTPRANDIAL INFLAMMATION & ENDOTOXEMIA
Erridge C et al Am J Clin Nutr 2007;86:1286 –1292
FAT UTILIZATION ➔ 72 HRSSoeters P et al Am J Physiol Endocrinal Metab 2012;303:E1397-1407
“CONTENT
FOOD&
HEALTH
AMOUNT TIME
DAILY FASTING – IMPORTANT FOR BODY RENOVATION
DAILY FASTING – IMPORTANT TO:☺ Burn off the excess body fat☺ Reduce & eliminate toxins & poisons body☺ Eliminate bad proteins☺ Regenerate body organs & restore functions
APOPTOSIS PROGRAMMED CELL DEATH – ESSENTIAL FOR:
☺ fetal growth ☺ correct architecture of organs and tissues☺ maintenance of organ homeostasis & functions☺ development of a normal immune system &☺ control of chronic inflammatory conditions such as ulcerative colitis and Crohn’s disease, rheumatoid arthritis and many others
AUTOPHAGY - CLEANING/RESTORATION ☹ Accumulation of junky proteins seen in chronic conditions & especially in Alzheimer´s Disease (amyloid beta or Tau protein) and cancer☹ Autophagy is turned off (dormant) by eating protein, glucose, insulin, low glucagon☺ Starvation/fasting turns on autophagy☺ Lysosome – a part of the cell - contains enzymes which degrade proteins.☺ One key regulators in both directions is an enzyme (kinase) called mammalian target of rapamycin (mTOR).
BENEFITS OF DIURNAL FASTING☺ Reduces oxidative stress/inflammation ☺ Normalizes "the hunger hormone“ – ghrelin☺ Normalizes insulin and leptin sensitivity ☺ Normalizes fat, sugar and protein metabolism☺ Boosts mitochondrial energy efficiency☺ Minimizes damage to cellular proteins, lipids & nucleic acids☺ Reducing disease and premature aging☺ Improves various biomarkers of disease
MICROBIOTA & DIURNAL RHYTMFeehley T, Nagler CR Nature 2014;514:176-177
DIURNAL RHYTHM &
MICROBIOTIC FUNCTIONS
Liang X et alCell. 2014;159:469-70
DIURNAL RHYTHM MICROBIOTIC FUNCTIONS
&FECAL
TRANSPLANTATION
Liang X et al. Cell. 2014;159:469-70
DAILY FASTING REDUCES OBESITY & IMPROVES HEALTHHatori M et al Cell Metabolism 2012;15: 848-860
MICROBIOTA, METABOLISM & DIURNAL RHYTMThaiss CA et al Cell. 2014;159:514-529
DIURNAL CONTROL OF GENE ACTIVITYPlikus MV et al J Biol Rhythm 2015;30:163-182.
GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606-613
☹ ↓ FFA oxidation☹ ↑ Endotoxin/s☹ ↓ SCFA production☹ ↓ Incretin secretion *☹ ↓ Butyrate production
☺↑FFA oxidation☺↓ Endotoxin/s☺↑ SCFA production☺↑ Incretin secretion☺↑ Butyrate production
* Incretin = hormone downregulating blood glucose
MICROORGANISMS:Yellow = beneficialGreen = pathogenic
INTERMITTENT FASTING & WEIGHTHatori M et al Cell Metabolism 2012;15: 848-860
NA=normal diet, free access, FA= free access to fat diet, NT & FT=time-restricted normal or fat diet
SKIPPING BREAKFASTvs.SKIPPING DINNER
human study – 17 participants
Nas et al Am J Clin Nutr 2017 E-pub
Fat oxidation
Carb Oxidation
Energy expenditure
Control
DIURNAL CHRONOBIOTICS PREVENTS & DELAYS ALZHEIMERS DISEASELaundry G, Liu-Ambrose T Front. Aging Neurosci 2014 Dec 8;6:325.
BLT = Bright light therapy
DAILY FASTING –AVOIDING LATE
NIGHT EATING AND SKIPPING
BREAKFAST – long-term effects
Zilberter T, Zilberter EYFront Public Health 2014;2:59
BREAKFAST – NOT YOUR MOST IMPORTANT MEAL?
PREVENTING & REVERSING AGING
☺ Premature ageing reversed by reactivating an enzyme, telomerase, that protects the tips of chromosomes.☺ Telomerase activity significantly increased following physical & psychological stress & poor eating☹ Inactivating telomerase will increase tumor growth by enabling cancer cells to use sugar & increase growth rate.☹ Inactivating telomerase leads to upregulation of app. 70 genes known or suspected to promote cancer growth and spreading through the body.
TELOMERESMayor S BMJ 2009;338:a3024
TELOMERES & HEALTHRichards JB et al Atherosclerosis 2008;200:271-277
☹Oxidative stress & chronic inflammation reduce the length of telomeres & promotes aging and chronic diseases (ChD)
☹ Leukocyte telomere length (LTL) inversely associated with: glucose/s, insulin, blood pressure, Il-6 carotid intima-media thickness most chronic diseases
☹☹☹ TELOMERIC STATUS – OBESITY ☹☹☹Kim S et al Cancer Epidemiol Biomarkers Prev 2009;18:816-820
TELOMERIC AGING & ATHEROSCLEROSISFitzpatrick AL et al Am J Epidemiol. 2007;165:14-21
Each shortened kilobase pair corresponds in younger subjects to with a threefold increased risk of:
☹myocardial infarction (hazard ratio = 3.08) &
☹Stroke (hazard ratio = 3.22)
HOMOCYSTEINE & TELOMERIC AGINGRichards JB et al Atherosclerosis 2008;200:271-277
The difference in length between the highest and lowest tertile of homocysteine levels was 111 base pairs (p = 0.004) eqv. to 6.0 years of telomeric aging & associated with ☹ decreased folate/s & ☹ increased C-reactive protein/s
( / )
AGING
Cherkas LF et al Arch Intern Med. 2008;168:154-158
☹ LTLs of most physically active subjects are 200 nucleotides longer than those of the least physically active subjects (p = .006) = about 10 yrs☺ LTLs of active twins are 88 nucleotides longer than that of less active twins (p 03)
SOCIOECONOMIC STATUS & TELOMERIC AGING Cherkas LF et al Aging Cell. 2006;5:361-365
☹ Low socio-economic status (SES) associated with harmful effects of smoking, obesity and lack of exercise & shorter life expectancy ☹ The mean difference in LTL between non-manual and manual groups was 163.2 base pairs (bp) (app 8 yrs) of which app 14 % (22.9 bp) was accounted for by higher BMI, smoking & lack of exercise
SOCIOECONOMIC STATUS & HEALTHKrieger N et al PLoS Med. 2005 Jul;2(7):e162
Analyses of 308 female twin pairs The working class twin fared worse & showed compared to her professional twin significantly higher :☹ Systolic blood pressure☹
TELOMERE LENGTH & PESSIMISM O´Donovan A et al. Brain Behavior, Immunity 2009;23:446-449
TELOMERE LENGTH & OMEGA-3 LEVELSFarzaneh-Far R et al JAMA. 2010;303:250-257
VITAMIN D & TELOMERIC AGINGRichards JB et al Am J Clin Nutr 2007;86:1420-1425
☺ Vitamin D - a potent inhibitor of inflammation & strongly associated with telomere length☹ The difference in telomere length between the highest and lowest tertiles of vitamin D was 107 base pairs (P = 0.0009), equivalent to 5.0 years of telomeric aging
David Perlmutter, MD,FACN, ABIHM is a Board-Certified Neurologist and Fellow of the American College of Nutrition
• Richard J Johnson, MD Professor and Chief of Nephrology, University of Colorado, Denver
GOVERNMENTAL SUBSIDIESGood Medicine 2007;16, number 4
HEALTH CARE COST INFLATION - USA from 2002: $ 5,440 pp to 2020: app $ 15000
= 280 vs 35 %Health Care costs were in 2002 $1.6 trillion = $
5,440 pp and were forecasted to be:
☹ 2011: $ 3 trillion-$ 10880 pp ☹ 2020: $ 4.8 trillion-$ 15000 pp =☹ 50 % of average family income after tax.
Heffler S et al. Health Aff (Millwood) 2002;21:207-218
COSTS FOR OBESITY TREATMENT - USA☹ The directs costs of treating obese is compared to lean 42 % higher Finkelstein EA et al. Health Affairs, 2009;28:822-831.☹Treatment of obesity $147 - $210 bill/ year
Cawley J and Meyerhoefer C. J Health Economics, 2012;31:219-230. ☹ Absentism – another $4.3 bill/year Cawley J, et al. J Occup Environ Med 2007; 49:1317-1324☹ Reduced productivity – a burden for the employer -$ 506 per fat employee/year Gates D. et al Occ Envir Med, 2008;50:39-45
Investment of $10 pp/py in proven community-based disease prevention programs with improvements in physical activity, nutrition, and prevensmoking and other tobacco could yield net annually savings in health ccosts:☺ more than $2.8 billion in 1-2 years, ☺ more than $16 billion within 5 years, ☺ nearly $18 billion within 10 - 20 years
Prevention for a healthier America: Investment in Disease Prevention yield Significant Savings, Stronger Communities Washington, D.C.: Trust for America's Health, 2008.
THE DILEMMA: PHARMA & MICROBIOTA ARE INCOMPATIBLE!☹ Antibiotics destroys about 90 % of microbiota functions: bile acid metabolism, eicosanoid and steroid hormone synthesis etcCaetano L et al. Antimicrob Agents Chemother. 2011;55:1494-1503
☹ Chemotherapeutics reduces microbiota 100-fold; decrease anaerobic bacteria up to 10,000-fold & increase in PPMs 100-foldVan Vliet MJ et al. Clin Infect Dis 2009;49:262-270
☹ Pharma as proton pump inhibitors (peptic ulcer) during pregnancy increase the risk of offspring getting asthmaAndersen AB et al. Aliment Pharmacol Ther 2012;35:1190-1198
☹ Anti-hypertensives induce gastrointestinal dysbiosis & reduce mucosa protection, espec. mucus production Nonzee V et al J Med Assoc Thai 2012;95:96-104.
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460 – 370 BC
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