Pea & Rice ProteinFormulated to reduce insulin resistance

P < 0.001Gannon et al., 2003 Am J Clin Nutr

Higher levels of protein improves A1c levels

1. Abou-Samra R, Keersmaekers L, Brienza D, Mukherjee R, Macé K. Effect of different protein sources on satiation and short-term satiety when consumed as a starter. Nutr J. 2011;10:139.

2. Diepvens K, D Haberer D, Westerterp-Plantenga M. Different proteins and biopeptides differently affect satiety and anorexigenic/orexigenic hormones in healthy humans. Int J Obes (Lond). 2008;32(3):510-518.

Multiple studies demonstrate that pea protein promotes satiety 1,2

It’s not that diabetes, heart disease, and obesity runs in your family. It’s that NO ONE runs in your family.

The influence of diabetes mellitus on clinical and structural outcomes after arthroscopic rotator cuff repair

• Sustained hypoglycemia increased the possibility of anatomical failure at the repaired cuff

• An effective glycemic control associated with better rate of healing after rotator cuff repair

Nam Su Cho, Seong Cheol Moon, et al. Am J of Sports Med, 43(4):991-7

Inhibition of MMPs

• Patients with metabolic syndrome, type-2 diabetes, hypertension, dyslipidemia and obesity have a generalized elevation of MMPs

• Research demonstrated that patients with the metabolic syndrome and type-2 diabetes have an increased risk of expressing disc herniation

• AGEs associated with hyperglycemia have been identified as promoters of disc herniation

Hopps E, Caimi G. Matrix metalloproteinases in metabolic syndrome. Eur J Intern Med, 2012;23(2):99-104Jhawar BS, Fuchs CS, et al. Cardiovascular risk factors for physician-diagnosed lumbar disc herniation. Spine J, 2006;6:684-91Sakellaridis N, Androulis A. Influence of diabetes mellitus on cervical intervertebral disc herniation. Clin Neurol Neurosurg, 2008;110:810-2Tsusu M, et al. Effect of AGEs on human disc herniation: intervertebral disc hernia is also effected by AGEs. Kurume Med J, 2002;49(1-2):7-13Jazini E, et al. Alterations in magnetic resonance imaging T2 relaxation times of the ovine intervertebral disc due to non-enzymatic glycation. Spine, 2012;37(4):E209-15

Mediterranean Diet for Diabetes

• Adhering to Mediterranean-style diet may help reduce risk for type-2 diabetes, even when people don’t lose weight or increase exercise levels

NYTimes.com

Lifestyle Changes Staves Off Diabetes, Death

• 6-year lifestyle intervention decreased incidence of diabetes, cardiovascular mortality, and all-cause mortality in adults with impaired glucose tolerance

The Lancet Diabetes & Endocrinology online

• During 23 years of follow-up, individuals in the intervention group had a 45% lower risk of developing diabetes

• Had a 41% decrease in cardiovascular mortality

Environment: Blood Sugar Balance & PMA

• Reduce Stress Related Insulin Production:• Two minutes after you experience stress, your body starts

producing cortisol. This triggers insulin production that lowers your blood sugar, which in turn increases your cravings for high GI foods. “I eat when I’m stressed.”

• Blunt Cortisol production with Adaptogenic Herbs (licorice, ashwaganda, rehmannia) Whey protein, or breathing techniques.

Protocol

Acid / Alkaline Balance

pH Balance & Premature Aging

APO –ENZYMES(Inactive)

ACTIVE ENZYME

COMPLEX

ENZYMECO-FACTORS

(vitamins, minerals, etc)

pH Balance & Premature Aging

APO –ENZYMES(Inactive)

MUCH LESSACTIVE

ENZYME COMPLEX

ENZYMECO-FACTORS

(vitamins, minerals, Etc)

Acidic pH < 7.0(Salivary)

pH Balance & Premature Aging

APO –ENZYMES(Inactive)

MUCH MOREACTIVE

ENZYME COMPLEX

ENZYMECO-FACTORS

(vitamins, minerals, Etc)

Alkaline pH > 7.0 (Salivary)

Key Concept

Even if the

nutrient cofactors

are available to

catalyze the

enzymatic

reactions, the

enzyme activity

will be greatly

diminished if the

body pH is not

optimal

With all the vitamins that I take,

why do I still feel lousy?

• pH balance and acid buffering are critical to human health and slowing the aging process

Whole Body Alkalization

5.8 & belowDangerous Range. Seek assistance of a licensed professional

6.0 – 6.2Unhealthy Range. Consider proper dietary changes

6.4 – 6.8Moderate Range. Consider slight dietary adjustments

7.0 – 7.4Optimal Rangefor a 24-hour period

8.0 – 9.0Too Alkaline. While not common, this is unhealthy

pH Balance & PMA

Salivary pH as a marker of plasma adiponectin concentrations in women

Conclusion:

• Results suggest that salivary pH is significant correlate of plasma adiponectin levels in women

• Salivary pH – a simple, inexpensive and noninvasive measure, could be promising avenue

Tremblay M, et al. Diabetol Metab Syndr. 2012

Most People Over 40 Are Acidic

• Most people’s diet and lifestyle are acidic

• Foods – dairy, meats, trans-fats, cooked oils, refined sugars, coffee, and carbonated drinks

• Stress, drugs, alcohol, stimulants are acidic

Most People Over 40 Are Acidic (cont’d)

• Research conducted at University of San Francisco Department of Medicine revealed:a) As we get older, our bodies accumulate acid wastes

b) Significant decreasing alkaline reserves from age 20 to 90

c) Alkaline reserves remain fairly constant until 40, at which point they decrease significantly

d) Most adult degenerative diseases (obesity, diabetes, CVD, osteoporosis) appear at age 40

e) Believed that examination of alkaline reserves warranted consideration for these diseases

J. Gerontology A Biol Sci Med Sci. Jan 1996, 51(1):B91-9

Smart Evaluations: Total ORACFN

Free Radical “Most Wanted” List: Nutrients to counteract

Hydroxyl• Most reactive of the ROS• Incapable of elimination by

body’s endogenous enzymes

Linked to DNA damage & cancerTurmeric, garlic, basil, oregano, cinnamon

Peroxyl Associated with CVD/atherosclerosisBroccoli sprout, onion, tomato, carrot, spinach, kale, Brussel sprouts

PeroxynitriteChronic inflammation & breakdownof vital proteins (collagen)

Acerola, quercetin, acai, mangosteen

Singlet oxygen Linked to cholesterol problems & CVDBlackcurrant, blueberry, cherry, acai, blackberry, raspberry

Super oxide anionToxic-free radicals leading to DNA damage & mitochondrial diseases

Apple, elderberry, blue corn

Whole Body Alkalization (cont’d)

• Acid/alkaline balance – helps entire internal biochemical environment

Formulation with combination of select phytonutrients, vitamins and minerals demonstrated to increase total functional ORAC

Daily organic superfruit and greens

Potassium citrate

Glutamine

Project Implementation

Incorporating Natural Approaches

for Detoxification and

Anti-Aging

The Hidden LoadWhat’s invisible ishurting us!

More than 287

toxic chemicalshave been found in newborn cord blood

“Specific genes are turned on and off at certain time intervals, and any disruption of this finely-tuned DNA methylation regulation may persistently alter

gene expression. The fetal epigenome is most susceptible during this developmental period to epigenetic modifiers in the maternal environment. An error during such a crucial time might lead to an abnormal phenotypic outcome

in the offspring.

Kanherkar, et al. Epigenetics across the human lifespan. Frontiers in Cell and Developmental Biology September 2014 (2):49

Exposure to Toxins

• Polybrominated diphenyl ethers (PBDEs): used as flame retardant

• Bisphenol A (BPA): packaging plastics

• Perfluorooctanoic acid (PFOA): non-stick cookware

• Acrylamide: a) carbs at high temperature; b) coffee

• Mercury: seafood

• Methyl tert-butyl ether (MTBE): a) second-hand smoke; b) gasoline additive

Association between urinary Bisphenol A concentration and obesity prevalence in children and adolescents

Conclusion: Urinary BPA concentration was significantly associated with obesity in this cross-sectional study of children and adolescents

JAMA 2012:308(11):1113-1121

Bisphenol A may cause

testosterone reduction by adversely

affecting both

testis and pituitary systems similar to estradiol

Toxicol Lett. 2010 Apr 15;194(1-2):16-25. Epub 2010 Feb. 6

Cash Register Receipts – A Source of BPA

http://dx.plos.org/10.1371/journal.pone.0110509

BPA is an Ovarian Toxicant

• “I think more scientists working today agree that BPA is an ovarian toxicant” – Dr. Flaws

• Review research published in Environmental Health Perspectives: ovarian toxicity among the most consistent and strongest effects found “in both animal models and in women”

BPA alternative disrupts normal brain-cell growth, is tied to hyperactivity

University of Calgary: Thinks it’s research is first to show that bisphenol-S – ingredient in many products bearing “BPA-free” labels – causes abnormal growth surges of neurons in an animal embryo

Health & Science

BPA substitute can trigger fat cell formation: Chemical used in BPA-free products exhibits similar endocrine-disrupting effects

The Endocrine Society, Mar 22, 2016

Reduce Your Exposure

Detox Your Body

26 Seconds.

Is all it takes

for the chemicals in your

personal care products to enter your bloodstream.

What’s in YOUR products?

Phase II Pathways

• Sulfation – toxins attach with sulfur compounds. Primary cortisol pathway

• Glucuronidation – glucuronic acid combines with toxins. Primarily aspirin pathway

• Glutathione conjugation – the attachment of glutathione to toxins to detoxify fat soluble toxins

• Acetylation – acetyl co-a is attached to toxins

• Amino acid conjugation – conjugation of toxins with amino acid xenobiotics

• Methylation – involves conjugating methyl groups to toxins. **estrogen**

Phase II Detox Pathways

Phase II System Inhibitors Sulfation NSAIDs, tartrazine (yellow foods dye),

molybdenum deficiency

Glucuronidation Aspirin, probenecid (drug used to treat gout)

Glutathione conjugation Selenium deficiency, vitamin B2 deficiency, glutathione deficiency, zinc deficiency

Acetylation Vitamin B2, B5 or C deficiency

Amino acid conjugation Low protein diet

Methylation Folic acid or vitamin B12 deficiency

Phase II Detox Pathways

Phase II System Required Nutrients InducersSulfation Cysteine, methionine,

molybdenumCysteine, methionine, taurine

Glucuronidation Glucuronic acid Fish oils, cigarette smoking, BCP, limonene-containing foods

Glutathione conjugation Glutathione, vitamin B6 Brassica family foods, limonene-containing foods

Acetylation Acetyl-CoA None found

Amino acid conjugation Glycine Glycine

Methylation S-adenosyl-methionine Lipotropic nutrients (choline,methionine, betaine, folic acid, B12)

10-Day

1) Nutritional Detox Powder

Regulating nutrients:

• L-Cysteine

• Magnesium

• Support optimal function of Phase I and Phase II enzymes

Antioxidants for support of Phase II:

• Comprehensive vitamin profile, including vitamins A, C, E and a broad spectrum of B vitamins help neutralize reactive intermediary compounds

• Pantothenic acid supports the production of ATP to power the reactions

10-Day Detox

2) A capsular formulation to support detoxification: supports detoxification. Provides bifunctional support to enhance the activities of several liver detox enzymes while promoting balanced activity of Phase I and Phase II detox pathways

3) Eating plan: a modified elimination diet rich in vitamins, minerals, and phytonutrients reduces the allergen and toxin load, helping the body to detoxify efficiently:

a) Listing of foods to choose from for Days 1 – 10b) Sample recipes/menu plan for each dayc) 3 meals a day

Take a Probiotic to Detoxify the Body

• Two new studies: taking a probiotic can help body detoxify

• Nutrition journal: 1) Probiotics help detoxify body of heavy metals, free radicals, and

dangerous bacteria by enhancing natural antioxidant status in body

2) Probiotic also significantly increased glutathione status (the number one internal antioxidant in the body) and decreased malondialdehyde

Asemi, A., Jazayeri, S. et al. Effect of Daily Consumption of Probiotic Yogurt on Oxidative Stress in Pregnant Women. Annals of Nutritional Medicine, 2012. 60(1), 62-28Ejtahed, H. Mohtadi-Nia, J. et al. Probiotic Yogurt Improves Antioxidant Status in Type-2 Diabetic Patients. Nutrition, 2012. 28, 539-543

10-Day Detox Protocol

• Nutritional Detox Powder: 2 scp. BID

• A capsular formulation to support detoxification: 2 caps BID

• Modified elimination diet

• Probiotic – lactobacillus acidophilus, NCFM, b. lactis Bi-07: 1 cap daily• 15 or 60 billion live organisms

Detox

Daily bifunctional support for detoxification:

• Supports the balance between Phase I and Phase II

• Provides nutrients used to support multiple Phase II detoxification pathways

• Silymarin and other traditional herbs provide antioxidant activity and supports overall liver function

Formula for Balanced Clearance of Toxins Through Phase I and Phase II

Ellagic acid induces transcription of the rat

glutathione S-transferase-Ya geneGarfinkel L, Garfinkel D.

Induction of glutathione S-transferase (GST) enzymes

can increase detoxification of carcinogens and reduce

carcinogen-induced mutagenesis and tumorigenesis. To

determine if the anticarcinogen ellagic acid induces

cellular enzymes which detoxify carcinogens, we

examined the effect of ellagic acid on the expression of

glutathione S-transferase-Ya. Rats fed ellagic acid

demonstrated significant increases in total hepatic GST

activity, hepatic GST-Ya activity and hepatic GST-Ya

mRNA. To determine if the observed increase in GST-Ya

mRNA was due to ellagic acid inducing transcription of

the GST-Ya gene, transfection studies were performed

with plasmid constructs containing various portions of

the 5' regulatory region of the rat GST-Ya gene. The

transfection studies demonstrated that ellagic acid

increased GST-Ya mRNA by inducing transcription of

the GST-Ya gene and demonstrated that this induction is

mediated through the antioxidant responsive element of

the GST-Ya gene.

Comparative chemopreventive mechanisms of green tea, black tea and selected polyphenol extracts measured by in vitro bioassaysSteele VE, Kelloff GJ, Balentine D, Boone CW, Mehta R, Bagheri D, Sigman CC, Zhu S, Sharma S.

Black tea extracts (hot aqueous, polyphenols and theaflavins) and green tea extracts (hot aqueous, polyphenols, epicatechin, epicatechin gallate, epigallocatechin and epigallocatechin gallate) were tested in nine standardized cell culture assays for comparative cancer chemopreventive properties. Most black and green tea extracts strongly inhibited neoplastic transformation in mouse mammary organ cultures, rat tracheal epithelial cells and human lung tumor epithelial cells. Nearly all tea fractions strongly inhibited benzo[a]pyrene adduct formation with human DNA. Induction of phase II enzymes, glutathione-S-transferase and quinone reductase, were enhanced by nearly all tea fractions, while glutathione was induced by only a few fractions. Ornithine decarboxylase activity was inhibited by nearly all the green tea fractions, but none of the black tea fractions..

Bifunctional Modulators support balance between Phase I and Phase II

Decrease of plasma and urinary oxidative

metabolites of acetaminophen after

consumption of watercress by human

volunteers.Chen L, Mohr SN, Yang CS.

To investigate the effect of the consumption of watercress

(Nasturtium officinale R. Br.), a cruciferous vegetable, on

acetaminophen metabolism, the pharmacokinetics of

acetaminophen and its metabolites were studied in a

crossover trial of human volunteers. A single oral dose of

acetaminophen (1 gm) was given 10 hours after ingestion

of watercress homogenates (50 gm). In comparison with

acetaminophen only, the ingestion of watercress resulted in

a significant reduction in the area under the plasma

cysteine acetaminophen (Cys-acetaminophen)

concentration-time curve and in the peak plasma Cys-

acetaminophen concentration by 28% +/- 3% and by 21%

+/- 4% (mean +/- SE; n = 7; p < 0.005), respectively.

Carcinogenesis. 2000 Jan;21(1):63-7● Carcinogenesis. 2000 Jan;21(1):63-7 ● Clin Pharmacol Ther. 1996 Dec;60(6):651-60

Inhibit overproduction of Phase I enzymes and up-regulate production of Phase II enzymes with:

• Decaffeinated green tea catechins

• Ellagic acid

• Watercress glucosinolates

AntioxidantsThe missing piece to support glutathione

Help reduce free radical formation

Function in the regeneration of glutathione

Aid in phase II detoxification

Antioxidant functionDetoxifying function

GSH

GSHGSSG

G R

Neutralized counterparts

G P x

Free radicals, H2O2

organic peroxides

NADP+ NADPH

GSH

X

G S T

Further breakdownand excretion

GSH = glutathione; = glutathione disulfide; = xenobiotics

GST = glutathione S-transferase; GPx = glutathione peroxidase; GR = glutathione reductase

GSSG

x

X

Glutathione: Antioxidant and detoxifying function

Niacinamide

Selenium

N-acetyl-L-cysteine

Broccoli extract

Vitamin C

Provide your patients with a powerful formula for balanced daily detoxification

• Bifunctional detoxification support:

• Methylated vit. B12, folic acid with nutrients to balance phase I and phase II

• Antioxidant protection and detoxification support:

• Vit. C, selenium, niacin (niacinamide), n-acetyl-L-cysteine (NAC), broccoli extract

• Kidney detoxification and kidney health:• Vit. B6, B12, Folate, cordyceps, Chinese salvia, NAC

• Once daily convenient packet

Heavy Metals: A Global Problem

Cadmium inhaled from polluted air and eaten in food raised in contaminated soil

Lead exposure comes from numerous sources, including drinking water, contaminated soil, household dust, and lead-based paint in older homes

Body’s natural mechanism for eliminating heavy metals

Metallothionein

Binds to heavy metals

in the cell

Transports heavy metal

out of the cell to the liver

Liver

Conjugated with glutathione (phase

II detoxification) transformed to mercapturate

Mercapturate

Excreted via urine or stool

Metallothionein

Support metabolism of heavy metals but do not facilitate excretion of certain healthful minerals (calcium, magnesium, selenium, zinc)

Metabolic Detoxification The importance of metallothionein for support of heavy metal metabolism

PhytonutrientsMetal-

activated transcription

factor-1

Metallothionein-1

Spent hops (Humuluslupulus), pomegranate rind extract (Punica granatum), prune skin extract (Prunus

domestica), watercress plant extract (Nasturitum

officinalis)

Heavy-Metal Detox – On-Going Care

1) 3 formulas in one packet to provide on-going liver and kidney detoxification

2) Supports the genetic expression of enzymes involved in the metabolism of heavy metals (3 tabs BID)

3) Minimum 30 days

Promoting Weight loss without Supporting Detox is Malpractice!

Persistent Organic Pollutants

DETOXFat Loss Patients!Weight Loss May Push

Toxins Into Bloodstream

“Serum concentrations of most POPs were higher in those with long-term weight loss”Int J Obes (Lond). 2010 Sep 7

Juicing and other fasting programs can actually deprive your body of essential nutrients needed to support detoxification.

Detoxification – 21st Century Model

• Body’s innate process of removing or altering metabolic wastes and acquired toxins

• Enables the body to perform its life processes unencumbered by detrimental elements and disruptive molecules

• Body’s natural innate processes to “recycle” or “take out the trash”

Healthy, Lean, Strong

91 year-old Betty Calman shows off the peacock pose

Are You Kidding Me?

• Tampons and pads are regulated by the FDA as medical devices

• Medical devices are not required to disclose ingredients

• Tampons – made from cotton, rayon, pulp fiber

• 94% of cotton in U.S. = GMO!

Are You Kidding Me? (cont’d)

• These materials may contain toxic disinfection by-products:a) From chlorine bleaching

b) Dioxins, furans, DBP

c) Pesticides from non-organic cotton

• FDA recommends that tampons be free of dioxine, etc…

• It is not a requirement

• Studies have shown the toxins are present in brands studied

FYI

• Feminine-care products are classified as “cosmetics” by FDA

• Means no specific tests are required to demonstrate their safety

• Avoid fragranced tampons

• Use “unscented” products

• Chlorine-free or unbleached tampons/pads

• Use organic – chemical-free (non-GMO particles)

Try This…

• Burn an organic tampon/pad – it burns slow and clean

• Burn a commercial brand (undisclosed ingredients)

Creates black smoke and thick residue

Indicates the pad has dioxins

Post Detox…

Environment

MicrobiomeEpigenetics

Us

GI Tract: Food sensitivitiesLeaky gut syndromeYeast/FungusDysbiosis ( Good bacteria)

Body Composition: Obesity

Insulin: Blood sugar problemsPre-diabetes/DiabetesInsulin resistance

Liver: Liver dysfunctionToxins/Chemical overload

Musculoskeletal System:Arthritis/Joint painSoft-tissue injuryCytokine, MMPS

Brain: SatietyInflammatoryNeurodegeneration

Dr. Rob’s Gut Matrix

The Gut’s the Body’s

Second Brain

Gut bacteria linked to age-related diseases

• Research suggests that treating a leaky gut may promote longevity

• Alterations in intestinal microbiota linked with aging and measures of frailty in elderly

Clark RI, Salazar A, et al. Distinct shifts in microbiota composition during drosophila aging impair intestinal function and drive mortality. Cell Rep. 2015;12:1656-67

Section VI: GI Treatment

4R Program

Section VI: GI Treatment

4R Program

Section VI: GI Treatment

4R Program: REMOVE

Pathogens, parasites, yeast

Food Allergens

Gastric irritants

Section VI: GI Treatment

4R Program

Stomach Acid

Digestive

Enzyme

Stomach Acid

Digestive

Enzyme

: REPLACE

Section VI: GI Treatment

4R Program

Beneficial bacteria

: REINOCULATE

Beneficial bacteria

Section VI: GI Treatment

4R Program

Nutrients

Heal GI lining

Nutrients

Heal GI lining

: REPAIR

1. Remove

• Removing offending substances from the diet

• Food allergens and other materials that negatively influence the intestinal environment:–Can cause localized irritation

–Trigger release of damaging chemicals into general circulation

–Affecting other tissues or organ

1. Remove (cont’d)

• Concentrated aromatic oils:• Thyme oil• Oregano oil• Sage leaf• Lemon balm leaf

• For upper respiratory issues/sinusitis

• Aromatic oils = open the bronchial

• Thyme oil – health of GI/upper respiratory

• Sage/lemon balm – herbs that complement and stabilize the fragile essential oils

1. Remove (cont’d)

Concentrated berberine formula for intestinal support

• Berberine HCL

• Oregon grape• Coptis root

• Chinese herbs, ginger, licorice, skullcap

• For healthy intestinal environment

• Dyslipidemia, dysbiosis

• Best suited for train-wreck patient

• B=bowel issues

2. Replace

I. Low-gastric acidity:• A formulation featuring betaine HCI combined with pepsin to

complement the natural production of digestive agents in the stomach.

II. Pancreatic enzyme insufficiency:• A formulation that features a comprehensive enzyme complex that

helps promote healthy digestive function. Containing protease, amylase and lipase.

• L. acidophilus NCFM and B. lactis Bi-07 (60 billion live organisms) – designed to relieve recurring bowel distress and related functional discomforts, such as occasional bowel urgency

• Helps relieve abdominal discomfort, bloating, cramping, bowel irritation, and occasional urgent bowel movements

3. Reinoculate – Probiotics (cont’d)

Xanthohumol strong clinical data

CardiovascularAnti-inflammatory/

Polyphenols/Antioxidant

ArthritisAnti-inflammatory

NFkB inhibition

Digestive HealthAnti-inflammatory

Polyphenols

Brain HealthAnti-inflammatory

Anti-oxidant/polyphenolsMitochondrial biogenesis

Xanthohumol

Excellent science: >250 publications in preclinical science

Next generation SKRM designed for enhanced bioavailability

Xanthohumol modifies kinases in favor of antioxidant protection

Bioavailable form of curcumin: CurQfen®

• Curcumin shows potent anti-inflammatory activity and research suggests it may help reduce inflammation-signaling molecules, such as NF-B, TNF-, COX-2, and PGE2

1

• Curcumin also shows potent antioxidant activity and research suggests it may help improve overall redox status through influencing antioxidants Nrf2, HO-1, and NQO12

• Delivery of significant concentrations of biologically active free curcuminoids has always been regarded as a major limitation for the efficacy of curcumin supplementation2

• CurQfen is a unique, patented blend of a stable curcuminoid and galactomannan compound (from fenugreek) designed for great bioavailability and more reliable clinical outcomes

1. Vecchi Brumatti L, Marcuzzi A, Tricarico PM, Zanin V, Giradelli M, Bianco AM. Curcumin and inflammatory bowel disease: potential and limits of innovative treatments. Molecules. 2014;19(12):21127-21153.

2. Rajasekaran SA. Therapeutic potential of curcumin in gastrointestinal diseases. World J Gastrointest Pathophysiol. 2011;2:1-14. 35. González-Reyes, S. Guzmán-Beltrán S, Medina-Campos ON, Pedraza-Chaverri J. Curcumin pretreatment induces Nrf2 and an antioxidant response and prevents hemin-induced toxicity in primary cultures of cerebellar granule neurons of rats. Oxid Med Cell Longev. 2013;2013:801418

3. Krishnakumar IM, Abhilash M, Gopakumar G, Dinesh K, Balu M, Ramadasan K. Improved blood–brain-barrier permeability and tissue distribution following the oral administration of a food-grade formulation of curcumin with fenugreek fibre. Journal of Functional Foods. 2015;14:215-225.

CurQfen: formulated for greater curcuminbioavailability

• In a randomized, crossover study of 50 subjects

• Single dose of 400mg of

• Curcumin levels were measured over 12 hours

• CurQfen group demonstrated 45.5 times more bioavailability when compared to standard curcuminoids

AKAY research in collaboration with Amala Cancer Research Institute in India and SMO connect clinical research services Pvt Ltd, India

Dr. Rob’s GI Restoration Protocols Remove & Replace – 30 Days

Ingredients Dosage

Berberine HCL, Oregon grape, Coptis root, Chinese herbs, ginger, licorice, skullcap

3 TID

Thyme oil, oregano oil, sage leaf, lemon balm leaf (If pt. has respiratory symptoms)

1 sg TID

Betaine HCL, pepsinTitrate up to a warming dose

Protease, amylase, lipase 1 tab w. each meal

Modified elimination food plan

EPA/DHA 4 g.

Dr. Rob’s GI Restoration Protocols Reinoculate & Regenerate – Next 30 Days

Ingredients Dosage

Medical food for inflammation and GI support 2 scp. BID

Specialized Pro-resolving Mediators 250 mg. daily

D3 5000 (check 25-OH D3 levels)

L. Acidophilus NCFM/b. Lacti Bi-07 (60 billion) 1 ca. daily

Modified elimination food plan 30-60 days

Include digestive enzymes if score indicatesIf autoimmune disease – may take up to 90 days

Retest

Paradigm shift

• SPM represent a paradigm shift in how we regulate the inflammatory response

Specialized Pro-Resolving Mediators (SPM)

α-linolenic acidEssential fatty acidsMust be acquired through diet

Inefficient multi-step conversion

EPA

DHA

Conditionally essential fatty acids support:• Cell membrane integrity• Brain and eye health•Healthy triglycerides levels•Heart health

SPMs

Unique role in supporting the resolution of the immune response and inflammation – necessary for healthy aging and active living•Neutrophil activity is curtailed•Macrophages remove dead neutrophils, bacteria and debris• Tissue is remodeled • Return to homeostasis (cells’ previous normal conditions)

Multi-step process, and production affected by certain health conditions*

Inefficient Conversion to meet needs in the face of inflammation,

particularly in an already compromised

host

Serhan CN. Nature. 2014;510:92-101

Advantages of pro-resolving mediators

• Brings biochemical precursor and products to site of action

• They play a role in inflammation and resolution

SPMs

• Signal for the activated immune cells to be killed- Apoptosis

• Signal macrophages to engulf those dead cells

• Signal promotes a molecular switch to change the role of macrophages to a resolving one

• Net result: suppresses further immune recruitment and promotes tissue repair

SPMs (cont’d)

• Act through specific cellular receptors that initiate intracellular signals

• Signals microbial phagocytosis and clearance

• SPM receptors “G-protein coupled receptor”

• Receptors span the cell membrane

• Receptor binding causes specific cell behaviors

Cell Behaviors Mediated by SPMs Tissue-Level Outcomes of SPM Actions

• Inhibit neutrophil recruitment• Reduce vascular permeability• Reduce endothelial cell proliferation and migration

(limit revascularization --- is this really the case?)• Promote lymphocyte removal of phagocytic cells

(efferocytosis or phagocytosis)• Reduce leukocyte infiltration• Reduce cytokine levels

Halt of inflammation

Promote tissue repair

Regenerate original structure and function and return to homeostasis

Resolvins protects from local inflammation and osteoclast mediated bone destruction

Conclusion: Indicates that resolvins directly interacts with human neutrophils and that an abnormality of neutrophil function in human disease can be modified with exposure to resolvins

FASEB Journal, Dec 22, 2005;p1-17

Resolvins mediate bone preservation

Conclusion: Results indicate that resolvins modulates osteoclast differentiation and bone remodeling by direct actions on bone

Journal of Immunology, 2013;190:689-94

Resolvins modulates osteoclast differentiation and bone resorption

Conclusion: indicated resolvins inhibits osteoclast (OC) growth and bone resorption by interfering with OC differentiation. This leads to a direct action in bone remodeling.

British Journal of Pharmacology, Sept 2008;p1214-1223

Clinical Uses and Advantages

Health Conditions Associated with Chronic Inflammation that

may benefit from SPM supplementation

Obesity

Metabolic Syndrome

Diabetes

Aging and age-associated diseases

Vascular disease such as cardiovascular disease and peripheral vascular

disease

Digestive disorders including Inflammatory Bowel Disease (IBD)

Autoimmune conditions

Arthritis

Without resolution, even a reduced inflammatory response can become chronicM

agn

itu

de

Time

Initiation

Serhan CN. Nature. 2014;510:92-101.Spite et al. Cell Metab. 2014;19(1):21-36.

SPMs act to resolveinflammation. Without resolution, even a reduced inflammatory response can become chronic, and full healing and return to homeostasis cannot occur

SPMs

Resolution

Balance between initiation and resolution is critical

So, are we ready for Monday morning??

“But I’ve heard…”

• “There’s lots of probiotics products out there and as long as it’s from a reputable company it’s going to be good.”

• “If 10 billion CFUs is good, then 20 billion is twice as good.”

• “Probiotics should always be refrigerated.”

• “Probiotics don’t need to be refrigerated.”

• “Probiotics should be taken on an empty stomach to reduce their destruction by stomach acid.”

• Patients should keep their open probiotics in the freezer.”

• “I just tell my patients to take yogurt.”

Obesity and Pollutants Contribute to Whole-Body Inflammation

University of Ottawa, Canada, literature review conclusion: obesity and environmental pollutants combined to increase inflammation in the body

Obesity Reviews, 15:19-28, 2014

Obesity GorillaPonders New Diet

Simple strategies first!