Digestive Care Expert Brenda Watson

Childhood obesity has more than doubled in children and quadrupled in adolescents over the past 30 years. According to the CDC, in 2012 more than one third of children and adolescents were overweight or obese. The long-term health effects of obesity in children include an array of chronic diseases. More needs to be done to prevent childhood obesity so that the children of today do not grow up to be the chronically ill of tomorrow.

Probiotic Prebiotic Lower Inflammation

In a recent study published in the monthly publication of the Brazilian Society of Pediatrics, Jornal de Pediatra, researchers studied overweight and obese children and teens taking the prebiotic fructooligosaccharide (FOS) in addition to vitamins A, C, and E plus a multi-strain probiotic formula containing the following strains:

Lactobacillus casei
Lactobacillus rhamnosus
Lactobacillus acidophilus
Lactobacillus bulgaricus
Streptococcus thermophilus
Bifidobacterium breve
Bifidobacterium longum

They found that, when compared to children taking a placebo, those children taking the synbiotic (probiotic + prebiotic) formula experienced a decrease in weight associated with a decrease in two inflammatory markers in the blood, TNF-alpha and IL-6, as well as an increase in adiponectin, a hormone released from fat cells that plays a role in regulation of insulin sensitivity (blood sugar control) and energy.

They found that, when compared to children taking a placebo, those children taking the synbiotic (probiotic + prebiotic) formula experienced a decrease in weight associated with a decrease in two inflammatory markers in the blood, TNF-alpha and IL-6, as well as an increase in adiponectin, a hormone released from fat cells that plays a role in regulation of insulin sensitivity (blood sugar control) and energy.

“It appears that, because of the association between obesity and inflammation, it can be proposed that the favorable effects of probiotics in controlling inflammation may play a role in obesity prevention and control,” stated the researchers.

This study is more evidence of a strong link between gut bacteria and metabolic health. Truly, our gut bacteria are in control of our health and affect all areas of the body—especially when it comes to maintaining a healthy weight. We can no longer consider that food and exercise are the only factors in achieving an ideal weight. As it turns out, the bacteria in our guts have a bigger say than even the foods we eat.

Many people do not yet realize that probiotics and prebiotics can have excellent benefits outside of the digestive tract, as found in this study. While it is true that a healthy diet plays a main role in helping children and teens get healthy—and stay healthy, balancing gut bacteria may be the missing piece that prevents these children from getting well. Share this article with parents you know who might not be aware of the wide-ranging positive effects of gut balance.

adolescents, Bifidobacteria, childhood obesity, Children, gut bacteria, healthy weight, ideal weight, inflammation, Lactobacillus, multi-strain probiotic, obese, overweight, prebiotic

You are likely already well aware that the obesity rate is sky high—two-thirds of Americans are overweight or obese. That’s over 65 percent. It is becoming clear that there is to more to the equation than simply calories in/calories out. There are a number of factors that are contributing to the expanding waistline of this country, one of which is our exposure to toxins known as obesogens.

Obesogens—a term coined by Bruce Blumberg, a biology professor at the University of California, Irvine in 2006—are dietary, pharmaceutical, or industrial compounds that alter metabolic processes and predispose some people to gain weight.

Many scientists are concerned about the estrogenic effects of these toxins. Certain obesogens are known as xenoestrogens—they exhibit estrogen function in the body, which interferes with normal hormone function. In a recent study published in the Public Library of Sciences One journal, researchers proposed the estrogen hypothesis of obesity, in which they suggest that obesity, particularly among men, is linked to the increase of xenoestrogen exposure from two main sources—soy food products and polyvinyl chloride (PVC) piping.

Maciej Henneberg, PhD, DSc, one of the authors, states, “Exposure to estrogen is known to cause weight gain, primarily through thyroid inhibition and modulation of the hypothalamus. Soy products contain xenoestrogens, and we are concerned that in societies with a high dietary saturation of soy, such as the United States, this could be working to ‘feminize’ the males.”

Usually, women gain weight more readily than men, but in Western countries men gain weight at an almost equal rate as women. The researchers believe this excess estrogen exposure is to blame.

“Another well-established source of xenoestrogen is polyvinyl chloride, known as PVC. This product is in prominent use in most wealthy countries, from plastic medical devices to piping for our water supplies.”

Did you ever think the soybean or vegetable oil you cook with, the plastic containers you eat from, or the PVC pipe carrying your tap water could be making you fat? Probably not. You won’t need to eliminate soy foods completely, but if you eat a lot of soy, you might want to limit your intake. In addition, avoid plastic containers with the number 3 inside the recycle symbol and use high-quality water filters on your tap water. (Reverse osmosis water filters remove the most toxins.)

estrogen, gain weight, men, obesity, obesogens, PVC, soy, toxins, xenoestrogens

Celiac disease is a condition that involves damage to the small intestines as a result of an inflammatory response to gluten from the diet.

People with celiac disease commonly report that they experience brain fog, which can include difficulty concentrating, trouble paying attention, lapses in short-term memory, difficulty finding words, temporary loss in mental sharpness or creativity, and confusion or disorientation. These same patients usually report that the brain fog dissipates after following a gluten-free diet for a period of time.

Until recently, these reports of improved symptoms after following a gluten-free diet were confined to doctors’ offices and patients’ homes. It was all anecdotal. No studies had been done to confirm or deny the phenomenon. A recent study published in the journal Alimentary Pharmacology and Therapeutics, is confirming what these patients and doctors have known for so long. They found that recently-diagnosed celiac patients with brain fog improved their cognitive function after following a gluten-free diet for a year.

“The study outcomes highlight the importance for individuals with celiac disease of maintaining a gluten-free diet not just for physical well-being but also for mental well-being,” stated Greg Yelland, PhD, lead researcher.

Improvements in short-term memory, movement, and processing speed in these patients occurred along with a healing and recovery of their intestinal lining. Before the diet, the patients were functioning at the level of someone with severe jet lag, and by the end of the study their cognitive function was the equivalent of someone who had recovered from jet leg over a 24-hour period.

This study is important because brain fog may be a sign of underlying celiac disease in people who are undiagnosed. An astonishing 83 percent of people with celiac disease have not been diagnosed with the disease.

I know that brain fog is a common symptom in so many people. It’s not just celiac disease, but also gluten sensitivity that underlies symptoms of brain fog. So many people find that they feel better—mentally and physically—after following a gluten-free diet. If you experience brain fog, you may want to consider this option as well.

brain fog, celiac disease, Gluten-free diet, Gluten-sensitivity, memory, mental well-being, symptoms

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Getting Fat—The Result or the Cause of Overeating?

We have been told that all it takes to lose weight is a reduction in calories and/or an increase in energy expenditure (exercise). So if we eat less calories or exercise more or both, we will lose weight. Supposedly, that’s how it works.

And yet, we continue to struggle with losing weight and keeping it off for good. Only a small percentage of overweight and obese people are able to maintain a weight loss of ten percent of body weight for one year.1 The reason for this goes beyond the simple calories in/calories out calculation. What researchers are discovering is that a calorie is not just a calorie. Rather, it’s the quality of the diet as a whole that determines whether a person will be able to lose weight and keep it off or not.

A recent paper published in the Journal of the American Medical Association proposes a new model of obesity that better explains why and how we get fat.2 The current model states that the Standard American Diet (SAD), full of convenient, highly palatable, energy-dense foods, causes people to overeat, which increases energy intake (calories in), while a sedentary lifestyle decrease energy expenditure (calories out). As a result, circulating fuels in the bloodstream (glucose from sugar and carbs, fatty acids from fats, and ketones from proteins) are more available, which increases fat storage and leads to obesity.

The new model proposes that diet quality—especially carbohydrate amount and type—as well as genetics and lifestyle factors such as inadequate sleep and stress, all contribute to an increase of fat storage, which decreases the circulating fuels in the bloodstream (sugar, fat, and ketones), triggering hunger (calories in) and lowering metabolism (which lowers the burning of calories). The result—obesity.

This new model helps explain why a calorie is not just a calorie and supports the fact that a low-carbohydrate diet versus a low-fat, high-carbohydrate diet of equal calories results in better weight loss, blood sugar control, and cholesterol levels.3 It also explains why a low- vs high-glycemic index diet (glycemic index measures the ability of a food to raise blood sugar) of equal calories decreases hunger.4

Other dietary factors that decrease fat storage (thus increasing the available fuel in circulation which quells hunger and improves metabolism) are a low refined sugar intake, high omega-3 and low trans fat intake, adequate protein, high micronutrient and phytochemical content (in other words, plenty of fruits and vegetables), and probiotics and prebiotics.1 We see a high quality of foods in these recommendations, coming back to the advice that the quality of diet is what is most important when it comes to weight loss.

So if you think that overeating causes you to be fat, it’s actually a poor quality of diet that causes overeating, which causes you to be fat. How can you improve your diet quality? Here are some tips:

  • Eat plenty of non-starchy vegetables and low-sugar fruits.
  • Eliminate sugar and grains.
  • Eat healthy fats such as omega-3 (fish oil), omega-9 (olive oil), and medium-chain triglyceride saturated fat (coconut oil), and reduce your intake of unhealthy omega-6 fats (most vegetable oils).
  • Eat protein throughout the day.
  • Eat fermented foods, which contain beneficial bacteria.

In conclusion, following the above dietary suggestions along with moderate caloric restriction with optimum nutrition (CRON) and exercise and stress reduction not only leads to permanent weight management, it is also the recipe for adding years to your life as well as life to your years.

References

  1. Kraschnewski JL, Boan J, Esposito J, et al., “Long-term weight loss maintenance in the United States.” Int J Obes (Lond). 2010 Nov;34(11):1644-54.
  2. Ludwig DS, Friedman MI, “Increasing adiposity: consequence or cause of overeating?” JAMA. 2014 Jun 4;311(21):2167-8.
  3. Shai I, Schwartzfuchs D, Henkin Y, et al., “Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet.” N Engl J Med. 2008 Jul 17;359(3):229-41.
  4. Chang KT, Lampe JW, Schwartz Y, “Low glycemic load experimental diet more satiating than high glycemic load diet.” Nutr Cancer. 2012;64(5):666-73.

beneficial bacteria, calories, exercise, fat storage, low-carbohydrate diet, obesity, omega-3, overweight, protein, Standard American Diet, sugar, Weight Loss

I blog about environmental toxins a lot because their harmful effects continue to be reported in scientific studies, yet little is done to curtail their use or educate the public about their harms. One class of toxins—the phthalates—is particularly troublesome because they are ubiquitous. They’re everywhere.

Phthalates are found in:

  • personal care products
  • cosmetics
  • perfumed products
  • adhesives
  • car care products
  • plastics used for food packaging, processing, and storage

Because phthalates are not chemically bonded to the plastics, they are easily leached and can enter the body via ingestion of food or beverage, inhalation, or contact with skin. Studies have found that almost everyone has urinary metabolites of phthalates. That is, almost everyone is exposed to phthalates, which is evidenced by their breakdown products found in urine.

In a recent study published in the journal Environmental Health Perspectives, researchers found a link between higher concentrations of urinary phthalate metabolites during pregnancy and neurobehavioral problems in their children at ages 6 to 10. Higher prenatal concentrations of phthalate metabolites were associated with physical symptoms such as headaches, stomach aches, feeling jittery, and muscular tension, as well as behavioral issues such as attention problems, rule-breaking behavior, aggressive behavior, and oppositional/defiant behavior. These problems occurred more often in boys than in girls.

Pregnancy is a vulnerable period, developmentally. Whatever a mother is exposed to during this time reaches the placenta and can affect the growing baby. The Environmental Working Group gives some great tips for avoiding phthalate exposure. Be sure to pass these on to anyone you know who is pregnant or who will be in the near future. As a matter of fact, it would be a good idea for anyone to follow these tips, pregnant or not.

avoiding phthalate exposure, behavior, boys, environmental toxins, phthalates, plastic, pregnancy

When you encounter a perceived threat, your body reacts by activating the fight-or-flight response—your adrenals pump out stress hormones that put the body and mind into a hyperaware, ready-for-anything mode. Digestion shuts down and the cardiovascular system pumps up in anticipation of, well, a fight or flight.

This bodily process is elegantly designed to help save our lives when we are in danger. It works quite well when utilized on occasion. The problem is that in today’s world, we are presented with constant mini-threats in the form of work stress, family issues, financial problems, and relationship troubles. Many people are in a state of chronic stress, putting out small fires all day long, all week long, month after month. Under chronic stress, our fight-or-flight response is constantly activated, which takes a big toll on our health. Inflammation increases, hormone levels alter, and energy runs low.

Chronic stress is a major contributor to disease. Not only are we more likely to experience mental disorders such as anxiety and depression, but our digestive health suffers (remember that the fight-or-flight response shuts down digestion), our heart health diminishes, and we experience weight gain, sleep problems, and trouble with memory and concentration.

In a recent study published in the journal Psychoneuroendocrinology, researchers found that women who were chronically stressed and eating foods high in fat and sugar gained inches around the waist, increased fat, had higher oxidative damage, and more insulin resistance when compared to women who were not under stress and eating the same foods. In short, the chronically stressed women were on the road to metabolic syndrome, the precursor to diabetes and heart disease.

“Diet appears to be a critical variable that can either amplify or protect against the metabolic effects of stress, but we still don’t know the details of how much it takes,” noted Elissa Epel, PhD, senior author.

Stress is a regular part of most people’s lives in the world we currently live in. We must remember that adding unhealthy foods to our already stressed-out existence will have consequences. Instead, why not choose foods that help to quell the inflammation that comes with stress? By eating more of the following three foods—while avoiding grains, sugar, and grain-fed meats—you can help deter the effects of chronic stress.

Non-starchy vegetables. Vegetables are some of the healthiest foods you can eat. As long as you avoid the starchy vegetables (corn and potatoes in particular) and fill your plate with plenty of colors, you will help to nourish your body and lower inflammation.

Low-sugar fruit. Many fruits are very high in sugar. It’s best to stick with nutrient-rich berries (strawberries, blackberries, blueberries, raspberries, etc.) because they are naturally low in sugar, which fuels inflammation.

Healthy fats. Not all fats are bad. Healthy fats are an important part of the diet. By eating plenty of omega-3 fats found in oily fish, walnuts, and flax and chia seeds, you will help to balance the inflammation response triggered by stress and a poor diet.

chronic stress, diet, digestion, disease, fat, fight-or-flight, healthy fats, inflammation, low-sugar fruits, non-starchy vegetables, sugar

On average, children in the United States develop six respiratory tract infections each year. Another infection—gastroenteritis, also known as the stomach flu—accounts for over 1.5 million outpatients visits, 200,000 hospital visits, and about 300 deaths each year. Together, these infections account for a considerable degree of illness in children. If you are a parent, you are familiar with the frequency of these conditions during childhood.

The search continues for therapies that will reduce these childhood infections. A recent review published in the journal Nutrition Reviews highlights a potential answer for children under two.

The authors conclude that the evidence “suggests that preventive use of prebiotics decreases the rate of infections requiring antibiotic therapy in infants and children aged 0–24 months.”

Prebiotics are non-digestible fibers that promote the growth of beneficial bacteria in the intestines.

The researchers also state that prebiotics may be an effective preventive treatment for decreasing the rate of overall infections in these children. The prebiotics used in the studies include oligosaccharides, galacto-oligosaccharides (GOS), fructo-oligosaccharides (FOS), fructans, inulin, and oligofrutose.

Interestingly, the researchers were unable to find studies using prebiotics to prevent infections in children over the age of two. They suggest such studies be undertaken, since older children are commonly introduced to new environments in which they are exposed to acute infections.

I recently blogged about a meta-analysis that found beneficial effects of probiotics for the treatment and prevention of cold and flu in children. Together, these two papers give us strong evidence that gut microbes have a major effect on our children’s immune health both in and out of the digestive system.

When taken together, probiotics and prebiotics pack a powerful punch. There is a synergistic effect between the two. Fortunately, you can eat foods high in the prebiotic inulin. Chicory root, Jerusalem artichoke, leeks, onions, garlic, and bananas all contain high amounts. A probiotic supplement plus prebiotic foods is a great combination to help maintain a healthy balance bacteria in your gut.

beneficial bacteria, Children, cold and flu, gastroenteritis, prebiotics, Probiotics, respiratory tract infections, stomach flu

Until recently, it was thought that the bladder—and therefore urine—is sterile, meaning that, in a healthy state, no bacteria live there. But a new study presented by researchers at the General Meeting of the American Society for Microbiology is changing how scientists view the urinary system.

Using an expanded culture technique able to detect bacteria that standard techniques do not, they found that urine from healthy women does, in fact, contain bacteria.

“Doctors have been trained to believe that urine is germ-free,” noted Linda Brubaker, MD, MS, one of the researchers. “These findings challenge that notion, so this research opens the door to exciting new possibilities for patient treatment.”

They found that the bacteria in urine of women with an overactive bladder (OAB) differs from that of healthy women.

“The presence of certain bacteria in women with overactive bladder may contribute to OAB symptoms,” noted lead investigator, Evann Hilt.

Could changing the balance of bacteria in the urinary system improve symptoms of overactive bladder? Scientists will next look at which bacteria are helpful and which are harmful, and whether certain bacteria trigger the development of overactive bladder as well as other urinary tract conditions. With this information, they will better be able to treat this condition. They may find that by altering the bacteria in the urinary system, they can improve symptoms of overactive bladder. There may one day be a probiotic specifically for this condition. I am sure there are many women out there crossing their legs and nodding, yes!

The results of this study are not surprising to me, since I have known for a while that probiotics can have a positive effect on urinary health. The mechanism of this benefit is not fully understood, but it seems to me that it must involve communication between bacteria within the urinary system. I will be interested to see how this research unfolds as scientists further explore the human microbiome. My hunch is that they will find bacteria in more areas of the body they previously thought did not contain microbes.

bacteria, bladder, human microbiome, overactive bladder, Probiotics, urinary health, urine, women

There is a distinct connection between changes in gut bacteria and autism, a topic I have written and blogged about before. A recent study presented at the annual meeting of the American Society for Microbiology found that children with autism spectrum disorders (ASDs) have different concentrations of bacterial metabolites, or chemicals produced by bacteria, in their stool when compared to children without ASD.

“Most of the seven metabolites could play a role in the brain, working as neurotransmitters or controlling neurotransmitter biosynthesis,” said Kang. “We suspect that gut microbes may alter levels of neurotransmitter-related metabolites affecting gut-to-brain communication and/or altering brain function.”

Of the 50 different metabolites they tested, seven were found to differ between those children with ASD and those without.

“Most of the seven metabolites could play a role in the brain, working as neurotransmitters or controlling neurotransmitter biosynthesis,” said Kang. “We suspect that gut microbes may alter levels of neurotransmitter-related metabolites affecting gut-to-brain communication and/or altering brain function.”

In a nutshell, they think that the bacterial metabolites are altering brain function. The next step would be to determine whether these altered metabolites might be a cause or confounder of the disorder. I certainly wouldn’t be surprised.

In addition, the scientists confirmed that children with ASD had a distinct and less diverse bacterial composition than children without ASD. A lack of gut bacterial diversity has been found in people with a range of health conditions and generally indicates a state of impaired digestive health. That they found less diversity in children with autism is not surprising, given that digestive disruptions are a common finding in these children.

It is my hope that this research leads to a more clear understanding of just what is happening in these children so that we can take more measures to prevent the condition in the first place and even reverse it in certain children. In the meantime, promoting good digestive health in these children is a must. Children with ASDs often do well by taking probiotics, digestive enzymes, and omega-3 fish oils, and by following a gluten-free, dairy-free diet. The Autism Research Institute is an excellent resource for finding a physician who understands how to treat autism by taking into consideration a range of possible contributing factors.

Autism, autism spectrum disorders, brain function, Children, Digestive Health, diversity, gut, gut bacteria, gut microbes, metabolites

Malnutrition (severe or moderate acute malnutrition) affects 23 percent of children in developing countries.1 The World Health Organization estimates that malnutrition is the cause of one-third of all child deaths.2 Malnutrition, or inadequate nutrition, manifests most noticeably as delayed growth, but also includes deficiencies in vitamins, minerals, essential fatty acids, and protein.

A recently developed intervention for severe acute malnutrition, known as Ready-to-use Therapeutic Food, is currently being distributed to hundreds of thousands of children in the developing world. Other food interventions, such as a lentil and rice dish called khichuri-halwa, are being utilized. A recent study published in the journal Nature sought to understand whether the development of gut bacteria during infancy was associated with improvements in malnutrition after such interventions in Bangladeshi children.3

The researchers first tested the stool of healthy Bangladeshi children on a monthly basis during the first two years of life to determine the healthy development of gut bacteria. That is, they used these findings as a benchmark of a normally maturing gut bacterial community. After all, the first two to three years of life see some of the biggest changes in gut bacterial composition, and by this age, the gut microbes resemble that of an adult.

Next, they tested the gut bacteria of children with severe and moderate acute malnutrition before, during, and after receiving either the Therapeutic Food or the lentil and rice dish. Before the interventions, gut bacteria was found to be immature—that is, the gut microbes were found were not fully developed as they were in healthy children. After the food interventions, the children’s gut microbiota immaturity was only partially improved—and temporarily, at that. By four months after the interventions had ceased, their gut microbes reverted back to their original, immature state.

The researchers suggest that either a longer food intervention or a different food that more resembles the children’s native diet is needed. They also recommend “next-generation probiotics using gut-derived taxa [groups],” which I believe will have the best impact. What if they isolated the gut microbes from the healthy children and gave them to the malnourished children? Those microbes would take up residence in the children’s guts, especially if the children were also given a food that those bacteria naturally thrive on.

Aside from lack of food, gastrointestinal (GI) infection is another cause of malnutrition. During a GI infection, the immune system is taxed in such a way that a broad range of nutrients are required to fight the pathogenic organism. Let’s not forget that a healthy gut microbiota can help ward off such infections in the first place—and can help improve the body’s nutrient capacity. You see, gut microbes play an important role in the harvest of nutrients from food. They help to break down food so that the body can efficiently absorb the nutrients it needs. When the community of gut microbes is not a healthy one, the ability to absorb nutrients adequately is compromised. When this occurs during infancy along with a lack of food or an infection, malnutrition can be worsened.

I cannot overemphasize the importance of developing a healthy gut balance during infancy. Avoiding medically unnecessary Cesarean sections and antibiotics during pregnancy (and during infancy for baby), breastfeeding for at least one year (more is better), and taking probiotics during and after pregnancy along with eating fermented foods is the best way to set infants up with a healthy balance of gut microbes, both in developing countries and here at home.

References

1. Lazzerini M, Rubert L, and Pani P, “Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries.” Cochrane Database Syst Rev. 2013 Jun 21;6:CD009584.
2. http://www.who.int/maternal_child_adolescent/topics/child/malnutrition/en/ Accessed 6/19/2014.
3. Subramanian A, Huq S, Yatsunenko T, et al., “Persistent gut microbiota immaturity in malnourished Bangladeshi children.” Nature. 2014 Jun 4.

breastfeeding, Children, fermented foods, food, gut microbes, gut microbiota immaturity, healthy gut balance, infection, malnutrition, Probiotics

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