Digestive Care Expert Brenda Watson

According to recent statistics, 29.1 million people—that’s 9.3 percent of the population—have diabetes. Almost 30 percent of these people have not been diagnosed, however. It gets worse. Fully 86 million more people—that’s over one third of U.S. adults—have prediabetes (high blood sugar, the precursor to diabetes), yet ninety percent of them don’t know it. Truly, these numbers reveal the epidemic nature of this largely preventable disease.

A recent study published in the Annals of Internal Medicine found that people diagnosed with diabetes during midlife are more likely to experience memory and cognitive problems during the next 20 years than those people with healthy blood sugar levels. A 60-year-old with diabetes will exhibit the same cognitive decline as a healthy person who is five years older. Diabetes shaves five years off your cognitive health, just like that.

“The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50,” noted lead researcher Elizabeth Selvin, PhD, MPH.

The study followed a group of almost 16,000 middle-aged adults and found 19 percent more cognitive and memory decline in people with poorly controlled diabetes, and found smaller declines even in people with controlled diabetes and prediabetes.

“Knowing that the risk for cognitive impairments begins with diabetes and other risk factors in midlife can be a strong motivator for patients and their doctors to adopt and maintain long-term healthy practices,” noted A. Richey Sharrett, MD, DrPH, another researcher.

News that high blood sugar increases risk for dementia is not new. In fact, Alzheimer’s disease is also known as type 3 diabetes. If you have not had your blood sugar checked recently, please do. Ask your doctor to also check your insulin level, which is a sign that blood sugar abnormalities may be on the horizon.

Alzheimer's, cognitive decline, dementia, diabetes, high blood sugar, memory, prediabetes

In 2011 the Institute of Medicine increased the recommended dietary allowances (RDA) of vitamin D from 400 to 600 IU for people aged 1 to 70. This was a welcomed increase, but many experts argued that it was not enough and recommended doses over 1,000 IU daily. In a recent paper published in the journal Nature, researchers state that the IOM’s 2011 vitamin D RDA—which doctors across the country are basing their vitamin D recommendations on—was miscalculated.

They attempted to calculate the dose that would need to be given to achieve a vitamin D blood level of at least 20 ng/mL in 97.5 percent of the population, the blood level determined to be adequate by the Food and Nutrition Board (FNB).* The problem is that the FNB used group averages instead of individual averages to calculate the RDA. Using individual averages, a dose of 600 IU would only achieve a blood level of 11 ng/mL for 97.5 percent of the population, a level considered to be a deficiency.

Using the correct statistical calculations, the researchers estimated that a dose of 8,895 IU/day—almost 15 times the current recommendations—would be needed to achieve blood levels of 20 ng/mL or more.

“The public health and clinical implications of an error in the calculation of the recommended dietary allowance for vitamin D are serious,” noted Paul Veugelers, PhD, an author of the paper. “Current public health targets are not being met.”

In another paper by the same researchers in conjunction with other prominent vitamin D researchers, a re-evaluation of the vitamin D RDA to account for body weight was also called for. As it turns out, overweight and obese individuals require much higher vitamin D doses (in the range of 12,000 to 20,000 IU daily) to achieve the same blood level as their lean counterparts. “We recommend clinical guidelines for vitamin D supplementation be specific for normal weight, overweight, and obese individuals,” they noted.

Vitamin D supplementation is something I recommend for almost everyone. Dr. Smith and I have blogged many times on the benefits of optimizing your vitamin D level. The Vitamin D Council is an excellent resource for more information on this essential nutrient.

 

*(Many experts feel that this “adequate” level is anything but, and recommend at least 50 ng/mL as an optimal level.)

essential nutrient, obese, overweight, RDA, recommended dietary allowance, vitamin D, vitamin D deficiency

Alzheimer’s disease affects over 5 million patients in the United States and 30 million worldwide. Recent estimates suggest that Alzheimer’s is now the third leading cause of death in the United States, behind cardiovascular disease and cancer. Women are affected more than men, such that a woman’s chance of developing the disease is now greater than her chance of developing breast cancer.

There is currently no medication that effectively treats the disease despite billions of dollars spent on research. In a recent study funded by the National Institutes of Health and published in the journal Aging, Dale Bredesen, MD, director of the Mary S. Easton Center for Alzheimer’s Disease Research at UCLA reports on case studies using a personalized therapeutic program that involves multiple modalities designed to achieve metabolic enhancement for neurodegeneration.

Each patient was treated in an individualized way based on lab results obtained at the beginning of the study. All patients followed a diet that eliminated simple carbohydrates and processed foods, and increased fruit and vegetable consumption. They fasted for a minimum of three hours between dinner and bedtime, and for a minimum of 12 hours between dinner and breakfast. They exercised on a regular basis and tried to sleep as close to eight hours as possible, taking melatonin if needed. Some patients added meditation and relaxation to address stress. Additional supplementation, sometimes extensive, was given to the patients based on their lab results. Many of the patients received vitamin D, coQ10, probiotics, fish oil, active B vitamins, and antioxidants. For a complete list of supplements, see the full study here. Some patients received hormone replacement therapy, again based on lab results.

Of the ten patients Bredesen treated, nine displayed improvement in cognition within three to six months. The one patient who did not improve had a very late stage Alzheimer’s disease, which may explain the lack of response. Of the six patients who had discontinued working or were struggling with their work, all of them experienced improved performance and could return to work or continue working.

“Results from the ten patients reported here suggest that memory loss in patients with subjective cognitive impairment, mild cognitive impairment, and at least the early phase of Alzheimer’s disease, may be reversed, and improvement sustained, with the therapeutic program described here,” noted Bredesen. “However, at the current time the results are anecdotal, and therefore a more extensive, controlled clinical trial is warranted.”

Although the protocol was not easy to follow, these patients were aware of the poor prognosis of their disease and that the cognitive decline was, for the most part, untreatable, so they were motivated to adhere to the treatment.

Dr. Bredesen is a pioneer in his field. His personalized approach to treating Alzheimer’s disease is commendable. His work is similar to the work done by other functional medicine doctors like Dr. David Perlmutter. More studies are needed to help bring such treatments to more doctors around the country so that we can finally get to the root cause of the imbalances that lead to such chronic diseases as Alzheimer’s.

Alzheimer’s disease, cognitive decline, diet, personalized, supplementation, treatment

Show of hands: do you take enzymes with every meal? As important as they are for healthy digestion, many people are still missing out on the benefits of enzymes. Even if you take a daily probiotic, there may be times when you have occasional bloating or upset stomach after eating. For those moments, a digestive enzyme supplement may help provide relief.

You may not realize it, but enzymes work differently than probiotics. They support the digestive process by working to break down the foods we eat more completely. And, when it comes to choosing the most effective enzyme formula, there are three important rules to follow. What are they?

Watch this eye-opening video to find out!

The 3 Rules for Enzymes explains how to choose the right enzyme formula based on a handful of simple guidelines that are surprisingly easy to remember—including why you should always look at the total number and variety of enzymes, since different enzymes are need to digest different types of food. You will also learn the difference between enzymes and probiotics, and how they complement each other to help you digest your foods more completely and help balance your digestive tract. Be sure to check it out!

digestive enzyme, Enzymes, healthy digestion, supplement

The beneficial effects of breastfeeding are many. Children who are breastfed are at less risk of developing ear infections, colds, asthma, obesity, diabetes, and even leukemia.1 Breastfeeding has also been linked to improved brain development and lower risk for attention-deficit hyperactivity disorder (ADHD) and other behavioral problems. Because ADHD and other behavioral problems are also linked to the child’s IQ—which is, itself, also affected by breastfeeding—a group of researchers sought to determine whether or not the link between breastfeeding and behavioral development is simply the effect of the child’s IQ.

In a study published in Nutrition Journal, researchers studied almost 900 Korean children aged eight to 11 years.2 As expected, they found an association between breastfeeding and the risk of developing ADHD. When they adjusted the results to account for differences in both the child’s and mother’s IQ, they still found an association, although it was a weakened link. Also as expected, the researchers found a link between a lack of breastfeeding and lower IQ. When they adjusted the results to account for mother’s IQ and a diagnosis of ADHD, they still found an association, although also somewhat weakened.

What all this means is that breastfeeding is linked to a decreased risk of developing ADHD and also to increased IQ level. It also means that higher IQ may have a mild protective effect on the development of ADHD, and having ADHD may contribute to a somewhat lowered IQ whether or not the child was breastfed. This study is a good example of how interconnected are the various factors that contribute to our well-being. Our environment—lifestyle, diet, and habits—affects how our genes—our potential—will be played out, and almost none of it is black and white or written in stone.

ADHD affects eight to 12 percent of school-aged children.3 While ADHD tends to run in families, associated factors like lack of breastfeeding, exposure to tobacco smoke, and alcohol exposure during pregnancy also play a role. Learning how to minimize ADHD risk by optimizing these lifestyle factors can go a long way toward curbing the current trend of increased ADHD incidence.

 

References

  1. Ip S, Chung M, Raman G, et al., “Breastfeeding and maternal and infant health outcomes in developed countries.” Evid Rep Technol Assess (Full Rep). 2007 Apr;(153):1-186.
  2. Park S, Kin BN, Kim JW, et al., “Protective effect of breastfeeding with regard to children’s behavioral and cognitive problems.” Nutr J. 2014 Nov 29;13(1):111.
  3. Biederman J and Fafaone SV, et al., “Attention-deficit hyperactivity disorder.” Lancet. 2005 Jul 16-22;366(9481):237-48.

ADHD, attention deficit hyperactivity disorder, breastfeeding, IQ

The intestinal lining is a protective interface between the digestive tract and the rest of the internal organs and systems. It is a semi-permeable lining that, when healthy, lets in small digested nutrients and keeps out larger undigested food particles and pathogens. When the intestinal lining is damaged, a condition known as increased intestinal permeability or leaky gut usually due to an inflammatory process in the intestines, larger food particles and pathogens can enter systemic circulation and trigger the immune system to create yet further inflammation that can travel through the bloodstream and reach areas of the body far from the digestive tract, where the damage originated.

In a recent study published in the journal Biological Psychiatry, researchers discovered a link between leaky gut and alcohol dependence. They found that gut bacteria that had migrated through a leaky gut triggered inflammation that was linked with alcohol craving in alcohol-dependent patients.

“This study suggests that there may be a link between inflammatory processes that develop when gut barriers to bacteria break down and risk for continued heavy drinking among people with alcohol use disorders,” noted John Krystal, the journal’s editor. “The findings suggest that it might be helpful to protect and restore gut integrity and to reduce inflammation when helping patients recover from alcohol use disorders.”

The study tested 63 alcohol-dependent patients for activation of inflammation and monitored for alcohol consumption and craving before and after the patients underwent an alcohol detoxification program. The results were compared with those from 14 healthy control patients. Those patients exposed to alcohol had a higher inflammatory response triggered by gut bacteria that was linked to alcohol cravings than they did after the detoxification, or when compared to the healthy controls.

This study is one more example of how our gut bacteria can control our mental state. Researchers have known for a while that inflammation plays a role in the development of some mental disorders, but they are still working out the details of the origin of that inflammation. Some of the research, like this study, has already linked the inflammation to gut bacteria. My hope is that this research leads to a gut-centered solution for these individuals, who may be more at the mercy of their gut microbes than we realize.

alcohol, alcohol craving, gut bacteria, gut microbes, inflammation, intestinal lining, intestinal permeability, leaky gut, mental disorders

Bisphenol A (BPA) is a chemical utilized in the manufacture of polycarbonate plastics and epoxy resins used in the linings of food cans, water bottles, and dental fillings. It is produced in high volumes throughout the world. In the United States it has been detected in 95 percent of the population. BPA is an endocrine-disrupting chemical, which means that it disrupts hormone function. BPA interferes with estrogen receptors, disrupts thyroid hormone function, binds to androgens (male hormones) and steroid hormones involved in lowering inflammation, and interferes with the central nervous and immune systems.

BPA exposure has been linked to increased production of liver enzymes, recurrent miscarriages, premature delivery, inflammation, oxidative stress, decreased semen quality, and male sexual dysfunction. BPA exposure has also been linked to cardiovascular disease. A recent study published in the journal Hypertension investigated the relationship between BPA exposure and blood pressure and heart rate variability in people aged 60 or over. Heart rate variability is a measurement of the variation of heart rate; reduced heart rate variability increases the risk of cardiac events. High blood pressure is a well-known risk factor for cardiovascular diseases.

In the study, those people who had the highest levels of BPA in their urine also had increased blood pressure and decreased heart rate variability when compared to those with the lowest BPA levels. In those participants without a previous history of high blood pressure—and therefore not taking medication to control blood pressure—the higher the BPA level, the higher was their blood pressure.

“I suggest consumers try to eat fresh foods or glass bottle-contained foods rather than canned foods and hopefully, manufacturers will develop and use healthy alternatives to BPA for the inner lining of can containers,” noted Yun-Chul Hong, MD, PhD, lead researcher.

This study comes on the heels of an announcement by the U.S. Food and Drug Administration that concluded BPA exposure to be safe at current consumption rates after reviewing over 300 scientific studies. This announcement is no different than what they have been saying for years, and goes against what many studies are finding. It is up to us as consumers to purchase products that do not contain this toxic chemical, but more regulations are needed to help protect our health in a world where BPA is almost ubiquitous.

bisphenol A, blood pressure, BPA, heart rate variability, plastics

Cigarette smoking causes almost half a million deaths each year in the United States alone. One in every five deaths in this country are attributed to smoking. Smokers are more likely to develop heart disease, stroke, and lung cancer than are nonsmokers. And smoking is responsible for one-third of cancer deaths in the United States. With all these scary statistics, it’s a wonder so many people still smoke. But the truth is smoking is highly addictive. It is a physical and mental addiction that takes hold and, for many, feels almost impossible to shake.

In a recent study published in the Journal of Psychopharmacology, researchers discovered that omega-3 supplementation helps reduce craving for cigarettes and also reduces the number of cigarettes smoked per day. The study involved 48 smokers aged 18–45 who smoked at least ten cigarettes daily for an average of eleven years. They were divided into two groups: one group received an omega-3 supplement containing 2710 mg EPA and 2040 mg DHA daily for one month, and the other group received a placebo.

“The substances and medications used currently to help people reduce and quit smoking are not very effective and cause adverse effects that are not easy to cope with,” noted Sharon Rabinovitz Shenkar, PhD. “The findings of this study indicated that omega-3, an inexpensive and easily available dietary supplement with almost no side effects, reduces smoking significantly.”

After thirty days, the smokers taking the omega-3 supplementation were smoking two less cigarettes per day without having been asked to change their smoking habits at all. They also had a decrease in nicotine cravings. Thirty days after the supplementation had been discontinued cigarette cravings increased slightly but were still lower than the initial amount before supplementation, suggesting that omega-3s exert an effect long after they are stopped.

addiction, cigarette smoking, cigarettes, DHA, EPA, omega-3, omega-3 supplementation, smokers

Antibiotic overuse is a problem that I discuss on a regular basis. One of the most detrimental effects of antibiotic overuse is the increase in obesity it is thought to contribute to. Dr. Smith recently blogged about the use of antibiotics during early infancy and its link to obesity later in life. A recent study published in the International Journal of Obesity adds to this research, finding that children who were exposed to antibiotics during the second or third trimester of pregnancy were at a higher risk of being obese at age seven. Infants born to mothers who delivered by Cesarean section were also at increased risk for obesity during childhood.

Of 727 mothers enrolled in the study, 436 were followed until the children reached age seven. Sixteen percent of the mothers used antibiotics during the second or third trimesters, which put them at an 84 percent increased risk for obesity compared with those children who were not exposed.

“Our findings should not discourage antibiotic use when they are medically needed, but it is important to recognize that antibiotics are currently overprescribed,” noted Noel Mueller, PhD. “Our findings provide new evidence in support of the hypothesis that Cesarean section independently contributes to the risk of childhood obesity.”

I wrote about the effects of antibiotics on the development of obesity in my latest book, The Skinny Gut Diet. Antibiotics alter the gut microbes in ways that lead to the development of obesity. Researchers are discovering that the type of bacteria you have in your gut determines whether or not you will be more likely to gain weight.

Setting up a healthy balance of gut bacteria early in life—and maintaining it throughout life—looks to be one of the best ways to avoid the weight gain trap that currently plagues two-thirds of the United States. Vaginal birth, breastfeeding, antibiotic use only when absolutely necessary, and a healthy diet rich in fruits and vegetables will go a long way toward establishing a healthy balance of gut bacteria. Probiotic supplementation can also help to support this balance.

antibiotic overuse, antibiotics, childhood, Children, gut bacteria, obese, obesity, pregnancy, The Skinny Gut Diet

Major depressive disorder is the most common type of depression and involves severe symptoms that interfere with an individual’s ability to work, sleep, study, eat, and enjoy life. Each year, about 6.7 percent of U.S. adults are affected by the condition, with women 70 percent more likely to be affected than men.

Scientists do not have a good handle on what actually causes depression. In some cases, a traumatic event can trigger its onset, but in other cases, no obvious trigger is evident. In a recent study published in the journal Biology of Mood & Anxiety Disorders, Turhan Canli, PhD, suggests that major depression be reconceptualized as an infectious disease.

Camli presents three arguments for why major depressive disorder should be considered an infectious disease:

  • Patients with major depressive disorder exhibit sickness behaviors such as loss of energy and feelings of illness. He sites inflammatory biomarkers as indicators of an illness-related origin.
  • Parasites, bacteria, and viruses are known to alter emotional behavior in infected individuals.
  • The human body is an ecosystem for microorganisms that are intricately related to the role of genetics.

“Deliberately speculative, this article is intended to stimulate novel research approaches and expand the circle of researchers taking aim at this vexing illness,” noted Canli.

Dr. Smith and I have blogged on this topic before. A number of studies point to alterations of mental status being linked to inflammation that originates from an infectious process somewhere in the body (often, the gut). This finding has the potential to greatly change how depression is researched and treated. I hope that others listen to Dr. Canli’s recommendations, which are currently way ahead of most others in his field.

depression, gut, infectious disease, inflammation, major depression, major depressive disorder, microorganisms

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