Results of a recent study suggest that regular consumption of dairy-based probiotics may be associated with lowered risk of preeclampsia in pregnant women. Preeclampsia is a condition during the second half of pregnancy in which high blood pressure and protein in the urine develop. The exact cause is unknown, but it can lead to complications since the only way to cure it is to give birth. Preterm labor may need to be induced in certain preeclampsia cases.

In the probiotic study, published in the American Journal of Epidemiology, data were analyzed from 33,399 Norwegian women. It was found that the women who regularly consumed lactobacilli-containing dairy products also had a 20 percent reduced risk in developing preeclampsia.

While this study does not prove causality, it only shows an association; studies like these pave the way for further trials investigating just what is happening here. The researchers stated, “Further strain/species-specific investigation is warranted with the use of randomized controlled trials for further evaluation of the effect of probiotics on preeclampsia.” The researchers suggested two possible explanations for probiotic benefit to preeclampsia: a possible local effect on cells surrounding the embryo, and/or an overall reduction in inflammation levels.

Taking probiotics during pregnancy has also been found to reduce belly size after pregnancy, maintain healthy blood sugar, and even help reduce later allergic illnesses. Always be sure to talk to your doctor about taking supplements during pregnancy, however. You want to be sure your doc is also on board.

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belly, birth, blood sugar, high blood pressure, inflammation, preeclampsia, pregnancy, preterm labor, Probiotics, protein, species, strain, Supplements, urine

Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar.  Join us! 

Anxiety, or worry, is experienced by just about everyone at some point. Some people have anxiety disorders, which are more serious conditions, but it’s safe to say that most people experience at least occasional anxiety. That’s why a new study on omega-3s found in fish oil is so exciting. It’s the first study to look at the effects of fish oil on anxiety in a healthy population—meaning, in people who don’t already have an anxiety disorder. It’s already known that fish oil can be helpful for those people. But what about people who only experience anxiety here and there?

The researchers took a group of medical students and gave them omega-3 supplements for three months. The supplements contained 2,085 mg of EPA and 348 mg of DHA. Another group got a placebo. After three months, the group taking the fish oil showed a 20 percent reduction in anxiety scores and a 14 percent reduction in the production of the inflammatory marker interleukin-6 (IL-6) over the placebo group.

IL-6 is an inflammatory cytokine. Depression and anxiety are both known to involve the production of inflammatory cytokines. This is one of the gut-brain connections, actually, since the inflammation can originate in the gut. Omega-3s were able to reduce these inflammatory compounds, highlighting just one way they may be helping mood disorders like depression and anxiety.

This week, if you tend to get anxious about things, even if occasionally, and you’re not taking fish oil, you might want to reconsider. The studies on fish oil are hard to ignore.

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Belly fat, or visceral adipose tissue (VAT), is the fat that accumulates around the organs in the abdomen. It is strongly related to metabolic disorders including insulin resistance, fatty liver and inflammation. Because of the close proximity of belly fat to the intestines, and the ability of gut bacterial toxins to affect inflammation outside the gut, the relationship of increased intestinal permeability, or leaky gut, to increased abdominal fat has been investigated. 

Indeed, previous studies in animals and in people with illnesses like Crohn’s disease¹ and non-alcoholic fatty liver disease (NAFLD), have found a link between leaky gut and belly fat. Until recently, however, no studies had been done in healthy humans. Now the picture is all coming together nicely, as a new study highlights.

In 55 healthy women, intestinal permeability was estimated by measuring urinary excretion of ingested nonmetabolizable sucralose and mannitol. (They measure the ratio of excreted sucralose to mannitol—if the sucralose level is high, it means it leaked through the gut, even though it shouldn’t.) Further, imaging was performed of subcutaneous fat (fat just under the skin) visceral fat, and liver fat. The researchers found that increased leaky gut was associated with increases in both visceral fat and liver fat content in healthy women.² This is important because previous studies have found this in people with illnesses, but it was not known if leaky gut could was associated with belly fat in healthy individuals. Now we have a better picture of this gut connection.

The women in the study had no history of gut disorders, yet some of them still had leaky gut, and those with the worst leaky gut also had the most belly and liver fat. The researchers stated, “The current findings suggest that even without pathologically compromised gut function, intestinal permeability still appears to play a role in visceral adipose and liver fat accumulation.” Importantly, they go on to mention the role that the gut microbiota plays in this picture. Alterations in gut bacteria composition has been associated with metabolic dysfunction,³ and gut bacteria help regulate gut barrier function,⁴ they mention.

They conclude, “Our data suggests that intestinal permeability may be an important part of the link between diet, gut microbial balance, inflammation, and metabolic disorders. The present findings are consistent with the emerging role of gut in metabolic health.”

Abdominal fat has even been considered an organ of its own, due to the many chemicals and hormones it produces, just as organs do. The role of VAT as a contributor to metabolic diseases is possibly the most important factor to consider when trying to reduce disease risk. That the accumulation of this belly fat is related to the gut, and might even originate in the gut, takes our search into the prevention of diseases yet one more step closer to the source. A healthy gut is truly the foundation of total body health.

References

1. Desreumaux P, et al., “Inflammatory alterations in mesenteric adipose tissue in Crohn’s disease.” Gastroenterology. 1999 Jul;117(1):73-81.
2. Gummesson A, et al., “Intestinal Permeability Is Associated With Visceral Adiposity in Healthy Women.” Obesity (Silver Spring). 2011 Aug 18. [Epub ahead of print]
3. Cani PD and Delzenne NM, “The role of the gut microbiota in energy metabolism and metabolic disease.” Curr Pharm Des. 2009;15(13):1546-58.
4. Sharma R, et al., “Molecular modulation of intestinal epithelial barrier: contribution of microbiota.” J Biomed Biotechnol. 2010;2010:305879.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Belly fat is usually detectible—people generally have a good idea if they tend to accumulate fat in their midsection, as opposed to their hips and bottom. But how do you know if your liver is fat? Well, abdominal fat and liver fat often go hand in hand. In fact, fat from the liver can be sent to the belly, and vice versa. Often, an underlying feature of both of these is inflammation, which may come from the gut. Nutrients and other substances—including fat, toxins and inflammatory compounds—are absorbed from the small intestine and travel straight to the liver via the portal vein.

A recent study found that obese individuals with high amounts of abdominal fat and liver fat are at increased risk for heart disease. The researchers found that liver fat is strongly associated with increased secretion of very-low-density lipoproteins (VLDL), which contain the highest amounts of triglycerides, known to increase heart disease risk.

It has long been known that abdominal fat can be dangerous. The increasing knowledge about the dangers of liver fat adds to the story, as these two go hand in hand, each setting the body up to be more susceptible to metabolic syndrome, type 2 diabetes and heart disease. Together, belly and liver fat mean trouble.

Both liver and abdominal fat can be reduced with exercise and weight loss. These steps, in addition to addressing any underlying gut dysfunction that may be contributing inflammation to the liver, can help reverse these metabolic precursors to heart disease.

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Vegetarians are 30 percent less likely to develop the bowel disorder diverticular disease than meat eaters, according to a recent study published by the British Medical Journal. Diverticular disease involves the development of pouches in the wall of the large intestine. Diverticulitis describes the inflammation of these pouches, which can be a painful condition, and may lead to further complications like peritonitis, an infection of the abdominal cavity following the rupture of diverticular pouches.

A low-fiber diet is known to contribute to the development of diverticular disease, and thus, a vegetarian diet has been suggested as beneficial. This new study, based on 47,033 participants, provides strong evidence to support a vegetarian diet. Over 15,000 participants in the study reported consuming a vegetarian diet. After 11.6 years follow up, and adjusting for other contributing factors like smoking, alcohol consumption and body mass index, vegetarians fared better than meat eaters in terms of risk of diverticular disease.

In addition, those participants with the highest dietary fiber intake—over 25 grams per day—had the lowest risk of being admitted to the hospital with, or dying from, diverticular disease compared with those only consuming 14 or less grams per day. The researchers suggest, “the opportunity for preventing the occurrence of diverticular disease and other conditions, such as colorectal cancer, probably lies in the modification of the diet.”

They also stated, to my dismay, that far more evidence is needed before dietary recommendations can be made to the general public. Sure, they do need to replicate this study and continue to learn about what specific dietary factors can have the greatest impact before recommending vegetarian diets to all, but they could certainly recommend increasing fiber-rich fruits, vegetables and whole grains, while decreasing unhealthy meats, in the meantime. I certainly do.

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The immune system is a complex organization of coordinated responses to “foreign” invaders in the body. Foreign invaders include microbes—bacteria, fungus, parasites and viruses—as well as toxins and even food. As a matter of fact, one major role of the immune system is to not respond to food. As is seen with food allergies, however, the immune system is not always successful at this. Food allergies involve an overactive immune response to certain foods, which would normally be recognized as harmless. 

The immune system is comprised of two main branches: the innate immune system and the adaptive immune system. The innate immune system, also known as cell-mediated immunity, involves an immediate non-specific immune response, often against pathogens. The adaptive immune system, also called humoral immunity, involves a delayed, specific, organized response involving the production of antibodies that later recognize invading microbes so that a more effective immune response can be mounted. The innate immune system involves the production of cells called T helper 1 (Th1) cells, and adaptive immunity involves the production T helper 2 (Th2) cells. T helper cells are lymphocytes, a type of white blood cell. They are like the messengers of the immune system, sending signals that stimulate various immune responses.

Th1 and Th2 responses are joined by another type of T helper cell known as Th17. Th17 and Th1 responses are both associated with over-active immune responses, as is seen in autoimmune conditions, in which the body mistakenly attacks its own tissues. Both these responses produce inflammation by way of cytokines, the immune equivalent of hormones. These three types of T helper cells are all regulated and balanced by cells known as T regulatory cells, or Tregs.¹

Are you confused yet? Think of all these T cells as a four-way seesaw.  Th1 and Th17 are on two prongs of one end, and Th2 and Tregs are on two prongs of the other. When all is well, this seesaw is in balance, like a harmonized symphony responding appropriately to that which the body comes into contact.  If out of balance, you may see higher levels of Th1 and Th17, an indication of underlying autoimmunity as is seen with type 1 diabetes, celiac disease, rheumatoid arthritis, psoriasis, multiple sclerosis and systemic lupus erythematous. In contrast, higher levels of Th2 and Tregs are characteristic of allergic conditions like asthma, food allergies and hay fever, and with immune suppression.

How can we balance immunity? Well, probiotics are one solution. Since over 70 percent of the immune system is in the gut, probiotics are in the right terrain for immune system communication. Probiotics help balance immune response.  Gut bacteria essentially “prime” the immune system,² educating it so that it responds appropriately to what passes through the digestive tract—and to what may ultimately pass through the small intestine and into the body.

Omega-3 fatty acids also affect immunity, largely by helping to balance the inflammatory response—an important aspect of immunity. You see, inflammation is a necessary physiologic occurrence.  But too much inflammation spells trouble.  The omega-3 fatty acids EPA and DHA found in fish oil help to quell inflammation at the right time.  They help stimulate the production of resolvins, chemicals knows to help “resolve” inflammation—or end it at the appropriate time.³ 

Further, the proper digestion of food is necessary so the immune system doesn’t have to work too hard.  When food is not broken down properly, undigested food particles can aggravate the gut, causing inflammation and even leaking through a permeable intestine (also known as leaky gut) and entering circulation where yet more inflammation is triggered, in a downward spiral of excess inflammation (which is at the basis of most, if not all, chronic disease).

Also important is regular bowel elimination, which can be attained by the consumption of dietary fiber—at least 35 grams per day. A diet rich in fruits, vegetables and whole grains is essential, and a fiber supplement can help reach 35 grams, which can be difficult to obtain through diet alone.

In essence, the HOPE Formula—High-fiber, Omega Oils, Probiotics and digestive Enzymes—can help improve digestive health and improve immune balance. Brenda and I have been recommending this formula for years for many good reasons. With the HOPE Formula, there is hope that your health will improve. 

References

1. Cooke A, “Th17 cells in inflammatory conditions.” Rev Diabet Stud. 2006 Summer;3(2):72-5.
2. Round JL and Mazmanian Sk, “The gut microbiota shapes intestinal immune responses during health and disease.” Nat Rev Immunol. 2009 May;9(5):313-23.
3. Serhan CN and Savil J, “Resolution of inflammation: the beginning programs the end.” Nat Immunol. 2005 Dec;6(12):1191-7.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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allergic conditions, autoimmunity, bacteria, balance immunity, DHA, Dietary Fiber, Digestive Enzymes, digestive tract, EPA, fish oil, food allergies, fungi, gut bacteria, high-fiber, HOPE formula, immune system, inflammation, leaky gut, microbes, Omega oils, omega-3 fatty acids, Parasites, Probiotics, regular bowel elimination, resolvins, small intestine, toxins, viruses

Autism is a developmental disorder characterized by severe abnormalities in communication, social awareness and skills, and behavior. Before the 1980s, autism occurred in 2 to 5 of every 10,000 children. Today about 1 in every 110 children gets autism. This rapid increase cannot only be attributed to improved diagnosis, and also indicates there is more to the disorder than simply genetics. Indeed, autism is a combination of genetic predisposition with environmental factors that triggers its development.

One aspect of contributing factors, at least in a subset of children, involves gut dysfunction. Many reports describe gastrointestinal symptoms and abnormalities in up to 84% of children with autism.[1] From constipation, diarrhea, abdominal discomfort, food sensitivities and abnormal gut flora to immune dysfunction and gut and systemic inflammation, the digestive system plays a central role in many cases of autism.

One gut abnormality—lactose intolerance—found in people with autism was recently reported in the journal Autism. Intestinal disaccharidase activity was measured in 199 individuals with autism. Disaccharidase is an enzyme that breaks larger sugars (disaccharides) like lactose, maltose and sucrose into smaller sugars like glucose. Deficiency of lactase enzyme, the enzyme that breaks milk sugar, or lactose, into galactose and fructose, was found in 58 percent of autistic children and 65 percent of autistic adults. In children, boys under 5-years-old had 1.7-fold lower lactase activity than girls of the same age, indicating the problem may be more severe in boys. The study concluded that lactase deficiency is common in autistic children and may contribute to abdominal discomfort, pain and the observed abnormal behavior seen in autism. Further, the study points out that most autistic children with lactose intolerance are not identified when doctors take a clinical history.

A decrease in activity of a variety of carbohydrate-digesting enzymes has been reported in children with autism.[2] Carbohydrase and disaccharidase enzyme deficiency results in the incomplete breakdown of carbohydrates in the small intestine. These partially undigested carbs move into the colon where they are greeted by a large supply of “hungry” bacteria—including potentially pathogenic bacteria. This may explain the increased presence of Candida and Clostridia species found in the guts of autistics.[3][4]

Carbohydrate-digesting enzymes are not the only digestive enzymes that may cause problems in autism. Fat malabsorption is seen in some autistic children, resulting in fatty, loose, floating, foul-smelling stools, also known as steatorrhea. Further, a particular enzyme known as dipeptidyl peptidase-4 (DPP4) may be deficient in those with autism. This enzyme breaks a specific peptide bond in gluten and casein proteins. In fact, it is thought that a deficiency in this enzyme is responsible for the incomplete breakdown of casein and gluten peptides (known as gluteomorphins and casomorphins) that act as opioids in the central nervous system and are thought to contribute to autistic symptoms. Following a gluten-free and casein-free diet has been found helpful in many autistics because it eliminates exposure to these peptides, often relieving symptoms. Supplemental DPP4 can be given in cases where accidental ingestion of gluten- or casein-containing foods is suspected, but it is not recommended as a replacement for the gluten-free, casein-free diet.

In all, we see a variety of enzyme deficiencies in autism and it would be wise to supplement with a digestive enzyme formula that includes a variety of enzymes. Further, due to the many digestive abnormalities seen in autism, the HOPE Formula (High-fiber, Omega oils, Probiotics and digestive Enzymes) is a wise daily maintenance program to support gut health.

[2] Horvath K, et al., “Gastrointestinal abnormalities in children with autistic disorder.” J Pediatr 1999;135:559-63.

[3] Finegold SM, et al., “Gastrointestinal microflora studies in late-onset autism.” Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.

[4] Shaw W, et al., “Assessment of antifungal drug therapy in autism by measurement of suspected microbial metabolites in urine with gas chromatography—mass spectrometry. The Clinical Practice of Alternative Medicine Magazine. 2000;1:15-26.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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An interesting study published in the journal Obesity points out that eating more soluble fiber, like that from apples and beans, and moderate exercise will selectively decrease belly fat.¹ The authors don’t seem to know why it is selective to belly fat, and not subcutaneous fat (fat just under the skin). I think one reason would be that the intake of high amounts of soluble fiber promotes growth of beneficial bacteria that produce short chain fatty acids, both of which may control some of the inflammation in the gut. Chronic inflammation causes marked increase in insulin resistance, and therefore, storage of more belly fat. Controlling this inflammation is key, and as we see, can be done by consuming soluble fiber.

Here are some recently discovered points that support the above concepts:

• Eating a high fat and sugar diet decreases the number of beneficial bifidobacteria and increases the number of potentially pathogenic gram negative bacterial species in the gut.
• As these potentially pathogenic bacteria die they release cell wall lipopolysaccharides (LPS) which happen to also be better absorbed through the gut lining when eating a high-fat, high-sugar, low-fiber diet on a regular basis. The LPS molecules easily pass through the epithelial gut lining and hit the gut immune system where they activate white blood cells including neutrophils, monocytes, and macrophages that all then release inflammatory cytokines: TNF alpha, IL-6 and IL-1 beta. These inflammatory cytokines can trigger inflammation in the small blood vessels throughout the body but probably start with the blood vessels in the intestines, causing endothelial dysfunction. This has been proven by measuring a significant decrease in blood vessel wall flexibility within minutes to hours after eating a high-fat, high-sugar meal.²  
• Conversely, supplementing with bifidobacteria and eating a plant-based, high-fiber diet seems to decrease translocation of LPS through the gut epithelial lining and may help prevent the negative effects of high-fat diet induced metabolic diseases.³
• The vascular inflammation in and around the intestinal tract, which is 20 or more feet in length, can stimulate stem cells adjacent to the blood vessel walls (known as stem cell pericytes) to develop into fat cells or adipocytes which accumulate wherever there are blood vessels in the abdomen—that’s almost everywhere!
• The inflammatory fire continues as the abdominal fat, or visceral fat (some people call it VAT) continues to produce more inflammatory cytokines (IL- 6, TNF alpha, etc.) that flow into other blood vessels, stimulating more stem cell conversion into fat cells or adipocytes.
• It is interesting that both vitamin D and stem cells are stored at high levels in abdominal fat. Perhaps the vitamin D is trying to cool down the inflammation and the stem cells are there to respond according to the body’s information: either make fat or something else.  

It makes sense that exercise  was found helpful for reducing abdominal fat. Exercise has many benefits. For one, it produces more adiponectin to help reverse the situation. Adiponectin is an anti-inflammatory hormone made in fat that both decreases inflammation in fat and travels to the pancreas to help sensitize and balance the release of insulin which can help reverse metabolic imbalances.

So it is pretty simple—eat your plant-based, high-fiber diet, supplement with probiotics (including good amounts of bifidobacteria), and exercise moderately on a regular basis.  Then be patient. The accumulation of abdominal fat, along with all the problems caused by this fat, including heart attacks and cancer, is reversible.

1.  Hairston KG, et al., “Lifestyle Factors and 5-Year Abdominal Fat Accumulation in a Minority Cohort: The IRAS Family Study.” Obesity (Silver Spring). 2011 Jun 16. doi: 10.1038/oby.2011.171. [Epub ahead of print]

2.  Plotnik GD, et al., “Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal.” JAMA. 1997 Nov 26;278(20):1682-6.

3.  Cani PD, et al., “Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia.”

Diabetologia. 2007 Nov;50(11):2374-83.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Did you know there is a link between Alzheimer’s disease and cholesterol levels? This has been known for sometime, actually. Middle-aged adults with high total cholesterol levels—even moderately high—are more likely to develop Alzheimer’s. And, very high HDL (good) cholesterol levels in older adults puts them at reduced risk of Alzheimer’s.

Two new studies takes this link even further. Researchers are trying to find genes that are linked to Alzheimer’s disease. The APOE gene has already been strongly linked to the disease—if you have two versions of APOE4 (one from mom, one from dad) then you are more likely to develop Alzheimer’s because this APOE version is inefficient at breaking down amyloid beta plaques in the brain. Amyloid beta plaques are the hallmark of Alzheimer’s disease.

The new studies have found five more genes related to the development of Alzheimer’s, The interesting part is the function of these genes. The genes are involved with cholesterol and inflammation—both of which have been implicated in the development of Alzheimer’s disease.

Researchers at the Scripps Research Institute have found that a chemical formed when cholesterol reacts with ozone (formed by inflammation) is involved in misfolding of amyloid beta, which makes it difficult to remove from the brain. The cholesterol link is interesting because cholesterol is produced in the liver, and the liver may be the actual source of amyloid beta in the first place, according to yet another recent study I blogged on recently.

Another finding comes from the University of California at Irvine. Cortisol, a hormone produced during stress, may also play a role in misfolding of amyloid beta. All the more reason to find some stress relief!

All these links of Alzheimer’s disease to processes that occur in other areas of the body make it even more important to eat a healthy diet, get plenty of exercise, and find ways to relieve stress. And if you have high cholesterol—do something about it! Your body is telling you that something is off. Are you listening to it?

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Omega-3 fatty acids are wonder nutrients that offer many benefits to the body, from head to toe. Now, even the mouth is included in the long list of body areas that function better after intake of omega-3s.

A recent study found that a moderate, daily intake of the omega-3s DHA and EPA (found in marine sources, usually fish oil) was associated with up to a 20 percent decreased risk of gum disease (periodontitis).

Gum disease is an inflammatory disease that is caused by microorganisms like the bacteria Streptococcus mutans, Candida albicans and Porphyromonas gingivalis. Usually antibiotics are prescribed in an effort to eliminate these bacteria, but other treatments have been used that target the inflammation of gum disease, like scaling and root planing (ouch!) and in extreme cases surgery.   

Omega-3s are most known for their anti-inflammatory effects, so it is not surprising that they would help quell inflammation in the mouth. Additionally, this study also found that omega-3 fatty acids also demonstrated antibacterial activity against oral pathogens.

The mouth is the very beginning of the digestive tract, and the bacterial balance in the mouth is proving to be more important than previously thought. In fact, gum disease is also associated with the development of heart disease! Everything is connected, folks, and it all goes back to the gut!

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