In some people who take antibiotics, the uncomfortable side effect of diarrhea results. This happens because antibiotics disturb the gut bacterial balance. Antibiotics, aptly named as they are, work by killing bacteria—both good and bad bacteria. This alteration of gut bacteria can result in an imbalance that favors pathogenic bacteria, resulting in diarrhea. This is known as antibiotic-associated diarrhea (AAD). One of the most severe forms of AAD is Clostridium difficile-associated diarrhea.

A recent review of 22 studies, and a recent meta-analysis of randomized controlled trials, both sought to determine the effectiveness of probiotics on the prevention of antibiotic-associated diarrhea. In the review, the lead researcher stated, “Overall in twenty-two studies, probiotic prophylaxis significantly reduced the odds ratio of developing AAD by approximately 60 percent. This analysis clearly demonstrates that probiotics offer protective benefit in the prevention of these diseases.” A researcher presenting the results of the meta-analysis stated, “The preventive effect of probiotic use remained significant regardless of species used, adult versus child populations, study quality score and antibiotic administered.”

These findings were presented at the American College of Gastroenterology’s 76^th Annual Scientific Meeting in Washington, D.C. in late October. The acknowledgement of the beneficial effects of probiotics by such a group is encouraging. Certainly, the evidence is impossible to ignore. Next time you are prescribed antibiotics, ask your doctor about taking probiotics. If your doctor is not familiar with probiotics, educate him/her!

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AAD, antibiotic, antibiotic associated diarrhea, antibiotics, bacteria, Clostridium difficile-associated diarrhea, Diarrhea, Gastroenterology, gut bacterial balance, imbalance, pathogenic bacteria, Probiotics

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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“Renew You” Challenge – This weekly challenge is about how heart health begins in your mouth.
Your digestive tract (what I like to call the gut) begins in your mouth. The thought, smell or sight of food triggers the release of amylase enzymes in the mouth to begin the digestion of carbohydrates. The chewing process is also important for the physical breakdown of foods and mixing them with amylase enzyme in saliva.

But guess what, there is much more to the mouth than saliva and teeth. There is a bacterial balance that can contribute to the health of the rest of the body, in a somewhat similar way as it exists in the intestine.

This is a relatively new concept and one that I find interesting. Certain pathogenic bacteria haven been known to cause the buildup of plaque and the development of gum disease. This is not new news. But what is new, is that these bacteria (and thus, gum disease) are linked to the development of heart disease.

A recent study has found that these bacteria are actually able to get into the bloodstream directly from the mouth. (Have you heard of leaky gut syndrome? This could be called leaky gum syndrome). These renegade bacteria trigger the development of blood clots, which lead to heart disease.

We can no longer look at different parts of the body and see them as separate. Everything is interconnected, and what happens in one area of the body has an effect on another. This is especially true in the digestive tract, due to its function, location, and direct connections to so many parts of the body.

So brush off that dental floss if it’s looking a little dusty. Everyday flossing, cutting back on sugar and refined carbohydrates, and brushing at least twice a day are great ways to keep your heart (and your body) healthy.

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As if smoking isn’t bad enough for your health, researchers recently discovered that cigarettes are “widely contaminated” with hundreds of species of infectious bacteria… yuck! Not only that, but they think those bacteria are somehow able to survive the smoking process, which means it’s not just smokers who are affected, but people exposed to secondhand smoke may be at risk too.

Talk about an eye-opener! When I heard the story I can’t say I was shocked, but it was interesting to learn that even though scientists knew they were going to find bacteria in cigarettes, even they were surprised that most of those bacteria are infectious to humans—like clostridium, klebsiella, and pseudomonas aeruginosa, which can cause damage the lungs, urinary tract and kidneys… holy smokes!

More research is planned to find out just how these bacteria affect human health, so it will be interesting to see what they learn. And in the meantime, do you really need any more reason to quit smoking???

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