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The Importance of Probiotics

Throughout this wellness series we have been talking about the genome centric lifestyle and what nutrients our bodies require to maintain its self-healing and self-regulating properties. Most the nutrients that our body needs can be found in the foods that we eat, however, over the years due to industrialization and commercialization of our food sources we have become deficient in three key essential nutrients Omega-3’s, Vitamin D and probiotics.

In this blog, we are going to specifically look at Probiotics and their role in health and wellness.

Two nervous systems

Our bodies are actually made up of two nervous systems.

  1. central nervous system, composed of your brain and spinal cord and the
  2. enteric nervous system, which is the intrinsic nervous system of your gastrointestinal tract.

Both systems were created from the exact same material during fetal development and both systems are in constant communication via the vagus nerve (tenth cranial nerve). It is now well established that the vagus nerve is the primary route your gut bacteria use to communicate with your brain through the production of neurochemicals (Hadhazy, 2010, n.p.).

Gut and brain communication

Many think that the brain is the organ in charge, however, your gut will send more information to the brain regarding the state of the body than the brain sends to your gut. The feeling of butterflies when nervous or an upset stomach when angry are examples of how the brain can affect the gut. The same is true on the flip side, problems in the gut can lead to problems with mental health, such as anxiety and depression.

Roles of gut bacteria

At birth our gut is sterile, but over time our gut develops a diverse concoction of bacteria based from our genetics and our environment. These bacteria are responsible for digestion, metabolism, extracting vitamins and other nutrients from the food that we eat, programming the immune system and, as we just learned, communicating with the central nervous system.

Probiotics in nature

Our ancestors ate fermented foods, ate crops straight from the ground rather than sterilizing them, lived in less sterile environments, but most importantly, our ancestors did not take the copious amounts of antibiotics that we do now. Although sterilization techniques have benefits, we do not ingest the same diverse amounts of probiotics our ancestors once did, thus we must consider supplementing these essential nutrients.

Like with all nutrients, including the essential nutrients we have talked about these last few weeks, the best way to get them is through the environment and then supplement if there is no source in the diet.

Foods high in probiotics

Foods that are good sources of probiotics include:

  1. Kimchi – a Korean side dish made of salted and fermented vegetables
  2. Kefir – a fermented milk drink using kefir grains
  3. Sauerkraut – fermented cabbage
  4. Kombucha – fermented black or green tea

Yogurt and probiotics

Many of my clients will ask me about yogurt. I, personally, am not a fan of yogurt for probiotics. The large majority of yogurt is very high in sugar, which as stated in a previous blog, is quite bad for our bodies. Yogurt is made from dairy and for most people dairy is an inflammatory food. Lastly, yogurt only has a couple different types of bacteria strains (Lactobacillus bulgaricus and Streptococcus thermophilus) which does not provide much diversity of bacteria for the gut. Therefore, I would prefer my clients not count on yogurt for probiotics.

Supplementing probiotics

Supplementing probiotics first depends on the person’s diet, if the patient has ever been on antibiotics before, and lastly, how recent the antibiotic use has been. There are several different doses and is best to choose that dose on a individual level.

The probiotics capsules we carry in our office range from 5 billion active probiotic cells to 300 billion cells. It is also vital to have live cultures. This typically means a refrigerated probiotic, but some may have stabilizers in them that keep the bacteria alive at room temperature. Lastly, having a diverse amount of bacteria in the probiotic is ideal. Different bacteria have different roles in the body and the more diverse the gut flora is, the more roles that can be accomplished.

The Research

As you can see, your gut plays a much more vital role in your health than previously thought possible. Below is more research showing just how crucial your gut is to your overall health and wellness:

Gene expression

Researchers have discovered that the absence or presence of gut bacteria during infancy permanently alters gene expression (remember our talks on epigenetic?). Through gene profiling, researchers were able to discern that gut bacteria influenced genes and signaling pathways involved in learning, memory, and motor control, suggesting gut bacteria are closely tied to early brain development and subsequent behavior. In a similar way, probiotics have also shown to influence the activity of hundreds of your genes, helping them to express in a positive, disease-fighting manner (Hadhazy, 2010, n.p.).

Mental health

Another interesting function of these gut bacteria is they produce hundreds of neurochemicals that the body and brain use to regulate physiological and mental processes such as learning, memory and mood. For example, about 95% of the body’s supply of serotonin is produced in the gut (Carpenter, 2012, n.p.). Serotonin is best known as the “feel-good” molecule and is involved in preventing depression, regulating sleep, appetite and body temperature. And this is just one of 40 different neurotransmitters produced in the gut, aka “the second brain” (Hadhazy, 2010, n.p.). This may explain why many times antidepressants may not work for some people or why kids with ADHD or those who do not sleep well usually have gut issues.

Anxiety and depression

Stress-induced changes to the microbiome may in turn affect the brain and behavior. A few studies suggest that defensive molecules the gut produced during infection, called inflammatory cytokines, disrupt brain neurochemistry and make people more vulnerable to anxiety and depression (Carpenter, 2012, n.p.). This may help explain why more than half of people with chronic GI disorders such as Crohn’s disease, ulcerative colitis and irritable bowel syndrome (IBS) are also plagued by anxiety and depression.

Obesity

The makeup of gut bacteria tends to differ in lean vs. obese people (Magrone, 2015, n.p.). This is one of the strongest areas of probiotic research to date. Obese individuals had about 20 percent more of a family of bacteria known as firmicutes, and almost 90 percent less of a bacteria called bacteroidetes than lean people. Firmicutes help your body to extract calories from complex sugars and deposit those calories in fat leading to obesity.

Immune system

Gut bacteria program our immune system from the time we are born by building up and maintaining the gut wall protecting us from outsiders as well as killing off any illness causing pathogens. At least 70 to 80 percent of our immune system lives in the gut (Vighi, 2008). There is research being presented that gut bacteria can train your immune system to distinguish between “foreign” microbes and those originating in your body, leading to new therapies using probiotics to treat a variety of diseases, particularly autoimmune diseases such as multiple sclerosis and Alzheimer’s.

Thus, if the appropriate immune tolerance developed in the gut is not established early in life and then maintained throughout life, then this can become a risk factor for the development of inflammatory, autoimmune and allergic diseases.

Antibiotics kill all bacteria, even the good stuff

The best way to protect microflora is by not taking antibiotics unless there is an actual bacterial infection. Antibiotics kill off ALL bacteria, even the good stuff. Antibiotics have a purpose and a great need when fighting bacterial infections. However, antibiotics do nothing for viral infections, therefore, be aware and do not be afraid to ask your doctor questions when prescribed antibiotics. Be sure that you are actually infected with bacteria or are at a high risk of bacterial infection before actually taking the antibiotic.

Overprescription of antibiotics

According to the CDC, across the United States, the number of antibiotic prescriptions given to children and adults remains high. Numerous studies have found that antibiotics are being prescribed for illnesses which do not require antibiotics, and the incorrect type of antibiotic, dose, or duration are often prescribed across all healthcare settings. In fact, in the United States, the Centers for Disease Control and Prevention estimates that one-third of all antibiotic prescriptions are unnecessary.

Unintended consequences from antibiotic overuse

  • Antibiotic resistant infections
    • Each year, over 23,000 Americans are dying because of bacteria that is resistant to antibiotics (CDC, 2018).
  • Longer healing time for infections
    • The type of antibiotics that are most often given to treat urinary tract infections are now considered ineffective for over 50 percent of the patients in many parts of the world (Felter, 2018).
  • Allergies and asthma
    • According to a large study, more than 792,000 children born between 2001 and 2013 who took antibiotics (or antacids) between birth and six months of age were linked with the development of allergies as well as asthma (Mitre, 2018).
  • Burden on health care system
    • The average patient, in 2009, facing an antibiotic-resistant infection can expect a medical bill anywhere from $18,588 and $29,069. This ads up to over $20 billion in health care costs each year in the U.S. (Krans, 2014).
    • In 2000, the U.S. lost $35 billion because of premature deaths, hospital stays, and lost wages related to antibiotic-resistant infections (Krans, 2014).
    • It is estimated that ∼150 000 ER visits are attributed to antibiotic-associated adverse events each year in the United States alone (Goldman, 2015).

What to do

  1. ASK QUESTIONS. Be sure to ask your doctor questions when an antibiotic is being prescribed.
  2. Remember, antibiotics do nothing for viral infections!
  3. If you have ever been on an antibiotic, then supplementing with a quality probiotic is necessary for optimal gut health.
  4. Decrease inflammation in the body by eating well, drinking lots of water and having good mental health.
  5. Eating fermented foods can help with proper gut flora.
  6. When supplementing, be sure to have a quality source and be sure to talk with a health professional about which level of dosage would work best for you.

 

Resources:

Bengmark, S. M.D. Ph.D. 1998. Immunonutrition: Role of biosurfactants, fiber, and probiotic bacteria. Nutrition. 14:585-594.

Carpenter, S. (2012, September). That gut feeling. Retrieved January 13, 2018, from http://www.apa.org/monitor/2012/09/gut-feeling.aspx

Hadhazy, A. (2010, February 12). Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being. Retrieved January 13, 2019, from http://www.scientificamerican.com/article/gut-second-brain/

Magrone, T., & Jirillo, E. (2015, February 24). Early Life Factors Influencing the Risk of Obesity. Retrieved January 13, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712533/

Mcloughlin, RM & Mills, KH. Influence of gastrointestinal commensal bacteria on the immune responses that mediate allergy and asthma. J Allergy Clin Immunol. 2011; 125 (5) : 1097-107

Grazul et al., Impact of probiotic supplements on microbiome diversity following antibiotic treatment of mice. Gut Microbes. 2016; 7(2): 101–114. Published online 2016 Mar 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856465/

Vighi et al., Allergy and the gastrointestinal system. Clin Exp Immunol. 2008 Sep; 153(Suppl 1):3–6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/

Center for Disease Control. Antibiotic Use in the United States, 2017: Progress and Opportunities https://www.cdc.gov/antibiotic-use/stewardship-report/conclusion.html

Center for Disesae Control. Containing Unusual Resistance, 2018. https://www.cdc.gov/vitalsigns/containing-unusual-resistance/index.html

Felter, Claire. The End of Antibiotics?. Backgrounder, March 2018. Retrieved March 15, 2019 from The Council on Foreign Relations at https://www.cfr.org/backgrounder/end-antibiotics

Mitre, et al. Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr. 2018 Jun 4;172(6):e180315. Retrieved March 15, 2019 from https://www.ncbi.nlm.nih.gov/pubmed/29610864

Krans, Brian. 5 Frightening Consequences of Overusing Antibiotics. Healthline,  March 11, 2014. Retrieved March 15, 2019 from https://www.healthline.com/health-news/five-unintended-consequences-antibiotic-overuse-031114#1

Goldman, Jennifer, et al. Tip of the Iceberg: Understanding the Unintended Consequences of Antibiotics. Pediatrics. 2015 Aug; 136(2): e492–e493. Retrieved March 15, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516949/

 

 

 

 

 

 

 

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The Importance of Vitamin D

Throughout this wellness series we have been talking about the genome centric lifestyle and what nutrients our bodies require to maintain its self-healing and self-regulating properties. Most the nutrients that our body needs can be found in the foods that we eat, however, over the years we have become deficient in three key essential nutrients Omega-3’s, Vitamin D and probiotics.

What is Vitamin D and where to get it

In this blog, we are going to specifically look at Vitamin D. Vitamin D is a hormone produced in the body via exposure to Ultraviolet B radiation and cannot be produced by the body without exposure to the sun. According to research, well over half of the population is deficient in Vitamin D. Even those in sunny climates rarely get enough sun exposure due to clothing and sunscreen. In this case, quality Vitamin D supplementation is recommended. 

Supplementing Vitamin D

As said above, the best source of Vitamin D is from the sun. Vitamin D is naturally found in very few foods and can be fortified in some. If not getting Vitamin D from natural sources it is best to look into quality supplementation. Like all supplements, be sure you know your source and read the ingredients – the less the better. The product we have in our office is made of two ingredients: Vitamin D and olive oil. The difference between capsules and oil is not much when it come to what is in the product, however, sublingual drops have a more effective absorption rate into the body. I usually recommend the sublingual drops for my patients for this reason.

The roles of Vitamin D

Vitamin D is crucial in virtually every human function including: growth and development, brain and nerve function, emotions and behavior, maintenance and repair of skin and bones, regulation of healing and inflammation, cholesterol levels, digestion, heart function, immune function, vision, vitamin production, digestive system function, cardiovascular health, etc.

How much Vitamin D does one need?

This can be a tricky question and it all depends on how much sun exposure one is getting. The Vitamin D Council recommends that healthy adults take 2,000 IU of vitamin D daily — more if they get little or no sun exposure. There’s evidence that people with a high amounts of body fat need more vitamin D than lean people. I recommend to my patients that during the winter months to be taking around 4,000 – 6,000 IUs daily and even more depending on size and symptoms. In the late spring, summer and early fall, I recommend that the best way to get Vitamin D is to be in the sun midday without sunscreen for 20 minutes in a swimming suit (for proper skin exposure) and for young kids 10 minutes. This will give enough daily Vitamin D. After the 10 or 20 minutes is up, please put on sunscreen. If someone is not comfortable going out into the sun for that amount of time without sunscreen, then that is perfectly fine, however, this person will need to continue supplementing at the recommended dose. The great thing about Vitamin D is it is very hard to overdose, so although one must be aware of how much they are taking, small to moderate amounts of Vitamin D are perfectly fine.

Preventing disease with Vitamin D

According to the Vitamin D Council, conditions associated with Vitamin D deficiency include: 

  • cancer
  • cardiovascular disease
  • diabetes and other endocrine diseases
  • infections and autoimmune disorders
  • mental health
  • learning disorders
  • musculoskeletal disorders
  • neurological disorders including autism and multiple sclerosis
  • dental caries and periodontal disease
  • respiratory diseases such as asthma and allergies
  • skin disorders
  • low fertility in women and men
  • PCOS (polycystic ovary syndrome)

This is the short list of disease that can be linked and attributed to Vitamin D deficiency.

Depression, pain and autoimmune

Signs of Vitamin D deficiency are different from person to person but most include altered moods and/or depression, chronic fatigue, chronic pain, chronic illness, frequent infections. The active 1,25(OH)2D form of vitamin D is a potent modulator of inflammation, and may play a role in turning off chronic inflammatory response. (Liu, 2018) Knowing this, Vitamin D should be recommended for anyone and everyone, but especially clients with chronic fatigue syndrome, fibromyalgia, or chronic musculoskeletal pain. Stewart Leavitt, Ph.D. states that “some researchers have found that vitamin D deficiency occurs in up to 85% of chronic musculoskeletal pain cases, especially those involving the lower back” (Faraj, 2003, 177).

Cancer prevention

Vitamin D-sensitive cancers are responsible for 257,000 deaths in 2007 – 46% of all cancer deaths in the U.S. in 2007 according to Jemal A, et al. (2007) Colon cancer could be reduced by 50% with vitamin D levels maintained above 34ng/ml and breast cancer could be reduced by 50% with vitamin D levels maintained at 52ng/ml (n.p.).

Just because cancer runs in your family, doesn’t mean you can’t try to prevent it. It all goes back to the principles of epigentics – we can determine the expression of a gene via our environment.

Cold and flu prevention

In study performed by Aloia, J et al., taking 800 IU/day of Vitamin D reduced the incidence of cold/flu by 70%, and decreased incidences of cold/flu by almost 100% for those taking only 2.000IU/day of Vitamin D. In children taking 1,200IU/day of Vitamin D during the winter time, 67% were less likely to contract Type A influenza. (Aloia, 2007, n.p.)

Pregnancy and infants

Women should most definitely be supplementing Vitamin D especially during pregnancy. Vitamin D does not pass the placental barrier well, so it is even more important that the mother be sufficient in Vitamin D. Pregnant women who are sufficient, not only help the direct health of their child, but they also have lower rates of preterm labor, preterm birth and infection, with the greatest effects being when women take 4,000IU daily. (Hollis, 2011, n.p.)

A challenge to the medical community

This blog barely skims the surface on the important and necessity of Vitamin D. As stated in this blog and in the research over and over again, people are dying because of a lack of knowledge on how this simple Vitamin can not only change their lives, but save their lives.

I challenge every MD, DC, DO, ND, PA, NP and every other health care abbreviation I missed to recommend vitamin D to each and every one of our clients. It is our responsibility as health care practitioners to give our clients the resources they need in order to give them the best chance of having a long, quality life. 

References

Al Faraj S, Al Mutairi K. Vitamin D Deficiency and chronic low back pain in Saudi Arabia. Spine 2003; 28: 177-179.

Aloia, J et al. Epidemic Influenza and Vitamin D. Epidemiology and Infection 2007, Vol 135 (7) pp. 1095-1098

Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation:a meta- analysis of randomized controlled trials. JAMA 2005; 293: 2257-2264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685053/

Boxer RS, Dauser RA, Walsh SJ, et al. The association between vitamin D and inflammation with the 6- minute walk and frailty in patients with heart failure. J Am Geriatr Soc. 2008;56:454-461.

Cannell et al. 2008 Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory Infections, and the Vitamin D Deficiency Epidemic. Annals of Otology, Rhinology & Laryngology 117 (11) : 864-870

Glerup H, Mikkelsen K, Poulsen L, et at. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int. 2000;66 419-424.

Hollis, Bruce, et al. Vitamin D Supplementation during Pregnancy Part 2 NICHD/CTSA Randomized Clinical Trial (RCT): Outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183324/

Jemal A, et al. Cancer statistics, 2007. Ca Cancer J. Clin. 2007 Jan- Feb; (1) : 43-66.

Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med. 2008; 168 (7): 771-772.

Liu, Wei, et al. The Anti-Inflammatory Effects of Vitamin D in Tumorigenesis. Int J Mol Sci. 2018 Sep; 19(9): 2736.

Munger, KL, Levin Kl, Hollis BW, et al. Serum 25- hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296: 2832-2838.

Pedersen LB, et al. 1, 25 dihydroxyvitamin D3 reverses experimental autoimmune encephalomyelitis by inhibiting chemokine synthesis and monocyte trafficking. J Neurosci Res 2007; 85: 2480-2490.

Richards, JB et al. Higher serum Vitamin D concentrations are associated with leukocyte telomere length in women. Am J. Clin Nutr 2007 Nov; 86 (5): 1420-5

Stewart Leavitt, Ph. D. Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain. Pain Treatment Topics June 2008

Von Essen, MR et al. Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010, 11, 344-349

 

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Supplementation vs. Nutraceuticals: What is the difference and why does it matter.

In the next portion of our blog series I will be listing the only supplements one should really need if following an epigenetic lifestyle. I am actually not a huge proponent of either supplements or nutraceuticals. However, both can be considered necessary depending on the situation.

Due to industrialization and commercialization of our food products, not being outside for the majority of the day anymore due to working inside and the over prescription of antibiotics, it has become much harder to get (and keep) a few of the essential nutrients we need to live to our best quality of life.. Thus, the necessity for supplementation.

Supplementation vs. Nutraceuticals

As soon as we sit down to do a Wellness and Prevention plan, many of my clients start talking about how many “supplements” they are taking. Calcium, Magnesium, Iron, Vitamin C, and Vitamin B’s are usually in the conversation. Put bluntly, this is not technically considered supplementation. This is nutraceutical therapy and there is are big differences between the two, although the nuance is not popularly recognized. I want to highlight these differences before we continue through this wellness series, as our next blogs will be speaking on proper supplementation when necessary.

Disease and Treatment Paradigm

Nutraceutical or nutritional therapy fall within the disease/treatment paradigm. A vitamin, mineral, or nutrient is prescribed to a patient due to have low blood levels of a certain nutrient like iron or calcium. However, many of these nutrients are readily found in the diet, as long as the person is eating what is necessary for the body (i.e. genome centric). These treatments are individualistic, based on the individual’s diagnosis and generally used for a short amount time until levels are back to normal.

Wellness and Prevention Paradigm

As nutraceutical therapy is to the disease/treatment paradigm, supplementation is to the wellness/prevention paradigm (Chestnut, n.d., n.p.).  Hippocrates once said, “Let food thy medicine and medicine be thy food.” That mantra has become harder and harder to live by due to industrialization and commercialization of our food sources along with the abundance of processed and synthetic foods.

True supplementation, as opposed to nutraceutical therapy, focuses on providing the proper amount of an essential nutrient which is not already found in the human diet (n.p.). Any vitamin, mineral, or nutrient that our human genome requires should be found, or at least used to be found, in our environment. Some such vitamins, minerals, or nutrients are much harder to come by as a part of a regularly accessible diet or environment, hence the need for supplementation.

What is an essential nutrient?

An essential nutrient is based on what is required for that species genome to thrive. Every member of that particular species requires the same essential nutrients, not just for a short period of time, but for life (Essential, n.d., n.p.). I use the same example we used in a previous blog post: can you think of any nutrient that one giraffe needs more than another giraffe? Is there any member of a species in the animal kingdom that has different nutritional needs than another member of its own species? Why would it be any different for the human species?

What is essential to our diet?

Essential, in biochemical terms, means that this specific nutrient cannot be produced by the body, therefore it must be ingested or absorbed from the environment, by every member of that species, for life. True supplementation is not individualistic, like nutriceuticals, but rather, is species-specific and species-wide (Chestnut, n.d., n.p.). One species, one diet.

The Big Three

There are only three essential nutrients that may require supplementation when following a genome-centric nutritional plan: omega-3, vitamin D, and probiotics (Essential, n.d., n.p.).

It is rare given our widespread industrialized food production processes, but there are some humans who may ingest plenty of omega-3, vitamin D, and probiotics naturally to avoid some or all supplementation (n.p.). It’s important to look at your diet and supplement based on your needs rather than taking vitamins in a way that is nutraceutical therapy.

Importance of knowing the difference

Knowing the difference is important because so many get wrapped up taking synthetic forms of vitamins and other nutrients, throwing all kinds of money at a situation that could be corrected by eating real food, mostly plants and then properly supplementing to fill the gaps. Everything one needs to be healthy can be found in our environment, so we need to start there and then supplement when necessary.

In the next few weeks we will discuss these occasions when supplementation may be necessary, as well as go into detail on how important these essential nutrients are for disease prevention.

 

Sources

Chestnut, J. L. (n.d.). Species Wide and Species Specific: The Science and Paradigm of Wellness & Prevention Nutrition. Retrieved September 18, 2018, from http://www.innatechoice.com/viewarticle.cfm?id=0D5B2CAB-A1FF-D8C7-F1F6993DA64D1052&return=/articles.cfm&ref=&plid=

Essential Supplementation. (n.d.). Retrieved September 18, 2018, from http://bonfirehealth.com/essential-supplementation-fish-oil-omegas-probiotic-efa/ (image)