Fit-for-duty-first-responders

Fit for Duty: Healthy Habits for First Responders

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

It has been said that being a fire fighter is not a job; but a way of life that invokes passion and dedication. The requirements involved are highly demanding, hazardous and risk filled. This “Call to Duty” unfortunately takes its toll on the body, mind and soul. Therefore, it is critical that one commit themselves to a lifestyle of healthy practices so as to avoid becoming a statistic of the fire service (Selndelbach ’14)

Sudden cardiac deaths:

  • Account for the largest proportion of on duty deaths (48%) amongst fire fighters annually (Eastlake ’13)
  • The strenuous duties of a fire fighter interact with a pre-existing risk profile (Kale ’09)

…..78% of firefighters know at least one fellow firefighter who has suffered a heart attack (Jerrard ’13)

Factors that contribute to unhealthy practices in the life of a fire fighter:

  • Shift work
  • Overexertion (Serra ’12)
  • Chaotic work environment (Smith ’12)
  • Irregular work hours
  • Unhealthy eating patterns; Less than 10 % have a healthy diet (Elliot ’07)
  • Sleep deprivation
  • No time or facilities to participate in moderate to high intensity non-work related activity
  • Exposure to a soup of chemical agents: smoke, toxic fumes and dangerous products of combustion that predispose one to cancer (Smith ’11; Serra ‘12)
  • Encountering high temperatures and noise levels (Serra ’12)

…..Each year, approximately 80,000 firefighters are injured and about 100 firefighters lose their lives in the line of duty (Smith ’11)

Body Composition Concerns: Disease Producing “Belly Fat”

  • More than 70% of US firefighters are overweight or obese (Haddock ’11)
  • Firefighters have the third highest prevalence of obesity among 41 male occupational groups in the United States (Choi ’11)
  • Excess fat is positively associated with frequency of:
  • 75% have prehypertension or hypertension (Tsismenakis ’09; NSCA ‘11)
  • Greater incidence of heart attacks and strokes (Beach ’14)
  • Abnormal blood lipid profile (cholesterol; LDL; triglycerides) (NSCA ’11)
  • Absenteeism in the workplace (Haddock ’11)
  • Less able to perform essential job duties (Beach ’14)
  • Increased risk of job related disability and musculoskeletal injuries (Jahnke ‘13a,b; (Mayer ’12)
  • Reduced muscular strength and increased back pain (NSCA ’1; Mayer ’12)

…..Yet surveys conclude that most firefighters underestimate the risk of added pounds and doctors often do not address the problem or offer a viable and long lasting solution such that the trend continues to worsen (Bauer ’12; Wilkinson ’14)

Sleep deprivation and excess daytime fatigue often cause: (Mehrdad ’13; Haddock ’13)

  • Depression (Carey ’11)
  • High injury rates (Elliot ’07)
  • Musculoskeletal pain (Lim ’14)
  • Accidents (Elliot ’07)

Firefighters experience both occupational and emotional stress (Gomes ’13)

  • Exposure to human suffering, injury and death (Serra ’12)
  • Self-blame (Meyer ’12)
  • Inadequate sleep
  • Financial challenges
  • Relationship problems

Few outlets are available to seek support and to learn coping skills (Meyer ’12)

  • The firehouse is not somewhere to show weakness (Meroney ’13)
  • Fire fighters consider themselves “stronger” than the problem and are unable to conduct “self-rescue” (Meroney ’13)
  • Fire fighters rarely speak out and ask for help
  • Details of their shift are not shared with family members

The high cost of Stress (McDowell ’13):

  • High risk factor for cardiovascular disease and other health problems (National Fallen Firefighters Foundation (NFFF); McDowell ’13)
  • Physical aches and pains
  • Sleep Deprivation
  • Obesity, inactivity, and poor eating habits
  • Depression or anxiety
  • Post Traumatic Stress Disorder
  • Suicidal thoughts and feelings (McDowell ’13)
  • Substance abuse including smoking
  • Marriage and Family problems
  • Anger issues

“The Solution”

FitRx (A prescription for finding internal transformation) is an intensive outpatient program with an individualized holistic approach that addresses wellness and optimal fitness from a medical, therapeutic, nutritional and physical wellness perspective

Medical:

  • Complete Medical assessment
  • Improved metabolic health profile (Cholesterol, high blood pressure, reduction of inflammation, blood sugar control)
  • Smoking cessation guidance
  • Sleep interventions for insomnia
  • Improved body composition and reduction of disease producing abdominal fat
  • Access to physical therapy support

Therapy:

  • Therapeutic interventions to address trauma, relationship issues, depression, anxiety, anger, etc.
  • Psychotherapy that focuses on the underlying causes and treatment of binge eating, compulsive overeating, and night eating syndrome
  • Resilience training and stress management
  • Mindfulness and relaxation techniques

Nutritional Guidelines and Meal Plans:

  • Emphasis on fitting a food plan into one’s lifestyle that includes convenient, economical, and healthy choices
  • Revealing that healthy doesn’t have to mean that it’s not great-tasting food
  • Recommendations for fire station meals away from home as well as suggestions for family cuisine
  • Healthy, convenient and alternative snacks to maintain vitality and alertness and replenish energy stores
  • Learning to be “satisfied” without battling cravings and hunger by practicing attuned and mindful eating
  • Avoiding gimmicky, extreme or difficult to follow plans that will not lead to permanent habits and good health
  • Sound nutritional advice that dispels nutritional  myths and educates one to make healthy choices

Physical Wellness: Create your own well designed fitness plan

  • Assessments consistent with those recommended by the fire service’s Wellness and Fitness Initiative of the International Association of Fire Fighters (IAFF) and the International Association of fire chiefs (IAFC)
  • The latest fitness trends like Cross Fit and P90x
  • Cardiovascular fitness, aerobic fitness and endurance training
  • Anaerobic capacity; muscular strength and core muscle endurance
  • Flexibility and yoga
  • Fitness on a budget while off duty:  Activities that fit into daily routine
  • Job specific functional exercises
  • Safe & applicable programs that can be done by all (rookies; 20 year veterans; individuals of size; and those rehabilitating from injury)

Maintenance and Follow-up:

  • A strong alumnae support system
  • Tracking devices to collect hard data that enhance accountability and long term success

 

Click here for References

Obesity-In-America

Will the American government ever accept that weight is not the issue and obesity is not the problem?

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

Experts doubt that obesity among preschoolers has fallen as much as the CDC reports based on a paucity of supporting evidence and few signs of behavioral change…

The CDC claims that there is a significant decline (43%) in preschooler (ages 2-5) obesity (Ogden, C et al JAMA February 2014). This data is based on the National Health and Nutrition Examination Survey or NHANES study which has been conducted annually since the 1960s and involves in-person interviews and physical exams. You need to have a healthy degree of skepticism about the validity of this finding.  The 2011-2012 version of the survey included 9,120 people; 871 of them were 2 to 5 years old. This would be considered a small survey size to make such a bold national claim because of the statistical limitations and potential for marked fluctuations. Such a change is at best fleeting in that rates have bounced around over the last decade

Anti-obesity campaigners credited everything from changes to the federal nutrition program for low-income women and children to the elimination of trans-fats from fast food, more physical activity in child-care programs and declining consumption of sugary drinks. First Lady Michelle Obama and others seized on the finding as a sign that efforts to combat the national obesity epidemic were paying off. The programs that have been implemented, from changing what’s in vending machines to the Let’s Move program (exercise initiative championed by Michelle Obama), target school-age children more than preschoolers.

This plunge may be a statistical fluke since other studies have not shown a comparable decline

A study of preschoolers in the federal WIC (Women, Infants and Children) program, which provides food vouchers, nutrition classes and counseling to low-income families, found virtually no change in obesity rates. The WIC study included more than 200,000 children while the CDC research looked at only a small population of 2 – 5 year olds. A larger set of data would most certainly be significantly more valuable.

Researchers found that the prevalence of obesity among 3 and 4 year olds in California’s Los Angeles County worsened from 2003 – 2011. Obesity rose from 17% to 20.4% (CDC’s Morbidity and Mortality Weekly Report 2013). There was a drop of 4% (19.5% – 15.5%) in the New York WIC study, though much less than a 43% drop CDC reported nationally. CDC’s Morbidity and Mortality Weekly Report 2013). An earlier CDC study of data collected at public health clinics, reported in JAMA in December 2012, found that the prevalence of obesity among 27.2 million children 2-to-4-year olds in low-income families fell (< 1%) to 14.9 percent in 2010 from 15.2 percent in 2003.

For obesity rates to drop, young children would have to eat differently, become more active, and sleep better. It turns out that research shows few signs of these changes among 2 – 5 year olds. In 2010 Whaley and her colleagues examined the effectiveness of WIC classes and counseling to encourage healthy eating and activities for women and children in the program. Television watching and consumption of sweet or salty snacks actually rose, while fruit and vegetable consumption fell – changes that could lead to weight gain. One positive was a rise in physical activity.

These statistical arguments emphasize decades of futility on behalf of the CDC, USDA and other government agencies that are determined to get under control the wrong enemy…WEIGHT. The problem may be part and parcel of the American Government expending too much energy, time and tax dollars on the ‘weights’ of preschool and young children by emphasizing statistical analysis of weight change and promoting the media hype that fuels a nation of dieters and creates a general obsession with being thin. There needs to be an acceptance of size diversity, emphasis on health, and incorporating lifestyle activity combined with appropriate measurements that support these initiatives rather than focusing on the weight on the scale. Habit changes should take the form of personal responsibility, mindful behaviors, stress reduction and reducing negative bias regarding size to counter the food industries’ infinite supplying our nation with an abundance of highly palatable foods designed to trigger overconsumption. If we cannot expect our country to limit the use of proven mind altering drugs such as marijuana, alcohol, tobacco and caffeine; do we honestly believe that there will ever be a successful campaign to remove pleasurable food choices from society? Not even in the Fairy Tale of Cinderella could they remove all the spinning wheels.

  1. CDC’s Morbidity and Mortality Weekly Report 2013
  2. (Ogden, C et al JAMA February 2014)
  3. Whaley, S (Public Health Enterprises Foundation) WIC Study

Ogden Journal of the American Medical Association 2014 focused on more than 9,000 adults and children in 2011-2012 and compared them to five previous obesity analyses dating back to 2003-04 We found overall that there was no change in youth or adults More older women are obese, but very young children seem to be slimming down Prevalence of obesity in children that age dipped from 14 percent in 2003-2004 to about 8 percent in 2011-2012 obesity prevalence ticked up in women 60 and older, from less than 32 percent in 2003-2004 to more than 38 percent in 2011-2012. Overall, more than two-thirds of adults are either overweight or obese, and more than 6 percent are extremely obese. There hasn’t been a big impact on prevalence in the last eight years, but at least there’s a leveling off.

 

Sitting-Bad-For-Your-Health

Sitting Can Be Detrimental to Your Health and it is not offset by Exercise!

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

Modern man sits more than he sleeps. Studies report that most individuals spend an average of 9.5 hours sitting and 7.7 hours sleeping (Healy ’07; Owen ’09). And 5.5 of those sitting hours are spent watching television (Nielson ‘10). Being sedentary (sitting for extended periods of time) can be detrimental to your health.

Being extremely sedentary makes the blood flow sluggishly, produces swollen ankles, shuts off electrical activity to the legs, and ultimately deteriorates cells. When you are sitting for extended periods of time the enzymes that break down fat are reduced by 90%, muscles utilize less fat, you burn less than one calorie per minute and fat rapidly accumulates. Sitting reduces metabolism which eventually contributes to obesity and significantly causes fat accumulation around the heart. Resting on your derriere can lead to poor posture and disability resulting in even greater inactivity. Being sedentary disrupts metabolic function producing resistance to insulin culminating in diabetes as well as increasing blood pressure, triglycerides and bad cholesterol (LDL) leading to cardiovascular disease. All of this sitting around can ultimately result in premature death.

Regardless of how much time you spend in moderate exercise, it does not counterbalance the harmful consequences of prolonged sitting. Leisure-time physical activity or daily bouts of “super-exercising” alone may not be a sufficient public health approach to prevent obesity. It’s a bit like smoking. Smoking is bad for you even if you get lots of exercise

We need to take walking breaks every hour, stand while talking on the phone, perform chair exercises at our desk, and take several trips to the rest room on long flights. Regularly standing up from a seated position was in fact found to be more effective than walking (Verikos ‘11). Interrupt watching TV with 10 minute sparks to rake leaves, garden, sweep, play with your children, run in place, or climb stairs. Utilize a motion sensor (accelerometer) to track activity and be mindful of the frequency with which you interrupt prolonged inactivity. A consistent body of emerging research suggests it is entirely possible that sitting is its own risk factor. So don’t just sit there, MOVE!


ReferencesBauman A et al Leisure-time physical activity alone may not be a sufficient public health approach to prevent obesity—a focus on China Obes Rev (2008) 9: 119 – 126
Dunlop D et al Sedentary Time in U.S. Older Adults Associated With Disability in Activities of Daily Living Independent of Physical Activity J Physical Activity and Health (February 5, 2014)
Ekblom-Bak E et al The importance of non-exercise physical activity for cardiovascular health and longevity Br J Sports Med (Sept 13, 2013)
Healy GN et al Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose Diabetes Care (2007) 30:1384–9
Larsen BA et al Associations of Physical Activity and Sedentary Behavior with Regional Fat Deposition Med Sci Sp Ex (2014) 46: 520 – 528
Nielsen Company Three Screen Report: Television, Internet and Mobile Usage in the US Vol 8 1st Quarter (2010)
Owen N et al Too much sitting: a novel and important predictor of chronic disease risk? Br J Sports Med(2009) 43: 81 – 83
Seguin R et al Sedentary Behavior and Mortality in Older Women American Journal of Preventive Medicine(2014) 46: 122- 135
van der Ploeg HP et al Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults Archives of Internal Medicine (2012) 172:494-500
Veerman JL et al Television viewing time and reduced life expectancy: a life table analysis British J Sports Med(2012) 46: 927-930Vernikos J Sitting Kills, Moving Heals Quill Driver Books (2011)
Smart-Snacking

Smart Snacking: Small portions and wait 15 minutes

Written by Leah Miranda on . Posted in Blog, From the Desk of Dr. Carson

In addressing cravings, there is often a controversy whether one should resist and abstain from snacking on tasty foods or to honor and satisfy the urge. Brian Wansink provides some interesting insight on this dilemma.

Individuals were presented either large or small portions of tasty snacks. The large portion consisted of 100 grams of chocolate chips, 200 grams of apple pie and 80 grams of potato chips totaling 1370 calories. The smaller portion consisted of 10 grams of chocolate chips, 40 grams of apple pie and 10 grams of potato chips totaling 195 calories. The participants were given as much time as needed to consume the snacks. Individuals were asked to rate hunger and cravings before the food was presented and 15 minutes after the taste test ended.

Individuals with access to smaller amounts had similar feelings of satisfaction as those exposed to larger amounts as both reported significantly less cravings. However, those presented larger portions had a mean intake of 103 (77%) more calories. This suggest that smaller portions can lead to a decline in hunger and desire and would help people limit food intake. Eating a smaller portion of palatable snack foods satisfies you just as much as a large portion. A small amount satisfies and does not magnify hunger and craving tendencies.

The message is to take a few bites, wait 15 minutes and your head and stomach will remember you had a tasty snack. This study does not address the emotional state of the participants nor their history of binge eating. It does provide some insight as to how a more flexible and permissive approach to satisfying cravings may eventually be implemented.


Reference: Van Kleef , Shimizu M and Wansink B Just a bite: Considerably smaller snack  portions satisfy delayed hunger and craving Food Quality and Preference(2013) 27: 96-100

The Second Brain: Beyond Gut Feelings (Part III)

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

Mood food connection

A MET receptor gene is found in brain regions tied to our socialization skills. Social withdrawal, irritability and repetitive behavior are symptoms of autism. A disruption of the MET signal or decreased MET protein expression contributes to an increased risk of autism spectrum disorder.

In autistic children, MET receptor function decreases brain development and gastrointestinal repair (Campbell-McBride ’09). Discovering why behavioral issues are exacerbated by gastrointestinal disturbances could provide insights to treatments for autism (Chaidez ’13).

The mood and food connection

In one study, individuals with nasogastric tubes were subjected to MRI scans. Researchers focused on parts of the brain that are active during stress. When melancholy music was played through earphones and saline was pumped through the tubes, there was no dampening of the neural response. Decreased neural activity was observed when fatty acid solutions were pumped through the tubes. Mood improved and hunger decreased with the presence of fatty acids in the gut (van Undenhauer ’11). This is a prime example of the connection between mood and food intake.

To compensate for these negative reactions to food ingredients, some foods contribute to healthy brain function. Live cultures in yogurt can create less activity in the emotional hyperactive brain regions. However, it is not known if this effect is beneficial. Sulfates serve a useful purpose by detoxifying metabolites of brain neurotransmitters. Toxins that originate in the gut, thus making the sulfate unable to perform a valuable function, can consume sulfates. Bacteria can also metabolize food sulfates into sulfite, as hydrogen sulfite is a toxic compound.


References:
Campbell-McBride Put Your Heart in Your Mouth Medinform Publishing (2007)
Campbell DB et al Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions Pediatrics (2009) 123: 1018 – 1024
Campbell-McBride N Gut and Psychology Syndrome (GAP Syndrome or GAPS) http://www.gaps.me/?page_id
Campbell-McBride N Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia Medinform Publishing (2010)
Chaidez V et al Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development J Autism Dev Disord (2013 Nov 6)
Kang DW et al Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children PLoS One (2013) 8:e68322
Labus JS et al Impaired Emotional Learning and Involvement of the Corticotropin-Releasing Factor Signaling System in Patients with Irritable Bowel Syndrome Gastroenterology (2013 august 13)
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry Rev Psyciatr Neurosci (2009) 34: 230 – 231
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry J Psychiatry Neurosci (2009) 34 (3): 230 – 231
Rodriguez T Gut Bacteria may Exacerbate Depression: Microbes that escape the digestive tract may alter mood Scientific American Mind (Noverber/December 2013) 24:9
Rodriguez T Ulcer Bacteria Linked to Cognitive Decline Scientific American Mind (November/December 2013) 24:9
Tack J et al A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome Gut (2006) 55: 1095 – 1103
Tillisch K and Labus JS Advances in imaging the brain-gut axis: functional gastrointestinal disorders Gastroenterology (2011) 140: 407 – 411
Tillisch K et al Consumption of fermented milk product with probiotic modulates brain activity Gastroenterology (2013) 144: 1394 – 1401
Van Oudenhove et al Fatty acid – induced gut brain signaling attenuates neural behavioral effects of sad emotions in humans J Clin Invest (2011) 121: 3094 – 3099

The Second Brain: Beyond Gut Feelings (Part II)

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

gut feeling

Image via http://www.ipgcounseling.com/growing_4.html

Foreign microbes that are known as clostridia are often present in the foods we eat. Clostridia are capable of escaping the defense mechanisms of our digestive tract and enter the blood stream though leaky gaps. This can activate the immune system and an inflammatory response. Additionally, these contaminants can cross the blood brain barrier, triggering depression and fatigue (Rodriguez ’13).

Studies reveal up to 85 percent of depressed patients experience leaks in their intestinal barriers. Bacteria also digest foods that produce toxins that are absorbed into the blood stream and enter the brain, which alters production of neurotransmitters and affects regions of the brain associated with emotions (Tillisch ’13; Labus ’13). Autoantibodies that attack the nervous system are also created from foreign invaders.

Gluteomorphins and casomorphins are byproducts of wheat and dairy that are similar in structure to opiates (morphine and heroin). These opiates are capable of crossing the blood brain barrier and interfering negatively with brain function. Children with autism and schizophrenia often do not digest milk and gluten properly and their guts are full of abnormal microbes.

Gut microbes and mental development

Several phenomenon related to gut microbes have been linked to autism (Kang ’13). For example, there are fewer types of gut bacteria in autistic children. Typically, 30 percent of children with autism experience lots of gastrointestinal problems, such as chronic diarrhea, constipation, esophageal reflux, IBS and ulcers that last into adulthood (Campbell-Mc’10). This association could result from damage to the gut lining, which allows neuron toxins to penetrate and enter the brain and affect mental development. An unusual dietary pattern results in 8 percent greater sensitivity to certain foods, which may also explain these abdominal symptoms.

Last week: The Second Brain: Beyond Gut Feelings (Part I)

Next week: The Second Brain: Beyond Gut Feelings (Part III)


References:
Campbell-McBride Put Your Heart in Your Mouth Medinform Publishing (2007)
Campbell DB et al Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions Pediatrics (2009) 123: 1018 – 1024
Campbell-McBride N Gut and Psychology Syndrome (GAP Syndrome or GAPS) http://www.gaps.me/?page_id
Campbell-McBride N Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia Medinform Publishing (2010)
Chaidez V et al Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development J Autism Dev Disord (2013 Nov 6)
Kang DW et al Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children PLoS One (2013) 8:e68322
Labus JS et al Impaired Emotional Learning and Involvement of the Corticotropin-Releasing Factor Signaling System in Patients with Irritable Bowel Syndrome Gastroenterology (2013 august 13)
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry Rev Psyciatr Neurosci (2009) 34: 230 – 231
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry J Psychiatry Neurosci (2009) 34 (3): 230 – 231
Rodriguez T Gut Bacteria may Exacerbate Depression: Microbes that escape the digestive tract may alter mood Scientific American Mind (Noverber/December 2013) 24:9
Rodriguez T Ulcer Bacteria Linked to Cognitive Decline Scientific American Mind (November/December 2013) 24:9
Tack J et al A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome Gut (2006) 55: 1095 – 1103
Tillisch K and Labus JS Advances in imaging the brain-gut axis: functional gastrointestinal disorders Gastroenterology (2013) 144: 1394 – 1401
Van Oudenhove et al Fatty acid – induced gut brain signaling attenuates neural behavioral effects of sad emotions in humans J Clin Invest (2011) 121: 3094 – 3099

The Second Brain: Beyond Gut Feelings (Part I)

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

With over 100 million neurons and a vast assortment of neurotransmitters present in the brain, the gut truly has a mind of its own—and our stress levels can alter the composition of our gut population of bacteria.

The ever-harmful symptoms of stressStress

When we experience stress, the central nervous system sends a signal from the brain and the stress hormone known as cortisol is released, which contributes to gut symptoms such as constipation, diarrhea and nausea. Changes in cortisol affect chronic anxiety disorders and irritable bowel syndrome (Tillish ’11, Labus ’13).

Gastrointestinal illness is commonly connected to behavioral health illnesses. Antidepressant drugs are commonly used for IBS treatment. 20 milligrams of Citalopram, for example, can effectively reduce abdominal symptoms of diarrhea, constipation nausea and pain (Tack ’06).

Two strains of bacteria support a link between gut microbes and stress. Lactobacillus helvisticus and Bifidobacterium longus are diminished during the administration of a stressful exam. However, they are present in higher concentrations during periods of reduced stress and anxiety.

High concentrations of Heliobacteria pylori (or H. pylori) that are capable of escaping the gut and entering the brain can inhibit memory, cognitive abilities and IQ. Aggregates of H. pylori are frequently found in cases of Alzheimer’s disease.

Next week: The Second Brain: Beyond Gut Feelings (Part II)


 

References:
Campbell-McBride Put Your Heart in Your Mouth Medinform Publishing (2007)
Campbell DB et al Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions Pediatrics (2009) 123: 1018 – 1024
Campbell-McBride N Gut and Psychology Syndrome (GAP Syndrome or GAPS) http://www.gaps.me/?page_id
Campbell-McBride N Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia Medinform Publishing (2010)
Chaidez V et al Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development J Autism Dev Disord (2013 Nov 6)
Kang DW et al Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children PLoS One (2013) 8:e68322
Labus JS et al Impaired Emotional Learning and Involvement of the Corticotropin-Releasing Factor Signaling System in Patients with Irritable Bowel Syndrome Gastroenterology (2013 august 13)
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry Rev Psyciatr Neurosci (2009) 34: 230 – 231
Neufeld, F Effects of gut microbiasota on the brain: Implications for Psychiatry J Psychiatry Neurosci (2009) 34 (3): 230 – 231
Rodriguez T Gut Bacteria may Exacerbate Depression: Microbes that escape the digestive tract may alter mood Scientific American Mind (Noverber/December 2013) 24:9
Rodriguez T Ulcer Bacteria Linked to Cognitive Decline Scientific American Mind (November/December 2013) 24:9
Tack J et al A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome Gut (2006) 55: 1095 – 1103
Tillisch K and Labus JS Advances in imaging the brain-gut axis: functional gastrointestinal disorders Gastroenterology (2011) 140: 407 – 41
Tillisch K et al Consumption of fermented milk product with probiotic modulates brain activity Gastroenterology (2013) 144: 1394 – 1401
Van Oudenhove et al Fatty acid – induced gut brain signaling attenuates neural behavioral effects of sad emotions in humans J Clin Invest (2011) 121: 3094 – 3099
How Diet & Hygiene Alter Gut Microbiota, Influence Our Health

How Diet & Hygiene Alter Gut Microbiota, Influence Our Health

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

After one year of age, the intestinal microbiota is 99 percent anaerobic and not homogeneous (Tillisch ‘13). The number of bacteria increases the further along the intestine it travels. Clostridium, Lactobacillus and Enterococcus are found only in the mucus layer of the small intestine, and Bacteroides are found in the distal feces. The entire bacterial colony is composed of genera, which are the larger categories, such as Lactobacillus, to which each species belongs. Genera are determined by the first microbes of which a baby is exposed, blood type and metabolic fitness, or gut health.

Understanding human microbiota is crucial, and can help identify what foods to eat in order to stay slim, how well we digest and utilize calories, and our vulnerability to inflammatory bowel disease (Brown ’12). Ineffective flora leads to inflammation, which can result in infection, compromised immune system, digestive diseases, obesity and cancer. However, scientists admit they currently do not know the exact mechanism linking disease and gut microbes.

Changes in diet impact our bacteria

Provided the diet remains consistent, the bacteria population will remain stable. But our environment and the foods we eat (whole foods, high fiber, resistant starches, legumes, nuts, seeds, produce and whole grains) greatly contribute to what determines our flora. Changes in diet explain 57 percent of our bacterial population; genetics explain 11 percent.

Throughout our lives, our diet contributes to the composition of gut flora and the disruption or integrity of the gut’s protective barrier.

  • A low fat/high fiber diet positively influences normobiosis, an environment dominated by healthy bacteria. Consuming yogurt increases lactobacillus, which produces lactic acid and staves off harmful bacteria.
  • A highly refined (sugar) and processed (fat) intake represented by the typical western diet contributes to overgrowth of pathological bacteria and yeast.

We need a better balanced diet!

The current average American diet consists of very little variety and is mostly composed of fewer than 30 different foods. It primarily consists of corn, soy and wheat, which is in sharp contrast to how our intestines adapted during the Paleolithic Times, or even as recently as 50 years ago.

As a result of the rapid change in our food supply, the modern American diet reduces the diversity of gut bacterial community. This has permitted only ‘generalist bacteria’ that can digest many different foods. Breaking up the friendly bacteria with which humans evolved and reducing the diversity of the gut bacterial community could be profound. The shift in the microbes could potentially cause several illnesses as we move away from normal healthy bacteria (Spencer ‘11).

The hygiene hypothesis

Consider the hygiene hypothesis of disappearing microbiota theory: Clean living and reduced exposure to bacteria may lead to maladjusted immune systems and ultimately make one vulnerable to allergies and inflammation (Blasser ’11). Bacteria can be transferred from one person or animal to another other, or from surfaces to hands. This exposure is minimized or eliminated by frequent washing and sanitization.

Fruits, vegetables, spices and herbs are contaminated with bacterial growth that is lost by extensive cooking and cleaning. Every time we are exposed to bacteria, it is possible to recolonize the colon with opportunistic germs or introduce foreign microorganism unfamiliar to the host.

Up Next: The Second Brain: Beyond Gut Feelings

 


References:
Blasser MJ and Flakow S What are the consequences of the disappearing human microbiota? Nature Reviews Microbiology (2009) 7: 887 – 894
Blasser MJ Antibiotic overuse: Stop the killing of beneficial bacteria Nature (2011) 47: 393 – 394
Brown K et al Diet-Induced Dysbiosis of the Intestinal Microbiota and the Effects on Immunity and Disease Nutrients (2012) 4: 1095 – 1119
Spencer MD et al Association between composition of the human gastrointestinal microbiome and development of fatty liver with choline deficiency Gastroenterology (2011) 140: 976
Tillisch K and Labus JS Advances in imaging the brain-gut axis: functional gastrointestinal disorders Gastroenterology (2011) 140: 407 – 411

Antibiotics: To Treat Or Not To Treat, That Is the Question

Antibiotics: To Treat Or Not To Treat, That Is the Question

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

Overly aggressive antibiotic prescriptions can pose challenges to a healthy bacterial population (Cox ’13, Blasser  ’09; ’11). Antibodies change the assortment of microbes and produce species that make it easier for the body to store a greater amount of fat in the liver from unused calories. Antibiotics also kill beneficial bacteria and allow harmful bugs (i.e. Clostridium difficile) to surge and produce excess toxins.

Broad-spectrum antibiotics can be ineffective for harmful resistant bacteria, while simultaneously killing protective bacteria. Historically, it was not unusual for individuals to receive 20 rounds of antibiotics by the time they reached the age of 20. There is a pattern suggesting that those who receive antibiotics in the first year of life put on more weight.

Opportunistic bacteria

There may be several bacterial strains that have evolved or mutated into a form that escapes destruction by the antibiotic administered. Some bacteria are capable of forming spores or biofilms (minerals such as Ca, Fe, or Mg and then combine with mucus or polysaccharides) that act as a shield and make it impossible to be attacked by probiotics or antibiotics. These opportunistic bacteria hide from the immune system and later capitalize and multiply to populate the gut colony following antibiotic treatment.

H.pylori and gut flora management

Treatment for Helicobacter pyloris, or H.pyloris, is a prime example of the complexity and need for balance when managing the gut flora. Though killing off these gastric residents may prevent or cure chronic ulcers, their eradication may lead to greater acidity and potential damage to the esophagus (GERD), Barrett’s esophagus and esophageal cancer (Benoit ’11). Additionally, killing H. pylori raises grehlin levels, which can raise appetite and subsequent weight gain (Roper ‘08). Reducing H. pylori also increases the risk of childhood asthma (Coelho ‘13).

Previous: The Origins of Microbiota…Thanks Mom!    Up Next: How Diet & Hygiene Alter Gut Microbiota, Influence Our Health


References:
Benoit SL and Mua RJM (HP0868) is a nickel-binding protein that modulates unease activity in helicobacter pylori mBio (2011) 2: e00039-1
Blasser MJ and Flakow S What are the consequences of the disappearing human microbiota? Nature Reviews Microbiology (2009) 7: 887 – 894
Blasser MJ Antibiotic overuse: Stop the killing of beneficial bacteria Nature (2011) 47: 393 – 394
Coelho LG et al rd Brazilian Consensus on Helicobacter pylori Arquivos de Gastroenterologia (2013) 50 (2)
Cox LM and Blaser MJ Pathways in microbe-induced obesity Cell Metab (2013) 17: 883 – 894
Roper J et al Leptin and ghrelin in relation to Helicobacter pylori status in adult males Journal of Clinical Endocrinology & Metabolism (2008) 93: 2350
The Origins of Microbiota… Thanks, Mom!

The Origins of Microbiota… Thanks, Mom!

Written by Leah Miranda on . Posted in Blog, From the Desk of Dr. Carson

When you were a fetus, your gut was empty and sterile. On your passage through the birth canal, your alimentary track was seeded with your mom’s microorganisms. Her bacteria create your unique flora. The circumstances are beneficial, as long as mom does not have dysbiosis—a microbial imbalance due to a predominance of harmful bacteria—which can lead to infections, digestive problems (i.e. colic and gas) and neurological problems (i.e. ADHD, OCD).

Microbiota & C-Sections

If a C-section was necessary, you missed out on exposure to your mother’s beneficial or harmful bacteria. However, research does not support that emergency C-sections have an influence on contributing to obesity in the future, even if the child is not exposed to the mother’s bacteria (Manun ’13). There is also speculation that contraceptives may have a negative effect on a newborn’s normobiosis.

Microbiota & Breast-feeding

A second contribution to a healthy flora occurs during breast-feeding. Infants with uninterrupted nursing that continues through the first year of life scored higher on IQ tests, had fewer GI infections and exhibited a lower risk of obesity (Belfort ’13). There is speculation that early bottle-feeding predisposes infants to early health problems due to alterations in the gut flora. According to Kalliomaki (Kalliomaki ’08), obesity is influenced by bacteria in the baby’s gut, attributed to substituting formula for breast-feeding. Formulas could be sterile or fortified with prebiotics and probiotics to mimic what naturally occurs. Often these supplements have a very high glycemic index (95), similar to pure sugar (glucose 100). Hydrolyzed formulas actually have been shown to increase inflammation (atopic dermatitis, cow’s milk allergies, wheezing).

A Baby’s Diet Is Key!

Conventional baby foods were not available until 1920. There may be subtle health consequences when mothers substitute convenient baby foods that are overly processed and refined, instead of preparing homemade foods. There is no proof that rice cereal, which is highly refined rice flour, has any beneficial effect on reducing the incidence of allergies (Greer ’08). Children not exposed to a variety of whole foods with real textures and flavors could influence the types of bacteria that flourish in their colon. As a result of consuming soft processed foods like graham crackers, cereals (Cheerios), pasta, pizza and mashed foods, families are raising picky eaters unwilling to eat traditional fruits, vegetables, whole grains and nuts (Greene ’09).

The American Academy of Pediatrics currently recommends meats to complement breast-feeding of infants. Meat supplies protein, iron and zinc, thereby adding nutritional value.

Next Up: Antibiotics: To Treat or Not to Treat, That Is the Question


ReferencesBelfort MB et al Infant feeding and childhood cognition at ages 3 and 7 years: Effects of breastfeeding duration and exclusivity JAMA Pediatr (2013) 167:836 – 844Greene A Feeding Baby Green: The Earth Friendly Program for Healthy, Safe Nutrition During Pregnancy, Childhood, and Beyond Jossey-Bass (2009)

Greenway F. Virus-induced obesity. Am J Physiol Regul Integr Comp Physiol 2006; 290:188-189

Greer FR et al Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas Pediatrics (2008) 121: 183 – 191

Kalliomaki M et al Early differences in fecal microbiota composition in children may predict overweight    Early differences in fecal microbiota composition in children may predict overweight AJCN (2008) 87: 534 – 538

Manun AA et al Cesarean Delivery and the Long-Term Risk of Offspring Obesity Obstet Gynocol (2013 Nov 6)