Wednesday, September 19, 2018

Wisdom Wednesday: What allows C. difficile to survive so well in the gut?


Clostridium difficile is a particularly hardy type of bacteria, which is very difficult to treat. It often affects people during a hospital stay – especially if they have taken antibiotics. Why is it this resilient, and does knowing this lead to better treatments?

According to some experts, Clostridium difficile infections are ever on the rise and becoming increasingly difficult to treat. This means that researchers need to find new and better ways of targeting this stubborn bacterium. Among other symptoms, C. difficile can cause diarrhea, which can range from mild to extremely severe. In the most extreme cases, the infection can even lead to death.

Recently, a team from the London School of Hygiene and Tropical Medicine in the United Kingdom made a new and important discovery: C. difficile releases a special compound that allows it to gain ground over gut bacteria and to establish a strong presence in the gut environment. This findings are now published in the journal PLOS Pathogens.

C. difficile infections often appear after a person has followed a treatment with antibiotics, because these drugs work by essentially killing bacteria. Unfortunately, antibiotic do not only destroy the bacteria that cause harm.

Antibiotics also disrupt the balance of the gut microbiota, which contains many types of bacteria that are harmless and promote or sustain the health of the intestines. When this happens, C. difficile sometimes takes hold – and fighting it is often very complicated.

For the first time, researcher Lisa Dawson and team found that the release of para-cresol by C. difficile affects the growth of many microorganisms in the gut and allows it to prevail over other bacteria.

Monday, September 17, 2018

LDL More Than 160 Tied to Increased Mortality in Low-Risk Patients

Patients deemed at low-risk for cardiovascular disease (CVD) but with LDL levels above 160 face increased mortality risks over the long term, a Circulation study suggests.

Over 36,000 adults in Texas (median age, 42) with an estimated 10-year risk for atherosclerotic CVD events below 7.5% had their lipid levels measured and were followed for a median of 27 years. During that time, nearly 1100 CVD deaths and 600 coronary heart disease (CHD) deaths occurred.

After multivariable adjustment, participants with LDL levels of 160–189 mg dL had a 70% increased risk for CVD mortality and more than twice the risk for CHD mortality, relative to those with LDL below 100 mg dL. Increasing levels of non-HDL cholesterol were also associated with higher mortality risks.

The researchers note that 2013 cholesterol guidelines recommend statins for low-risk patients when LDL reaches 190 mg dL, with a class IIb recommendation for considering treatment at 160 mg dL. They say their current findings "suggest a stronger consideration of using the LDL-C greater than 160 mg dL cutoff."

My Take:
The medical norms for LDL are less than 130 mg dl. However, many labs list the medical norm as less than 100 mg dl as that is the goal of statin drug therapy. Many physicians like to drive the LDL level less than 60 mg dl, although the research indicates no additional benefit in cardiovascular risk is associated with this goal.

Friday, September 14, 2018

Nutrition and Functional Neurology: Partners in Holistic Patient Care

Sweeping through models of chiropractic care, functional neurology is transitioning away from the limited concept of vertebral fixations to embracing the concept of neural tone, championed by the very originator of chiropractic – D.D. Palmer. Indeed, the updated definition of subluxation put forth by the Council for Chiropractic Practice in 2013 plainly states that subluxation is “a neurological imbalance or distortion in the body associated with adverse physiological responses and/or structural changes which may become persistent or progressive.” Following this line of reasoning, functional neurology opens the discussion to a range of causes of the neurological imbalances, including (i) inflammation, (ii) nutritional problems, (iii) hormonal imbalances, (iv) emotional stress, and (v) structural derangements that dominated earlier models of chiropractic interventions.

The positive aspect of functional neurology is its reorganization of nerve cells, making possible the restoration or bypass of connections that have become disrupted or damaged. A perfect example would be performing exercises to recover from [a] stroke. The negative aspect of functional neurology, however, is that if a neuronal pathway is not fired, synaptic connections may become inactive with the loss or inactivation of neurotransmitters and receptors, as exemplified by the risk of cognitive decline in the elderly and the undertaking of exercise to counteract that effect. Both of these transformations of nervous system activity have become known as neuroplasticity, not limited to neural injury or recovery but also including the remodeling of dendrites, synapse turnover, long-term potentiation, and neurogenesis. One striking example out of many demonstrating the phenomenon of neuroplasticity was offered by an observational study of London cab drivers, in which there was a redistribution of gray matter in their brains as they became familiar with the city’s layout.

Wednesday, September 12, 2018

Wisdom Wednesday: The Dirty Dozen


Every year, the Environmental Working Group (EWG) releases the “Dirty Dozen” – a list of the 12 non-organic fruits and vegetables highest in pesticide residues.

Pesticides are substances commonly used in agriculture to protect drops from damage caused by insects, weed pressure and diseases. To compile the Dirty Dozen list, the EWG analyzes over 38,000 samples taken by the USDA and FDA to single out the worst offenders.

While the EWG claims that this list can help consumers avoid unnecessary pesticide exposure, some experts – including food scientists – argue that the list is scaring the public away from consuming healthy foods.

Pesticides are tightly regulated by the USDA, and recent reports indicate that pesticide levels found on 99.5% of conventional produce are well below recommendations set by the EPA. The USDA Pesticide Data Program ensures that the U.S. food supply “is one of the safest in the world,” due to rigorous testing methods.

However, many experts argue that continuous exposure to pesticides – even in small doses – can build up in your body overtime and lead to chronic health conditions.

Additionally, there is concern that the safe limits set by regulatory agencies don’t take into consideration the health risks involved with consuming more than one pesticide at a time.

Monday, September 10, 2018

The Man Who Sold America On Vitamin D – And Profited in the Process

Dr. Michael Holick’s enthusiasm for vitamin D can be fairly described as extreme. The Boston University endocrinologist, who perhaps more than anyone else is responsible for creating a billion-dollar vitamin D sales and testing juggernaut, elevates his low levels of the stuff with supplements and fortified milk. When he bikes outdoors, he won’t put sunscreen on his limbs. He has written book-length odes to vitamin D, and has warned in multiple scholarly articles about a “vitamin D deficiency pandemic” that explains disease and suboptimal health across the world.

His fixation is so intense that it extends to the dinosaurs. What if the real problem with that asteroid 65 million years ago wasn’t a lack of food, but the weak bones that follow a lack of sunlight? “I sometimes wonder,” Holick has written, “did the dinosaurs die of rickets and osteomalacia?”

Holick’s role in drafting national vitamin D guidelines, and the embrace of his message by mainstream doctors and wellness gurus alike, have helped push supplement sales to $936 million in 2017. That’s a ninefold increase over the previous decade. Lab tests for vitamin D deficiency have spiked, too. Doctors ordered more than 10 million for Medicare patients in 2016, up 547% since 2007, at a cost of $365 million. About 1 in 4 adults 60 and older now take vitamin D supplements.

But few of the Americans swept up in the vitamin D craze are likely aware that the industry has sent a lot of money Holick’s way. A Kaiser Health News investigation found that he has used his prominent position in the medical community to promote practices that financially benefit corporations that have given him hundreds of thousands of dollars – including drugmakers, the indoor-tanning industry and one of the country’s largest commercial labs.

In an interview, Holick acknowledged he has worked as a consultant to Quest Diagnostics, which performs vitamin D tests since 1979. Holick, 72, said that industry funding “doesn’t influence me in terms of talking about the health benefits of vitamin D.”

Friday, September 7, 2018

“Transparency” as Mask? The EPA’s Proposed Rule on Scientific Data

The Environmental Protection Agency (EPA) recently proposed excluding from consideration in setting environmental standards any studies whose raw, individual-level data are not publicly available. This proposal was preceded by the wholesale exclusion from the EPA’s scientific advisory boards of academic scientists who receive research grants from the agency – and their replacement by industry-funded scientists. It is hard to interpret these actions as anything other than an attack on the use of hard scientific evidence to set environmental standards.

Open science has growing support, and justly so. However, studies conducted at academic institutions and involving humans, which are regulated by the Health Insurance Portability and Accountability Act (HIPPAA) and institutional review boards (IRBs), must maintain a basic regard for privacy. Great progress in understanding pollution’s effects has been made by adding exposure information to large cohort studies that were established to explore cardiovascular disease or cancer. Such studies have been used, for example, to analyze concentrations of metals in blood, urine, or toenails and to attribute air pollution exposure to people according to their residential address. Precisely because these studies include measurements of many potential confounding factors, it is difficult to make the data public without also making participants identifiable. For example, after Hurricane Katrina, a local newspaper published a map of the locations of deaths. It showed no roads, and the only geographic data included were neighborhoods. Yet researchers were able to correctly identify the residential address for most of the people who died.

It is difficult to believe that EPA leaders do not know that few human cohort studies could comply with their requirements – and therefore difficult not to conclude that the real purpose of the proposal is to eliminate a vast body of highly relevant data from consideration, resulting in a weakening of standards that are no longer supported by “sufficient scientific evidence.”

My Take:
The attacks on science in the current political climate are real and dangerous. The EPA has been under a gag order since the new administration took office. Please read my blog “Chemicals Found in Many U.S. Streams” posted on April 28, 2017. Just enter “EPA” in the search box in the upper left hand corner of my blog page. This study was completed prior to the gag order but published after the gag order with no comment from the EPA who sponsored the study.

Bottom Line:
This anti-science trend is reminiscent of my high school world history class study on the Dark Ages. I have always found it hard to believe that people could be so ignorant, even a thousand years ago. Those that ignore history are doomed to repeat it.

Source: August 30, 2018 The New England Journal of Medicine

Wednesday, September 5, 2018

Wisdom Wednesday: A Soy-based Diet Could Help Strengthen Bones


A new study has investigated the impact of dietary soy on bone strength in postmenopausal women. The authors conclude that eating more soy might in fact strengthen bones in women of all ages.

The reduction in bone density and strength that is common in postmenopausal women is of huge concern. As women age, osteoporosis, reduced activity levels, and weight gain act together to decrease bone health and negatively impact metabolism. Osteoporosis and bone weakness increases the risk of fractures, which then lead to even more inactivity and weight gain, exacerbating the issue further. As the population becomes – on average – older and heavier, bone health is an important area of medical science to study.

To investigate, researchers from the University of Missouri in Columbia utilized so-called low-capacity running rats, which have lower fitness levels.

The researchers surgically removed the ovaries of half of the rats to mimic menopause. The scientists fed half of the rats a soy-based diet and the remaining animals a corn-based diet. Both diets contained the same amount of calories. They weighed the rats every week for the duration of the 30-week trial.

Then, the team took blood samples, tested bone strength, and assessed body composition. The analysis showed that, although turnover markers were not significantly altered, the leg bones of soy-fed rats were stronger than the bones of the rats that were fed a corn-based diets.