Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Sep

2020

Hair Style Products are Mostly Safe

By Ray Schilling | breast cancer, Cancer, lung cancer, toxins

A recent study concluded that hair style products are mostly safe when it comes to causing cancer. In the past there was some concern that the dyes for hair coloring could cause cancer. In a previous blog I mentioned that hair stylists are at a greater risk for developing bladder cancer. But in customers who had their hair colored this was more difficult to prove. The new study reviewed by CNN was based on a large cohort of 117,200 female nurses at Brigham and Women’s Hospital in Boston.

These 30-55-year-old nurses were observed for 36 years. Detailed information about hair coloring was part of the study.

Results of the hair coloring study

Women with light and medium use of hair dyes did not develop non-melanoma skin cancers, hematopoietic cancers or squamous skin cancers. The same was true for bladder cancer, melanoma, estrogen receptor positive breast cancer, progesterone receptor positive breast cancer and hormone receptor positive breast cancer. Furthermore hair coloring did not cause brain cancer, colorectal cancer, kidney cancer and lung cancer. 5% of women who ever used hair dyes did develop basal cell skin cancer; there was a total of 22,560 basal cell cancers that occurred.

The BJM showed that women who colored their hair regularly (termed “cumulative dose”) developed 24%-31% more breast cancer. This breast cancer was estrogen negative breast cancer (31%) and progesterone negative breast cancer (24%). They also developed 24% more ovarian cancers and 17% colorectal cancer than controls who did not dye their hair. Myeloid leukemias were also more common in the heavy use hair coloring group with 29% and follicular lymphomas with 13%. Other forms of leukemia were not more frequent.

Discussion

50% to 80% of women and about 10% of men ages 40 and older are using hair dye regularly in the United States and Europe. The above cited cancer frequencies were based on women with dark hair and a cumulative dose of more than 200 applications of permanent hair dye. Translated into years of application of hair dye this means coloring your hair for 16 to 17 years, if you color your hair once a month. The study is very powerful due to the large number of women examined and the amazingly long time of 36 years of observation.

Heavy use, medium and light use of hair dyes

It is interesting to note that only the heavy use of hair dye resulted in a few significant cancer figures. The light use (1 to 99 times) and medium use (100 to 199 times) of hair dyes did hardly lead to any cancer. There were some exceptions where light use of hair dye led to 34% more bladder cancer and to 67% more follicular lymphomas. These were oddities, because the lighter use of hair dyes led to higher amounts of these cancers than medium and heavy use. This is not what the researchers expected.

Hodgkin’s lymphoma and breast cancer

Hodgkin’s lymphoma was about 3- to 5-fold more common in all hair coloring categories compared to non-use of hair dye. The authors discussed subgroups of women as well. They noticed that black women using permanent hair dye had a higher risk to develop breast cancer than white women who only had a borderline increased risk. Estrogen negative, progesterone negative and hormone negative breast cancer was more likely to be caused by heavy use of hair dyes.

No association between the following cancers and hair dye use

The present study could not find an association between ever using hair dye and the following. The study found no association with cutaneous squamous cell carcinoma, melanoma, ovarian cancer and colorectal cancer. In addition there also was no association with kidney cancer, lung cancer, and brain cancer. But it found a slight increased risk (5%) of basal cell carcinoma.

The study contains no information regarding the specific ingredients in hair dye that are carcinogenic. In the US supervision of permanent hair dyes by the FDA is rather loose. This leaves the manufacturer mostly in charge regarding the composition of the hair dyes. This is different in Europe and in Japan. Here manufacturers removed several carcinogenic substances from hair dyes because of regulations by the local regulatory bodies. This could have a cancer-lowering effect in these countries.

Hair Style Products are Mostly Safe

Conclusion

This large study from the British Medical Journal, published Sept. 2, 2020 explains the relationship of cancer risk to permanent hair dyes. The study lasted 36 years and involved 117,200 female nurses. More than 96% of the women were Caucasians. This study showed that for most people who use permanent use hair dyes there is no association with most cancers. However, there was an association between a few cancers and the use of hair dyes. These were in 5% basal cell skin cancers. But breast cancer (31% estrogen receptor negative, 24% progesterone receptor negative), ovarian cancer (24%) and 17% colorectal cancer were among these too. There was also an increased risk of Hodgkin’s lymphoma.

Effect of screening by FDA regarding carcinogenic substances in hair dyes

All this data was based on the hair dyes used in the US. Supervision of permanent hair dyes by the FDA is rather loose, with the manufacturer being mostly in charge. This is different in Europe and in Japan. Here local regulatory bodies instructed manufacturers to remove several carcinogenic substances from hair dyes. This could have a cancer-lowering effect in these countries.

Sep

2020

How to Manage Clot Formation with Covid-19

By Ray Schilling | blood clots, heart attack, immune system, Infectious Disease, Inflammation, Lung Disease, Mortality, Stroke

A publication in the Canadian Medical Association Journal describes how to manage clot formation with Covid-19. A significant amount of cases among Covid-19 patients come down with clotting problems. This means that an infection with SARS-CoV-2 (or Covid-19 coronavirus) may initially present with a fever and cough. But a few days later it can suddenly turn into a dangerous disease with severe clots, multiple organ failures and death.

Clot occurrence with Covid-19

It is important to realize that most patients with SARS-CoV-2 do not need hospitalization. But physicians admit 10 to 15% of patients to the hospital. Of these 20% end up with treatment in the Intensive Care Unit (ICU). Of all the hospitalized patients between 5% and 30% develop some form of thrombotic event. Notably, complications of clot formation can be a stroke, a heart attack, a pulmonary embolism or a deep vein thrombosis in the leg. In a recent study from the US 400 random hospitalized patients with Covid-19 144 patients were admitted to the ICU. 4.8% had radiologically confirmed deep vein thrombosis. Overall there were 9.5% with thrombotic events that developed during the hospital stay.

How does a coagulopathy develop with Covid-19?

Truly, SARS-CoV-2 enters the body cells through an interaction of its viral spike protein with the angiotensin-converting enzyme 2 (ACE2) receptor. To explain, numerous organs and tissues express this receptor. This includes lung alveolar type 2 epithelial cells, endothelium, the brain, heart and kidneys. To emphasize, ACE2 leads to angiotensin II degradation. With the SARS-CoV-2 stimulation of the ACE2 receptor there may be an accumulation of angiotensin II, which causes a procoagulant state. Injury of the endothelium explains inflammation in the lining of the blood vessels in multiple organs. Commonly affected organs are lungs, heart, kidneys and intestines. The inflammatory reaction is what can lead to clot formation. When part of an organ has died off because of mini clots that destroyed part of the organ, this process can eventually lead to organ failure. Lung failure, heart failure and kidney failure can develop in these sick patients.

Adequate vitamin D blood levels are important for the immune system

By all means, vitamin D is very important for the integrity of the immune system. With vitamin D blood levels below 15 to 20 ng/mL (37.5–50 nmol/L) the immune system is paralyzed, and any viral or bacterial infection tends to overwhelm the body. Of course, this is the reason why the mortality due to Covid-19 coronavirus is highest in patients with these low vitamin D blood levels. People with secondary illnesses (diabetes, arthritis, autoimmune diseases, cancer) and patients above the age of 60 have the lowest vitamin D blood levels and have the highest mortality rates. This publication describes this in more detail.

Best vitamin D blood level is in the upper normal range (50-80 ng/mL)

Above a vitamin D blood level of 30 ng/mL (=75 nmol/L) a patient’s immune system is functioning normally. However, the immune system is strongest at a vitamin D blood level of 50–80 ng/mL (125–200 nmol/L), which is the upper range of the normal level for vitamin D in the blood.

Keep in mind that vitamin D toxicity occurs only above 150 ng/mL (375 nmol/L).

Specific effects of vitamin D on Covid-19

There are three major effects that vitamin D has.

A strengthening of the epithelial barrier not allowing the coronavirus to penetrate into the lung tissue as easily.
Release of defensins and cathelicidin, two crucial antiviral polypeptides that eradicate any virus in the system.
Interruption of the “cytokine storm”, an overwhelming inflammation which is responsible for viral pneumonia to develop. Without the cytokine storm there is no damage to the lungs and people do not need treatment in the ICU. This is particularly important for people above the age of 60 and for people with pre-existing diseases.

In like manner, with the stabilizing effect of vitamin D regarding the immune function more severe forms of Covid-19 can turn into less severe forms with a better outcome.

Treatment of patients with Covid-19 who have clotting problems

Patients need to be assessed with respect to their risk of developing clots. This publication describes that high risk patients have elevated D-dimer levels. When blood clots dissolve the body produces D-dimer, a protein fragment. Normally the D-dimer test is negative in a person that does not produce clots. But in sick patients with Covid-19 who form clots this blood test typically shows D-dimer >2500 ng/mL. In addition the tests show high platelet counts (more than 450 × 10⁹/L), C-reactive protein (CRP) >100 mg/L and an erythrocyte sedimentation rate (ESR) >40 mm/h.

Indeed, with this constellation of blood tests in a severe Covid-19 case in the ICU setting, the physician uses heparin intravenously or subcutaneously to counter clot formation. However, this needs to be balanced against the risk of causing severe internal bleeding.

Separate from the anticoagulant effect, heparin seems to also suppress inflammatory cytokine levels. In addition, heparin suppresses neutrophil chemotaxis and migration. Physicians rescued many patients from death using heparin therapy.

Risk versus benefit clinical trials of heparin therapy are required

At this point there are only retrospective clinical trials available to describe risk versus benefit of heparin therapy. Some show no difference, others do. There are two international clinical trials on their way to shed more light on this situation. Until the results of these clinical trials are available, physicians need to treat patients to the best of their knowledge.

How to Manage Clot Formation with Covid-19

Conclusion

Clot formation in sick Covid-19 patients is responsible for many deaths in Covid-19 patients. The SARS-CoV-2 (or Covid-19 coronavirus) causes a cytokine storm with injury to the lining of the arteries. This can affect multiple vital organs and the condition may lead to organ failure. This activates the clotting system and causes clots all over the body. When this process occurs, patients get very sick and the death rate climbs. Physicians were able to rescue some patients with heparin therapy. Two international clinical trials are on the way. Hopefully these trials answer questions about this newer treatment method. The downside of heparin therapy is the complication of massive bleeding, which causes deaths as well. When it comes to Covid-19, don’t rely on curative medicine. Strengthen your immune system by preventative therapy like vitamin D3 that can interrupt the cytokine storm.

And even with a “well-prepared” immune system it is extremely important to follow all the guidelines of distancing, disinfecting and wearing face masks. We need all the help we can get!

Aug

2020

Health Benefits from Vitamin C Supplements

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, diet, heart attack, High Blood Pressure, immune system, Mortality, Stroke

Notably, there are health benefits from vitamin C supplements as I will explain below. A recent publication in the Journal of Intensive Care stated that vitamin C may lower ventilator time for sick patients in the ICU. In this case, researchers performed a meta-regression analysis. It is important to realize that higher doses of vitamin C changed the need for ventilation. Vitamin C given intravenously or by mouth significantly reduced the need for ventilation in sick patients. To explain, the researchers pooled eight clinical trials and compared them to a control group who did not receive vitamin C treatment. In detail, the researchers noted that there was a 14% reduction with regard to ventilator use in the treatment group. To clarify, they had received vitamin C infusions while patients who did not receive vitamin C infusions served as controls.

Five of the clinical trials involved patients who received 10 hours or more ventilation treatment. Certainly, these patients were sicker than the average ICU patients. They experienced a 25% reduction of ventilator time after receiving between 1 and 6 grams of vitamin C. The physicians gave this intravenous or orally.

History of Mega doses of vitamin C

Indeed, in the 1940’s mega doses of vitamin C were given intravenously in an attempt to treat polio. Eventually, in the late 1960’s Linus Pauling called high doses of vitamin C the “healing factors for diseases”. But subsequent clinical investigations showed that vitamin C had limitations. The Oregon State University website reports that some of the claims about vitamin C in the past went overboard. Here are some points about vitamin C that we need to remember.

Vitamin C is an important cofactor in many enzymatic reactions, such as the biosynthesis of collagen, carnitine and neuropeptides. In addition, the regulation of gene expression requires vitamin C and vitamin C is an important antioxidant.
A prospective cohort study showed that higher vitamin C blood levels lowered the risk of high blood pressure, coronary heart disease and strokes.

More effects of vitamin C

Patients in need of a surgical procedure benefitted from vitamin C. Researchers showed that vitamin C was a valuable adjunct to conventional medicine in cardiovascular disease Vitamin C reduced arrhythmia and myocardial injury following cardiac procedures.
There is insufficient evidence that regular vitamin C intake prevents cancer. Randomized controlled clinical trials reported no effect of vitamin C on cancer.
10 grams per day of vitamin C has no association with toxic or adverse effects in most people. However, some adults are more sensitive to vitamin C and develop gastrointestinal disturbances and diarrhea with megadoses of vitamin C. For these people physicians recommend taking up to 2 grams per day of vitamin C.

Vitamin C and disease prevention

Several clinical trials involving vitamin C supplements showed significant positive effects on patients. Below I am briefly reviewing these clinical trials.

Endothelial function

Endothelial function was improved with doses of above 500 mg of vitamin C. This likely is the reason that there is a reduction of cardiovascular disease in people who consume 1000 mg of vitamin C daily.

High blood pressure

Vitamin C at 500 mg daily lowers high blood pressure. A clinical trial found that 500 mg of vitamin C daily lowers the systolic blood pressure by 3.84 mm mercury and the diastolic blood pressure by 1.48 mm mercury. Over several years’ time this can prevent premature heart attacks and strokes.

Vitamin C and the immune system

Vitamin C is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Heart failure, strokes and heart attacks

Many studies showed some effects on reduction of heart attacks, strokes and congestive heart failure. With respect to strokes there was a 42% risk reduction over 9.5 years when the highest vitamin C plasma level was compared to the lowest level. But results regarding heart attack prevention and prevention of CHF were only marginal.

Cancer and vitamin C

Stomach cancer: there was a 45% reduction of stomach cancer when high vitamin C plasma level cases were compared to low plasma level cases.

Colon cancer: A pooled study based on 13 prospective cohort studies showed that vitamin C supplementation reduced colon cancer risk by 19%.

Large B cell lymphoma: After 11 years of follow-up the Women’s Health Initiative found that vitamin C supplementation reduced diffuse large B cell lymphoma by 31%.

Researchers could not show significant effects of vitamin C on other cancers.

Type 2 Diabetes (=adult onset diabetes)

A large European study going on for 12 years showed a strong inverse relationship between blood levels of vitamin C and the onset of diabetes. Patients with the highest vitamin C blood levels had a 62% lower risk of developing diabetes. Physicians compared this to low level vitamin C controls.

Mortality reduction with vitamin C supplementation

In the EPIC-Norfolk prospective study a clear inverse relationship was found with higher vitamin C blood levels and a reduction in risk of all-cause mortality.

Recommended dietary allowance for vitamin C

The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, in view of the above mentioned clinical trials I would recommend the following. Supplement with 500 mg to 1000 mg of vitamin C daily to have enough vitamin C reserves. The reason I say this is that the official dietary recommendation was based on preventing scurvy, the historic insufficiency disease of vitamin C. In addition, as mentioned before, vitamin C is safe to take up to 10 grams per day. Many physicians recommend taking a smaller amount of vitamin C found to prevent strokes, high blood pressure, type 2 diabetes, improve endothelial function and strengthen the immune system.

Health Benefits from Vitamin C Supplements

Conclusion

In my review I discussed health benefits from vitamin C supplements. Briefly, doctors noted that severely sick patients on respirators in the ICU setting were able to reduce the ventilator use. This was significant after they received between 1 and 6 grams of intravenous or oral vitamin C. However, patients with the highest vitamin C supplementation had a 62% lower risk of developing diabetes than low level vitamin C controls. Vitamin C lowered high blood pressure moderately and prevented strokes by 42%. Vitamin C stimulates the immune system together with vitamin D, A, E and some trace minerals. There are many more health benefits from vitamin C supplements. The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, I take 1000 mg of vitamin C daily as the evidence shows that this is healthier.

Aug

2020

Poor Diets Threaten Americans and Cause Diseases

By Ray Schilling | alcohol, Alzheimer’s disease, Cardiovascular disease, diet, exercise, fish oil, Fitness, food, heart attack, Hormones, lifestyle, Lung Disease, Nutrition, Obesity, polyunsaturated oil, Smoking, Stroke, sugar

A new Federal Nutrition Research Advisory Group stated that poor diets threaten Americans and cause diseases. More than 500,000 people in the US are dying every year because of poor nutrition. 46% of adults have unhealthy diets; but children have even more, namely 56%. In 1979 the US healthcare cost was 6.9% of the gross domestic product. Compare this to 2018 when the US healthcare cost was 17.7% of the gross domestic product.

The Federal Nutrition Research Advisory Group states: “Poor diets lead to a harsh cycle of lower academic achievement in school, lost productivity at work, increased chronic disease risk, increased out-of-pocket health costs, and poverty for the most vulnerable Americans.”

You can improve your diet quality

When you start cutting out junk food and other processed foods, the quality of your food intake is improving. Eat more vegetables, and fruit. Eat wild salmon, which provides omega-3 fatty acids. Do not consume vegetable oils like soybean oil, canola oil, safflower oil, corn oil and grapeseed oil. They all contain omega-6 fatty acids. Omega-6 fatty acids are essential fatty acids and they convert mainly into energy. But the problem is that our western diet contains too many omega-6 fatty acids. Omega-6 fatty acids can convert into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other. Use cold-pressed extra virgin olive oil instead for cooking and on salads.

How does poor quality food affect your health?

Researchers are aware of trans fats causing Alzheimer’s disease, heart attacks and strokes for a long time. They increase the bad LDL cholesterol, decrease the good HDL cholesterol. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol. The FDA has started to initiate steps in 2015 to make the use of trans-fats in the food industry illegal. Completion of this in the US occurs in early 2020.

Japanese trans-fat study (Alzheimer’s disease)

This Japanese study followed 1,628 Japanese community residents (men and women) for about 10 years. Researchers used the typical trans fatty acid, elaidic acid to monitor the accumulation of trans fats in patients. This is possible with a simple blood test, which serves as a marker for industrial trans fats. 377 participants developed dementia (247 Alzheimer’s disease and 102 vascular dementia). Based on the blood elaidic acid levels earlier in the study individuals with higher trans-fat levels were more likely to develop Alzheimer’s disease as the study progressed. Patients whose trans-fat blood levels were in the higher range were 50% to 75% more likely to develop Alzheimer’s disease or dementia.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits. Note that it is not only your dietary habits that determine this, but in addition, several lifestyle factors.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack. It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking. Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, consuming too much alcohol causes cancer of the colon and rectum in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into your system and adds to chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Poor Diets Threaten Americans and Cause Diseases

Conclusion

A new Federal Nutrition Research Advisory Group has been formed, which noted that many Americans follow very poor diets. 46% of adults in the US have unhealthy diets; but children have even more poor diets, namely 56%. This is of concern, because in time this causes a variety of diseases discussed here. Instead of just treating the symptoms of these diseases, it is important to improve the diet people are on, which prevents the development of these diseases. A well-balanced diet not only prevents diseases, it also leads to longevity and healthy aging without Alzheimer’s disease. Take care of what you eat, and be sure it is healthy!

Part of this text was published before here.

Aug

2020

Eating Fish Protects the Brain from Air Pollution

By Ray Schilling | Dementia, diet, fish oil, Inflammation, omega-3 fatty acids

Research on white women aged 70 years or older found that eating fish protects the brain from air pollution. Dr. Ka He from the Columbia University of New York published the new study on July 15, 2020 in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

1,315 women who did not have dementia at the start of the study enrolled in it. Researchers measured the air pollution of the areas where the women lived. They also measured their omega-3 fatty acid blood levels. They found that women from polluted areas who ate the lowest amounts of fish and had the lowest amounts of omega-3 fatty acids in their blood, had the highest amount of brain shrinkage.

Methods of determining brain shrinkage, omega-3 fatty acids and pollution

The amount of brain shrinkage was determined with MRI scans of the brain. The amount of white brain matter was measured, particularly the size of the memory-sensitive hippocampus. Blood omega-3 fatty acid content was determined in red blood cells. Pollution was determined by the fine particulate matter in air pollution at the address where the patient lived. Every woman in the study received a diet questionnaire regarding fish consumption. From this information the researchers determined the average fish consumption per week. This included broiled and baked fish, non-fried shellfish, canned tuna, tuna casserole and tuna salad. Deep fried fish was not part of the list, because other studies showed that deep-frying damages omega-3 fatty acids.

More details regarding the study

The researchers adjusted the study according to age, smoking status, and other factors that could affect brain shrinkage. Women with the highest intake of omega-3 fatty acids had the highest volume of white matter in their brains as MRI scans showed. Specifically, the researchers noted the following findings:

Women with the highest omega-3 fatty acid level had 410 cubic cm white matter
Women with the lowest omega-3 fatty acid level had 403 cubic cm white matter
Each quartile increase in air pollution caused shrinkage of white matter by 11.52 cubic cm in those women with low omega-3 fatty acid consumption
In women with higher omega-3 fatty acid levels each quartile increase in air pollution caused shrinkage of white matter by only 0.12 cubic cm
Women with the highest omega-3 fatty acid intake had the highest volume of the hippocampus

Comments by the lead author of the study

Dr. Ka He stated: “Our findings suggest that higher levels of omega-3 fatty acids in the blood from fish consumption may preserve brain volume as women age and possibly protect against the potential toxic effects of air pollution.” But Dr. Ka He cautioned: “It’s important to note that our study only found an association between brain volume and eating fish. It does not prove that eating fish preserves brain volume. And since separate studies have found some species of fish may contain environmental toxins, it’s important to talk to a doctor about what types of fish to eat before adding more fish to your diet.”

Limitations of study

The study was involving older white women. This means that the results cannot be generalized to Afro Americans, Hispanics or Asians. The researchers examined exposure to pollution only later in life, not in early life or midlife. Hopefully future studies will examine what happens with lifelong exposure to pollution.

How to limit mercury exposure when eating fish

Omega-3 fatty acids are abundantly present in fish. It has plaque-reducing properties and also reduces the risk for abnormal heart beats. Overall this means less cardiovascular disease. The American Heart Association recommends a 3.5 oz. serving of fatty fish (salmon, mackerel, lake trout, herring or sardines) twice per week.

Mercury and other pollutants

Pollution of the air, soil and rivers is causing accumulation of mercury and other heavy metals in ocean water.

This affects fish that live in the ocean. There is a pecking order of predators with the larger fish feeding on the smaller fish. The bigger the predator fish, the more mercury and other pollutants they accumulate. According to this link the safest seafood is wild salmon, pollock and oysters.

High mercury content of predator fish

Tuna is too high in mercury, so is swordfish, and shark is even worse. I only consume fish from freshwater lakes or rivers, as well as salmon, oysters and shrimp. This way I get the lowest exposure to mercury. Why is mercury bad for you? It is a neurotoxin. It can harm your brain, heart, kidneys, lungs and the immune system. Specific symptoms can include loss of peripheral vision and lack of coordination with balancing problems. There may be impairment of speech and hearing. The key is to avoid mercury exposure.

Smaller fish low in mercury

The first line of defense is to stick to the smaller fish. They are they prey of the large predator fish. The following fish/mussels belong into the low mercury group (alphabetical order): anchovies, catfish, clam, crab, crawfish, flounder, haddock, herring, mackerel, mullet, oyster, perch, pollock, salmon, sardines, scallops, shrimp, sole, squid, trout and whitefish.

Molecularly distilled omega-3 fatty acid supplements

You may want to supplement your omega-3 fatty acid intake by fish oil capsules. It is important that you choose the more expensive higher potency products. A molecular distillation process that removes mercury, PCB and other heavy metals creates these higher potency products. This way you only get the enriched omega-3 fatty acids in pure form. EPA and DHA in one capsule should be in the 900 mg to 1000 mg range, not less. I take 2 capsules twice per day as a daily supplement. This helps you to balance the omega-6 to omega-3 ratio, which cuts down any inflammatory process (from too many omega-6 fatty acids) in you.

Eating Fish Protects the Brain from Air Pollution

Conclusion

A new study from the Columbia University of New York has shown that women older than 70 can preserve the white matter of their brains by consumption of fish. This included the hippocampus which is crucial for memory. The researchers measured the recent exposure of these women to pollution. They noted that the women who were exposed to the highest amounts of pollution had the best protection of the white matter of their brains by the highest consumption of omega-3 fatty acids from fish. Omega-3 fatty acids are also important to prevent heart attacks and strokes. Omega-6 fatty acids can cause inflammation, but when enough omega-3 fatty acids are part of the nutrition, the omega-6/omega-3 fatty acid ratio switches towards anti-inflammation and health.

How to consume omega-3 fatty acids safely

Omega-3 fatty acids are in fish and seafood. Unfortunately, mercury is contaminating these foods. But when you stick to the smaller fish and use molecularly distilled omega-3 supplements you can largely avoid this problem.

Parts of this text has been published before here.

Jul

2020

The Immune System Changes With Age

By Ray Schilling | autoimmune disease, diet, fish oil, food, immune system, Infectious Disease, lifestyle, omega-3 fatty acids, vaccinations, Vitamins and supplements

When we are young, we do not think about our immune system, but the immune system changes with age. When we are older than age 60, we notice that we may be taking longer to recover from a flu.

How does the immune system work?

There are two parts to the immune system, the innate immune system and the adaptive immune system. The innate immune system works to protect us from bacteria, viruses, toxins and fungi from the time we are born. The adaptive immune system uses B lymphocytes from the bone marrow to produce antibodies against viruses. This provides often lifelong immunity against this specific virus, but takes 3 to 5 days to kick in. Vaccinations can also trigger antibody production to protect us from viruses in the future. Both the adaptive and the innate immune system work together closely.

What are the ingredients for a fully functioning immune system?

The immune system consists of various immune organs that are distributed throughout the body. The bone marrow produces lymphocytes, granulocytes, macrophages, eosinophils and basophils. The adenoids in the back of the nasal passages and the tonsils in the back of the throat contain a lot of lymphocytes that are ready to protect us from colds and flus. We have lymph nodes throughout the body and they are connected with lymphatic vessels. The lymph nodes filter the lymph fluid that travels in the lymphatic vessels.

Other sites of lymphocyte production

The small intestine contains the Peyer’s patches, a collection of lymphocytes that protect our gut from invading bacteria or viruses. The spleen is located in the left abdominal cavity under the diaphragm. It removes old red blood cells and provides lymphocytes for the immune system. The thymus gland is located between the breast bone and the trachea. It changes bone marrow derived lymphocytes (B cells) into T lymphocytes that can process antigens from viruses and pass them on to the adaptive immune system for a full antibody response.

Cellular interactions between various players of the immune system

Back in the 1970’s it was already known that there were bone marrow derived B lymphocytes and thymus processed T lymphocytes. We knew then that B cells were involved in antibody production (adaptive immunity). T lymphocytes were thought to turn into killer T lymphocytes to kill cancer cells. But some T cells were T helper cells to process antigen and present it to B lymphocytes for antibody production.

More research since then refined what we know about the cells of the immune system.

Natural killer cells (NK cells)

Natural killer cells (NK cells) are part of the innate immune system. They attack cancer cells and cells that are infected by viruses. It takes about 3 days for their full action to develop. NK cells utilize the cell surface histocompatibility complex to decide whether to destroy a cell or not. T cell lymphocytes do not have the ability to do that. In the Covid-19 coronavirus situation NK cells play an important role to combat the disease right away.

Monocytes

They are large white blood cells that can differentiate further into macrophages and dendritic cells. Monocytes are part of the innate immunity, but they have an antigen presenting capability, which makes them also part of the adaptive immunity.

Memory T cells

The immune system learns to adapt to viruses and bacteria that we have come in contact with. The reason for the memory of the immune cells are the memory T cells. They replicate like stem cells, which keeps a clone of T lymphocytes, T helper cells and cytotoxic T killer cells in the background. They circulate through the body including the lymph glands and the spleen.

Immunosenescence as we age

There are several factors that come together, which age our immune system. The term for this is “immunosenescence“. There are genetic differences and differences due to the sex hormones. Estrogens increase the response of the immune system. In contrast, progesterone and androgens (including testosterone) decrease the immune response. This may be the reason why women tend to live longer than men.

As we age there are more and more memory T cells (both cytotoxic T cells and T helper cells). This weakens the formation of the natural killer cells (NK cells) of the innate immune system. Even the initiation of the adaptive immune system can be slower when we age and also the response to the flu vaccine. In addition, this can pave the way to autoimmune diseases.

The immune system changes with age: Evidence of immunosenescence

The following 3 factors show whether a person has immunosenescence:

The immune system has difficulties to respond to new viruses/bacteria or to vaccines
Accumulation of memory T cells crowding out cells of the rest of the immune system
Low-grade inflammation that is chronic and persists (“inflamm-aging”)

The process of immunosenescence starts with the involution of the thymus gland around the time of puberty. At that time the sex hormone secretion is highest. At the same time a growth factor from the bone marrow and the thymus gland decreases. It has the name interleukin-7 (IL-7). The end result is a slow decrease of the innate immune system with age and a more substantial weakening of the adaptive immune system due to a lack of naïve T and B cells.

Chronic viruses can weaken the immune system further

The varicella herpes zoster virus causes chickenpox. In some people the chickenpox virus can persist, but the immune system actively keeps it controlled. In the 60’s or 70’s when the immune system is weakened from aging, there can be a flare-up as shingles, a localized form of the chickenpox virus.

Another virus, the human cytomegalovirus can cause a chronic infection that often persists lifelong. In this case the immune system is chronically weakened because of a massive accumulation of T memory cells, which keeps the human cytomegalovirus infection at bay.

What we need when the immune system changes with age

Vitamin A

Both the innate and adaptive immunity depend on vitamin A and its metabolites. The skin cells and mucosal cells function as a barrier, which is important for the innate immunity. The skin/mucosal lining of the eye, the respiratory tract, the gastrointestinal and genitourinary tracts help the innate immunity to keep viruses and bacteria out of the body. Vitamin A is important to support macrophages, neutrophils and natural killer (NK) cells. In addition, vitamin A supports the adaptive immune system, namely T and B lymphocytes, so that the body can produce specific antibodies against viruses.

I do not take vitamin A supplements as I eat diversified foods like spinach, vegetables, poultry, Brussels sprout, fish and dairy products that contain vitamin A and carotenoids.

Vitamin C

This vitamin is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Vitamin D

The immune system is very dependent on vitamin D as the immune cells all contain vitamin D receptors. People who have less than 10 ng/mL of vitamin D in the blood are vitamin D deficient. They have much higher death rates when they get infected with the Covid-19 coronavirus.

Vitamin D regulates the expression of target genes. At the center is the vitamin D receptor, which is a nuclear transcription factor. Together with the retinoic X receptor (from vitamin A) the vitamin D receptor binds small sequences of DNA. They have the name “vitamin D response elements” and are capable of initiating a cascade of molecular interactions. The result is a modulation of specific genes. Researchers identified thousands of vitamin D response elements that regulate between 100 and 1250 genes.

You need enough vitamin D for your immune system

When enough vitamin D is present in the blood (more than 30 ng/mL) the immune system releases the peptides cathelicidins and defensins, which effectively destroy bacteria and viruses.

Vitamin D has mainly an inhibitory function regarding adaptive immunity. It inhibits antibody production from B cells and also dampens the effect of T cells. Researchers reported that vitamin D3 is useful in the treatment of autoimmune diseases.

I am a slow absorber of vitamin D3 as repeat blood vitamin D levels showed. I need 10,000 IU of vitamin D3 daily to get a blood level of 50-80 ng/mL (=125-200 nmol/L). This is the higher range of normal. Everybody is different. Ask your physician to check your blood level of vitamin D. Toxic vitamin D blood levels are only starting above 150 ng/mL (= 375 nmol/L).

Vitamin E

This is a vitamin that is fat soluble and helps the body to maintain its cell membranes. But researchers found that vitamin E also stimulates the T cell-mediated immune response. This is particularly important for the aging person to prevent respiratory tract infections. I take 125 mg of Annatto tocotrienols per day (this is the most potent form of vitamin E).

Vitamin B6

This vitamin is important for antibody production by B cells. Vitamin B6 regulates the metabolism of amino acids, which in turn form proteins. Antibodies and cytokines require vitamin B6. The T helper immune cells that initiate an adaptive immune response depend on vitamin B6 as well. I take a multi B complex vitamin (Mega B 50) twice per day, so I supplement with a total of 100 mg of vitamin B6 daily.

Folate

Folic acid is a coenzyme for the metabolism of nucleic acids and amino acids. Studies in humans and animals have shown that folate deficiency leads to increased susceptibility to infections. People with folate deficiency develop a megaloblastic anemia with immune weakness that leads to chronic infections. With my B complex supplement I get 2 mg of folic acid daily.

Vitamin B12

Methylation pathways depend on vitamin B12 as a coenzyme. Vitamin B12 is also involved as a coenzyme in the production of energy from fats and proteins. In addition, hemoglobin synthesis depends on vitamin B12. Patients with vitamin B12 deficiency develop pernicious anemia. These patients also have a weak immune system due to natural killer cell activity suppression and because circulating lymphocyte numbers are significantly decreased.

Treatment with cyanocobalamin reverses the immune weakness rapidly and treats pernicious anemia at the same time. I take 50 micrograms twice per day as part of the Mega-B50 multivitamin tablet. But I also inject 1000 micrograms of vitamin B12 every 6 months subcutaneously to be sure it is absorbed into the body. In older age the intrinsic factor from the stomach lining, which is required for absorption of vitamin B12 in the small intestine, can be missing, leading to vitamin B12 deficiency despite swallowing supplements.

Minerals required for a good immune response

Researchers identified five minerals that are essential for a strong immune system. They are zinc, iron, selenium, copper and magnesium.

Zinc

Zinc is important for a normal function of the innate and adaptive immune system. As zinc cannot be stored in the body, taking regular zinc supplements (30 to 50 mg daily) is important. I take 50 mg of amino acid chelated zinc daily.

Iron

Iron is important for cell oxygen transport and storage, DNA synthesis and for mounting an effective immune response. In particular it is the T cell differentiation and proliferation where iron is needed. Iron deficient people get a lot of infections because the immune system is paralyzed. I eat one spinach salad or steamed spinach daily, which gives me enough iron supply per day.

Selenium

Selenium is a trace mineral that is important for a normal immune response and for cancer prevention. When selenium is missing, both the adaptive and innate immune system are suffering. In this case viruses are more virulent. With selenium supplementation cell-mediated immunity is improved and the immune response to viruses is more potent. I take 200 micrograms of selenium per day.

Copper

Deficiency in copper results in a very low neutrophil blood count and causes susceptibility to infections. Copper is a trace mineral that participates in several enzymatic reactions. It is important for the innate immune response to bacterial infections. A well-balanced Mediterranean diet contains enough copper, which is why I do not supplement with extra copper.

Magnesium

An important cofactor for vitamin D in the body is magnesium. Magnesium participates in many enzymatic reactions. Between vitamin D and magnesium, the immune system is strengthened. I take 150 mg of magnesium citrate twice per day. By the way, magnesium also helps us to get a restful sleep, if we take it at bedtime.

Other dietary factors that strengthen the immune system

Polyunsaturated omega-3 fatty acids

It is important to note that polyunsaturated omega-3 fatty acids are essential for the body and help to modulate the immune system. I take 1800 mg of omega-3 (EPA/DHA) twice per day. I also like to eat fish and seafood at least 3 times per week.

Probiotics

Prebiotics benefit both the innate and the adaptive immune system. They strengthen the epithelial gut barrier, which is an important innate immune defence. Probiotics also lower the risk for Clostridium difficile gut infections. I take one probiotic every morning.

The Immune System Changes With Age

Conclusion

The immune system consists of different organs like the bone marrow, the spleen, lymph glands, Peyer’s patches in the gut, the thymus gland and more. There is the innate immune system, which responds immediately to a virus like the Covid-19 coronavirus. The adaptive immune response involves antibody production against, for instance, the measle virus or the mumps virus. With the aging process the immune system slows down (immunosenescence). This involves an accumulation of memory T cells and a depletion of natural killer cells (NK cells). This means that the innate immunity is getting weaker as we age and chronic inflammation occurs more often. This is the reason why people above the age of 65 get more severe symptoms from the Covid-19 coronavirus. They are also more affected by influenza-type illnesses.

Take supplements to strengthen the immune system

I reviewed the cofactors of a healthy immune system in some detail. It is important that you pay attention to these, particularly the vitamin D3 intake. With a strong immune system, we can survive viral infections better, including the current Covid-19 coronavirus. Future research will likely detect how to reactivate a sluggish immune system in older people. This way vaccination responses following flu injections will become more reliable in seniors.

Jul

2020

Key Factors for Centenarians

By Ray Schilling | alcohol, Alzheimer’s disease, Cancer, Cardiovascular disease, Diabetes, diet, exercise, fasting mimicking diet, fish oil, food, heart attack, Mortality, olive oil, omega-3 fatty acids, Prevention, Processed food, stress, Stress management, Stroke

A study from Washington State University (WSU) showed some of the key factors for centenarians to survive. The publication of the study goes back to June 17, 2020. In general, it was common knowledge that genetics plays a role in 25% to 35% of centenarians for their survival. That is to say, the remainder is the result of lifestyle factors. It is important to realize that the environmental factors play a significant role in the survival of centenarians, said Rajan Bhardwaj, a second-year WSU medical student. He and his research team determined what allowed centenarians to reach an age of 100 or above. Briefly, they identified the following factors that were necessary.

Three factors identified by the Washington State University study

walkability of the neighbourhood, which encourages regular exercising
belonging to the higher socioeconomic class
a high percentage of working population in the neighborhood (a mixed population) was also important

In the discussion the authors of the WSU study said that “blue zones” of centenarians had been mentioned before in the literature. To clarify, these are areas in the world where more than the average of centenarians live. Dan Buettner used the term “blue zones” in a National Geographic article about where centenarians were located.

The blue zones

He wrote a book about the location of the 5 blue zones. Notably, they are located in Sardinia (Italy), the islands of Okinawa and a group of Seven Day Adventists in Loma Linda. California. In addition, the Nicoya Peninsula of Costa Rica, and the island of Icaria, Greece complete the 5 blue zones. Specifically, Dan Buettner described the following characteristics of the lifestyle of centenarians.

They engage in regular physical activity
Mostly eating a plant-based diet including legumes
Calorie intake is moderate
Moderate intake of alcohol, mostly wine
Having a purpose in life
Engaged in family life
Having an active spiritual life
Reducing stress
Engaged in social life

Other attributes of centenarians

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27^th Annual World Congress on Anti-Aging Medicine. In particular, the topic of his talk was “Positive Psychological Attitudes of Centenarians “. Dr. Hertoghe is an endocrinologist in Belgium. He took an interest in people above the age of 100. These people, he felt, are special people with a very optimistic outlook on life. Dr. Hertoghe went on to say that centenarians have a will to live. Indeed, they adapt to changes; they have a sense of purpose, and they stay active.

More positive attributes of centenarians

Other psychological features, by the same token, show that they have a positive mood and they avoid stress and anxiety. Another key point is that they have self-determination. It must be remembered also that they are very sociable, have close family ties, love their relationships and often have a strong religious faith. In addition, there is a connection between their basic values, beliefs and spirituality. Truly, centenarians insist on their freedom and they have a feeling of youth. For one thing, centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing some of the details that Dr. Hertoghe gave.

The will to live

For one thing, it takes courage to grow old, and all centenarians have this. They say “Life is worth living”. Essentially, they have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Surprisingly, their mortality was only 33.3%. Be careful what you wish for!

Adaptability

In other words, this describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. However, 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group had a 2%-4% lower mortality risk. They had a 36%-55% higher probability of not developing cognitive impairment. That is to say, they rated themselves to be in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. In essence, these high resilient centenarians had no short-term health decline.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48% in males. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%. Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

The fasting mimicking diet helps you to reach a longer life

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet. The FMD makes chemotherapy more tolerable.

Key Factors for Centenarians

Conclusion

As we reviewed the factors that lead to longevity, we learnt that engaging in regular moderate exercise is one of the key factors. But belonging to the higher socioeconomic class and living in a mixed neighborhood with people from all walks of life is also important. We also reviewed the blue zones according to Dan Buettner. Mostly eating a plant-based diet including legumes with moderate calorie restriction prolongs your life. Add to this moderate intake of alcohol, mostly wine, and having a purpose in life. Augment this further with being engaged in family life, having an active spiritual life and reducing your stress level.

Living longer is a matter of fulfilling these longevity factors

With all of this you are on your way to become a centenarian. A review by Dr. Hertoghe in a lecture given at an Anti-Aging Conference in Las Vegas in 2019 added more criteria centenarians have. He provided references regarding the will to live, being adaptable, remaining active and harboring positive emotions. The more of these factors you can adopt, the longer you will live. At the same time, you will avoid getting diseases like heart attacks, strokes or cancer, which leads to a longer and healthier life.

The above text contains parts of this blog. The part about the fasting mimicking diet was published here before.

Jul

2020

Fat Deposits Mean Higher Covid-19 Risk

By Ray Schilling | Diabetes, diet, food, heart attack, Infectious Disease, Inflammation, lifestyle, Mortality, Nutrition, Obesity, Stroke, sugar, Weight loss

A new study showed that fat deposits mean higher Covid-19 risk. This study was reviewed here.

The article is based on the June 10, 2020 publication of the British Medical Journal.

They did large population studies showing that obesity is an independent risk factor for severe disease and death from Covid-19. One study with 428,225 participants had 340 admitted to hospital with confirmed Covid-19 coronavirus. 44% of them were overweight and 34% were obese. Another study, the OpenSAFELY study used linked electronic health records. 17,425, 445 participants were included and 5,683 Covid-19 deaths occurred. In this study there were 29% overweight and 33% obese persons. The researchers noted a dose-response relationship between excess weight and severity of Covid-19. The researchers removed confounding factors like age, sex, ethnicity, and social deprivation.

Critical illness and death rates in overweight and obese people

They realized that critical illness caused by Covid-19 was increased compared to normal-weight people as follows.

Covid-19 risk 44% higher in overweight people
Covid-19 risk 97% higher in people with obesity

This means that the risk for serious illness from Covid-19 was 1.44-fold for overweight persons and 1.97-fold for obese persons compared to normal-weight controls. The OpenSAFELY study also looked at the death rates from Covid-19 for people with obesity. Two obesity categories were investigated: obesity with a BMI of 30-34.9 and BMI of greater than 40 compared to normal-weight controls. Here are the death rates.

BMI of 30-34.9: 1.27-fold increased risk
BMI of greater than 40: 2.27-fold risk

Possible mechanisms explaining fat deposits mean higher Covid-19 risk

The researchers mentioned three possible mechanisms why overweight and obese people may have higher Covid-19 disease and death rates than normal-weight controls.

First, angiotensin converting enzyme-2 is found with higher frequency in fat cells of overweight and obese persons. Researchers are aware of the fact that the Covid-19 coronavirus uses this enzyme to enter body cells. It may also be the reason that fat cells become reservoirs that can shed virus for much longer than in normal-weight people with less fat cells. They pointed out that others have seen this also and found it with other viruses. In the case of influenza A, obesity prolonged viral shedding by 42% compared to normal-weight controls. And with H1N1 influenza obesity was an independent risk factor for hospitalization and death.

Weaker immune system, more lung resistance

Secondly, any virus can weaken the host’s defence of the immune system. Researchers showed this previously with the influenza virus. But now with Covid-19 coronavirus the cytokine storm due to a weak immune system is a major factor in making the viral infection worse. A lack of vitamin D is another factor in promoting the cytokine storm.

Third, obesity decreases lung function and it is difficult to improve this. There is greater lung resistance in the airways and it is difficult to expand the lungs in obese patients. When the doctor transfers patients with obesity to the intensive care unit, it is more difficult to increase their oxygen saturation with artificial ventilation.

Unhealthy environment, so fat deposits mean higher Covid-19 risk

The researchers point out that we live in a very unhealthy environment. In 2016 there were 1.9 billion people worldwide who were overweight or obese. These figures are rapidly rising. Presently about 65% to 70% are overweight or obese in the UK or the US. Obesity causes high blood pressure, heart disease, strokes, type 2 diabetes and cancer. We are all surrounded by processed food with extra salt, sugar, wheat and other unhealthy ingredients. The high mortality and deaths rates of Covid-19 in overweight and obese people point to the problem that society has.

Reduce salt, sugar and saturated fats in food

The culprits are salt, sugar and saturated fats. Merchants and food producers must reduce them in processed food. In the UK new government regulations have already resulted in lower salt content in foods. As a result, there is less high blood pressure and cardiovascular disease is in decline. All nations need to reduce salt, sugar, and saturated fat. When the weight comes down, we all are less prone to catching dangerous viruses.

Fat Deposits Mean Higher Covid-19 Risk

Conclusion

The pandemic has taught us a new lesson, namely that overweight and obese people are at higher risk of contracting Covid-19 coronavirus. In a research paper of the British Medical Journal concrete figures showed that the Covid-19 risk is 44% higher in overweight people and that it is 97% higher in people with obesity. The OpenSAFELY study also showed that obese people with a BMI of 30-34.9 have a 1.27-fold increased risk of catching Covid-19. But morbidly obese people with a BMI of greater than 40 have a 2.27-fold risk of catching Covid-19. There is a clear linear dose-response curve between the amount of fat a person accumulates and the risk for Covid-19.

Cut out junk food and decrease your risk for Covid-19

Covid-19 is directly related to the amount of junk food we eat. As a result we can say that eating junk food increases the Covid-19 risk. The opposite is true also: sensible eating and cutting out junk food makes you lose some pounds, and your risk for Covid-19 decreases.

Jul

2020

Probiotics and a Phage Blend for Digestive Problems

By Ray Schilling | Abdominal Pain, antibiotics, diet, Gastrointestinal Disease, immune system

In general, probiotics and a phage blend for digestive problems can help patients with irritable bowel syndrome (IBS). It is important to realize that about ¾ of Americans suffer from digestive problems. They develop symptoms of gas, bloating, diarrhea and stomach pains. To put it another way, about 1 in 7 Americans suffer from the condition, called chronic irritable bowel syndrome. That is to say, he underlying problem is an imbalance of gut bacteria where the bad ones outnumber the good ones. There are a number or reasons why bowel flora gets disrupted. We eat more processed foods, less fiber, and beef products from industry farms contain antibiotic residues. In feedlots for beef cattle antibiotics are fed to the animals as growth promoters. The residues in the meat kill the good bacteria in our guts and the bad ones proliferate. This causes digestive problems, but also weakens our immune system.

How probiotics work

Probiotics can restore our gut flora to a large extent. But some of the probiotic action gets lost in the stomach from the acidic milieu. A recent publication from a panel of gastroenterologists has not supported the wide use of probiotics. They came to the conclusion that probiotics have not shown enough benefit to a number of clinical conditions. The researchers mentioned Crohn’s disease, C. difficile infection, ulcerative colitis and irritable bowel syndrome (IBS) in particular of not responding to probiotics. But this may be because of inactivation of some of the power of the probiotics by stomach acid. In addition, by not using phages to potentiate the probiotic action probiotics may fail to permanently to improve the gut flora. I have previously discussed the importance of probiotics for the gut flora.

History and use of bacteriophages

Bacteriophages are now often just called phages. Dr. Frederick Twort, an Englishman detected phages in 1915 during World War I. Essentially a phage consists of either DNA or RNA and a protein envelope around this. Phages are very specific for certain bacterial strains. They attach to the bacteria and inject their own DNA or RNA into the bacteria. This stops the bacteria from multiplying, but makes the bacteria produce many more identical phages. Phages are useful to control the growth of problem bugs including antibiotic-resistant bacteria. However, the regulatory agencies were slow to approve phages despite a good safety record. Life Extension Magazine recently published a review article about this subject.

Phages helping to protect probiotic bacteria

Phages naturally play a role in keeping the gut flora stable. In this lengthy review, published in January 2020 phage actions are reviewed. It also mentions the connection between the gut flora and the immune system. The Life Extension Magazine article mentioned above describes experiments that show the action of phages. E. coli is the main bacterium in the large intestine. It is also the bacterium that can cause pneumonia, diarrhea and urinary tract infections.

Experiments with bacteria and phages in Petri dishes

According to the Life Extension Magazine article researchers did experiments with Bifidobacterium longum, one of the desirable gut bacteria. This was placed on a Petri dish along with E. coli bacteria. In a second Petri dish Bifidobacterium longum, E. coli and a phage mix were placed. After 5 hours there was hardly any growth of Bifidobacterium longum in the first petri dish, as it was crowded out by E. coli. The result in the second Petri dish was interesting: the Bifidobacterium longum colonies were 7000-times higher in number than in the other Petri dish without the phage mixture. The phages had selectively attacked the E. coli bacteria, which made room for the Bifidobacterium longum bacteria to multiply.

Animal experiments with bacteria and phages

The Life Extension Magazine review mentions animal experiments with phages next. One group of mice received B. longum and the disease-causing E. coli in their food. The other group had the same bacteria plus a mix of phages directed against E. coli. For the phage group the results within 24 hours were as follows.

The E. coli count in the small intestine was 10-fold lower, in the large intestine 100-fold lower and in the fecal matter 100-fold lower.
The phage group also had a 100-fold increase of the B. longum count in the small intestine. The large intestine also had a 100-fold increase of the B. longum count. And there was a 40-fold increase of B. longum in the fecal matter.

Control mice without the phage mix developed constipation and intestinal segments showed redness, swelling and leaks. In contrast, the phage mix group of mice showed no side effects and had improved digestive function.

Human studies using probiotics and a phage blend for digestive problems

Safety tests of phage therapy were next in 2005 involving 15 volunteers. There were no side effects using two different phage concentrations to diminish E. coli. Researchers had done other safety experiments in Russia and in Poland in the past. Patients with ulcerative colitis responded with improved symptoms and improved endoscopic findings to treatment with two probiotics. They received fermented milk products (Cultura) containing live lactobacilli (La-5) and bifidobacteria (Bb-12) for 4 weeks. There were 51 patients with ulcerative colitis and 10 patients with familial adenomatous polyposis. Abdominal cramps, Involuntary defecation, leakage and the need for napkins were significantly reduced in both groups. An endoscopic score of inflammation showed a significant decreased when the baseline exam was compared to the exam after the 4-week intervention.

Literature review about phages

Here is a thorough review in a publication dated 2011, which describes research from Poland and other countries describing the action of bacteriophages, now simply called phages. It lists many human experiments and shows that phages are safe to use in humans.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) presents with a pathological intestinal function, which can be quite disabling. Another name for it is “spastic colon”, because many patients complain of significant bowel spasms. Some health providers still use this alternative term. This syndrome is more common among women and there is a theory that female hormones may have something to do with the pathophysiology of irritable bowel syndrome. Testosterone on the other hand may have a calming effect on the gastrointestinal tract.

Symptoms and treatment of IBS

Generally speaking, irritable bowel syndrome occurs first in the teens or early twenties, but then frequently tends to become chronic. The patient chiefly complains of abdominal bloating and distension. Bowel movements lead to a marked relief of pain. There is often mucous in the stools. After a bowel movement there is often a feeling that the rectum did not empty entirely, even though it did. Food intake or stress can bring on these symptoms and they always occur during the waking period. At nights most patients have no pain.

Among other measures taking probiotics alone or mixed with phages can normalize the bowel flora. In older men IBS symptoms may indicate a reduction in testosterone production. If the blood contains a low testosterone level, the physician may want to replace the missing testosterone with injections or bioidentical testosterone creams. This can improve IBS in older males.

A safe delivery system for probiotics and a phage blend for digestive problems

Life Extension has developed a dual capsule that brings the inner content safely through the stomach and protects the mix of probiotics and phages from stomach acid. The capsule only opens in the small intestine where it releases its content of probiotics and phages into the gut. This allows the good bacteria like B. longum to multiply and suppresses E. coli, which would otherwise interfere with the beneficial bacteria.

Probiotics and a Phage Blend for Digestive Problems

Conclusion

About ¾ of Americans suffer from digestive problems. Many have a disbalance of the gut flora. But it is not easy to replace poor gut flora with a healthy one. Recent research showed that a combination of 7 probiotic strains with a mix of 4 E. coli fighting phages can give tremendous relief from bloating, diarrhea and abdominal cramps to patients with irritable bowel syndrome (IBS). Life Extension has developed a special dual capsule that “sneaks” the capsule through the stomach. It will only open in the small intestine. This way the content of the inner capsule with the mix of probiotics/phages stays safe from the stomach acid. At the end many more beneficial bowel-bacteria are growing in the small and large intestine. This normalizes the symptoms of the patient and leads to better digestion of food. Probiotics and phages are the new players in the gut microbiome.

Jun

2020

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

By Ray Schilling | antibiotics, Infectious Disease, Mortality

A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The discovery of teixobactin took place in 2015. It is a peptide with 11 amino acid units. Teixobactin is derived from a gram-negative bacterium, Eleftheria terrae. It is the first of a new class of antibiotics that can kill superbugs. Two examples, for instance are methicillin-resistant Staphylococcus aureus and resistant Mycobacterium tuberculosis. Researchers have been battling with difficult solubility of teixobactin and problems synthesizing this peptide in the laboratory. Teixobactin binds to the membranes of the bacteria it fights. This is a new mechanism for this new class of antibiotics, different from conventional antibiotics.

Mechanisms of fighting bacteria resistant to conventional antibiotics

But it is exactly this quality that is necessary to fight the antibiotic-resistant bacteria. The researchers showed that teixobactin binds weakly to a component of the bacterial cell wall, called “Lipid II”. But they found a second mechanism, namely blocking precursors of cell membrane synthesis in the bacteria they fight. Because of these unique mechanisms it is possible for them to fight a multitude of bacteria resistant to conventional antibiotics. Teixobactin has a unique molecular structure, which makes it difficult for resistant bacteria to develop resistance to it.

Antibiotic resistance

Resistance to antibiotics is a worldwide problem. There are several factors that worked together to make antibiotic resistance such a big issue. For instance, in the past many doctors prescribed antibiotics for any viral cold, even knowing that antibiotics only work against bacteria. Aside from this, the agricultural practice of using antibiotics as a growth stimulator is also an important factor for antibiotic resistance to develop. It is the bacteria that become resistant, not the human body. Several clinical entities involving resistant bacteria exist that show the magnitude of the problem.

Flesh-eating disease

Necrotizing fasciitis (or flesh-eating disease) can develop when you swim in contaminated waters and the bacterium, Vibrio vulnificus enters through skin sores or wounds. The CDC warns that you should stay out of salt water or brackish water, if you have a skin wound. The flesh-eating bacteria, Vibrio vulnificus can become very aggressive, once it has entered the body. Right now, 1 out of 5 people who get infected will die and many people require ICU treatment. Others need limb amputations. All of this can happen within only 1 or 2 days of becoming ill. The hope is that with the development of teixobactin as an injectable medication or as an oral pill there will no longer be deaths, amputations and scarring due to this bacterium, as the antibiotic will very quickly eradicate Vibrio vulnificus. I have previously written about what hospitals can do to fight superbugs.

The most common antibiotic-resistant bacteria

Here is a brief review of the most common antibiotic-resistant bacteria.

Mycobacterium tuberculosis

Since the 1950’s and 1960’s tuberculosis was treatable with a combination of two antibiotics over a period of six months to two years. But in the last 10 years more and more resistant strains of tuberculosis have developed. This is called multi-drug-resistant TB. In 2013 statistics showed that 3.7% of newly diagnosed tuberculosis cases were multi-drug-resistant TB. Many of these cases can be traced back to prisons and homeless shelters.

Methicillin-resistant Staphylococcus aureus (MRSA)

MRSA has become a common resistant bacterium that can present with difficult to treat boils in the skin, but also as a fulminant infection as necrotizing fasciitis (or “flesh-eating disease”). About 1/3 of the cases of flesh-eating disease are caused by MRSA.

Clostridium difficile (C. difficile)

This gut bacterium is naturally resistant to many antibiotics. The rest of the gut bacteria usually suppress the growth of C. difficile. But many patients can get overgrowth of C. difficile in their gut following treatment with antibiotics. Recolonization with probiotics can help to reintroduce a balanced bowel flora. In the US about 500,000 individuals come down every year with diarrhea due to C. difficile. This leads to approximately 15,000 deaths yearly.

Vancomycin-resistant Enterococci (VRE)

Physicians find enterococci in the gut and the female genital tract of patients. They can become resistant when the patient is treated with vancomycin for another infection. The VRE can then become a problem of its own with difficult to treat infections in the genital tract of females, the gut or in wounds from surgery. It has become a problem in immunocompromised patients.

The gonorrhea causing bacteria

In the last 70 to 80 years Neisseria gonorrhoea, the cause of gonorrhea, has been treated with only one antibiotic, but gradually the bacterium developed antibiotic-resistance. Lately, with more and more resistant strains of Neisseria gonorrhoea, the CDC has recommended to treat gonorrhea with two overlapping antibiotics.

Carbapenem-resistant Enterobacteriaceae (CRE)

There are two problem bugs among this category of enterobacteria, Klebsiella species and Escherichia coli (E. coli). These bacteria reside in hospitals where they can accumulate and are present in patients with immune system compromise. Medical devices like catheters and ventilators transmit these bacteria. Once a patient is sick with CRE, there is a danger of blood poisoning (septicemia), which has a high death rate.

How do regular antibiotics kill bacteria and how can they become resistant?

Normally, when antibiotics are not resistant, they interfere with the cell membrane production of the bacteria. Specifically, conventional antibiotics prevent bacteria from synthesizing a molecule, called peptidoglycan. Without peptidoglycan bacteria are not stable enough to survive in humans. But there are other mechanisms as explained in this link how antibiotics manage to kill bacteria.

Now I like to address the question how bacteria can become resistant to conventional antibiotics. This happens with overuse of antibiotics, i.e. prescribing antibiotics when a person suffers from a viral illness where antibiotics do not work. Other overuse comes from agriculture where cattle in feed lots get antibiotics as growth promoters. The FDA is strongly criticizing this practice, because residuals of antibiotics in beef can alter the bowel flora in man. The antibiotics kill all the sensitive bacteria. But the resistant bacteria, that have undergone mutations and adapted to the antibiotics, will survive.

Why teixobactin and analogues can avoid resistance

Since the detection of teixobactin many analogues have been synthesized. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The teixobactin analogues need more fine tuning, but they will be a breakthrough in the treatment of resistant bacteria. As this peptide attacks two targets on bacteria, it is not easy for bacteria to develop resistance against these new antibiotics.

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

Conclusion

Resistant bacteria have become a serious health concern in the last decade. Physicians overprescribing antibiotics and farmers feeding antibiotics to cattle in feedlots as growth promoters were the driving forces. In 2015 came the breakthrough and discovery of teixobactin. This is a peptide with 11 amino acid units. Teixobactin is a derivative of a gram-negative bacterium, Eleftheria terrae. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. In the meantime, researchers have been able to improve solubility by developing teixobactin analogues. More research is necessary. But all of the researchers who work in this field claim that this will very soon be extremely useful for patients with super bugs. This super-antibiotic will be a weapon fighting super bugs. Before the release of this medication clinical trials will be the next step.