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2016-11-03
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Seminarium Stockholm 2016‐11‐04
ATT VÄLJA HÄLSA:”Hedra Dina tarmbakterier på det att det må gå
Dig väl och Du må länge leva på jorden”
Stig Bengmark MD PhD UCL, London University, UK
DIFFERENT LIFESTYLE – DIFFERENT DISEASE PATTERNClayton P, Rowbotham J Int. J. Environ. Res. Public Health 2009;6:1235‐1253
HUR BEHANDLAR VI MÄNNISKOSLÄKTET?Dramatisk ökning av kroniska sjukdomar, allt större babies,
allt tidigare pubertet & svåra förlossningsskador!
FORSKNING & FRAMSTEG 2011
Bebac 26, and Mokolo 23, two male Western lowland gorillas at the Cleveland Metropark Zoo are
obese and with heart disease.
The Plain Dealer July 5 2011
INDUSTRIAL & AGRICULTURAL REVOLUTION100 % increase in intake of animal fats
5000 % increase in intake of dairy‐derived foods 10000 % increase in intake of refined sugar (1 lb => 100 lb) ENVAR
SIN EGEN HÄLSAS SMED !
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DUBESTÄMMER SJÄLV!
Nyutexaminerade läraren
Harriet Jenkins, 25 år,
Southhampton, bantade bort 95 kg på
18 månader och gick från
storlek 30 till 10
JOHANNA´S (28 år) ERFARENHET”Jag har sett många av dina föreläsningar och läst dina texter många gånger om.”
Fick våren 2013 Ulcerös proktit & gjorde då helomvändning gällande kosten.
Jag äter numera varken spannmål, mjölkprotein eller socker.
”Denna kostomläggningen är det bästa som har hänt mig då alla mina problem (förstoppning, depression, ångest, PMS (mensbesvär), urinvägsinfektioner, näsblod, migrän etc har försvunnit helt. ”
Lars Olov Bygren
Baguette (95, pumpernickel 40)), White suger (68), Candy bar (55), Yellow Banana (54),
MOST FATTENING FOODSJon Brower Minnoch, USA 1941 ‐1983, 635 kg
• Alcohol
• Bread & Pasta, Pastries
• Butter
• Cheese
• Chips
• Fast food & takeaways
• Fried food
• Jam and marmalade
• Milk & Latte
• Potatoes & other tubers
• Red meat
• Salted nuts
• Tomato ketchup
• Soft drinks
NEGATIVT FÖR MÄNNISKORS HÄLSA?
Bröd 1 ‐Mycket högt glykemiskt index ‐GI
2 ‐ För litet fibrer
3 ‐ Starkt upphettat
4 ‐ Innehåller gluten
Mejerivaror1 ‐ För mycket hormoner och tillväxtfaktorer,
2 ‐ Innehåller proinflammatoriskt kasein,
3 ‐ långkedjiga fetter (ofta mättade) dominerar
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VÄXTFÖRÄDLING
VÄXTFÖRSÄMRINGhttp://www.nutritionsecurity.org/PDF/Food%20
Nutrition%20Decline.pdf
FRUCTOSE IN FRUITS Dr Mercola 2010
FRUCTOSE & MEMORY LOSSAgrawal R, Gomez‐Pinilla F J Physiol 2012;590:2485–2499
MEDITERANIEN DIET & MEMORY Valls‐Pedret C et al JAMA Intern Med 2015 E‐pub
INCREASED LIFE EXPECTANCY: 47 78 YEARS but an TZUNAMI OF CHRONIC DISEASES Fontana L Biochimica et Biophysica Acta 2009;1790:1133–1138
• Cardiovascular disease (CVD), cancer, stroke and diabetes account for about 70% of deaths in the US and Europe.
• About 80% of adults > 65 yrs have at least one chronic disease, & 50% have two or more of these chronic diseases.
• > 40% of cancer & > 80% of all heart disease, stroke and type 2 diabetes are preventable with elimination of unhealthy diets, physical inactivity, and tobacco consumption)
PROGNOSIS DIABETES USA – 2050Boyle et al. Population Health Metrics 2010, 8:29
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PROGNOSIS ALZHEIMER USA – 2050Hebert LE et al Arch Neurol 2003;60:1119‐1122
FORECAST TO 2030 – USA + UK (375 mill)Wang YC et al Lancet 2011;378:815‐825
Rising prevalence of obesity is a worldwide health concern as it forecasts an increased burden from diseases such as diabetes, coronary heart disease, cancers, osteoarthritis and stroke. The trends project by the year 2030 in two ageing populations, USA and UK:
• 76 mill more obese adults
• 6–8∙5 mill additional cases of diabetes
• 6‐7 mill additional cases of cardiovascular disease
• 492 000–669 000 additional cases of cancer
• Loss of 26–55 mill quality‐adjusted life years
• Increase in costs of these preventable diseases by $ 50–68 bill/year = SEK 428 – 582 miljarder
FUTURE SCENARIOThe annual health care costs in the US was in the year 2002 $1.6 trillion e.g.about $ 5,440 per person, It is forecasted to have doubled by the year of 2011= $ 10880 e.g. > $ 3 trillion &2020 to be 4.8 trillion ($ 15000 pp) Heffler S et al. Health Aff (Millwood) 2002;21:207‐218
KOSTNADER FÖR FETMA I USA.• mellan $147 och $210 miljarder per år
Cawley J and Meyerhoefer C. J Health Economics, 2012;31:219‐230.
• + kostnader får absentism – ca $4.3 miljarder per år Cawley J, et al. J Occup Environ Med 2007; 49:1317‐1324
• + kostnader för lägre produktivitet ‐ belastar arbetsgivaren med $ 506 per fet anställd och år Gates D. et al Occ Envir Med, 2008;50:39‐45
• Feta vuxna orsakar 42 % mer i direktasjukvårdskostnader. Finkelstein EA et al. Health Affairs, 2009;28:822‐831.
• Per capita sjukvårdskostnader för de med sjuklig fetma(BMI >40) är 81 % högre än för normalviktiga. År 2000, la man ner 11 miljarder på vård av denna grupp. Arterburn DE, Maciejewski ML Int J Obes, 2005;29: 334‐339.
En kommunal investering med bara 10 dollar per person, med ökadfysisk aktivitet, förbättrad matkultur och eliminering av rökning kanspara 16 miljarder dollar per år inom fem år. Detta medför enavkastning på $ 5.60 för varje investerad $1 invested. Som exempelså kan Medicare per år spara 5 miljarder av sina 16 miljarder , Medicaid spara 1.9 miljarder dollar och Övriga Försäkningsbolaginte mindre än 9.1 miljarder. Prevention for a healthier America: Investments
in Disease Prevention yield Significant Savings, Stronger Communities Washington, D.C.: Trust for America's Health, 2008.
OBESITY ‐ THE GLOBAL TZUNAMI‐ strongly associated to modern
agriculture & mass‐produced cheap processed foods
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GLOBAL STROKE STATISTICS
Thrift AG et al Int J Stroke2014;9:6‐18
Metabolic Syndromedangerous manifestations:
• Abdominal obesity
• High blood pressure
• Elevated blood sugar
• Elevated blood triglycerides
• Low HDL cholesterols
• Fatty liver (& fatty skeletal muscles)
• High Uric acid
THE QUARTET OF DEATHwww.bengmark.com
• Excessive body weight
• Hypertension
• Impaired glucose homeostasis/insulin resistance – glucose intolerance
• Atherogenic dyslipidemia: changes in serum
cholesterol, increased triglycerides, decreased high density lipoprotein (HDL) cholesterol, and an increase of “small dense” low‐density lipoprotein (LDL) particles
Waist circumferencemen: < 102 cm women: <88 cm Fasting glucose 3,9 ‐ 5,9 mmol/LTriglycerides: < 1,7 mmol/LLow‐density lipoprotein cholesterol(LDL), men: < 2,5 – 3,0 mmol/LSystolic blood pressure: (SBP) < 130 mmDiastolic blood pressure: (DBP) < 85 mm
NORMAL VALUES POSTPRANDIAL HYPERLIPIDEMIA IN METABOLIC SYNDROMEAlcala‐Diaz JF et al. Plos One 2014;9:e96297
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CANCER & GENES Anand P et al Pharm Res 2008;25:2097‐2116
ÂHARMONY
LIFESTYLE
&
HEALTHEXERCISE FOOD
REGULAR EXERCISE & MORTALITYGebel K et al JAMA Intern Med 2015
WHO’s guidelines suggest that “significant health benefits can accrue through accumulation of at least 150 minutes of moderate activity per week”
661 000 persons followed during 14 years:
• No exercise – the highest mortality
• 150 min/w moderate exercise, low speed ‐ 20 %
• 150 min/w moderate exercise, more speed ‐ 31 %
• 450 min/w moderate exercise, more speed ‐ 39 %
• 1500 min/w moderate exercise, high speed ‐ 20 %
ÂCONTENT
FOOD
&
HEALTH
AMOUNT TIME
ÂGOOD FOR MICROBIOTA – GOOD FOR HEALTH
Avoid toxic substances:
Alcohol, tobacco, pesticides, drugs, AGE & ALEs, casein, gluten, zein, refined sugars, flour etc
Avoid processed foods Eat fresh greens
GUIDE TO PESTICIDES
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THE MICR0BIOTA‐OBESITY CONNECTIONMoran CP, Shanahan F Best Pract Res Clin Gastroenterol 2014;28:585–597
METABOLIC SYNDROME – DYSBIOSISTremellen K, Pearce K Med Hypotheses 2012;79:104‐112
LIFE STYLE CAUSES OF DEATH – USADanaei G Plos Med 2009,6(4),e
THE BATTLE FIELD
POSTPRANDIAL INFLAMMATIONGENERAL INFLAMMATION
CHRONIC DISEASES
Myles IA Nutrition Journal 2014;13:61
ENDOTOXIN ‐ THE VILLAIN & ASSOCIATED DISEASES:Alzheimer Jaeger LB et al. Brain Behav Immun. 2009; 23: 507–17
Cognitive impairment Lee JW et
al. J Neuroinflammation 2008; 5: 37
Arterio‐/Coronary Diseases Heo SK et al Immunol Lett 2008;120:57‐64
Diabetes type 1 Nymark M et al Diabetes Care 2009 32(9): 1689–1693
Diabetes type 2 Andreasen AS Intensive Care Med. 2010;36:1548‐1555
Cancer Hsu RY et al Cancer Res.
2011;71(5):1989‐1998
Chronic Liver diesases Nolan JP Hepatology 2010;52:1829‐1835.
•ADHD, allergy, ALS, autism, autoimmune diseases, bipolardisease, cataracts, chronicfatigue syndrome, COPD, fibromyalgia, glaucoma, gulf warsyndrome, HIV, iritis, macular degeneration, minimal encephalopathy, multiplesclerosis, nephropathies, obesity, osteoporosis, paradontosis, Parkinson, polycystic ovary syndrome, rheumatoid disease, stress, schizophrenia, stroke, uveitis
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Erika Isolauri & Seppo SalminenALLERGY, ADHD & PROBIOTICS
2001 – Mothers from families with high burden of allergies receivedduring the last 2‐4 weeks of pregnancy and the baby during first 6 mo Lb GG
Kalliomäki M et al. Lancet 2001;357(9262):1076‐1079.
2003 – 14/53(26 %) in the probiotic group and 25/54 (46 %) in the placebo group developed atopic eczema
Kalliomäki M et al Lancet 2003;361(9372):1869‐1871
2015 Probiotic‐treated individuals showed no ADHD or Asperger syndrome ‐ 0/40 = 0 %
in contrast to placebo group ‐ 6/35 17.1%) e.g. almostevery 6th child
Pärtty A et al Pediatr Res. 2015;77:823‐828.
NEONATAL GUT MICROBIOTA & ALLERGYFujimura KE et al Nature Med 2016 E‐pub
Gut microbiota bacterial depletions and altered metabolic activity are implicated in childhood atopy and asthma. Stools from 298 neonates, aged 1–11 months, were investigated.
The highest risk group to develop atopy/asthma wasobserved with
• lower abundance of certainbacteria such as Bifidobacterium, Akkermansia & Faecalibacterium
• higher abundance of particularfungi Candida and Rhodotorula &
• metabolome enriched for
pro‐inflammatory metabolites.
LIFESTYLE, THE DEADLY QUARTET & LIVER DISEASEDyson JK et al Postgrad Med J 2015;91:92‐101 HEALTH ADVICE – NEW TREND
MICROBIOTA – FAVORITE FOODS – UNCOOKED! www.bengmark.com INFLAMMATION REDUCTION – ECOBIOLOGICALSraw & fresh plants, pro- and synbiotics
isothiocyanates in cruciferous vegetables, anthocyanins and hydroxycinnamic acids in cherries, blueberries, epigallocatechin-3-gallate (EGCG) in green tee, chlorogenic acid and caffeic acid in fresh coffee beans & fresh tobacco leaves,capsaicin in hot chili peppers, chalcones in apples, euginol in cloves, gallicacid in rhubarb, hisperitin in citrus fruits, naringenin in citrus fruits, kaempferol in white cabbage, blueberries myricetin in berries,rutinand quercetin in apples and onions, resveratrol and other procyanidin dimers in red wine. virgin peanuts, blueberries various curcumenoids, the main yellow pigments in turmeric curry foods, and daidzein and genistein from soybean
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FOODS RICHEST IN ANTIOXIDANTS
• Cloves, ground 314,446
• Sumac bran 312,400
• Ceylon Cinnamon 267,536
• Sorghum, bran, raw 240,000
• Oregano, dried 200,129
• Turmeric, ground 159,277
• Acai berry, freeze‐dried 102,700
• Sorghum bran, black 100,800
• Sumac grains, raw 86,800
• Cocoa powder 80,933
• Cumin seed 76,800
• Maqui berry, powder 75,000
• Parsley, dried 74,349
• Sorghum bran, red 71,000
• Basil, dried 67,553
• Curry powder 48,504
• Sorghum, grain 45,400
• Sage 32,004
1 Cloves, ground 314,446
2 Sumac bran 312,400
3 Cinnamon, ground 267,536
4 Sorghum, bran, raw 240,000
5 Oregano, dried 200,129
6 Turmeric, ground 159,277
7 Acai berry, freeze‐dried 102,700
8 Sorghum, bran, black 100,800
9 Sumac, grain, raw 86,800
10Cocoa powder, unsweetened
80,933
11 Cumin seed 76,80
12 Maqui berry, powder 75,000
13 Parsley, dried 74,34
14 Sorghum, bran, red 71,000
15 Basil, dried 67,55
16Baking chocolate, unsweetened
49,92
17 Curry powder 48,50
18 Sorghum, grain 45,40
19 Chocolate,powder 40,20
20 Maqui berry, juice 40,000
TWO VERY DIFFERENT CINNAMONS
Ceylon (true) cinnamon 267536 μmolTE/100g compare turmeric – 159277 TE
Saigon (cassia) cinnamon 15170 µmolTE/100g
Eat with care – contains a substance, coumarin, which may harm the liver, also in a small dosis ‐ should not exceed
0,1 mg/kg body weight & day
ANTI‐INFLAMMATORISK GURKMEJA‐COCKTAIL
½ ‐ 1 glas fruktjuice – t.ex. ananas, äpple el dyl
1 toppad matsked gurkmeja
1 rågad tesked Ceylonkanel, ej Saigonkanel (giftigt)
Upp till ¼ tesked chilipeppar (Cayenne)
Knivsudd pulver av kryddnejlika
½ ‐ 1 matsked äppelcidervinäger
1 tesked citronjuice
Blandas och dricks 1‐2 gånger dagligen
Alternativ är att köpa färsk gurkmeja, skära i små tärningar
och mixa i sallad dagligen!
2015‐06‐26 Stig Bengmark
ANTI‐INFLAMMATION FOODS• Artichokes
• Avocado
• Berries:blackberries, blueberries, raspberries, strawberries
• Fermented, microb‐enriched vegetables
• Garlic
• Green tea
• Kale
• Maitake mushroom
• Nutmeg
• Parsley
• PRE‐, PRO‐ & SYNBIOTICS
• Red grapes
• Tomato,
• Turmeric
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GLUTATHION IN FOODS Nmol/g
Broccoli (flower) 440
Parsley (leaf) 400
Spinach 400
Yellow squash (fresh) 320
Yellow squash (frozen) 70
Potato (raw) 230
Potato (boiled 15 min) 110
Tomato 170
Green pepper 170
Tangerine 140
Broccoli (stem) 140
Cauliflower 130
CHLOROPHYLL IN FOODS microg/cup
Parsley 380Spinach 240Cress, garden 160Green beans 80Arugula 80Leeks 80Endive 50Sugar peas 50Chinese cabbage 40
OMEGA 3 IN FOODS mg/200 cal. serving
Flax seeds 12060
Chia seeds 7160
Radish seeds 3360
Salmon, wild, raw 2840
Walnuts 2780
Basil fresh 2750
Oregano, dried 2730
Cloves, dried 2650
Mackerel, fresh 2610
Salmon, farmed, raw 2410
Broccoli, cooked 2350
Bioavailability of Nutrients Used to Weight Nutrient Density Scores
Iron 18
Riboflavin 95
Niacin 30
Folate 50
Vitamin B6 75
Vitamin B12 50
Vitamin C 70–90
Vitamin K 20
NUTRIENT DENSITY – Group A. Di Noia J. 2014
• Water cress 100.00
• Chinese cabbage 91.99
• Chard 89.27
• Beet green 87.08
• Spinach 86.43
• Leaf lettuce 70.73
• Parsley 65.59
• Romaine lettuce 63.48
• Collard green 62.49
• Turnip green 62.12
• Mustard green 61.39
• Endive 60.44
• Chive 54.80
• Kale 49.07
• Dandelion green 46.34
• Red pepper 41.26
• Arugula 37.65
• Broccoli 34.89
• Pumpkin 33.82
• Brussels sprout 32.23
NYTTIGHETER I GRÖNSAKER –Champions league
• Romansk sallad 63
• Grönkål 62
• Kålrotsblad 62
• Senapsblad 61
• Endiver 60
• Gräslök 55
• Vintergrönkål 49
• Vattenkrasse 100
• Kinesisk kål 92
• Mangold 89
• Rödbetsblad 87
• Spenat 86
• Cikoria 73
• Bladsallad 70
• Persilja 66
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NUTRIENT DENSITY – Group B. Di Noia J. 2014
• Scallion 27.35
• Kohlrabi 25.92
• Cauliflower 25.13
• Cabbage 24.51
• Carrot 22.60
• Tomato 20.37
• Lemon 18.72
• Iceberg lettuce 18.28
• Strawberry 17.59
• Radish 16.91
• Winter squash 13.89
• Orange 12.91
• Lime 12.23
• Grapefruit,red 11.64
• Rutabaga 11.58
• Turnip 11.43
• Blackberry 11.39
• Leek 10.69
• Sweet potato 10.51
• Grapefruit, white 10.47
ADVANTAGES OF RAW FOOD VEGAN DIET 1Fontana L et al . Rejuvenation Res. 2007;10:225–234
Consuming a low‐calorie low‐protein vegan diet, composed of unprocessed and uncooked plant derived foods
Recruited from The St. Louis Vegetarian Society and a Raw Food online magazine (Raw Food News, www.rawfoods.newsmagazine.com).
SBP=Systolic blood pressure, DBP=Diastolic blood pressure, HOMO‐IR=homeostatic model assessment ‐ a method used to quantify insulin resistance and beta‐cell function, hsCRP=high sensitive c‐reactive protein – indicator of inflammation
ADVANTAGES OF RAW FOOD VEGAN DIET 2Consuming a low-calorie low-protein vegan diet, composed of unprocessed and uncooked plant derived food. Recruited from The St. Louis Vegetarian Society and a Raw Food online magazine (Raw Food News, ww.rawfoods.newsmagazine.com)
SBP=Systolic blood pressure, DBP=Diastolic blood pressure, HOMO‐IR=homeostatic model assessment ‐ a method used to quantify insulin resistance and beta‐cell function, hsCRP=high sensitive c‐reactive protein – indicator of inflammation ,HDL‐C “good cholesterol”, LDL‐C “bad cholesterol ”
ADVANTAGES OF RAW FOOD VEGAN DIET 3 Fontana L ET AL. Rejuvenation Res. 2007;10:225–234.
PROSTATIC CANCER – PSA & PLANT DIETNguyen JY Integr Cancer Therapies 2006;5:214‐223
6 Months 1600 calorie Green Diet with or without meat consumption – 14 patients
BRISK WALKING & PROGRESS OF PROSTATIC CANCERRichman AL et al. 2011;71:3889‐3895
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TELOMERE/TELOMERASE ACTIVITY & LIFESTYLE IN LOW‐RISK PROSTATIC CANCER
Ornish D et al Lancet Oncol 2013;14:1112‐1120
VEGAN DIET & HEALTHKatcher HI et al Ann Nutr Metab 2010;56:245–252
Employees ( insurance company) with overweight and/or diabetes received either a low‐fat vegan diet or regular food for 22 weeks. The vegan group reported improvements in: ● general health (p = 0.002)
● physical functioning (p = 0.001)
●mental health (p = 0.03)
● general vitality (p = 0.004)
● overall diet satisfaction (p = 0.001)
● reduced food costs (p = 0.003), but
● increased difficulty finding foods when eating out
FOOD INTAKE & INFLAMMATION www.bengmark.com
• 1. Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES
• 2. Higher intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc.
• 3. Higher intake of heat‐ and storage‐induced proteotoxins: glycated (AGEs), lipoxidated molecules (ALEs),processedcarbohydrates induces: ‐ Dysbiosis: reduced numbers & diversity‐ Various body membranes leak like a sieve; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood‐brain barrier etc.
Homo erectus2 milj – 100 000 years BC
”diet consisted in GREEN LEAVES, WILD GRASSES, flowers,berries, nuts, honey,& less tubers, roots, occasional in red meat, shellfish and bird's eggs.”
PALEOLITHIC DIET“Much support that our genes, adapted during million of years to the lifestyle of our prehistoric ancestors badly tolerate the dramatic changes, especially in food habits, which have occurred”.
Eaton BS, Konner M. Paleotlithic nutrition: a consideration of its nature and current implications. N Engl J Med 1985;312:283-289
Contained more of: (X = times more) Minerals 2 X Fibers 4 to 10 XAntioxidants 10 XOmega‐3 FA 50 X Lactic acid bacteria >1010 X
Contained less of:(X = times less)
Protein 2 XSaturated FA 4 XSodium 10 X
80/10/10 DIET80 % raw greens
10 % vegetable fats
10 % vegetable proteins
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FUTURE NUTRITION OF CRITICALLY ILL !Hospital‐made nutrition solutions !
Fresh fruit and vegetable juices ! Green Smoothies! Gaspacho etc !
DIET & LONGEVITYRobbins J: Healthy at 100: The Scientifically Proven Secrets of the
World's Healthiest and Longest‐Lived Peoples
Read: http://thepdi.com/hunza_health_secrets.htm
Szabo G Gastroenterology 2015;148;30‐36 Szabo G, Gastroenterology 2015;148;30‐36
STORAGE & UTILIZATION OF ENERGY
EASY ACCESS 1 – GLYCOGENSkeletal muscles 500 gr (2500 cal)
Liver 100 gr (500 cal)
EASY ACCESS 2 – TRIGLYCERIDES Visceral fats up to 6 kg = app 55000 cal
DEPOT FAT – TRIGLYCERIDES Subcutaneous, slow release, examples:
App 30 % fat (app 70 kg) = 190 000 cal
App 50 % fat (90‐100 kg) = 315 000 cal
App 90 % fat (635 kg) = 540 000 cal
PRESENT POOR EATING – POOR IMMUNITY PALEO
THE FRONT DOOR – SHORTCUT 1app 60 % are Sugar and Suger‐like substances
which enters the body in upper jejunum via mainlythe arterial system < 15 %
THE BACK DOOR – THE DANGEROUS ROUTEapp 30 % animal fats & vegetable oil enters via the the body via the lymphatic system and remains in circulation for hours > 10 %
THE MAIN DOOR< 20 % raw greens, vegetables, fruits are Foods for
Microbiota and reaches the large intestineafter 2‐3 hours, enhancing immune system &
preventing inflammation app 80 %
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PREVENTING DYSBIOSIS IS KEY TO DISEASE & INFECTION CONTROL
1936‐ Brandtzaeg P et al Gastroenterology 1989;97:1562‐84
• A striking local preponderence (70‐90 %) of IgA immunocytes (plasma cells, plasma blasts) in the gut
• The gut content is constantly testedby recognition cells such as dentritic cells (DC), which
• Programmes/”Tunes” the immune system
• Each DC commands about 1200 T‐cells
• If deranged microbiota ‐ DYSBIOSIS & LEAKY GUT will induceINFLAMMATION & facilitateINFECTION
DENDRITIC CELL & IMMUNE REGULATIONVan Baarlen P et al PNAS 2009;106:2371–2376
THE DENDRITIC CELL IN ACTION Kraehenbuhl JP, Corbett M. Science 2004;303:1624‐1625
DISCRETE PERSISTANT INFLAMMATION ‐ A MOTHER OF DISEASE
Bengmark S. J Clin Nutr 2004;23:1256‐1266
SYSTEMIC INFLAMMATIONFinch CE, Crimmins EM Science 2004; 305:1736–1739
Individuals with higher levels of inflammatory markers/s: C-reactive protein, fibrinogen, factor VIII activity, interleukin-6 and TNF-α etc.
but yet no obvious signs of disease,are candidates to develop CHRONIC DISEASES andCOMPLICATIONS TO DISEASE & TREATMENTS
SIGNS OF CHRONIC INFLAMMATIONUnexplained fatigue, sleep problems, frequent headache, hair loss, gray hair, dandruff, acne, skin rashes, dry eyes, frailnails, dry mouth or increased salivation, reduced sex functions, irregularmenstruations, obstipation or diarrhea, osteoporosis, overweight, frequentinfections, mental depression, easybreathless, sweaty feet, sweaty hand
palms etc. www.bengmark.com
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CLUSTERING & RISK PROFILEQvarnstrom M et al J Clin Periodontol 2010; 37: 805–811
BREAKING THE VICIOUS CIRCLE
INFLAMMATION
INFECTION
Treatment alternatives:Antibiotics Reduces infections but Deranges Microbiota ‐ Creates DysbiosisIntestinal Reconditioning ‐ Pro/Synbiotics ‐ Restores Microbiota
PHARMA & MICROBIOTA – INCOMPATIBLE!Antibiotics destroys about 90 % of microbiota functions: bile acid metabolism, eicosanoid and steroid hormone synthesis etcCaetano L et al. Antimicrob Agents Chemother. 2011;55:1494‐1503
Chemotherapeutics reduces microbiota 100‐fold;
decrease anaerobic bacteria up to 10,000‐fold &
increase in PPMs 100‐foldVan Vliet MJ et al. Clin Infect Dis 2009;49:262‐270
Pharma as proton pump inhibitors (peptic ulcer) during pregnancy increase the risk of offspring getting asthmaAndersen AB et al. Aliment Pharmacol Ther 2012;35:1190‐1198
Anti‐hypertensives induce gastrointestinal dysbiosis &reduce mucosa protection, espec mucus production Nonzee V et al J Med Assoc Thai 2012;95:96‐104.
HYPNOTICS & RISK OF DEATHKripke DF et al BMJ Open 2012:2
Any HypnoticHazard Ratio (95% Confidence Interval)
P Value
< 18 pills/year 3.60 (2.92 - 4.44) <.001
18 - 132 pills/year
4.43 (3.67 - 5.36) <.001
> 132 pills/year 5.32 (4.50 - 6.30) <.001
MICROBIOTA, IMMUNITY, DISEASEMaynard CL et al Nature 2012;489, Sept 13:431‐441
EUBIOSIS DYSBIOSISDYSBIOSIS
facilitates
OBESITY& DISEASE
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DIFFERENT MICROBIOTA IN OBESE vs LEANAngelakis E et al Future Microbiol. 2012;7: 91–109
GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606‐613
• ↓ FFA oxida on
• ↑ endotoxin/s
• ↑SCFA production
• ↓incretin secretion
• ↓ butyrate production
• ↑FFA oxidation
• ↓ endotoxin/s
• ↓ SCFA production
• ↑Incretin secretion
• ↑butyrate production
PROCESSED FOODS INDUCE DYSBIOSIS
• Certain foods induce systemic inflammation: ‐ animal products, espec diary, rich in IGF‐1 ‐ refined carbohydrates promotes IGF‐1 synthesis (liver)
• Increase expression of inflammatory messengers
• Induce dysbiosis
• Increase membrane leakages &
• Destabilize the immune system
Contributory are: Mental & physical stress, lack of physical activity,, vitamin D deficiency, lack of anti‐inflammatory minerals; Mg, Zn, Se, lack of omega‐3 FAs etc. www.bengmark.com
PROCESSED FOODS – DELETARIOUS FOR MICROFLORA
• About 80 % of our food is processed: rich in sugars, leavening agents & or completely synthetic ingredients – absorbed in small intestine and will not reach colonic & feed microbiota.
• Meats and oils are not good foods for microbiota ‐ high levels of antibiotic‐resistant bacteria 81 % of ground turkey, 69 of pork chops, 55 % of ground beef, 39 percent of chicken breasts, wings and thighs (USA). www.bengmark.com
HIGH FAT DIET & MICROBIAL TRANSLOCATIONAmar J et al EMBO Mol Med 2011;13:559‐572
Live intestinal bacteria found present in large numbers in adipose tissue (MAT), mesenteric lymph nodes (MLN) and blood AFTER ONLY ONE WEEK ON HIGH FAT DIET (HFD)
ANTI ‐ OBESITY FOODS Trigueros L et al Crit Rev Food Sci Nutr 013;53:929–942
• Omega‐3: inhibiting lipid synthesis & increasing thermogenesis (krill oil, flax seed)
• Monounsaturated fatty acids:lowering leptin& enhancing lipolysis (olive oil, canola oil, avocado).
• Conjugated Linoleic Acid: increasing oxidation (mushrooms)
• Phenolic compounds & Antioxidants; Catechin (blackberries, dark chocolat), Saponins (beans & legumes), Anthocyanins(eggplant/brainfood, black current, green bananas, cranberries, blueberries, asparagus) Isoflavones (soy beans)
• Dietary calcium: Increasing adipocyte metabolism, reducing storage of fat & fecal fat excretion. (Soy/tofu, spring greens, spinach, watercress, broccoli, kale, chickpeas, almonds, sesame seeds, dried figs, currents).
• Dietary fibres; promoting secretion of anorexigenic/appetite reducing peptides (husk, po‐fiber)
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FOOD INTAKE & INFLAMMATION
• 1. Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES
• 2. High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc.
• 3. High intake of heat‐ and storage‐induced proteotoxins: glycated (AGEs), lipoxidated molecules (ALEs),processedcarbohydrates induces: ‐ Dysbiosis: reduced numbers & diversity‐ Various body membranes leak like a sieve; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood‐brain barrier etc.
DYSBIOSIS, ENDOT0XIN,
INFLAMMATION & DISEASE
Daulatzai MA CNS & Neurol Disorders
2015,14,110‐131
Dubos RJ, Schaedler RW J Exp Med 1962;115:1161‐1172
CASEIN & GLUTEN IMPAIRS LACTOBACILLUS GROWTH
Without casein and gluten With casein and gluten
GLUTEN & SURFACE MOLECULE EXPRESSIONSClass II, CD86, CD40, CD54 Nikulina M et al J Immunol 2004;173:1925‐1933
100 µg/ml gluten matches the effects of 10 ng/ml LPS (ENDOTOXIN)
GLUTEN‐RELATED DISORDERSBiesiekierski JR, Iven J. Unit Eur J Gastroenterol . 2015;3:160
A NEW ENTITY ‐ GLUTEN SENSITIVITY (GS) Sapone A et al. BMC Medicine 2011, 9:23
Often seen in diffuse often ignored distresses: lack of energy, mental depression, encephalopathy/‘foggy mind’, diffuse abdominal pain, bloating, diarrhea, eczema and/or rash, various headaches, numbness in the legs, arms or fingers, joint pain, fatigue etc.
Gluten‐free diet ‐ increases energy, enthusiasm, well‐being &
‐ improve clinical signs.
‐ Prevent & improve chronic diseases.
Freedom of symptoms reported in several chronic diseases & also a few cases of therapy‐resistant EPILEPSY & NON‐ALZHEIMER DEMENTIA
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GLUTEN SENSITIVITY & CHRONIC DISEASESRuuskanen A et al. Scand J Gastroenterol. 2010;45:1197‐1202Glutenoids affects genetic markers: HLA‐B8, HLA DQ2, HLA DQ8,
increase systemic inflammation & are associated with diseases such as: • ADHD
• arthritis
• Addison´s disease allergy
• Autoimmune disorders
• Autism
• Bipolar disease
• Dermatitis herpetiformis
• Diabetes mellitus
• Epilepsia• Graves´disease, infections
• Inflammatory bowel diseases – IBD
• Irritable bowel syndrome – IBS
• Lupus erythematosus
• Mental depression
• Myasthenia gravis
• Obesity • Osteoporosis
• Pernicious anemia
• Polymyalgia rheumatica
• Psoriasis
• Schizophrenia
• Scleroderma
• Sepsis
• Sjögren’s syndrome
• Thyreotoxicosis
• Vitiligo
NON‐CELIACS & DYSFUNCTIONAL FLORATiellström B et al Scand J Gastroenterol. 2007;42:1204‐1208
• Children with celiac disease (CD) known to have an aberrant gut microflora.
• Non-CD relatives have impaired intestinal microbial metabolism:
• - significantly lower level of acetic acid and total SCFAs – significantly increased level of i-butyric acid and free tryptic activity (FTA) than healthy controls.
GLUTEN‐FREE DIET & TYPE 1 DIABETESMatteo‐Rocco P et al. J Clin Endocrinol Metab 2003;88: 162–165
Gluten‐free diet tried in 15 patients with diabetes but no gluten intolerance
Insulin sensitivity increased significantly in 12/14 subjects after six months on gluten‐free diet (P 0.04) & decreased again in 10/13 subjects after 6 months on “normal” diet (P=0.07)
GLUTEN‐FREE DIET in IRRITABLE BOWEL SYNDROME Biesiekierski Jr et al. Am J Gastroenterol 2011;106: 508‐514
EXCLUSION DIET (wheat +15) IN ADHDPelsser LMJ et al Lancet 2011;377:494‐503
Crossover study 100 children, aged 4‐8 yrs, 9 weeks + 4weeksA. Total, B. Inattention, C. Hyperactivity D. Abbreviated Connor Scale scores (ACS)
Total Inattentionnn
Hyperactivitytyt
Connor scale
WHEAT/GLUTEN SPECTRUM DISORDERSAziz I et al. Curr Opin Gastroenterol 2016;32:120‐127.
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WHEAT – NEW & ANCIENT – IBSSofi F et al. Br J. Nutr. 2014;111:1992‐1999
Abdominal pain Bloating
Stool consistancy Tiredness
Nausea
PROTEIN – ATIs (amylase‐trypsin inhibitors) TRIGGERS INFLAMMATIONhttp://medicalxpress.com/news/2016‐10‐links‐protein‐wheat‐inflammation‐chronic.html
• ATIs – a non‐gluten protein ‐ app 4 % of wheat proteins – have strong inflammation‐inducing abilities. A potent microflora should have ability de break down ATIs. ATIs known to induce:
• Coeliac disease
• Asthma
• Multiple Sclerosis
• Rheumatoid arthritis
• Inflammatory bowel disease
• Non‐coeliac sensitivity
• Systemic lupus erythematosus
• Autoimmune encephalomyelitis etc
AMYLASE INHIBITORS INDUCE INFLAMMATIONJunker Y et al J Exp Med. 2012;209:2395‐2408
LPS = Endotoxin
ATIs – THE REAL VILLAINS Schuppan D, Zevallos V. Dig Dis. 2015;33:260‐263
PROLAMINS & TRYPTOPHAN/CORTEXChoi S et al Physiol Behov 2009;98:156‐162
An up to 8‐fold decrease in cortex tryptophan & similar decrease in serotonin observed after feeding:
• Marked reductions; Zein (corn)
• Significant reductions: Casein (dairy) & Gluten (wheat, rye, barley)
• Small reductions: Lactalbumin (dairy)
• Small increases: Vegetable protein (soy)
ANCIENT GRAINS
• Amaranth – Aztec culture, high protein & mineral content• Quinoa – Inca culture, high protein & mineral content• Sorghum (durra, jowari, milo) ‐5th in world, versatile, low energy, most cost‐effective
• Millet – 6th highest in world, versatile, mild flavor• Teff – staple in Ethiopia, tiny seed, high mineral content •
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SORGHUM (durra, jowari, milo) – A SUPER GRAIN!Dykes L, Rooney LW Cereal Foods World 2007;52:105‐111
Many thousend top athletesagree, among them the two best tennis players of the world –
Novak Djokovic & Andy Murray, who abstain from gluten, lactoseand processed carbohydrates, insisting that this gives them
much greater energy.
Brix S et al J Allergy Clin Immunol 2015;135:277‐280
DYSBIOSIS‐INDUCED METABOLIC DISORDERS Cani PD et al Diabetes 2008;57:1470‐1481
LPS concentration 10 to 50 X higher than those obtained during septic shockMitaka C. Clin Chim Acta 2005; 351:17‐29
Bifidobacterimspp.
LPS = ENDOTOXIN – THE VILLAIN
MICROBIOTA OF HUNTERER‐GATHERERS – HADZAsSchnorr SL et al Nat Commun. 2014,5,3654
Paleolithic lifestyle (Hadza, Tanzania) leads to compared to European (Italians):
• Much greater Microbial Richness
• Much Richer Biodiversity
• Absence of Bifidobacterium (no dairy?)
• Enrichment: in Prevotella, Treponema & unclassified Bacteroidetes
• Peculiar arrangement of Clostridiales taxa most likely reflecting an enhanced ability the Hadzas to digest and extract valuable nutrition from fibrous plant foods.
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MICROBIOTA FUNCTIONS: Amino acid
biosynthesis for phenylalanine, tyrosine, tryptophan, and lysine is highly represented by multiple genes + precursor to amino acids and metabolites such asglutamate, alanine, aspartate, pyruvate, glycine, serine, and threonine. Also rich in genes involved in branched‐chain amino acid (BCAA) catabolic pathwaysRampelli S et al Curr Biol 2015 E‐pub
MICROBIOTA ‐ AFRICAN & EUROPEANDe Filippo C et al Proc Natl Acad Sci USA 2010; 107:14691–14696
FAMILY DIFFERENCES – AMERICANS, AMERINDIANS, MALAWIANSYatzunenko T et al Nature 2012;486:222‐227
MICROBIOTA DIVERSITY – ANCIENT CULTURESClemente JC et al Science Advances 2015 E‐pub HIGH FODMAP CONTENT
• Lactose (also known as milk sugar; in milk, yogurt and ice cream)
• Fructose (also known as fruit sugar; in fruit, high‐fructose corn syrup, honey and agave syrup)
• Sorbitol, mannitol, and other “‐ol” sweeteners (also known as sugar alcohols); in certain fruits and vegetables & some sugar‐free gums and candies)
• FOS (fructo‐oligosaccharides, Fructans); in bananas, onion, chicory root, garlic, asparagus, leeks
• GOS (galacto‐oligosaccharides); artichoke, lentils, soy
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1. Fruktos ‐ Undvik: Äpple, päron, vattenmelon, fruktjuice, torkad frukt, honung. Välj i stället: Apelsin, kiwi, bär, honungsmelon, banan, druvor, ananas, jordgubbar.2. Laktos ‐ Undvik:Mjölk från ko, get, får, glass, mjölkchoklad. Välj i stället: Laktosfria produkter, havre‐och risbaserade produkter.3. Oligosackarider ‐ Undvik: Ärtor, bönor, linser, lök, vitlök, vete, råg, korn. Välj i stället: Tomat, palsternacka, morot, squash, paprika, ris, potatis.4. Sockeralkoholer ‐ Undvik: Tuggummi och halstabletter med xylitol och sorbitol, blomkål, sockerärtor, avokado.Välj i stället: Drycker sötade med sackaros, glukos, syntetiska sötningsmedel eller stevia.
Maccaferri S et al Dig Dis 2011;29:525–530
LEAKY BARRIERS
• Gastrointestinal tract
• Airways
• Skin
• Oral cavity
• Vagina
• Nose
• Eye cavity
• Placenta
• Blood brain barriers
INFLAMMATION IN OBESE PREGNANT WOMENBasu S et al Obesity 2011;19:476‐482
MCP1 IL‐8 IL‐6 TNFα Leptin CD14 TLR4 TRAM2
LEAKY PLACENTAA shocking 9/20 (43 %) of umbilical cord blood, cultivated from healthy neonates, born by cesarean section, demonstrate positive growth: Enterococcus faecium, Propionibacterium acnes, Staphylococcus epidermidis & Streptococcus sanguinisJiménez E et al. Curr Microbiol 2005;51:270–274.
ATHEROSCLEROSIS & BACTERIAL DEBRISNicolaou G et al J Atheroscler Thromb 2012;19:137‐1498
Bacteria & bacterial debrisin human atheroma, in the past considered harmless,
seems to contribute to disease progression via TLR‐ dependent lipid body formation in macrophages
PERIDONTITIS‐CHRONIC DISEASE CONNECTIONWu Z, Nakanishi H. J Pharmacol Sci 2014;126:8‐13
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THE MARCH from AGRICULTURE AQVA‐ & HORTICULTURE‐based diet
Friday Aug 18.2011
President Bill Clinton – now a vegan
radically changed diet, lost 20 lbs. in weight
& improved his health, Clinton tells CNN.
After experiencing periodic heart problems leading up to the 2004 surgery, the former junk food lover now calls himself a vegan,
shunning meat, eggs, dairy and almost all oil
saying: "I like the vegetables, the fruits, the beans, the stuff I eat now“
"I feel good, and I also have … more energy."
PLANT‐BASED DIET & CORONARY ARTERY DISEASEEsselstyn CB Prev Cardiol. 2001;4:171–177
• Safe: grains?, legumes, lentils, vegetables, fruits, nuts and seeds
• Unsafe: oils, dairy foods, meat, poultry, & fish (frequently containing unacceptable levels of PCBs, dioxin, and mercury)
VITAMIN K IN FOODS micrg/100 grThyme, dried 1715
Sage, dried 1700
Parsley raw 1640
Amaranth leaves 1160
Kale raw 817
Mustard greens, raw 497
Spinach, raw 483
Basil, fresh 413
Beat greens, raw 400
Turnip greens, raw 251
Lettuce, raw 174
Broccoli raw 102
PALEOLITHIC DIET“Much support that our genes, adapted during million of years to the lifestyle of our prehistoric ancestors badly tolerate the dramatic changes, especially in food habits, which have occurred”.
Eaton BS, Konner M. Paleotlithic nutrition: a consideration of its nature and current implications. N Engl J Med 1985;312:283-289
Contained more of: (X = times more) Minerals 2 X Fibers/greens 4 to 10 XAntioxidants 10 XOmega‐3 FA 50 X Lactic acid bacteria >1010 X
Contained less of:(X = times less)
Protein 2 XSaturated FA 4 XSodium 10 X Processed carbohydrates > 1000 X
IGF‐1, INFLAMMATION CHRONIC DISEASECarrera‐Bastos P et al. Res Rep Clin Cardiol 2011;2:15‐35
• The Neolithic Revolution, provided increasing access food to insulinotropic & IGF‐1‐raising foods; ‐ dairy products are rich in IGF1 ‐ grains & sugars induce synthesis of IGF‐1.
• The human genome has not, and will not, adapt to the high levels of insulin/IGF‐1 signaling (I1S)
• Modern man should attempt to develop a more Paleolithic‐type diet.
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IGF & TOLL‐STIMULATORY FOODSExcess in refined, processed foods e.g. ‐ Foods rich in IGF‐1, and/or IGF‐1 promoting &
‐ Toll‐stimulatory (inflammation‐inducing) foods:
• increase expression of inflammatory messengers
• reduce microbiota
• increase membrane leakages
• destabilize the immune system
Contributory are: Lack of physical activity, mentaland physical stress, Vitamin D deficiency, lack of anti‐inflammatory minerals; Mg, Zn, Se, lack of omega‐3 fatty acids etc. www.bengmark.com
DAIRY CONSUMPTION & IGF‐1The Endogenous Hormones and Breast Cancer Collaborative Group
Lancet Oncol 2010; 11: 530–42
• a positive association between intake of dairy products or milk and IGF‐I conc. reported in several cross‐sectional studies
• increase in IGF‐I in response to a higher intake of milk and dairy products observed in both younger and older participants
• IGF‐I conc. found significantly lower in vegans compared with lactoovo‐vegetarians and omnivores in the EPIC‐Oxford cohort
Dennis Burkitt 1911 ‐ 1993Suggested that many Western diseases, rare in Africa are primarily the result of diet and lifestyle.
Reported an association between low fibre in diet higher risk of colorectal cancer as well as other diseases such as CHD and diabetes
GI PERISTALSIS – UK vs UGANDAAppr GI transit time: UK: 100 hrs vs Uganda: 20 hours Appr stool weight: UK 60 g/day vs Uganda 600 g/day Burkitt DP et al Lancet 1972;300 (7792):1408‐11
British geriatric patients:
GI transit time: >14 days in > half of the patientsBrocklehurst JC, Khan MY. Gerontol Clin 1969;11:293‐300
DAVID JP BARKER 1838 –The thrifty epigenotype hypothesis ‐
Barker, D.J.P. Maternal Nutrition, Fetal Nutrition, and Disease in Later Life". Nutrition, 1992;13: 807‐813Curr Opin Nephrol Hypertens 1997; 6:106‐110
We know that “disorders of adult life, including coronary heart disease, stroke and diabetes, arise through interaction between influences in our adult lifestyle and genetically determined susceptibility.”
“Recent research, however, suggest that growth in utero may also play an important role” “Even brief periods of … may permanently change/`reprogramming´ the body…and lead to persistent changes in blood pressure, cholesterol metabolism, insulin response to glucose, and in a range of other metabolic, endocrine and immune parameters.”
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FOOD INTAKE & INFLAMMATION
• 1. Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES
• 2. High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc.
• 3. High intake of heat‐ and storage‐induced proteotoxins: glycated (AGEs), lipoxidated molecules (ALEs),processedcarbohydrates induces: ‐ Dysbiosis: reduced numbers & diversity‐ Various body membranes leak like a sieve; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood‐brain barrier etc.
Louis Camille Maillard 1878 – 1936Undertook studies of the reaction between amino acids and sugars, and suggested association to development of chronic disease, especially renal disease.
This work was considered a major contribution, and the reaction was named after him – Maillard reaction & he was awarded several prices, including the French Academy of
Medicine award in 1914.
AGE & PREMATURE AGINGNagai R et al J Clin Biochem 2014;2014:55:1‐6
AGES/ALES IN TISSUESDys‐functioning, glycated proteins induceabout 50 times more FREE RADICALS thannon‐glycated proteins (AGEs and ALEs), • accumulate in tissues (amyloid) &
• make the body auto‐fluorescing,
• impair DNA repair mechanisms, induce tissue accumulation of toxins reduce antioxidant defense * induce inflammation & infection * weaken immune system & * accelerate development of various diseases Thorpe SR, Baynes JW Amino Acids 2003;25:275‐281
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AGEs & INFLAMMATION‐INDUCTIONBohlender JM Am J Physiol Renal Physiol 2005;289:F645‐659
AGEs IN VARIOUS MILK PRODUCTSBaptista J, Carvalho R Food Res Int 2004;37:739‐747
ACRYLAMIDE IN FOODS & HEALTHDas AB, Srivastav BB Toxicol Mech Methods 2012;22:163‐169
Acrylamide has been studied
extensively for more than 40 years, but the first detection of acrylamide in carbohydrate‐rich foods was made as late as 2002
Acrylamide has a number of adverse effects on the human body ‐two major effects being NEUROTOXICITY & CARCINOGENICITY
Toasted bread contains several‐fold more of acrylamide than untoasted
Wheat: 11–161 vs < 5 mg/kg . Rye: 27–205 vs 7–23 mg/kg
Granby K et al Food Additiv Contamin 2008; 25:921–929
HEAT & ACRYLAMIDE PRODUCTIONTareke C et al J. Agric. Food Chem. 2002;50:4998‐5006
AGEs/ALEs IN FOODSHEATED MEAT (espec. bacon, sausages), POULTRY,
FISH: AGE content increases with exposure to temperature:
boiling (1000 kU/serving), frying (9000 kU/serving)Goldberg T et al. J Am Diet Assoc 2004;104:1287‐1291
HEATED DAIRY: powdered milk (rich in ice cream, baby & clinical nutrition formulas) & cheese, espec. hard cheeses
HEATED GRAIN PRODUCTS: Toasted bread, breadcrusts & crisp breads
HEATED VEGETABLE OILS: heated olive oil ca 8000 kUOTHERS: Egg yolk powder, lecithin powder, coffee, espec
dark roasted, hard‐cured teas, roasted and salted peanuts, dark and sugar‐rich alcoholic beverages, broth, Chinese soy, balsamic vinegar, Cola drinks etc
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DISEASES WITH ELEVATED AGEs/ALEs• ADHD
• Aging
• Allergy
• Autoimmune diseases
• Alzheimer´s disease• Amyotrophic lateral sclerosis
• Atherosclerosis
• Cardiovacular diseases
• Cataract• Chronic liver diseases• Chronic pulmonary disorders
• Creutsfeldt‐Jakob disease
• Diabetes
• Epilepsia
• Familial amyloidoticpolyneuropathy
• Fibromyalgia• Glaucoma• Hormone deficiencies• Macula degeneration• Nephropathies
• Obesity• Osteoporosis• Paradontosis• Parkinson´s disease • Polycystic Ovary Syndrome• Rheumatoid diseases• Ruptured Achilles tendon• Sepsis• Stroke
AGE PRODUCTION & POSTPRANDIAL INFLAMMATIONAlssema M et al Br J Nutr 2014;11:1‐10
AGE & PREMATURE AGINGNagai R et al J Clin Biochem 2014;2014:55:1‐6
AGE – ALE & OPHTALMIC DISEASES Smuda M et al Biochemistry 2015;54:2500‐2507
SPICES – EFFECTS ON HB‐GLYCATIONwild caraway = vild kummin Naderi Gh et al Indian J Pharm Sci. 2014; 76: 553–557.
HEALTH ON LOW AGE & EXERCISEMarcias‐Cervantes et al Nutrition 2015;31:446‐451
Power of Low AGE diet + exercise
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LINKING DIETARY CHOLINE‐RICH
FOODS (MEAT, FISH, MILK,
EGG,) & PRODUCTION OF TRIMETHYLAMINE
(TMAO) –
a risk factor for atherosclerosis
Wilson Tang WH et al
PROCESSED MEAT & RISK OF CANCER• Oesophageal cancer
Salehi M et al Nutr Rev 2013;71:257‐267, Huang W et al Cancer Causes Control 2013;24:193‐201
• Stomach cancer Larsson SC J Natl Cancer Inst 2006;98:1078‐1087
• Pancreatic cancer Larsson SC, Wolk A Br J Cancer 2012;31;106:603‐607
• Colorectal cancer Chan DS et al Plos One 2011;6:e20456
• Bladder cancer Wang C, Jiang H Med Oncol 2012;29:848‐855
• Lung cancer Yang WS et al Ann Oncol 2012;23:3163‐3170
• Ovarian cancer Kolahdooz F et al Am J Clin Nutr 2010;91:1752‐
1763, Wallin A et al Br J Cancer 2011;104:1196‐1201
PROCESSED MEAT AND UNHEALTHMicha R et al. Circulation 2010;121(21):2271‐2283Metaanalysis of 20/1598 totally including 1218380 individuals with 23889 cases of CHD, 10797 cases of diabetes mellitus and 2280 cases of stroke.
Conclusion: Processed, but not unprocessed, meat is associated with 42% higher risk of CHD and 19% higher risk of diabetes mellitus (P<0.001).
No association with stroke observed.
Nitrates? AGEs? ALEs?
Nitrates & byproducts promote vascular dysfunction and atherosclerosis, reduce insulin secretion, impair glucose tolerance, & streptozotocin, a nitrosamine‐related compound containd diabetogenic compound.
37 698 men and 83 644 women (2.96 million person‐ years) followed for > 28 years.
‐ Premature deaths increased with 13 % by eating red meat &
‐ 20 % by eating processed meat: cured, bacon, sausages, patémeatballs, hamburgers etc Pan A et al Arch Intern Med 2012;172:555‐563
448,568 men and women, age 35‐69 studied during 13 years:
‐ A daily piece of steak is associated with a 13 % greater chance of dying during the study (13 years)
‐ An extra daily serving of processed red meat linked to a 20 % higher risk of death during the study.
‐ 72 % increased risk of dying in heart disease &
‐ 11 % increased risk of dying in cancer Rohrmann S et al BMC Medicine 2013;11:63
FISH INTAKE & HEALTH
Vegetarians have a 22 % lower risk to get colorectal cancers; in the colon 19 %, in the rectum 29 % comp to non‐vegetariansOrlich MJ Frazer GE et al JAMA Intern Med. 2015; 175:1727
Meta‐analysis shows that fish consumption is associated with a 63 % reduction in mortality such as prostate cancer
Szymanski KM et al Am J Clin Nutr 2010;92:1223‐1233.
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DAIRY-INDUCED INFLAMMATION
Dietary proteins of cow´s milk induce inflammation:• release inflammatory mediators
• increase intestinal permeability
• induce leakage of large molecules; albumin, hyaluronan etcJalonen T J Allerg Clin Immunol 1991;88:737, Isolauri E Gastroenterology 1993;105:1643, Bengtsson U et al. J Clin Exp Allerg 1996;26:197, Allerg Clin Immunol 1997;100:216
ESTROGENS IN MILK Malekinejad H et al J Agric Food Chem 2006;54: 9785‐9791
Background: The dramatic increase in testicular, breast, prostate, ovarian, and corpus uteri, and large bowel cancers.
60‐80% of the intake of estrogens originates in the Western world from milk and other dairy foods.
The daily intake of total estrogens through milk
is 372 ng/L
“which is dramatically more than currently recognized.”The content is twice as high in 3.5 % fat milk than in non‐fat milk & extremely high in butter!
DIET AND BREAST CANCERCarroll KK Cancer Res 1975;35:3374‐3383
THE JAPANESE EXPERIENCE
The age-adjusted death rate in ChDs such as prostatic cancer rose in Japan during the period 1948 - 98
25-foldParallel to increases in intake of :
egg 7 Xmeat 9 X dairy 20 X Ganmaa D et al Medical Hypotheses 2003;60:724-730
PROSTATIC CANCER&
MILKCONSUMPTION
Ganmaa D et al Int. J. Cancer 2002,98,262–267
BOVINE MILK &
CORONARY HEART DISEASE
Artaud‐Wild SM et al. Circulation 1993;88:2771‐
2779
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PROSTATIC CANCER DEVELOPMENT IN EASTASIA
Zho Y et al Asian J Androl 2015;17:48–57
BREAST CANCER: INCIDENCE & MORTALITY ‐ 2030
Chajès V, Romieu I Maturitas 2014;77:7– 11
EARLY MILK CONSUMPTION & RISK OF PROSTATIC CANCER
Torfadottir JE et al Am J Epidemiol 2012; 175:144‐538,894 men born 1907 to1935 followed a mean 24.3 years & 1123 diagnosed with prostatic cancer
2,268 participants reported their milk intake in early, mid‐, and current life.
Daily milk intake in adolescence associated with a 3.2‐fold risk of advanced prostate cancer (95% CI: 1.25, 8.28)
suggesting that frequent milk intake in adolescence increases risk of advanced prostate cancer later in life.
DAIRY RISK FACTORS IN PROSTATIC CANCERAune D et al Am J Clin Nutr 2015;101:87‐117
In a Physicians Health Study, 21,660 men were followed for 28 years. 2806 men developed prostatic cancer & 305 died.
Total intake of dairy products was associated with increased incidence of prostatic cancer (HR = 1.12)
‐ Larger intake of skim/low‐fat milk was associated with greater risk of nonaggressive prostatic cancer &
‐ Larger intake of whole milk only with fatal prostatic cancer & progression to fatal disease after diagnosis (HR = 2.17)
BOVINE MILK & CHRONIC DISEASES• Allergy Rautava S, Isolauri EJ
Pediatr Gastroenterol Nutr. 2004 Nov;39:529‐535
• Breast cancer Outwater JL et al Med Hypotheses1997;48:453‐461, Hjartåker A et al Int J Cancer 2001;93:888‐893
• Colorectal cancerManousos O et al Int J Cancer 1999;83:15‐17, Ma et al J Nat Cancer Inst;2001:93:1330‐1336
• Chronic constipationIacono G et al N Engl J Med 1998;339:1100‐1104
• Coronary heart diseaseBriggs RD et al. Circulation1960;21:538‐542, Marshall T BMJ 2000;320:301‐305
• Diabetes type 1 Gimeno SGA, De Souza JMP Diabetes Care 1997;20:1256‐1260, Virtanen SM et alDiabet Med 1998;15:730‐738
• Malabsorption O´Keefe SJD et al Am J Clin Nutr 1991;54:130‐135
• Ovarian cancer Larsson SC et alAm J Clin Nutr. 2004;80:1353‐1357, Ganmaa D, Sato A Med Hypotheses.
2005;65:1028‐1837
• Parkinson disease Park M et al. Neurology 2005;64:1047‐1051
• Testicular and prostatecancer Ganmaa D et al. Med Hypotheses 2003;60:724‐730, Qin LQ et al Nutrition and Cancer 2004;48:22‐27
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CALCIUM I FOOD mg/100 g food
Daily need: 1000-1300 mg
• Baking powder 11300
• Herb salt 3180
• Parmesan cheese 1380
• Sesami seeds 980
• CHEESE 28 % 750
• Agar 600
• Nettles 490
• Persil 340
• Dill 343
• Peas 300
• Beans 300
• Almonds 265
• Sunflower seeds 265
• Flax seeds 198
• Sardines 190
• Brazil nuts 180
• CREAM 135
• MILK 120
• Digestive biscuits 110
• Fish 100
• Spinach 90
• Black current 90
• BREAD, wheat whole 48
• BUTTER 18
• HAMBURGERS 10
• FRENCH FRIES 9
• KETCHUP 7
MAGNESIUM IN FOODS mg/100 gr
• Pumpkin &Squash seeds 540
• Cacao 20‐22 % 520
• WHEAT bran 355
• Sesami seeds 350
• WHEAT germs 290
• Almonds 280
• Soya beans 265
• Cashew nuts 260
• Rosehip, dry 240
• Oat bran 235
• Peanuts 190
• Beans 190
• Peanuts 188
• Peas 150
• Lentils 80
• Spinach 79
• Prunes 52
• Avocado 41
• Banana 35
• CHEESE 35
• Broccoli 23
• FRENCH FRIES 35
• BREAD, whole wheat 24
• HAMBURGERS 20
• KETCHUP 18
• MILK 15
• CREAM 14
• BUTTER 3
MAGNESIUM DEFICIENCY ‐MANIFESTATIONSMg involved in > 300 biochemical processes• Bone demineralization ‐ osteoporosis
• Obesity
• Body aches, muscle twitches
• Leg cramps, headaches and migraines
• Fatigue or low energy
• Restless sleep
• Premenstrual syndrome
• Chronic bowel problems
• Insulin resistance
Left untreated Mg deficiency will lead to more life‐threatening conditions: hypertension, heart disease, stroke, type 2 diabetes, osteoporosis ….
HORMONAL ENVIRONMENTAL ”DISRUPTORS”
Up to 80 % of milk come from pregnant cows & contains significant amounts of:‐ Pituitary hormones: PRL, GH, TSH, FSH, LH, ACTH ‐ Steroid hormones: estrogen, progesterone, testosterone etc‐ Hypothalamic hormones: TRH, LHRH, GnRH, GRH ‐ Gastrointestinal peptides‐ Halogenated aromatic hydrocarbones‐ Advanced glycation & lipoxidation end products(AGEs/ALEs)
FREE ESTROGENS IN DAIRYpg/g Wolford ST, Argoudelis CJ J Dairy Science 1979;62:1458‐1463
E1 E2 ‐ 17β E3
Whole milk 3.7 6.4 9.0 Skimmed milk 20.2 3.4 8.2 Whey 3.6 1.5 3.0 Cottage cheese 34.9 10.8 6.1 Butter 539.4 82.3 86.8
Compare 1266 322 51 Malekinejad H et al J Agric Food Chem 2006;54: 9785‐9791
MEJERIFRIA – MJÖLKALTERNATIVwww.bengmark.com
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METABOLIC SYNDROME IN COWSHostettler‐Allen RL et al J Anim Sci 1994;72:160‐173
Modern feeds of dairy cows, less forage‐based and rich in starch & carbohydrates (corn, maize grains, barley, molasses and dextrose) are likely to induce, also in cows: Insulin resistance,
observed in calves fed on intensive milk‐ and lactose diet
ENTERAL NUTRITION INDUCES DYSBIOSISHaskel Y et al. Crit Care Med 1994;22:108‐113
Synthetic clinical nutrition solutions induce:
• loss of mucosal protein content
• intestinal microbial overgrowth
• leaky gut‐ Vivonex (Nestle) 53%
‐ Criticare (Mead‐Johnson) 67%
‐ Ensure (Ross Lab) 60%
• "Cow's milk in the past has been oversold as the perfect food, but we are now seeing that it isn't the perfect food at all and the government really shouldn't be behind any efforts to promote it as such.“ Benjamin Spock, M.D., Los Angeles Times, November 18, 1992
• “I would call milk perhaps the most unhealthful vehicle for calcium that one could possibly imagine, which is the only thing people really drink it for, but whenever you challenge existing dogma...people are resistant.“ Neal Barnard, M.D., Director of the Physician's Committee for Responsible Medicine www.pcrm.org
PRO‐ & PREBIOTICSDruarte C et al Adv Nutr 2014;5:S624‐S633
FECAL TRANSPLANTATION Rao K, Safdar N J Hosp Med 2016;11:56‐61
FLORA IN WESTERNERS• Lb plantarum, a dominating LAB, observed in only 25 % of omnivorous Americans & in 65 % of vegetarian AmericansFinegold SM et al. Human intestinal microflora in health and disease Academic Press, London, UK, 1983. pp 3‐31
• Benefial & common colonic LACROBACILLI present only in about 50 % or less of healthy Scandinavians:Lb plantarum 52 %, Lb rhamnosus 26 %, Lb paracasei ssp paracasei 17 %Ahrné S et al. J Appl Microbiol 1998;85:88‐94
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MICROBIOTA & OBESITYMillion M et al. Int J Obesity 2012;36:817‐825
Obese (n=68) Controls (n=44) P‐value
L. plantarum 0 (0%) 8 (18.2%) 0.0004
L. paracasei 10 (14.7%) 17 (38.6%) 0.004
L. reuteri 6 (8.8%) 1 (2.3%) 0.16
L. rhamnosus 3 (4.4%) 4 (9.1%) 0.27
L. ruminis 3 (4.4%) 4 (9.1%) 0.27
L. salivarius 5 (7.4%) 2 (4.5%) 0.43
ENDOTOXIN & OBESITYFei N, Zhao L. ISME J. 2012 E‐pub
A person weighing 175 kg lost 51.4 kg after
23 weeks on VEGAN TYPE FOOD recovered from hyperglycemia and hypertension.
The endotoxin‐producing Enterobactercloacae B29 ‐ found to constitute 35% of the gut bacteria ‐ decreased to non‐detectable.
The Enterobacter cloacae inoculated in germfree mice induced obesity & insulin resistance.
THE GREAT Pwww.bengmark.com
•Plantarum
•Paracasei
•Pediococcus pentosaceus
Lb paracasei – the master?• the strongest inducer of Th1 & repressor of Th2 cytokines when more than 100 strains are compared Fujiwara D et al. Int Arch Allergy Immunol 2004;135:205–215
CONTROL OF PATHOGENS
The ability of 50 different LAB to control 23 different pathogenic Clostridium difficiletested:
27 were totally ineffective18 antagonistic to some
5 effective against all:2 strains ‐ Lb paracasei s. paracasei
3 strains ‐ Lb plantarum
Naaber P et al. Med Microbiol 2004;53:551‐554
FERMENTATION ABILITY• The ability of 712 different LAB to ferment
oligofructans (inulin, phleins) studied:
• 16/712 able to ferment the phleins &
• 8/712 able to ferment the inulin type fibre.
• Only four species had the ability:Lactobacillus plantarum (several)Lactobacillus paracasei subsp. paracasei, Pediococcus pentosaceus &
Lactobacillus brevisMüller M, Lier D. J Appl Bact 1994;76:406‐411
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CHOICE OF LACTIC ACID BACTERIA (LAB) AS
PROBIOTICSWe harvested and studied the abilities of various LAB to controlinflammation and infection of
355 strains from humans
180 strains from plants www.bengmark.com
UNIQUE PROPERTIES OF LAB IN SYNBIOTIC 2000
• All induce several Bioactive Proteins – five cross‐react with stress proteins
• All transcribe NF‐B – to the largest extent L plantarum and L paracasei
• All produce pro‐inflammatory (IL‐1, IL‐8) and anti‐inflammatory (IL‐10) cytokines, to a large extent L plantarum, and to less extent Leuconostoc mesenteroidesLjungh Å, Microb Ecol Health Dis 2002;3, Suppl 4:4 Kruszewska D et al Microecol. Ther. 2002;29:37
UNIQUE PROPERTIES OF LAB IN SYNBIOTIC 2000
• All induce several Bioactive Proteins – five cross‐react with stress proteins
• All transcribe NF‐B – to the largest extent L plantarum and L paracasei
• All produce pro‐inflammatory (IL‐1, IL‐8) and anti‐inflammatory (IL‐10) cytokines, to a large extent L plantarum, and to less extent Leuconostoc mesenteroidesLjungh Å, Microb Ecol Health Dis 2002;3, Suppl 4:4 Kruszewska D et al Microecol. Ther. 2002;29:37
SYNBIOTIC 2000 & BETA‐DEFENSINSWehkamp J et al Infect Immun. 2004;72:5750‐5758
SYNBIOTIC 2000Synbiotics AB, Sweden: www.synbiotics.se, [email protected]
400 billion Lactic acid bacteria:
1010 of Pediococcus pentosaceus 5‐33:3
1010 of Leuconostoc mesenteroides 32‐77:1
1010 of Lactobacillus paracasei sbsp. paracasei
1010 of Lactobacillus plantarum 2362
10 gram bioactive fibers:
2.5 g of betaglucan
2.5 g of inulin
2.5 g of pectin
2.5 g of resistant starch www.bengmark.com
SYNBIOTIC 2000 INHIBITS GROWTH OF MULTIRESISTANT BACTERIAProfessor Val Edwards‐Jones, Manchester, UK
Multi‐resistant Acinetobacterbaumanii
Multi‐resistant Klebsiella
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SYNBIOTIC 2000 IN LUNG INJURYIlkgul O et al Br J Int Care. 2005;15:52‐57
• Placebo Only fibres Synbiotic 2000
SYNBIOTIC 2000 IN LIVER TRANSPLANTATIONRayes N et al. Am J Transplant 2005;5:125-131
50 to 85 % of transplant patients develop nosocomial infections within 30 days.Synbiotic 2000 or Only fibres daily from the day before surgery + during 14 postop days
30 day-infection rate:Synbiotic 2000 1/33 - 3 %Only fibres 17/33 - 51 %
SYNBIOTIC 2000 IN LIVER TRANSPLANTATION
Isolated bacteria: Synbiotic 2000 Fibres only
Enterococcus faecalis 1 11
Escherichia coli 0 3
Enterobacter cloacae 0 2
Pseudomonas aeruginosa 0 2
Staphylococcus aureus 0 1
Total 1 18
Rayes N et al. Am J Transplant 2005;5:125‐131
SYNBIOTIC 2000 IN PANCREATECTOMYINFECTIONS: Control (Only fibers) 16/40 - 40 % Synbiotics 2000 5/40 - 13 % p< 0.05
Synbiotic 2000 Control Wound infections 4 6Peritonitis 0 5Pneumonia 0 4Urinary 1 1Sepsis 0 2Cholangitis 0 1Empyema 0 1Total 5 20
Rayes N et al. Ann Surg 2007;246:36-41
SYNBIOTIC 2000 IN PANCREATECTOMYISOLATED BACTERIA:
Synbiotic 2000 FibresEnterobacter cloacae 2 8Enterococcus faecalis/faecium 1 7Escherichia coli 0 7Klebsiella pneumoniae 2 2Proteus mirabilis 1 1Staphylococcus aureus 0 2Total 6 27
Rayes N et al. Ann Surg 2007;246:36-41
SYNBIOTICS IN ACUTE PANCREATITISOláh A et al Hepato‐gastroenterology 2007;54:36‐41
Synbiotic 2000 Fibres OnlyTotal number of infections 9/33 ( 27 %) 15/29 ( 52 %)Pancreatic abscesses 2 2Infected necrosis 2 6Chest infections 2 4Urinary infections 3 3SIRS 3 5MOF 5 9SIRS + MOF 8 14 p<0.05Late (>48h) MOF 1 5Complications 9/33 15/29 p<0.05Surgical drainage 4/33 ( 12 %) 7/29 ( 24 %)Mean hospital stay 14.9 ±6.5 19.7±9.3Dead 2/33 ( 6 %) 6/29 ( 18 %)
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SYNBIOTICS IN ACUTE PANCREATITISOláh A et al Hepato-gastroenterology 2007;54:36-41
Isolated Microorganisms: SYNBIOTIC 2000 Fibres OnlyPseudomonas aeruginosa 1 4Enterococcus faecalis 1 2Enterobacter spp 1 1Streptococcus spp 2 -Staphylococcus aureus 1 1Enterococcus faecium 1 -Candida spp - 2Staphylococcus haemolyticus - 1Serratia spp - 2Klebsiella spp - 1Escherichia coli - 1Stenotrophomonas maltophilia - 1Citrobacter freundii - 1
Total 7 17
SYNBIOTIC 2000 IN MULTIPLE TRAUMA102 patients supplied 15 days with either Synbiotic2000 Forte or placebo
The treated patients demonstrated reduced:‐Mortality‐ Rate of infection (P = 0.01)‐ Rate of SIRS & severe sepsis (P = 0.02) ‐ Numbers of days on mechanical ventilation (P= 0.001) ‐ ICU stay (P = 0.01)Kotzampassi K et al. World J Surgery 2006;30:1848‐1855
SYNBIOTIC 2000 IN TRAUMA PATIENTSSpindler-Vesel A et al. JPEN 2007;31:119-126
TOTAL NUMBER OF INFECTIONS:
Alitraq Abbott‐Ross (glut+arg) 16/32 50 %
Nova Source Novartis (+guargum) 17/29 58 %
Nutricomp peptide Braun (+peptide) 13/26 50 %
Nutricomp standard (+Synbiotic 2000) 4/26 15 %
NUMBER OF CHEST INFECTIONS: Alitraq Abbott‐Ross (glut +arg) 11/32 34 %
Nova Source Novartis (+guargum) 12/29 41 %
Nutricomp Braun (peptide) 11/26 42 %
Nutricomp standard (+Synbiotic 2000) 5/26 19 %
REDUCTIONS IN INFECTIONS/POSITIVE BLOOD CULTURES
Liver transplantation, 66 patients1
Patients with postop. infections 16 => 1 = 94 per cent
Patients with pos. blood cultures 11 => 1 = 91 per cent
Pancreatdoudenectomy for cancer, 80 patients2
Patients with postop. infections 16 => 5 = 69 per cent
Patients with pos. blood cultures 27=> 5 = 82 per cent
Severe pancreatitis – 62 patient3
Patients with infections 15 => 9 = 40 per cent
Patients with pos. blood cultures 17 => 7 = 59 per cent
Severe trauma, treated with Synbiotic 2000 Standard – 52 patients4
Patients with infections 23/30 (77 %) => 17/35 (49 %)
Severe trauma, treated with Synbiotic 2000 Forte – 72 patients5
Patients with post‐trauma infections 13 => 5 = 62 per cent Patients with pos. blood cultures 13 => 5 = 62 per cent
REDUCTIONS IN USE OF ANTIBIOTICS, ARTIFICAL RESPIRATION, TIME IN ICUs & IN HOSPITAL
Liver transplantation – 66 patients1
Days on Antibiotics 3.8 => 0.1 = 3.7 (97 %)
Days in ICUs 10.2 => 8.8 = 1.4 (14 %)
Days in Hospital 27.9 => 27.8 = 0.1(3 %)Pancreatdoudenectomy for cancer ‐ 80 patients2
Days on Antibiotics 10 => 2 = 8 (80 %)Days in ICUs 6 => 2 = 4 (67 %)
Days in Hospital 22 => 17 = 5 (23 %)
Severe acute pancreatitis – 62 patients3
Days in Hospital 19.7 => 14.9 = 4.8 (24 %)Severe trama treated with Synbiotic 2000 Forte – 65 patients5
Days on Artificial Respiration 24 => 19 = 5 (21 %)
Days in ICUs 41.3 => 27.7 = 13.6 (33 %)
MULTI-STRAIN SYNBIOTICS IN DISTAL COLITIS
Rectal application, 10 patients, studied before (D0), and after 7 (D7), 14 (D14) and 21 (D21) days of treatment:
D0 D7 D14 D21
Urgency 1.9 1.2 1.0 1.0
Episodes of diarrhoea 2.4 1.3 0.9 0.8
Nightly diarrhoea 0.5 0.1 0 0
Visible blood 2.2 1.2 0.8 0.8
Consistency of stool 1.1 0.9 0.7 0.8
Pathmakanthan S, et al, Gut 2002; 51(Supp lIII) A307
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COMMUNICATION BETWEEN THE GUT, GUT MICROBIOTA &
THE BRAIN –endocrine,
neurocrine and inflammation‐relatedcommunications
Mayer et al J Neurosci2014;34:15490‐15496
DIET, MICROBIOTA ANXIETY & DEPRESSION
Luna RA, Foster JA Current Opinion in Biotechnology
2015, 32:35–41
DIET, MICROBIOTA ANXIETY
& DEPRESSION
Luna RA, Foster JA Current Opinion in Biotechnology
2015, 32:35–41
FMT IN MULTIPLE SCLEROSIS – 3 PATIENTSBorody Th et al Am J Gastroenterol 2011;52, Suppl 2; abstract 952
Patient 1. Male 30 yr, wheel‐chaired, constipation.
5 FMT infusions. Regained ability to walk. Remains well & without any relapses, 15 years post‐FMT.
Patient 2. Male 29 yr, wheel‐chaired, severe constipation. 10 daily FMT infusions. Regained ability to walk. 3 years on maintains normal motor, urinary and GI function.
Patient 3. Female 80 yr, severe chronic constipation. now walking long distances unassisted. Two years post‐FMT, the patient is asymptomatic.
SonnenburgJustin & Erica
The Good Gut‐ Your weight‐ Your mood‐ Your health
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Gut microbiota, immune
development and function
Bengmark S.
Pharmacological
Research
2013 March;69:87‐113
VITAMIN D – FUNCTIONSHolick MF Mol Asp Med 2008;29:361–368
VITAMIN D – IMMUNE EFFECTS ‐ decrease T‐cell activation & proliferation,
‐ inhibit dendritic cell maturation/ differentiation
‐ induce tolerogenic dendritic cells
Supplementing vitamin D reported to: ‐ prevent acute and chronic diseases
‐ improve allograft survival
‐ decelerate loss of allograft function
‐ prevent acute rejection in transplantation
VITAMIN D & TELOMERIC AGING
Vitamin D ‐ a potent inhibitor of inflammation
The difference in telomere length between the highest and lowest tertiles of vitamin D was 107 base pairs (P = 0.0009), equivalent to 5.0 years of telomeric agingRichards JB et al Am J Clin Nutr 2007;86:1420‐1425
VITAMIN D DEFICIENCY & DISEASE• Aging
• Allergy
• Alzheimer’s disease
• Asthma
• Athletic performance
• Autism
• Cancer
• Cavities
• Colds
• Crohn´s disease
• Cystic fibrosis
• Depression
• Diabetes 1 and 2
• Eczema
• Heart disease
• Hearing loss
• Hypertension
• Infertility
• Influenza
• Insomnia
• Maculardegeneration
• Migraines
• MultipleSclerosis
• Muscle pain
• Myopia
• Obesity• Periodontal disease
• Pre‐eclampsia
• Psoriasis
• RheumatoiddiseasesSchizophrenia
• Seizures
• Septicemia
• Tuberculosis
• Vaginosis/fluor
VITAMIN D DEFICIENCY IN SURGERY
85 % of patients undergoing hip or knee replacement
Breijawi N et al Eur Surg Res 2009;42:1–10
77 % of chronic pancreatitis patients Dujsikova H et al Pancreatology 2008;8:583–586
57 % obesity surgery patients (79 % in black and Hispanic) Gemmel K et al Surg Obes Rel Dis 2009,5, 54–59
67 % of renal transplantation patients Ducloux D et al Transplantation 2008;85: 1755–1759
95% of Afro‐Americans undergoing renal transplantation Tripathy SS et al Transplantation 2008;85: 767–770
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VITAMIN D IN BABIESArnberg K et al Acta Paediatr 2011;100:1244‐1248
A cross‐sectional study in 255 infants aged 9 months. 97 % received vitamin D supplementation.
Mean plasma 25‐hydroxyvitamin D:
77.2 ± 22.7 nM
Association between vitamin D &
low HDL (p = 0.003), low cholesterol (p = 0.002) and low triglycerides (p = 0.010), low body mass index (p = 0.005) and low waist
circumference (p = 0.002).
VITAMIN D & BREAST CANCERMohr SB et al Breast J 2008;14:255‐60
AUTISM & LATITUDE Grant WB, Soles CM (latitude)Dermatoendocrinol. 2009;1:223‐228
VITAMIN D & CANCER GROWTHSwami S et al Endocrinology 2012;153:2576‐2587
.Mouse models of breast cancer and prostate cancer: vitamin D₃ and 1,25‐dihydroxyvitamin D₃ (calcitriol) in large doses(5000 IU/kg) & compared with a control diet (1000 IU/kg).
VITAMIN D & CHRONIC LYMPHOCYTIC LEUKEMIA PROGNOSISShanafelt TD et al Blood 2011;117:1492‐1498
VITAMIN D & ALLERGYSharief S et al J Allergy Clin Immunol 2011;127:1195‐1202
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VITAMIN D & ASTHMA IN CHILDREN
Only 9.4% of children with asthma have a sufficient vitamin/s (> 30 ng/mL).
Children with well‐controlled asthma have higher Vitamin D/s than children with un‐controlled or partially controlled asthma (P = .023)
A significant positive correlation exists between forced vital capacity % vitamin D/s (P = .040)
A positive correlation exists between vitamin D/s and so called Childhood Asthma Control Test (P = .011) Chinellato I et al J Pediatr 2011;158:437‐441
VITAMIN D & CYSTIC FIBROSISRovner AJ et al Am J Clin Nutr 2007;86:1694 –1699
VITAMIN D & MATERNAL VAGINOSISBodnar LM et al J Nutr. 2009;139:1157‐1161
VITAMIN D IN DEPRESSIONHögberg G et al Acta Paediatrica 2012;101:779‐783
54 Swedish depressed adolescents. Mean serum 25OHD was 41 at baseline and 91 nmol/L (p<0.001) after oral supply of vitamin D during 3 months (4000 IU/d during 1 month and 2000 IU/d 2 months)
Significant increases observed: • Well‐being (p<0.001)
• Depressed feeling (p<0.001)
• Irritability (p<0.05) (p<0.001)
• Tiredness (p<0.001)
• Mood swings (p<0.01)
• Sleep difficulties (p<0.01)
• Weakness (p<0.05)
• Ability to concentrate (p<0.05)
• Pain (p<0.05) &
• Significant amelioration of depression according to the MFQ‐S (p<0.05)
VITAMIN D & INFECTION/INFLUENZA TRAINING, VITAMIN D & MUSCLE POWERCarillo AE et al Clinical Nutrition 2012 E‐pub
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VITAMIN D DEFICIENCY – COSTSGant WB et al Prog Biophys Mol Biol 2009;99:104‐113
36 % of direct and 28 % of indirect Health Costs are associated with vitamin D deficience:
Cardiovascular 13.5 and 7.5 respInfections incl influenza 7 and 6.5 respType 2 diabetes 7 and 2.4 respCancer 6.4 and 9.6 respOsteoporosis 1.5 and 0.5 respMultiple sclerosis 1 and 0.2 resp
SUBSTITUTING VITAMIN DGant WB et al Prog Biophys Mol Biol 2009, 99:104‐113
to all European to 40 ng/mL would reduce the direct economic burden of disease by 11.4%, or EUR 105,000 000 000
the indirect economic burden of disease by 6.4 % or EUR 82,000 000 000
the total reduction in economic burden of disease by 17.7%, or
EUR 187,000 000 000
PRESENT THE ENTRANCE OF ENERGY PALEO
THE FRONT DOOR – SHORTCUT 1app 60 % are Sugar and Suger‐like substanceswhich enters the body in upper jejunum via
mainly the arterial system < 15 %
THE BACK DOOR – THE DANGEROUS ROUTEapp 30 % animal fats & vegetable oil enters via the the body via the lymphatic system and
remains in circulation for hours > 10 %THE MAIN DOOR
< 20 % Raw greens, Vegetables, Fruits are foodsfor Microbiota and reaches the large intestine,
enhancing immune system, preventing inflammation‐ app 80 %
Wein S. Diabetes Metab Res Rev 2009;25:185‐194MCFAs: Coconut oil and palm kernel oil are the top sourcesLCFAs: C14, C16, C18 – mainly from dairy and meat
PORTAL VEIN, THORACIC DUCT, HEPATIC ARTERYPORTÅDERN, STORA LYMFGÅNGEN, LEVERARTÄREN
SATURATED FATTY ACID METABOLISMMCFA: Coconut Oil 85,2, Palm kernel oil 81,5, Palm Oil 45,3, Olive Oil 14.5 (70 % monosaturated)
LCFA: Animal fats
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POSTPRANDIAL LIPIDEMIA & INFLAMMATION
Khor A et al Nutr Res. 2014;34:391‐400.• Postprandial inflammatory activity is a strong risk factors for atherosclerosis Ebenbichler CF Curr Opin Lipidol 1995;6:286–290 (& other chronic diseases)
• increases content of endotoxin in blood (eqv to smoking 3 cigarettes) Erridge C et al Am J Clin Nutr 2007;86:1286 –1292
• leads to cascades of inflammatory and oxidative stress
• Ceriello A et al. Diabetes 2004;53:701–710
• release of tumor necrosis factor‐α, a key proinflammatory cytokineErridge C et al Am J Clin Nutr 2007;86:1286 –1292
• increases numbers of & activates leukocytes Alipour A et al Arterioscler Thromb Vasc Biol 2008;28:792–797
• Inflammatory reaction potentiated by simultaneous intake of sugar Ceriello A et al. Diabetes 2004;53:701–710
POSTPRANDIAL METABOLISM + VINEGARMitrou P et al Eur J Clin Nutr 2015;69:734‐739
INSULIN
TRIGLYCERIDES
POSTPRANDIAL INFLAMMATION & ENDOTOXEMIAErridge C et al Am J Clin Nutr 2007;86:1286 –1292
FAT UTILIZATION 72 HRSSoeters P et al Am J Physiol Endocrinal Metab 2012;303:E1397‐1407
ÂCONTENT
FOOD
&
HEALTH
AMOUNT TIME
DAILY FASTING –IMPORTANT FOR BODY RENOVATION
• DAILY FASTING:
• Burn off the excess body fat
• Reduces & eliminates toxins & poisons body
• Eliminates bad proteins
• Body organs regenerate & restore functions
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APOPTOSIS ‐ PROGRAMMED CELL DEATH
• Essential for fetal growth
• For correct architecture of organs and tissues
• For maintenance of organ homeostasis & functions
• For development of a normal immune system
• For control of chronic inflammatory conditions such as ulcerative colitis and Crohn’s disease, rheumatoid arthritis and many others
AUTOPHAGY CLEANING/RESTORATION
• Accumulation of junky proteins seen in chronic conditions & especially in Alzheimer´s Disease (amyloid beta or Tau protein) and cancer
• Autophagy is turned off (dormant) by eating protein, glucose, insulin, low glucagon
• Starvation/fasting turns on autophagy
• Lysosome – a part of the cell ‐ contains enzymes which degrade proteins.
• One key regulators in both directions is an enzyme (kinase) called
mammalian target of rapamycin (mTOR).
BENEFITS OF DIURNAL FASTING• Reduces oxidative stress/inflammation
• Normalizes "the hunger hormone“ – ghrelin
• Normalizes insulin and leptin sensitivity
• Normalizes fat, sugar and protein metabolism
• Boosts mitochondrial energy efficiency
• Minimizes damage to cellular proteins, lipids & nucleic acids – hereby
• Reducing disease and premature aging
• Improves various biomarkers of disease
MICROBIOTA & DIURNAL RHYTMFeehley T, Nagler CR Nature 2014;514:176‐177
DIURNAL RHYTHM
&MICROBIOTIC FUNCTIONS
Liang X et alCell. 2014;159:469‐70
DIURNAL RHYTHM MICROBIOTIC FUNCTIONS
&FECAL
TRANSPLANTATION
Liang X et al. Cell. 2014;159:469‐70
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DAILY FASTING REDUCES OBESITY & IMPROVES HEALTH
Hatori M et al Cell Metabolism 2012;15: 848‐860
MICROBIOTA, METABOLISM & DIURNAL RHYTMThaiss CA et al Cell. 2014;159:514‐529
DIURNAL CONTROL OF GENE ACTIVITYPlikus MV et al J Biol Rhythm 2015;30:163‐182.
GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606‐613
• ↓ FFA oxida on
• ↑ endotoxin/s
• ↑SCFA production
• ↓incretin secretion
• ↓ butyrate production
• ↑FFA oxidation
• ↓ endotoxin/s
• ↓ SCFA production
• ↑Incretin secretion
• ↑butyrate production
INTERMITTENT FASTING & WEIGHTHatori M et al Cell Metabolism 2012;15: 848‐860
NA=normal diet, free access, FA= free access to fat diet, NT & FT=time‐restricted normal or fat diet
DIURNAL CHRONOBIOTICS PREVENTS & DELAYS ALZHEIMERS DISEASELaundry G, Liu‐Ambrose T Front. Aging Neurosci 2014 E‐pub BLT = Bright light therapy
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DAILY FASTING –AVOIDING LATE
NIGHT EATING AND SKIPPING BREAKFAST
– long‐term effects
Zilberter T, Zilberter EYFront Public Health 2014;2:59
BREAKFAST – NOT YOUR MOST IMPORTANT MEAL?
PREVENTING & REVERSING AGING
• Premature ageing reversed by reactivating an enzyme, telomerase, that protects the tips of chromosomes.
• Telomerase activity significantly increased following physical & psychological stress & poor eating
• Inactivating telomerase will increase tumour growth by enabling cancer cells to use sugar & increase growth rate.
• Inactivating telomerase leads to upregulation of app. 70 genes known or suspected to promote cancer growth and
spreading through the body. (Blackburn et al.)
TELOMERESMayor S BMJ 2009;338:a3024
TELOMERES & HEALTHOxidative stress & chronic inflammation reduce the length of telomerases & promotes aging and chronic diseases (ChD) Leukocyte telomere length (LTL) inversely associated with:
• glucose/s, insulin, blood pressure, Il‐6 • carotid intima‐media thickness
• most chronic diseasesRichards JB et al Atherosclerosis 2008;200:271‐277
TELOMERIC STATUS – OBESITYKim S et al Cancer Epidemiol Biomarkers Prev 2009;18:816‐820
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TELOMERIC AGING & ATHEROSCLEROSIS
Each shortened kilobase pair corresponds in younger subjects, to
a threefold increased risk of: ‐myocardial infarction (hazard ratio = 3.08) & ‐ stroke (hazard ratio = 3.22)Fitzpatrick AL et al Am J Epidemiol. 2007;165:14‐21
HOMOCYSTEINE & TELOMERIC AGING
The difference in length between the highest and lowest tertile of homocysteine levels was 111 base pairs (p = 0.004)eqv. to 6.0 years of telomeric aging
associated with ‐ decreased folate/s & ‐ increased C‐reactive protein/s (CRP/s) Richards JB et al Atherosclerosis 2008;200:271‐277
PHYSICAL ACTIVITY & TELOMERIC AGING
LTLs of most active subjects are 200 nucleotides longer than those of the least active subjects
(p= .006) (app 10 yrs)
LTLs of active twins are 88 nucleotides longer than that of less active twins (p= .03) Cherkas LF et al Arch Intern Med. 2008;168:154‐158
SOCIOECONOMIC STATUS & TELOMERIC AGING
Low socio‐economic status (SES) associated with harmful effects of smoking, obesity and lack of exercise & shorter life expectancy
The mean difference in LTL between non‐manual and manual groups was 163.2 base pairs (bp) (app 8 yrs)
of which app 14 % (22.9 bp) was accounted for by higher BMI, smoking & lack of exercise
Cherkas LF et al Aging Cell. 2006;5:361‐365
SOCIOECONOMIC STATUS & HEALTH
Analyses of 308 female twin pairs The working class twin fared worse & showed compared to her professional twin significantly higher :- Systolic blood pressure- Diastolic blood pressure- Low-density lipoprotein cholesterolKrieger N et al PLoS Med. 2005 Jul;2(7):e162
TELOMERE LENGTH & PESSIMISM O´Donovan A et al. Brain Behavior, Immunity 2009;23:446‐449
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TELOMERE LENGTH & OMEGA‐3 LEVELSFarzaneh‐Far R et al JAMA. 2010;303:250‐257
VITAMIN D & TELOMERIC AGINGVitamin D ‐ a potent inhibitor of inflammation & associated with LTL
The difference in LTL between the highest and lowest tertiles of vitamin D was 107 base pairs (P = 0.0009), equivalent to 5.0 years of telomeric agingRichards JB et al Am J Clin Nutr 2007;86:1420-1425
David Perlmutter, MD,FACN, ABIHM is a Board‐Certified Neurologist and Fellow of the American College of Nutrition
• Richard J Johnson, MD Professor and Chief of nephrology, University of Colorado Denver
14 Forskare: ”Nu krävs kraftfulla åtgärder mot nötkött och flygresor”
Publicerad DN 2015‐02‐27
Svenskarnas globala utsläpp från köttkonsumtion och flygresor motsvarar hälften av de totala utsläppen på hemmaplan.
De totala utsläppen orsakade av svensk konsumtion har ökat med 17 procent den senaste 20 åren. Konsumtionsvolymerna har stigit kraftigt och åtgärderna för att minska utsläppen har varit otillräckliga. http://www.dn.se/debatt/nu‐kravs‐kraftfulla‐atgarder‐mot‐notkott‐och‐flygresor/
Agriculture, particularly meat & dairy products, accounts for:
•70 % of global freshwater consumption
•38 % of the total land use & •21 % of the world's greenhouse gas emissions
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THE PROBLEM OF WATER SHORTAGE
More than half of the water used in the United States goes to livestock production L. Beckett & J. W. Oltjen J Animal Science 1992;71:818‐8268
4000 lit (18000?) of water is needed to produce 1 kg of meat compared to 14 lit to produce one kg of grain Audubon News Jan 2000
Every kg of beef that is avoided can save up to 4000 (18000?) liters of water Boyan S: How Our Food Choices can Help Save the Environment.
•App 56 billion animals are reared and slaughtered for annual human & pet consumption each year
•expected to double by 2050 (About 10 animals per individual! )
•most increases will occur in the developing world Steinfeld et al. 2006
ATT BETÄNKA:Cirka 25 procent av svenskens klimatavtryck kommer från maten.
Nötkött orsakar 40 ggr högre utsläpp än t.ex. bönor ‐ kyckling ”bara” 4 ggr.
Av den energi som nötkreatur konsumerar blir ytterst litet kvar:
nöt 0 %, gris 10 %, kyckling 15 %.
Resten försvinner bl. a. till djurens tillväxt och till kroppsvärme hos djuren.
”COSTS” OF LIFESTOCK PRODUCTION• 70% of United States grain goes to feeding farm animals USDA 1991
• It takes almost 7 kg of corn and soy to produce one kg of pork.Cattle‐Fax 1989
• Nearly 800 million people could be fed by all the grains currently fed to US livestock Professor David Pimental NY
IMPACT OF AGRICULTURE 2Tilman D, Clark M Nature 2014;515:518‐522
• Diets high in processed foods: refined sugars, refined fats, oils and meats has produced
• 2.1 billion people becoming overweight or obese
• While almost One billion people still suffer from inadequate diets & insecure food supplies
REMEMBER 1Every second of every day, one “football field” of tropical rainforest is destroyed in order to
produce 257 hamburgersBoyan S. How Our Food Choices can
Help Save the Environment
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REMEMBER 2Food production will need to increase by
100 per cent by the year 2050
IMPACT OF AGRICULTURE 3Tilman D, Clark M Nature 2014;515:518‐522
Increases in body mass indices (BMI) will increase global incidences of chronic diseases, such as type II diabetes, coronary heart disease and some cancers, ‐ these three predicted to become two‐thirds of the global burden of disease by 2050
REMEMBER 4App 80% of health care
costs are due to overconsumption of
mainly
agriculture‐produced
Western‐type diet.
WHAT CAN WE DO? “A substantial contraction in meat consumption in high‐income countries should benefit health, reducing the risk of ischaemic heart disease obesity, colorectal cancer etc”.McMichael AJ et al Lancet 2007; 370: 1253–63
THE EASIEST WAY?“Halting the increase of greenhouse‐gas emissions from agriculture, especially livestock production, should therefore be a top priority, because it could curb warming fairly rapidly.”McMichael AJ et al Lancet 2007; 370: 1253–63
A better way - less energy, less pollution
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DIET AND REDUCED RISK OF DISEASE
Tilman D, Clark M Nature 2014;515:518‐522
AGRICULTURE, HEALTH, GREEN‐HOUSE EFFECTSFrid S et al Lancet 2009; 374: 2016–2025
ENVIRONMENTAL FOOTPRINTSB & R Vale Time to eat your dog, Guide to sustainable living 2009
Cow ,milking 30 lit/day 19.6 gha *Sheep 1.6 ghaHuman –developed world 6 ghaLarge dog 1.1 ghaHuman being developing world 1 ghaPig 0.6 ghaJeep/SUV 0.41 ghaSmall dog 0.3 ghaCat 0.15 ghaHamster 0.014 gha
* = global hectare, one gha = 10000 sqmet, total app 15 bill gha
One average dog eats the same amount of meat as
4 average Humans
The estimated 500 000 000 dogs on Earth
eat as 2 billion average Humans
REMEMBER 5
www.bengmark.com
”Make friendwith your
microbiota!”
Thank you!
