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Region Skåne SD‐dag Scandic Triangeln, Malmö
m2016‐04‐05
Västerländsk livstilkost, kronisk sjukdom och smärta
Stig Bengmark MD PhD UCL ‐ London University, UK
EVERY MAN -“THE SMITH OF
HER/HISOWN HEALTH”.
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!
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)
MORTALITY per 100 000 inhab. 1995Willcox CF et al Ann. N.Y. Acad. Sci. 2007;1114: 434–455
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PROGNOSIS DIABETES USA – 2050Boyle et al. Population Health Metrics 2010, 8:29
PROGNOSIS ALZHEIMER USA – 2050Hebert LE et al Arch Neurol 2003;60:1119‐1122
FUTURE PROSPECT ‐ CANCERBray F, Møller B Nat Rev Cancer 2006;6:63‐74
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 accruing an
• 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
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
LIFESTYLE & CHOLESTEROL/S
Mg/dL mM/L
Westerners <200 <5.18
Rural Chinese 127+15 3.3+0.4
Hunters‐gatherers 123+7 3.2+2.2
Non‐human
Primates 90‐135 2.3‐3.5
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Boutenko V. Green for Life. North Atlantic Books Calif, USA, 2010
FOOD PATTERN UGANDIAN CHIMPANZEESPotts KB et al Int J Primatol 2011;32:669‐690
ripe fruits = RFunripe fruits = UFyoung leaves = YLseeds, flowers
OBESITY ‐ THE GLOBAL TZUNAMI‐ strongly associated to modern
agriculture & mass‐produced cheap processed foods
Baguette (136, pumpernickel 68), White suger (92), Candy bar (97), Yellow Banana (84),
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
Du väljer själv! Nyutexaminerade
läraren Harriet Jenkins,
25 år, Southhampton, bantade bort 95 kg på
18 månader och gick från
storlek 30 till 10
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DAILY BLOOD GLUCOSE VARIATIONSFreckmann G et al J Diabetes Sci Technol. 2007; 1: 695–703
Normal:72‐108 mg/dL = 4‐6 mmmol/lfasting, max 157 = 8.7 after meal.
POSTPRANDIAL HYPERLIPIDEMIA IN METABOLIC SYNDROMEAlcala‐Diaz JF et al. Plos One 2014;9:e96297
STORAGE & UTILIZATION OF ENERGY
EASY ACCESS 1 – GLYCOGENLiver app 100 gr = 500 (800 cal)
Skeletal muscles app 500 gr = 2500 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 %
A‐laget – GI < 20 * Aubergine, * Squash/Zucchini * kikärtor, vissa bönor * vitlök & annan lök, * jordnötter, valnötter, * tomat, * rå broccoli, * rå grönkål, * rå spenat, * råa salladsblad, * rå fänkål, * råa rotfrukter t.ex. kronärtskocka, men också råa morötter, rå potatis, råa rödbetor, rå palsternacka, rå kålrot
• Makaroner: 64
• Pizza: 86
• Ravioli: 56
• Ris: 83
• Risnudlar: 131
• Snabbnudlar: 67
• Fullkornspagetti: 53
• Spagetti: 59
• Kålrot, kokt: 103
• Morötter, kokta: 101
• Palsternacka: 139
• Potatis kokt: 80
• Potatis, bakad: 121
• Potatis, ångkokt: 93
• Rödbetor, kokta: 91
• Gröna ärtor, kokta 68
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GI < 50 GI < 20• FRUKT OCH GRÖNSAKER
• Citron, grapefrukt, hallon, jordgubbe, körsbär persikor, plommon m.fl.
• Svamp, Gröna linser
• QUINOA, BOVETE, SIRGHUM, TEFF, AMARANTH
• Sojabönor, Svarta bönor, kidneybönor, limabönor mungbönor, vaxbönor vita bönor.
• Cashewnötter & andra fröer
• Gröna ärtor, Kikärtor
• Mörk choklad
• Osötad marmelad,
• Grön/omogen banan
• Rotfrukter som Palsternacka, Potatis och Rödbetor som är försiktigt kokt, kyld och därefter lätt uppvärmd igen.
• Aubergine, quash
• Kikärtor, vissa bönor
• Vitlök och annan lök
• Jordnötter, valnötter
• Tomat
• rå broccoli
• rå grönkål
• rå spenat
• råa salladsblad
• rå fänkål
• AVOKADO
• råa rotfrukter t.ex. kronärtskocka, men också råa morötter, rå potatis, råa rödbetor, rå palsternacka, rå kålrot ligger i närheten (skär gärna råa rotfrukter i lövtunna skivor och strö över salladen).
DNA – Not Your Destiny!Anand P et al Pharm Res 2008;25:2097‐2116
Stressors like a calorie‐rich diet:
• turn genes on and off
• activate epigenetic markers
• modify histones
• add methyl groups to DNA strands,
• & seem to affect what gets passed down to the offspring
CANCER & GENES Anand P et al Pharm Res 2008;25:2097‐2116
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
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!!!!!!!! WARNING SIGNALS !!!!!!!Unexplained 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
Lars Olov Bygren
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
“Recent research suggest that growth in utero may play an important role…….”
“Even brief periods of (“inflammation”)… may permanently change & reprogram (the immune system) & lead to persistent changes (later in life)
in blood pressure, cholesterol metabolism, insulin response to glucose, and in a range of other metabolic, endocrine and immune parameters.”
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.
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.
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PREVENTING DYSBIOSIS –KEY TO DISEASE & INFECTION CONTROLborn 1936 ‐ Brandtzaeg P et al Gastroenterology 1989;97:1562‐84
• A striking localpreponderence in the gut (70‐90 %) of IgAimmunocytes
• The gut content is constantlytested by recognition cells such as dentritic cells (DC), which
• Programs/fine tunes the immune system
• Each DC commands about1200 T‐cells
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
POSTPRANDIAL INFLAMMATION
DYSBIOSISGENERAL INFLAMMATION
&CHRONIC DISEASES
Myles IA Nutrition Journal 2014;13:61
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
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CLUSTERING & RISK PROFILEQvarnstrom M et al J Clin Periodontol 2010; 37: 805–811
METABOLIC SYNDROME – DYSBIOSISTremellen K, Pearce K Med Hypotheses 2012;79:104‐112
BREAKING THE VICIOUS CIRCLE
INFLAMMATION
INFECTION
Antibiotics Reduces infections but DerangesMicrobiota ‐ Creates DysbiosisIntestinal Reconditioning ‐ Pro/Synbiotics ‐Restores Microbiota
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 DEATH”Bengmark S Hepatobiliary Surg Nutr. 2015;4:278‐288
• 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
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LIFE STYLE CAUSES OF DEATH – USADanaei G Plos Med 2009,6(4),e
GLOBAL STROKE STATISTICS
Thrift AG et al Int J Stroke2014;9:6‐18
Dennis Burkitt 1911 ‐ 1993Observed an association between low fibre in diet, higher risk of colorectal cancer & diseases such as CHD and diabetes.
Suggested that many Western diseases, rare in Africa, are mainly a result of “poor” diet & lifestyle.
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
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
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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.
MICROBIOTA – FAVORITE FOODS – UNCOOKED! www.bengmark.com
80/10/10 DIET80 % raw greens
10 % vegetable fats
10 % vegetable proteins
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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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
ANTI ‐ OBESITY FOODS Trigueros L et al Crit Rev Food Sci Nutr 2013;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, millet), 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)
”FIRE EXTINGUISHERS” – THE ”CHAMPIONS LEAGE” OF ANTIOXIDANTS
Kryddnejlika
SB1
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
SUMAC/STAGHORN – A FAVOURITE ‐ Enourmously rich in proteins, fibres, vitamins, antioxidants and minerals
‐ Anti‐inflammatory,
‐ Anti‐fungal,
‐ Anti‐infectious
‐ Diuretic
‐ Anti‐carcinogenic
‐ Possess estrogen‐like behavior
‐ Helps in treatment of menstrual disorder & cramps.
PROSTATIC CANCER – PSA & PLANT DIETNguyen JY Integr Cancer Therapies 2006;5:214‐223
6 Months 1600 calorie Green Diet – 14 patients
Slide 63
SB1 Stig Bengmark; 2015-09-09
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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
MAGNESIUM DEFICIENCYMg involved in > 300 biochemical processes
Early symptoms of Mg‐deficiency are:
• 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 such as hypertension, heart disease, stroke, type 2 diabetes, osteoporosis, & others.
ANTINUTRITIONAL FACTOR‐ PHYTIC ACIDREDUCED/ELIMINATED BY:
Soaking: Cereals and legumes are often
soaked in water overnight
Sprouting: The sprouting of seeds, grains and legumes, also called germination, causes phytate degradation
Fermentation: Organic acids, formed
during fermentation, promote phytic acid breakdown. Lactic acid fermentation is a common method, a good example is sourdough.
Combination of these methods will reduce phytate content substantially ‐soaking, sprouting and lactic acid fermentation can reduce the phytic acid content of for example quinoa seeds by up to 98 %.
MAGNESIUM/s & PREMATURE DEATH Reffelmann Th et al. Atherosclerosis 2011;219:280‐284.
Mortality in subjects with Mg++ ≤ 0.73 mmol/l was in comparison to higher Mg++ concentrations significantly higher for all‐cause deaths: 10.95 death vs 1.45 deaths (7x) & for cardiovascular deaths: 3.44 deaths vs. 1.53 deaths (2.4x) per 1000 person years.
FUTURE NUTRITION OF CRITICALLY ILL !Hospital‐made nutrition solutions !
Fresh fruit and vegetable juices ! Green Smoothies! Gaspacho etc !
PHARMA & MICROBIOTA – INCOMPATIBLE!ANTIBIOTICS destroy about 90 % of microbiota functions: bile acid metabolism, eicosanoid and steroid hormone synthesis etcCaetano L et al. Antimicrob Agents Chemother. 2011;55:1494‐1503
CHEMOTERAPEUTICS reduce 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
PROTON PUMP INHIBITORS during pregnancy increase the risk of offspring getting asthmaAndersen AB et al. Aliment Pharmacol Ther 2012;35:1190‐1198
ANTIHYPERTENSIVES induce gastrointestinal dysbiosis &reduce mucosa protectionNonzee V et al J Med Assoc Thai 2012;95:96‐104.
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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
LIFESTYLE, THE DEADLY QUARTET & LIVER DISEASEDyson JK et al Postgrad Med J 2015;91:92‐101
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
Bifidobacteriumspp.
HIGH FAT MEAL – ENDOTOXIN/sHarte AL et al Diabetes Care 2012;35:375‐382
Non‐obese controls (NOC) (n = 9), obese subjects (n = 15), impaired glucose tolerance (IGT) (n = 12), type 2 diabetes (n = 18).
HIGH FAT DIET & MICROBIAL TRANSLOCATIONAmar J et al EMBO Mol Med 2011;13:559‐572
Live intestinal bacteria found present in large numbers in blood, adipose tissue (MAT) & mesenteric lymph nodes (MLN) AFTER ONLY ONE WEEK ON HIGH FAT DIET (HFD)
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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GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606‐613
• ↑ Endotoxin/s
• ↓ FFA oxidation
• ↓ SCFA production
• ↓ Butyrate production
• ↓ Incretin secretion
• ↓ Endotoxin/s
• ↑FFA oxida on
• ↑ SCFA production
• ↑ Butyrate production
• ↑ Incretin secretion
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
Dubos RJ, Schaedler RW J Exp Med 1962;115:1161‐1172
CASEIN & GLUTEN IMPAIRS LACTOBACILLUS GROWTH
Without casein and gluten With casein and gluten
BACTERIA & GLUTEN‐INDUCED ZONULIN RELEASE Fasano A Physiol Rev 2011;91: 151–175
GLUTEN & SURFACE MOLECULE EXPRESSIONSClass II, CD86, CD40, CD54 Nikulina M et al J Immunol 2004;173:1925‐1933
100 µg/ml gluten = the effects of 10 ng/ml LPS (ENDOTOXIN)
GLUTEN SENSITIVITY & CHRONIC DISEASESRuuskanen A et al. Scand J Gastroenterol. 2010;45:1197‐1202
Glutenoids affects genetic markers: HLA‐B8, HLA DQ2, HLA DQ8,
increase systemic inflammation & are associated with diseases such as:
• ADHD
• arthritis
• Addison´s disease, Graves´disease,
• allergy
• Autoimmune disorders
• Autism
• Bipolar disease
• Diabetes mellitus
• Dementia
• Epilepsia
• infections
• Inflammatory bowel diseases – IBD
• Irritable bowel syndrome – IBS
• Lupus erythematosus
• Mental depression
• Myasthenia gravis
• Obesity
• Osteoporosis
• Pernicious anemia
• Polymyalgia rheumatica
• Psoriasis
• Schizophrenia
• Sclerodermia
• Sepsis
• Sjögren’s syndrome
• Thyreotoxicosis
• Vitiligo
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IBS‐ASSOCIATED CHANGESCzaja‐Bulsa G. Clin Nutr 2015;34: 189‐94 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
GLUTEN‐FREE DIET in IRRITABLE BOWEL SYNDROME Biesiekierski Jr et al. Am J Gastroenterol 2011;106: 508‐514
GLUTEN‐RESTRICTED DIET 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)
GLUTEN‐FREE DIET & TYPE 1 DIABETESPastore MR et al. J Clin Endocrinol Metab 2003;88: 162–165
Gluten‐free diet tried in 15 patients with diabetes without gluten intolerance
Six months on gluten‐free diet increased insulin sensitivity (IS) significantly in 12/14 subjects after (P 0.04) &
return to “normal” diet reduced IS in 10/13 subjects (P=0.07) after 6 months
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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.
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)
RFECOMMENDED TYPES OF GRAINS
Cereal Grains –Wheat (includes spelt, emmer, farro, einkorn,
Kamut®, durum)
– Rice ‐Millet – Corn (maize, popcorn) ‐Wild
Rice – Oats ‐ Triticale – Barley ‐ Sorghum – Rye
‐ Teff – Canary Seed ‐ Job’s Tears – Fonio
Pseudocereal Grains Amaranth ‐ Buckwheat – Quinoa
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 •
SORGHUM (durrah, jowari, milo) – A SUPER GRAIN!Dykes L, Rooney LW Cereal Foods World 2007;52:105‐111
SORGHUM/DURRAH – SUGGESTED HEALTH BENEFITS
• Antioxidants of sorghum are higher than in other grains Awika JM, Rooney LW Phytochemistry 2004;65:1199‐1221
• may inhibit cancer tumour growth Yang L et al J Agr Food Chem 2009;57:1797‐804
• may protect against insulin resistance Farrar JL et al Phytother Res 2008;22:1052‐1056
• may help manage cholesterolCarr TP J Nutr 2005;135:2236‐2240
• may help manage melanomaGómez‐Cordovés C et al J Agr Food Chem 2001;49:1620‐1624
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MICROBIOTA ‐ AFRICAN & EUROPEANDe Filippo C et al Proc Natl Acad Sci USA 2010; 107:14691–14696
Rural Africans Europeans
G+
G- G-
G+
Yanomamis
MICROBIOTA DIVERSITY – ANCIENT CULTURESClemente JC et al Science Advances 2015 E‐pub
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
Louis Camille Maillard 1878 – 1936
Suggested an association between highly heated foods & development of chronic diseases – espec. Chronic RENAL disease.
He was awarded several prices, including the French Academy of Medicine award in 1914.
“SMOKING WITH THE STOMACH”Heating of foods above 100 C ‐ frying, grilling, roasting, baking glycatedproteins (AGEs and ALEs),
which induce about 50 times more FREE RADICALS than non‐glycated proteins ‐
accumulate in tissues (amyloid), impair DNA repair, induce accumulation in tissues of toxins, reduce antioxidant defense & accelerate disease development Thorpe SR, Baynes JW Amino Acids 2003;25:275‐281
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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 & 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
”SMOKING WITH THE STOMACH”Systemic inflammation (high CRP), as seen in COPD, high BMI, hypertension, & affect lung function with a negative effect on forced vital capacity (FVC ). Margetardottir OB et al COPD. 2009 ;6:250‐255
Eating cured meats: (bacon, sausage, luncheon meats, and cured hams) induces inflammation and reduces: FEV1
3 to 4 times/mo – 12 ml
5 to 13 times/mo – 42 ml
14 or more times/mo – 110 ml Jiang R et al Am J Respir Crit Care Med 2007;175:798–804
COPD & ANTIOXIDANT INTAKETabak C et al Am J Respir Crit Care Med 2001;164:61–64
Intake of solid fruits & esp. catechin(tea & apple) is associated with an increase in
FEV1 of + 130 ml &reduction of four main COPD symptoms: chronic cough, phlegm, breathlessness (p < 0.001)
Intake of flavonol and flavone (vegetables) associated with reduction in chronic cough.
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
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HEAT & ACRYLAMIDE PRODUCTIONTareke C et al J. Agric. Food Chem. 2002;50:4998‐5006
AGEs IN VARIOUS MILK PRODUCTSBaptista J, Carvalho R Food Res Int 2004;37:739‐747
stored 1 yearstored 2 years
SPICES – EFFECTS ON HB‐GLYCATIONwild caraway = vild kummin Naderi Gh et al Indian J Pharm Sci. 2014; 76: 553–557.
STEAM COOKING, STEAM BAKING – ADVANTAGESBirlouez‐Aragon et al, Am J Clin Nutr 2010;91:1220–1226
Effects of steamcooking and baking (STMD) compared to conventional preparation of foods (STD) followed during 4 weeks 2 x 62 persons ‐ improvements observed in:
• Fasting insulinemia (7.63 => 6.52 mU/L, p=0.01)
• HOMA (Hb A1c,) (1.35 => 1.12 mmol/L, p=0.002)
• AGE&ALE: CML (0.50 => 0.36 ng/mmol, p=0.002)
• Vitamin C levels ( (mg/d) 60.7 => 86.1, p= 0.003)
• Total Fat intake ( 92.0 => 78.9 g, p=0.001) & fats in blood reduced
DAIRY & HORMONAL ”DISRUPTORS”
Almost all 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)
DIET AND BREAST CANCERCarroll KK Cancer Res 1975;35:3374‐3383
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EARLY MILK INTAKE & RISK OF PROSTATE CANCERTorfadottir JE et al Am J Epidemiol 2012; 175:144‐53
8,894 men born 1907 to1935 followed
> 24.3 years 1123 were diagnosed with prostate cancer.
Daily milk intake in young age increased the risk of advanced prostate cancer later in life
3.2 times
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 DEVELOPMENT IN EASTASIA
Zho Y et al Asian J Androl 2015;17:48–57 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
DAIRY CONSUMPTION ‐ CHINA
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LINKING DIETARY CHOLINE
(MEAT, FISH, MILK, EGG,) & PRODUCTION OF TRIMETHYLAMINE
(TMAO) –
a great risk factorfor atherosclerosis
Wilson Tang WH et al N Engl J Med 2013;368;1575‐1584
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 contain 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 % compared to non‐vegetariansOrlich MJ et al JAMA Intern Med. 2015 E‐pub
Meta‐analysis shows that fish consumption is associated with a 63 % reduction in prostate cancer‐specificmortality.
Szymanski KM et al Am J Clin Nutr 2010;92:1223‐1233.
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PRESENT THE ENTRANCE OF ENERGY PALEO
THE FRONT DOOR – SHORTCUT 1app 60 % of western foods are Sugar and Suger‐like substances, which enters the body in upperjejunum 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 %
ENDOTOXIN & OBESITYFei N, Zhao L. ISME J 2013;7:880‐884
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 2000 FORTESynbiotics AB, Sweden: www.synbiotics.se
400 billion Lactic acid bacteria:
1011 of Pediococcus pentosaceus 5‐33:3
1011 of Leuconostoc mesenteroides 32‐77:1
1011 of Lactobacillus paracasei sbsp. paracasei
1011 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.synbiotics.se; www.foodpharmacy.sehttp://bengmark.com/category/synbiotics/https://www.facebook.com/stig.bengmark
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
NEUTROPHILS IN LUNG TISSUETok D et al J Trauma 2007;62:880‐885
• Synbiotic 2000 9.00±0.44• Only LAB 8.40±0.42 • Only the fibres 31.20±0.98 • Placebo 51.10±0.70 • p< 0.05
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
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 %)
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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
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, Regained ability to walk. Remains 15 years post‐FMT well & without any relapses.
Patient 2. Male 29 yr, wheel‐chaired, Regained ability to walk and maintains 3 years post‐FMT normal motor, urinary and GI functions.
Patient 3. Female 80 yr, wheel‐chaired. Thepatient is two years post‐FMT walking long distances unassisted .
PSYCHO‐NEUROLOGICAL DISORDERS & GUT CONNECTION
• ADHD De Theije CG et al Pediatr Allergy Immunol 2013 E‐pub
• Autism De Theije CG et al Brain Behav Immun 2013 E‐pub
• Alzheimer Alam MZ et al CNS Neurol Disord Drug 2013 E‐pub
• Chronic fatigue syndromeFrémont M et al Anaerobe 2013;22:50‐56
• Encephalopathy Liu Q et al Hepatology 2004;39:1441‐1449
• Mental Depression Dinan TG, Cryan JF NeurogastroenterolMotil 2013;25:713‐719
• Myalgic encefalomyelitisFrémont M et al Anaerobe 2013;22:50‐56
• Multiple sclerosis Ochoa‐Repáraz J et al Gut Microbes 2010;1:103–108
• Parkinsons Dis Cersosimo MG et al J Neurol 2013;260:1332‐1338
• Schitzophrenia Severance EG Schizophren Res 2013;148:130‐137
Microbiota
Minds
MoodMELANCHOLIC MICROBES?
Dinan TG, Cryan JFNeurogastroenterol Motil
2013;25:713‐719
PSYCHO‐NEUROLOGICAL DISORDERS & GUT CONNECTION
• ADHD De Theije CG et al Pediatr Allergy Immunol 2013 E‐pub
• Autism De Theije CG et al Brain Behav Immun 2013 E‐pub
• Alzheimer Alam MZ et al CNS Neurol Disord Drug 2013 E‐pub
• Chronic fatigue syndromeFrémont M et al Anaerobe 2013;22:50‐56
• Encephalopathy Liu Q et al Hepatology 2004;39:1441‐1449
• Mental Depression Dinan TG, Cryan JF NeurogastroenterolMotil 2013;25:713‐719
• Myalgic encephalomyelitisFrémont M et al Anaerobe 2013;22:50‐56
• Multiple sclerosis Ochoa‐Repáraz J et al Gut Microbes 2010;1:103–108
• Parkinsons Dis Cersosimo MG et al J Neurol 2013;260:1332‐1338
• Schitzophrenia Severance EG Schizophren Res 2013;148:130‐137
FUTURE TARGETS FOR CLINICAL STUDIES• ANTIBIOTIC–RESISTENT INFECTIONS
• THERAPY–RESISTENT VIRAL INFECTIONS: EBOLA – to protect staff & treat the sick
• CHRONIC LIVER DISEASE ‐ Liver transplantation
• CHRONIC KIDNEY DISEASE – patients on dialysis
• ADHD
• PREGNANT WOMEN & NEWBORNS
• CHRONIC KIDNEY DISEASE – patients on dialysis
• HIV
• TRANSPLANTATION OF OTHER ORGANS,
• PATIENTS ON IRRADIATION AND CHEMOTHERAPY
• CHRONIC PULMONARY DISEASE – COPD
• ALZHEIMER
• OBESITY AND SEVERE DIABETES
• PSYCHIATRIC & NEUROLOGICAL DISEASES: MILD DEMENTIA – ENCEPHALOPATHY, MENTAL DEPRESSION, SCHITZOPHRENIA, MULTIPLE SCLEROSIS, ALS, CHRONIC FATIGUE SYNDROME, MYALGIC ENCEPHALITIS
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CHRONIC KIDNEY DISEASE – A GREAT SOCIETAL BURDEN Rostaing LP, Malvezzi P N Engl J Med 2016;374:982‐984
Chronic kidney diseases (CKD) ‐ a major worldwide societal burden. The prevalence is in the US app 14%, ‐ 1 million persons suffer end stage renal disease (ESRD)
• 700,000 (70.8%) are treated with dialysis
• 300,000 (29.2%) treated with transplantation
• over 100,000 patients are waiting list for a kidney transplant in the US
• only 15 to 16% will receive a kidney transplant,
• 32 to 34% are from live donors.
The costs for treating ESRD exceed in the US $48 billion.
EVOLUTION OF DIALYSIS FILTERSBonomini M et al. Int. J. Mol. Sci. 2015;16:29508–29521
HEMODIALYSIS Removal of protein‐bound uraemic toxins.
Among others indoxylsulphate, p‐cresyl
sulphate, showed high protein‐binding ratios (more than 95%) and low reduction rates by HD (less than 35%).
NiwaT Blood Purific2013;35 Suppl 2:20‐25
LIVING WITH CHRONIC RENAL FAILUREHeiwe S et al. Physiother Res Int. 2003,8,167‐177
”You feel like you’re poisoned … the feeling of fatigue is something like that.”
”I’ve got to force myself to do anything, not that I can’t, but I know how I will feel after, so I avoid it because the cost is too high.”
”When we retired we thought we would be able to travel. But dialysis has stopped that.”
”That’s really hard, not just for me but for my husband.”
Andersson KE, Naumann PE. Malmö University Hospital 2006
Schematic presentation on how a dysregulated nutrient intake may promote insulin resistance and metabolic inflammation.
Peter Stenvinkel Nephrol. Dial. Transplant. 2015;30:1656-1664
© The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
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PROBIOTICS IN DIALYSIS PATIENTSDunn SR et al Int. Dairy Journal 1998;8:545‐553
Previous studies have shown in dialysis patients
1. A deficient microflora
2. Oral non‐absorbable antibiotics reduces toxins such as dimethylamine (DMA) & nitrosodimethylamine (NDMA).
Two strains Lb Acidophilus (NCFMTM, BG2F04) supplied twice daily in 19 patients in a dose of 109 did significantly decrease:
‐ DMA/s from 282+91 to 163+82 µg dL~1 (P=0.001)
‐ Blood NDMA decreased in 7/19 patients (P"0.0053) by an average of 46%, from 236+69 to 118+38 ng kg~1 of blood.
‐ Body weight and caloric intake) improved n 6/19 from 49.8+3.8 to 51.4+3.8 kg (P=0.05)
‐ Caloric intake increased in In 6/19 patients from 27.9+3.7 to 32.4+8.2 kcal kg~1 of body weight resp. (P=0.05)
SYNBIOTICS IN DIALYSIS PATIENTS – a pilot studyRossi M et al Clin J Am Soc Nephrol 2016;11:223‐231
A daily dose of 15 grams of prebiotics: inulin, fructo‐oligosaccarides (FOS) & galacto‐oligosaccarides (GOS), + 9 x 10 billion of nine different strains of Lactobacillus, Bifidobacteria and Streptococcus genus supplemented during a 6 week in a crossover study in 37 patients.
A decrease in serum p‐cresylsulfate (PCS) &
favorable modification of the stool microbiome observed.
Large‐scale clinical trials are justified.
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 %
FAT UTILIZATION 72 HRSSoeters P et al Am J Physiol Endocrinal Metab 2012;303:E1397‐1407
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
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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
POSTPRANDIAL INFLAMMATION & ENDOTOXEMIAErridge C et al Am J Clin Nutr 2007;86:1286 –1292
VINEGAR & POSTPRANDIAL METABOLISMMitrou P et al Eur J Clin Nutr 2015;69:734‐739
ÂCONTENT
FOOD
&
HEALTH
AMOUNT TIME
HEALTH & CIRCADIAN RYTMFroy O Physiology 2011;26:225‐235
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BENEFITS OF DIURNAL FASTING• Reduces oxidative stress
• Boosts mitochondrial energy efficiency
• Normalizes ghrelin "the hunger hormone“
• Normalizes fat, sugar and protein metabolism
• Normalizes espec insulin and leptin sensitivity
• 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
MICROBIOTA, METABOLISM & DIURNAL RHYTMThaiss CA et al Cell. 2014;159:514‐529
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
DAILY FASTING REDUCES OBESITY & IMPROVES HEALTH
Hatori M et al Cell Metabolism 2012;15: 848‐860
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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?
SonnenburgJustin & Erica
The Good Gut‐ Your weight‐ Your mood‐ Your health
FOUR PRINCIPLES FOR WELLBEING1. Honour 12 Health Commandments
2. Daily intake of Antiinflammatory Spice Cocktail
3. Daily gut reconditioning with Synbiotics –mixture of antiinflammatory beneficialbacteria and bioactive fibres – chosen för their ability to control inflammation
4. Daily practice of fasting for regeneration, healing, detoxification etc – the so called6/18 principle or ”Skipping breakfast”
1. Begränsa/ta bort socker och sockerlikt: bröd, pizza, pasta, kokt ris, kokta rotfrukteri/ur kosten.
2. Begränsa intaget av fruktsocker främst genom att utesluta kolsyrade drycker – läsk.3. Begränsa/ta bort mejerivaror ut kosten.4. Begränsa köttintag till mest vild fisk, och vilt. Undvik gris och begränsa nöt till
högst 300 gr per vecka. 5. Begränsa/ta bort ur kosten all mat som någonsin blivit upphettad över 100
grader.6. Begränsa expositionen för bakteriegiftet endotoxin och omvärldsgifter/pesticider
finns också i t.ex. damm.7. Begränsa expositionen för läkemedel.8. Ta så långt möjligt bort inflammationsframkallande proteiner som kasein
(mejerivaror), gluten (vete, råg och korn) och zein (majs) ur kosten.9. Låt majoriteten av din kost vara färska råa grönsaker och fruktermed låg
sockerhalt, men gärna högre fetthalt, färska eller torkade kryddor och teer somsätter ner inflammation (olivte, yerba mate‐te och grönt te)
10.Ät rikligt med växtprotein/fiber/antioxidant‐rik föda: sädeskorn, fröer, ärtor, bönor, linser, mandel och nötter. & fetter med kortare kedjelängder speciellt kokosoch avokadofetter..
11.Tillför rikligt av vitamin D, omega‐fett, gurkmeja och probiotika –anti‐inflammationens fyra hörnpelare.
12.Praktisera om möjligt dygnsfastamellan kl 18 och kl 12 nästa dag.
2016-04-03
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