IBD and Diet, the Role of Foods, and Genetics

A recent article in Medscape (Expert Rev Clin Immunol. 2013;9(8):735-747.) looked at the role of foods in the management of IBD. The author Lynette Ferguson summarised some of the key areas, and this summary is a synopsis of her paper.

Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease, which are both inflammatory disorders of the gastrointestinal tract. Both types of inflammatory bowel disease have a complex aetiology, resulting from a genetically determined susceptibility interacting with environmental factors, including the diet and gut microbiota. Genome Wide Association Studies have implicated more than 160 single-nucleotide polymorphisms in disease susceptibility. Consideration of the different pathways suggested to be involved implies that specific dietary interventions are likely to be appropriate, dependent upon the nature of the genes involved. Epigenetics and the gut microbiota are also responsive to dietary interventions. Nutrigenetics may lead to personalized nutrition for disease prevention and treatment, while nutrigenomics may help to understand the nature of the disease and individual response to nutrients.

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Probiotics Reduce Hepatic Encephalopathy Risk by 50%

At the International Liver Congress 2013: 48th Annual Meeting of the European Association for the Study of the Liver (EASL). An abstract was presented exploring the role of probiotics in the reduction of risk for development of hepatic encephalopathy Abstract 78. Presented April 26, 2013.

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Thyroid Health Requires Nutrient Sufficiency

When a patient or client presents with thyroid challenges, it is worth remembering that the thyroid is a dynamically affected tissue which means that it may spontaneously revert to normal. The natural history of sub-clinical hypothyroidism is variable; thyroid function normalises spontaneously in some subjects, whereas it progresses to overt hypothyroidism in others[1],[2]

The clinical evidence is clear that prior to offering thyroid replacement, identifying underlying triggers for thyroid dysfunction is a must.

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In Utero Exposures and Future Medical and Ideological Risks

The fact we are not ill more often is due to the remarkable capacity our bodies have to revert to a state of ‘homeostasis’ – a somewhat dull word provided by Walter Cannon in the early 20th century to summarise the work of the physiologist Claude Bernard who was based in Paris in the 1850s. It has dominated biology, physiology and medicine ever since. Homeostasis is regularly used to describe the exquisite intrinsic ability we possess to respond to, counteract and adapt to external and internal sources of damage and disturbance to maintain health/function in us and other living organisms.

A more contemporary – albeit controversial term to describe this is: ‘Homeodynamics’.[1] This is the concept that we are not static but constantly adapting. Homeodynamics, accounts for the fact that the internal milieu of complex biological systems is not permanently fixed, is not at equilibrium, and is subject to dynamic regulation and interaction among various levels of organisation. Aging, senescence and death are the final manifestations of unsuccessful homeodynamics and in utero exposure represents the first opportunity and experience  for remodelling and constant adaptation.

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Mechanism of Fatty Acids Anti Inflammatory Effects – Explained?

Most Nutritional Therapists are comfortable in the concept and application of concentrated essential fatty acids especially fish oils as a means of altering abnormal inflammatory pathways in the body. Some EFA’s are perceived to be anti-inflammatory and others pro-inflammatory. Whilst the simplistic dichotomy of interpretation (Omega 3 Anti/Omega 6 Pro) has kept many a student content that they have mastered the art of complex fatty acid biochemistry – the reality is that cell membranes operate in a state of competitive inhibition with fatty acids of all carbon chain lengths and their role is highly sophisticated and complementary.

So…the paper out in the journal Cell this month (Sept 2010) from the lab of Prof. Olefsky at the University of California is a really exciting addition to the extensive research available – in that it elegantly describes a key anti-inflammatory mechanism using a G-protein coupled receptor.[1]

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Dendritic Cells Aid Intestinal Homeostasis and Disease

Inside our gastrointestinal tract live a family of specialised cells, co-dependent on bacteria and nutrients to send a calming message to the mucosal tissues. They have a number of variations in their make up but they are vital in their role as diplomats, passing sensitive information across the borders to provide a long term peaceful mission and maintain oral tolerance. Essentially they induce either protective immunity to infectious agents or tolerance to innocuous antigens, including food and commensal bacteria. This recent article out in the Journal of Clinical Investigation explores the current understanding of how these cells contribute to health and illness.[1]

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Vegas, Pregnancy, Immunity and Allergy Prevention!

The saying is ‘what happens in Vegas stays in Vegas’, or if you are English ‘what happens in Blackpool….’ but the same cannot be said about what happens in utero, as increasing evidence supports the understanding that the maternal nutritional environment and early feeding affects the health of the foetus beyond infancy and into adulthood.[1],[2] An article in Nature’s Mucosal Immunology this month explores some of the key events in foetal and neonatal immune management.[3] It stimulated a revisit to the area of what to consider for parents to be and mums of young children when they ask ‘is there anything I can do to prevent or reduce the risk of allergy or atopy in my child’.

The first moments, weeks and months of life can determine the health outcomes of an individual over the duration of their lifetime and this knowledge represents a significant choice for prospective parents. Fortunately the remarkable adaptability of the immune and central nervous system means that there are numerous opportunities in the early years of life to positively influence health outcomes even if the early stages were less than optimal.

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Vitamin D Halves Asthma Hospitalisation Risk

There seems no end to the illnesses this secasteroid is capable of influencing, although it should be of no real surprise that Vit D deficiency is linked to the respiratory condition asthma. The reason….mucosal tissues such as those found in the lung are rich with immune receptors that are intimately tied into the Vit D receptor family. Vitamin D up regulates a specific gene that produces over 200 anti-microbial peptides, some of which work like a broad-spectrum antibiotic.

Because of its beneficial role in respiratory tract infections and immune system modulation, it has been hypothesised that vitamin D status might affect the risks for exacerbations.[1] This paper shows show that children with initial circulating vitamin D levels of 30 ng/mL or less (vitamin D insufficiency) have a 50% greater risk for severe exacerbation over the course of a 4-year clinical trial of asthma treatment than children with circulating vitamin D levels of 30 ng/mL or greater (vitamin D sufficiency) at the start of the trial.

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More Evidence to Support Vit D as an Anti Viral Compound

Last year I wrote a number of posts relating to mechanisms related to mucosal immune defences, in particular the innate immune defences and how we as Nutritional Therapists may advise our patients of evidence based strategies. This paper out in the open access journal Plos One adds further validity to the vitamin D recommendations I proposed.

Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections.[1]

This paper in PLOS Biology describes how almost 200 adults had their serum 25-hydroxyvitamin D levels measured, without knowing what was been investigated.

One hundred ninety-eight participants, 85 men and 113 women, with an age range of 20–88, were enrolled in the study.

The researcher found that people with fair skin, lean body mass and who supplemented with vitamin D had the highest levels of 25-hydroxyvitamin D. People who achieved 38ng/ml or higher 25-hydroxyvitamin D level had a remarkable 50% reduction in the risk of developing acute respiratory tract infections and a significant reduction in the number of days ill (p<0.0001).

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Is There A Rural/Urban Gradient In The Prevalence Of Eczema? A Systematic Review And What Can Be Done About It?

One in 10 schoolchildren in the western world suffers from eczema and even developing nations have also seen an increasing trend in the last few decades. There are many proposals to explain the increased incidence, one area of relevance is the environmental impact. Falling under the often misused ‘hygeine hypothesis’ title it has been proposed that there is a reflective difference in the gradient between rural and urban children. Implying the environmental impact on the developing immune system of children is different and therefore less protective in the urban setting.

This concept has now been studied in a recent article in the British Journal of Dermatology.[1] By conducting a Medline and Embase data base review studies that compared the incidence between the two environments were reviewed. Some 26 papers were assessed with 19 demonstrating a higher risk for eczema in an urbanised area, of these 11 were regarded as being statistically significant. A further 6 studies showed a lower risk of eczema in an urbanised area, of which just 1 was statistically significant.

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