Trilogy: Getting Ahead of the Doctor's Advice
January 25, 2021
Enough influential voices have been raised within the orthodox medical community ‚first from the research community and then from respected practicing physicians ‚to create momentum for recognition of the efficacy of at least a few dietary supplements. Multivitamins and minerals were first to gain acceptance. That was an easy choice for doctors to make. After all, the first vitamins were each associated with terrible deficiency diseases that could be cured by supplementing the diet with concentrated forms of the vitamins. Multivitamins/minerals were viewed as protection against and compensation for a poor diet. Omega-3 fish oils met stiffer resistance. Just two years ago, most cardiologists across the United States remained skeptical of their value to cardiovascular health despite more than 40 years of supportive research. But the consuming public was way ahead of them. Omega-3 fish oils surpassed multivitamins as the number one selling dietary supplement in the country a few years ago. If the doctors would not act, a populace fearful of cardiovascular disease would. More recently, the news has been peppered with stories describing new findings tying the gut microbiota to multiple issues of health and disease. Brain health, cardiovascular health, immunity, skeletal health, and, it seems, the state of each body system from our outer skin inward can be helped or hindered by the trillions of bacteria and other microbes in our digestive tract and all over our bodies. Probiotics, with their ability to alter the gut microbiome, have become the new darlings of health.
MULTIVITAMINSThe concept of healthful nutrition at the end of the 19th century recognized just the three macronutrients, fat, protein, and carbohydrate plus a vague group of micronutrients as minerals. All other nutrients remained hidden behind an opaque curtain of wonder. In the early 20th century, Casimir Funk referred to as yet unisolated micronutrients as ‚vitamines‚ (from vita = life, and amine = a nitrogenous substance essential for life). The term was accepted by the scientific community in 1912.1 The ‚e‚ at the end of ‚vitamine‚ was later removed when it was realized that vitamins need not contain nitrogenous amines. In the 1920s and early 1930s, Hungarian researcher Dr. Albert Szent-Gy∂rgyi worked to isolate the factor from citrus fruits that had been known for centuries to prevent scurvy. We now know it as vitamin C. At about the same time, a vitamin essential for calcium absorption and metabolism and prevention of the bone disease, rickets was discovered. It was vitamin D, with the identification of the structure of vitamin D2 occurring in 1932. Characterization of vitamin D3, the form made in skin exposed to ultraviolet light, did not occur until 1937. And the work goes on. Researchers frequently uncover new and important roles for well-known nutrients. Consider Vitamin D. New information tells how vitamin D improves immunity, underpins healthy pregnancy, inhibits cell proliferation while stimulating cell differentiation, controls appropriate and healthful insulin secretion, helps control blood pressure, sustains muscle strength, and, of course, supports a healthy skeleton resistant to osteoporosis and osteomalacia,2 and helps prevent and treat Multiple Sclerosis,3 reducing relapses by 50% to 70%.4 The desire to protect patients from frightening vitamin deficiencies and preserve their health led physicians to accept the value of multivitamins as dietary supplements. Major marketers took note of the science and followed suit with the introduction of the vast arrays of multivitamin/ mineral formulas.
OMEGA-THREE FATTY ACIDSThe pre-agricultural diet of our huntergatherer ancestors was varied, providing calories dense with micronutrients. It was higher in fiber, with abundant fruits and vegetables, and heavily infused with lean, wild meat, fish, poultry, nuts, and seeds. This evolutionary diet was lower in total fat and saturated fat but contained significantly more omega-3 versus omega-6 polyunsaturated fatty acids (PUFAs) than today. The primary forms of omega-3 fatty acids were EPA and DHA from wild meats. The ratio of omega-6 fatty acids to omega-3 fatty acids from plant and animal foods is estimated to have been 2:1 in Paleolithic days and may have reached 1:1 in the coastal dwelling clans where seafood was consumed. Modern dietary habits drag us far away from the ideal 2:1, or 1:1, ratios of omega-6 to omega-3 fatty acids. Ratios today range from 10:1 up to 20:1 or 25:1 depending on one‚s diet, leaving us deficient in omega-3 fatty acids compared to the diet upon which humans‚ genes and biochemistry were established. Farm-raised meats from animals fed grains bring us elevated levels of omega-6 fatty acids largely as arachidonic acid. When we fry foods in omega-6 rich vegetable oils, or use vegetable oils in salad dressings and in mayonnaise, or put them in baked goods (e.g. pies, cakes, crackers, and muffins), we end up feeding ourselves large quantities of omega-6 linoleic acid. Omega-3 and omega-6 fatty acids are important components of cell membranes. They are converted by cells into significantly different chemically active substances. The fatty acids influence eicosanoid metabolism, gene expression, inflammation, cell-to-cell communication, and, most significantly, cardiovascular health and the risk of death from heart attack. A dietary balance of omega-6 to omega-3 is essential for normal growth and maturation, as is an adequate intake of the element zinc. For example, the omega-3 fatty acid, docosahexaenoic acid (DHA) is needed for the normal, full development of the brain, and of the retina of the eye, particularly in premature infants.
HOW MUCH DO I NEED?Analyses of Paleolithic diets indicate that our progenitors were exposed to, and adapted to, a daily intake of 4.17 grams of EPA and DHA. Keep this number in mind. Coastal Japanese who consume large quantities of seafood take in about 5 or 6 g of EPA and have a very low incidence of cardiovascular disease. Controlled human trials have shown that 1.8 to 3.6 g per day can greatly improve blood chemistry and lower the risk of cardiac events, so we can see that the coastal Japanese are well protected. But dietary analyses of populations in Europe and the US reveal daily intakes of omega-6 fatty acids ranging from a low of 5 g up to 17 g per day. If the ideal target is a 2:1 ratio, which is not only healthful but also reflects the Paleolithic ratio, then 2.5 g to 8.5 g of EPA would be required each day. These figures surround the 4.17 grams calculated above, 2.75 or 3 grams of which were probably EPA.
HEALTHY HABITSEating less meat, using eggs from freerange chickens, replacing red meat with seafood, and increasing fresh vegetable consumption will reduce the intake of omega-6s and boost the intake of omega-3s. Eliminating vegetable oils other than olive oil and coconut oil from baking and cooking practices will drop omega-6 intake. These easily adopted dietary modifications will enhance the beneficial impact of any omega-3 fatty acids in the diet although they will probably not drive one‚s fatty acid balance to the ideal 2:1 ratio. Supplementation becomes necessary. Coupling the dietary recommendations above with an intake of 2 g of EPA from fish oil supplements should achieve the desired cardiovascular benefits. If you are unable to eschew pastries and just can‚t bear the thought of a summer barbecue without grilled steak, then your supplementation can be increased to balance the extra omega-6 fatty acids. Supplements totaling 4 or 5 g of EPA would be recommended. Modern high potency capsules make it easier to swallow supplemental dosages of 2 grams to 5 grams of omega-3s. Omega-3s have leapfrogged multivitamin/ mineral formulas to become the most popular dietary supplement sold today.
PROBIOTICSYou‚ve got to love all those bacteria cohabiting your digestive tract. They certainly love you! Just look at all the helpful little things they do, starting at the moment of birth.
Milk Digestion:Some of the bacteria that first inhabit babies‚ intestines are colonic Bifidobacteria. B. infantis, for example, is a dominant organism in breast milk that digests the milk‚s healthy sugars into metabolites that are essential for growth. B. catenulatum, B. adolescentis., B. longum, B. breve, and B. bifidum are also there, working away in infants as well as adults.5, 6, 7
Fiber Digestion:Certain bacteria ferment fiber, producing short-chain fatty acids (e.g. acetic acid, butyric acid) that serve as energy sources for cell growth of the intestinal wall.8 Bifidobacteria longum and infantis, Lactobacilli plantarum, paracasei, helvetica, rhamnosus, and acidophilus, as well as Streptococcus thermophilus, are key players.
Immune Support:Probiotic bacteria produce natural antibiotics that gain access to and interact with our cells, affecting the body‚s response to infection and reducing disease risk.9 Brain health: Gut microbes produce most neurotransmitters that can impact our stress responses, cognitive functioning, depression, autism,10 and Parkinson‚s disease.11
Body Weight Management:In health, metabolites of beneficial bacterial species may affect our metabolism by stimulating hormones and the endocannabinoid system. If these friendly species decline, leading to dysbiosis and deterioration of one‚s metabolic health, chronic low-grade inflammation may occur that triggers adiposity and insulin resistance.12 Certain probiotics may help reestablish a healthy microbiome that can aid weight loss.
- Lactobacillus gasseri may cause a significant loss of abdominal fat.13
- Lactobacillus plantarum is has a profound effect on body mass index while at the same time lowering blood pressure.14
- Lactobacillus paracasei reduces inflammation and alters the way we store fat.15
- Lactobacillus animalis, subspecies lactis reduces body fat and improves glucose tolerance.
GUT (COLON) HEALTHThe microbiome directly controls gut health and plays a role in the development or absence of intestinal disorders like diverticulitis, Crohn‚s disease, ulcerative colitis and other inflammatory bowel diseases characterized by bloating, cramps, abdominal pain, and, not too infrequently, blood in the stool. Expansive diversity and the abundance of healthy bacteria is key to gut health.
- Piro A, Tagarelli G, Lagonia P, Tagarelli A, Quattrone A., Casimir Funk: his discovery of the vitamins and their deficiency disorders. Ann Nutr Metab. 2010;57(2):85-8.
- Oregon State University, Linus Pauling Institute Micronutrient Information Center http://lpi.oregonstate. edu/mic/vitamins/vitamin-D
- Lucas RM, Byrne SN, Correale J, Ilschner S, Hart PH,Ultraviolet radiation, vitamin D and multiple sclerosis. Neurodegener Dis Manag. 2015 Oct;5(5):413-24.
- Pierrot-Deseilligny C, Souberbielle JC,Vitamin D and multiple sclerosis: An update. Mult Scler Relat Disord. 2017 May;14:35-45. doi: 10.1016/j.msard.2017.03.014.Epub 2017 Mar
- Silvia Arboleya, Claire Watkins, Catherine Stanton, and R. Paul Ross Gut Bifidobacteria Populations in Human Health and Aging, Front Microbiol. 2016; 7: 1204.
- Turroni F, Peano C, Pass DA, Foroni E, Severgnini M, Claesson MJ, Kerr C, Hourihane J, Murray D, Fuligni F, Gueimonde M, Margolles A, De Bellis G, O‚Toole PW, van Sinderen D, Marchesi JR, Ventura M. Diversity of bifidobacteria within the infant gut microbiota. PLoS One. 2012;7(5):e36957.
- A. Marcobal and J. L. Sonnenburg Human milk oligosaccharide consumption by intestinal microbiota Clin Microbiol Infect. 2012 Jul; 18(0 4): 12‚ì15.
- David R≠os-Covi°n, Patricia Ruas-Madiedo, Abelardo Margolles, Miguel Gueimonde, Clara G. de los Reyes-Gavil°n, and Nuria Salazar, Intestinal Short Chain Fatty Acids and their Link with Diet and Human Health, Front Microbiol. 2016; 7: 185.
- Rooks MG1, Garrett WS, Gut microbiota, metabolites and host immunity, Nat Rev Immunol. 2016 May 27;16(6):341-52.
- Dinan TG, Cryan JF. The Microbiome-Gut-Brain Axis in Health and Disease. Gastroenterol Clin North Am. 2017 Mar;46(1):77-89.
- Quigley EMM. Microbiota-Brain-Gut Axis and Neurodegenerative Diseases, Curr Neurol Neurosci Rep. 2017 Oct 17;17(12):94.
- Patterson E, Ryan PM, Cryan JF, Dinan TG, Ross RP, Fitzgerald GF, Stanton C. Gut microbiota, obesity and diabetes. Postgrad Med J. 2016 May;92(1087):286-300.
- Million M, Angelakis E, Paul M, Armougom F, Leibovici L, Raoult D., Comparative meta-analysis of the effect of Lactobacillus species on weight gain in humans and animals. Microb Pathog. 2012 Aug;53(2):100-8.
- Sharafetdinov KhKh, Plotnikova OA, Alekseeva RI, Sentsova TB, Kaganov BS.,
., Vopr Pitan. 2012;81(1):80-5.
- Aronsson L, Huang Y, Parini P, Korach-Andr© M, H•kansson J, Gustafsson JÖ, Pettersson S, Arulampalam V, Rafter J., Decreased fat storage by Lactobacillus paracasei is associated with increased levels of angiopoietin-like 4 protein (ANGPTL4), PLoS One. 2010 Sep 30;5(9). pii: e13087.