Marc Joseph Nutrition - Blog

The current issue of Discover Magazine includes a cover story (”Autism: It’s Not Just in the Head“) that is to-date likely the best, easy-to-understand overview of the latest biomedical understandings and treatments for autism:

A disparate group—immunologists, naturopaths, neuroscientists, and toxicologists—is turning up clues that are yielding novel strategies to help autistic patients. New studies are examining contributing factors ranging from vaccine reactions to atypical growth in the placenta, abnormal tissue in the gut, inflamed tissue in the brain, food allergies, and disturbed brain wave synchrony. Some clinicians are using genetic test results to recommend unconventional nutritional therapies, and others employ drugs to fight viruses and quell inflammation.

Above all, there is a new emphasis on the interaction between vulnerable genes and environmental triggers, along with a growing sense that low-dose, multiple toxic and infectious exposures may be a major contributing factor to autism and its related disorders. A vivid analogy is that genes load the gun, but environment pulls the trigger. “Like cancer, autism is a very complex disease,” says Craig Newschaffer, chairman of Epidemiology and Biostatistics at the Drexel University School of Public Health, “and it’s exciting to start asking questions about the interaction between genes and environment. There’s really a very rich array of potential exposure variables.”

“What we’ve got here is a far more comprehensive set of characteristics for autism,” says [Harvard pediatric neurologist Martha] Herbert, “one that can include behavior, cognition, sensorimotor, gut, immune, brain, and endocrine [hormone] abnormalities. These are ongoing problems, and they’re not confined just to the brain. I can’t think of it as a coincidence anymore that so many autistic kids have a history of food and airborne allergies, or 20 or 30 ear infections, or eczema, or chronic diarrhea.” …

Herbert likens autism to a hologram: “Everything that fascinates me is in it. It’s got epidemiology, toxicology, philosophy of science, biochemistry, genetics, systems theory, the collapse of the medical system, and the failure of managed care. Each child that walks through my door is a challenge to everything I ever knew, and each child forces me to think outside the box and between categories.” …

… All this marks a Copernican-scale shift in our approach to the disorder. I myself [the article’s author, Jill Neimark] was irresistibly drawn to the subject when viewing an online video of a heavily affected 11-year-old who, after a series of chelation treatments to remove mercury, announced to his mother, “Mom, I’m back from the living dead.” The statement was heartbreaking in its simple eloquence. Mercury chelation, in this particular child’s case, was a near panacea.

Why should you care?

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For a while now, non-fish sources of Omega-3 fat DHA (docosahexaenoic acid), such as the one produced from microalgae by Martek Biosciences, have been produced and incorporated into many consumer products, such as:

• Infant formulas
• Dairy products
• Nutrition bars
• Dietary supplements
• Etc.

To-date, though, there hasn’t been a non-fish source of EPA (eicosapentaenoic acid), the other primary Omega-3 fat shown to have important health benefits.

Recently, a UK company called Water4life introduced an algae-derived Omega-3 supplement that contains both DHA and EPA.

A couple of notes on it:

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In a study published in the journal Diabetes, researchers found that increased belly fat led to the production by fat cells of higher levels of inflammatory molecules that may directly promote systemic (whole body) inflammation. This increase in systemic inflammation may, in turn, raise the risk for several diseases, such as heart disease, diabetes, cancer, and cognitive decline.

There are two types of abdominal fat:

1. Subcutaneous fat - found just beneath the surface of the skin (the fat you can “pinch”)
2. Visceral fat - found in the spaces between internal organs

(Image: LA Times)

Visceral fat appears to be the primary source of the problem:

[T]he research team says visceral fat likely contributes to increases in systemic inflammation and insulin resistance. They sampled blood from the portal vein [which routes blood to the liver from the gastrointestinal tract] in obese patients undergoing gastric bypass surgery and found that visceral fat in the abdomen was secreting high levels of an important inflammatory molecule called interleukin-6 (IL-6) into portal vein blood.

“The portal vein is filled with blood that drains visceral fat,” says first author Luigi Fontana, M.D., Ph.D., assistant professor of medicine at Washington University in St. Louis and an investigator at the Istituto Superiore di Sanita, Rome, Italy. “Portal vein blood had levels of IL-6 that were 50 percent higher than blood from the periphery.”

Increased IL-6 levels in the portal vein correlated with concentrations of an inflammatory substance called C-reactive protein (CRP) in the body. High CRP levels are related to inflammation, and chronic inflammation is associated with insulin resistance, hypertension, type 2 diabetes and atherosclerosis, among other things …

… “Many years ago, atherosclerosis was thought to be related to lipids and to the excessive deposit of cholesterol in the arteries,” Fontana says. “Nowadays, it’s clear that atherosclerosis is an inflammatory disease. There also is evidence that inflammation plays a role in cancer, and there is even evidence that it plays a role in aging. Someday we may learn that visceral fat is involved in those things, too.”

Evidence Building

This latest study is one of many to highlight the influence of excess fat on systemic inflammation and disease risk. Here are links to a few other studies:

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Last week, I wrote about the potential risks of exposure to the estrogenic chemical, bisphenol-A.

Another class of chemicals that may have negative health effects is phthalates, which are used in plastic packaging, cosmetics, shampoos, soaps, lotions, lubricants, paints, and pesticides. Phthalates are also commonly used as a softener for products made using PVC (polyvinylchloride) and as a key ingredient in fragrances. One kind of phthalate helps prevent the fragrance in perfumes, lotions, shampoos, make-up, nail polish and hair sprays from degrading.

Research has shown that phthalates impair testicular function in rats and are linked to abnormal sperm counts and anti-androgenic effects in humans, such as decreased testosterone levels. In recent years, a significant population-wide decline in testosterone levels has been observed in American men. More than 75% of the US population has measureable levels of several phthalates in the blood.

Latest Research

A study (full-text PDF) published in the latest issue of Environmental Health Perspectives further explored the potential negative effects of phthalates. Researchers found that adult males with the highest urinary levels of several different phthalates were more likely to be insulin resistant and obese.

Study Limitations

The study’s authors note that:

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Methylation, the donation of methyl (CH3) molecules, is a primary mechanism by which genes in a cell’s DNA are turned off. Lack of methyl groups or removal of methyl groups (demethylation) causes genes to remain or become activated.

In a process called epigenetics, cells also use methylation to specialize later in development without relying upon the instructions contained in the cell’s DNA. This type of specialization is especially vulnerable to environmental factors, such as nutritional deficiencies and exposure to toxins.

In a recent study published in the journal Neuron, researchers suggest that this type of epigenetic methylation may be key in forming memories.

In their experiments, the researchers conditioned fearful memories in rats by giving the animals mild shocks when they were in a specific training chamber. The researchers could then test whether the rats remembered the conditioning by observing whether they froze when placed in the chamber.

Using drugs that inhibit methylation, the researchers showed that methylation was necessary for rats to form such memories. Particularly importantly, the researchers found that the level of methylation directly controlled the activity of genes known to either suppress or promote memory formation. The memory suppressor gene they studied is called protein phosphatase 1, and the memory-promoting gene is called reelin.

“To our knowledge, this study is the first to present evidence that DNA methylation, once thought to be a static process after cellular differentiation, is not only dynamically regulated in the adult nervous system but also plays an integral role in memory formation,” concluded Miller and Sweatt. They wrote that their findings indicate that DNA methylation has been co-opted by the central nervous system as a “crucial step” in regulating gene activity involved in memory formation.

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Environmental advocacy agency, Environment California (EC), just issued an interesting report titled, “Toxic Baby Bottles,” on the potential health risks of bisphenol-A released from common polycarbonate plastic baby bottles:

Press Release

Executive Summary

Report (PDF)

EC found that five of the leading plastic baby bottles leached bisphenol-A at levels greater than those shown to cause harm in several animal studies.

Bisphenol-A is an estrogen-mimicking chemical and a widespread environmental contaminant. From the press release above:

The U.S. Centers for Disease Control and Prevention found bisphenol A in the urine of over 95% of people they tested. Alarmingly, the median level of bisphenol A found in humans is higher than the level that causes adverse health effects in animal studies.

Sources

Bisphenol-A is commonly used to make clear polycarbonate plastic for baby bottles and is also found in:

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Adding to a growing body of evidence that links Omega-3 fatty acid intake with healthy bone growth, a study just out in the American Journal of Clinical Nutrition (AJCN) found that healthy teenage boys with higher serum levels of Omega-3 fatty acids, especially DHA (docosahexanoic acid), had significantly greater bone mineral density accrual between the ages of 16 and 22.

This result is important, as bone growth during the teenage years is key to building a high peak bone mass that may reduce the risk of developing osteoporosis later in life.

In a related earlier study published in the AJCN, researchers found that among older adults age 45 to 90, a higher ratio of Omega-6 to Omega-3 fatty acid intake was associated with a significantly lower bone mass density at the hip.

Omega-3 fats EPA and DHA are found primarily in fish oil, while the main sources for Omega-6 fats in the diet are vegetable oils (corn, soybean, sunflower, safflower). Most people eat far too much Omega-6 fats relative to Omega-3 fats. The estimated ratio in Western diets is 15:1, whereas a ratio between 1:1 to 4:1 is believed to be optimal.

How Fat Intake Affects Bone Growth

The exact mechanism for how higher levels of Omega-3 fats and/or a lower Omega-6/Omega-3 fat intake ratio may assist bone growth is not yet entirely understood. However, an accompanying editorial to this month’s study in the AJCN, makes some interesting observations:

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Garlic is a plant with many potential medicinal benefits, including:

• Cardiovascular effects
• • Reduction of mildly elevated cholesterol and triglyceride levels
  • Decreased oxidation of LDL cholesterol (antioxidant)
  • Improved arterial elasticity
  • Reduced platelet stickiness & increased fibrinolytic (anti-clotting) activity
• Anti-microbial actions
• • Anti-bacterial/yeast/viral
• Anti-cancer effects
• • Reduced risk for developing several types of cancer, including colon, stomach, & esophageal

However, as this recent paper notes, for best results it’s important to:

1. Crush the garlic and allow it to sit for a few minutes before adding it to a cooked dish. With crushing, alliin, the sulfur-containing amino acid in garlic, comes in contact with the enzyme alliinase, which converts alliin to allicin. Allicin and related sulfur compounds (thiosulfinates) are believed to be the primary compounds responsible for garlic’s healthy effects.
2. Only cook the garlic for a brief period of time at moderate heat or lower once it’s added to the dish. The paper’s authors noted that garlic’s anti-platelet strength was preserved in both crushed and uncrushed garlic samples when they were cooked at under 400 degrees F for less than 3 minutes. Whereas cooking for 6 minutes reduced the anti-platelet effect in the crushed garlic and completely suppressed it in the uncrushed sample. Cooking for 10 minutes completely inhibited the anti-platelet effect in both samples.

Garlic prepared and eaten as above is preferred. Garlic supplements with standardized allicin content are an ok second choice. However, since a garlicky taste* can sometimes even be noticed with deodorized supplements, and supplements likely can’t replicate all of the potentially beneficial compounds found in raw garlic, this is a case where I’d definitely go with the food.

* Parsley eaten with or after a meal can help to blunt garlic odor.

Regular and moderate garlic intake (e.g., 1 to 2 cloves per day) may be a useful part of an overall program for maintaining a healthy heart.

Note: Because of garlic’s anti-clotting effects, people taking anticoagulant (blood-thinning) drugs, such as Coumadin or aspirin, should work with their physician or nutritionist to determine if garlic use is safe and appropriate.

$50 trillion. That’s the Government Accountability Office’s (GAO) estimated present value of the financial promises the federal government has made over the next 75 years. Medicare obligations represent more than $32 trillion of that amount, and have increased more than three-fold since 2000.

Now the scary part: We don’t have anywhere near the expected revenues to pay for those promises.

Why should you care?

Well, if you’re currently receiving or will soon qualify for Medicare, there will likely need to be significant reductions in the benefits offered to keep the program from going bankrupt.

And if you’re younger, there are several big reasons why you should care:

1. Your parents’ Medicare benefits will likely be reduced, and that, in turn, may directly affect their out-of-pocket costs and potential dependency on you to help pay for them.
2. Your taxes will likely be raised to keep Medicare solvent.
3. The level of Medicare benefits available today most certainly will not be available to future generations.

What You Need to Know

The GAO, the U.S. government’s accountant and investigative agency, is currently led by David Walker, comptroller general. Over the last year, Walker, his colleagues, and representatives from both conservative and progressive think-tanks have been touring the country as part of a Fiscal Wake-Up Tour, in an effort to alert this country’s citizens to the impending crisis.

This past Sunday, Walker took his compelling message to CBS News’ 60 Minutes:

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Last Fall, I posted on a study that looked at vitamin D deficiency among pregnant women in Northern Europe:

Vitamin D Deficiency During Pregnancy

And now, a new North American study has been released that both confirms and heightens the need for concern regarding vitamin D levels in both pregnant women and their newborns.

In this latest study published in the Journal of Nutrition, researchers looked at vitamin D levels in both black and white women and their newborns in Pittsburgh, PA. Over 90 percent of the women took prenatal vitamins during pregnancy.

What the researchers found was simply amazing:

• More than 83 percent of black women and 47 percent of white women had insufficient or deficient levels* of vitamin D at delivery.
• More than 92 percent of black newborns and 66 percent of white newborns had insufficient or deficient levels* of vitamin D at delivery.

* In this study, deficiency and insufficiency levels were defined as <37.5 nmol/L and 37.5 to 80 nmol/L, respectively. 80 nmol/L is recognized by most leading vitamin D researchers as a minimum level of sufficiency, with higher levels (e.g., 110 to 125 nmol/L) likely being more optimal.

Clearly, the current vitamin D intake recommendation for pregnant women (600 IU/day) is not adequate. Remember, nearly all of the mothers in this study were also taking prenatal supplements.

The results of this study give even more urgency to the call earlier this year for an increase in the vitamin D upper-limit (UL) recommendation.

Bottom line

Mothers and their newborns in Northern latitudes are at significant risk for vitamin D deficiency. Sunshine (UVB rays) hitting the skin is the primary source of vitamin D. And with many adults in sunnier climates diligently avoiding the sun and using high-number sunscreens, even mothers living in Southern latitudes are potentially at risk for deficiency.

As discussed here, adequate daily intake levels may be at least 2,000 IU/day, and possibly higher, for individuals not getting regular, limited sun exposure.

Ideally, you want to target a vitamin D (25-hydroxyvitamin D) blood level toward the high-end of the sufficiency range (45 to 50 ng/mL or 112 to 125 nmol/L).

Vitamin D isn’t just important for pregnant women and their children. It’s also key in helping to reduce the risk of:

• Several types of cancer (colon, breast, pancreatic, prostate, ovarian, etc.)
• Multiple sclerosis
• Influenza
• Nursing home admission
• And more …

Vitamin D is one nutrient in which you definitely don’t want to be deficient.