Mind-Body Balance: The Science of Allostasis

Lecture by Mark Pettus transcribed by Carolann Patterson

lostandfound

Direct your eye inward and you’ll find a thousand regions in your mind yet undiscovered.  Travel them and be expert in home-cosmography.” - Henry David Thoreau

Learning objectives for this lecture are to:

  • Review the concepts of allostasis and allostatic load.
  • Connect the burden of allostatic load with a biologic basis for chronic complex medical disease.
  • Review strategies for reducing allostatic load, reducing disease risk, and promoting health.

al·lo·sta·sisˌ aləˈstāsis/noun. 1. the process by which the body responds to stressors in order to regain homeostasis.

Allostatic Load and Health

Our brain weighs 3 pounds and contains trillions of neurons and wired connections. Our brain is the interpreter of all environmental inputs in our lives. The brain is not geared toward accuracy. It is geared toward SURVIVAL…and sometimes, it doesn’t interpret signals in the right way….

1 out of 2 Americans currently has a chronic complex disease. 1 out of 4 has a meaningful disruption in their lives. This is the result of The Contemporary Convergence, where the Gene-Epigenome + Environment + Microbiome = Outcome, an outcome that is equal to how the outside gets inside us. The outcome sends clear signals that Health is not just a matter of DNA...

TimecoverJan2010

The science of epigenetics reveals how the choices we make can change our genes – and those of our kids [John Cloud, Time magazine January, 2010].

Allostasis is the ability to achieve stability through CHANGE... Your DNA is therefore not your destiny.

Health is a byproduct of gene-environmental compatibility and so it follows: 

Change Your Life:Change your Genes.

An Ancient Design in Modern Times: 

The social and cultural context in which we live has moved forward at lightning speed into the 21st century.  Our genetic endowment and the survival edge it brings with it are still Primitive.  Our design has maintained many of the Stone Age imperatives, but life in the fast lane has not. We are not well adapted for this and we will eventually break down. 

Here's how things have shifted from Ancient to Modern: 

  • THEN: Targeted fight-flight [quick turn off and on]
  • NOW: Anxiety, fear, PTSD, depression, all chronic, complex diseases [always on]
  • THEN: Energy Conservation [quick turn off and on]
  • NOW: Obesity and Metabolic Syndrome [does not turn off, we are always saving for a rainy day that will never come]
  • THEN: Immunity [quick turn off and on]
  • NOW: Autoimmunity and allergy [constant hyper-vigilant state]
  • THEN: Promotion of clotting
  • NOW: Heart attack and stroke [hyper-vigilant clotting]

Three great Nobel-prize-worthy researchers in the field of Mind-Body Science:       

Richard Davidson PhD, Director, Waisman Lab Neurosciences, University of Wisconsin Medical School; Bruce S. McEwen, PhD, Alfred E. Mirsky Professor, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University; and Robert Sapolsky PhD, John A. and Cynthia Fry Gunn Professor of Neuroscience and Primatology, Stanford University

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Primal Neurobiological Systems are deeply rooted, well adapted systems that are aligned throughout our body:

  • Fight-Flight - [or the “stress response” as identified by Bruce McEwen]. We might not even know when it is engaged or we might sense gut discomfort or shortness of breath, but there are always high levels of reasoning behind being hi-jacked.
  • Reward Response – Dopamine is our body’s reward transmitter. We receive health promoting rewards through Love, Exercise, and Mental Engagement. Equally, non-health promoting reward responses are promoted through Drug Use, Alcohol, and Sugar. It is possible to recreate a healthy reward system, by changing an unhealthy one.
  • Attachment or Bonding – we are born to bond. Babies take longer to develop and the greater the bonding, the greater the chance for survival. More attachment leads to more dopamine. There is a specie tendency to be drawn in by others, but social connectivity can disrupt as much as it can heal.

An increased allostatic load yields poor health outcomes - a sudden overload of stress can create a life-threatening health crisis. Too much stress over time can also create life-threatening situations. Cardiovascular disease and depression are the top two causes of disability in the industrialized world. As many as 5 percent of Americans are experiencing symptoms of depression at any point in time. High levels of cortisol are known to decrease serotonin receptors in our pre-frontal cortex. Decreased serotonin activity in the brain is central to the feelings of despair and depression.

The Stress Response: CRH [Corticotropin Releasing Hormone] stimulates release of the adrenal corticotropic hormone [ACTH] from the pituitary gland. ACTH travels in the blood to the adrenal glands which then produce the hormone cortisol. Powerful boosts of cortisol and adrenaline inhibit higher levels of conscious thinking and increase hyper-focus on a very specific target of concern.

The Stress Response: CRH [Corticotropin Releasing Hormone] stimulates release of the adrenal corticotropic hormone [ACTH] from the pituitary gland. ACTH travels in the blood to the adrenal glands which then produce the hormone cortisol. Powerful boosts of cortisol and adrenaline inhibit higher levels of conscious thinking and increase hyper-focus on a very specific target of concern.

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Thoughts [being "lost at sea"]Behaviors [away from healthy choices]Emotions and Feelings [fear, sadness, anxiety] are all manifestations of fight:flight that increase blood pressure, insulin, sugar, and a fatty mid-section, while decreasing memory and resilience.  

We are also driven by another neurobiological system - the reward-motivation response. It is hard getting through life without the experiences that inspire, motivate and reward us with meaning and feelings of optimism, hope and joy.  Resilient individuals have cultivated a reward system that is resistant to setbacks, sometimes catastrophic or chronic. Life's difficulties do not diminish their capacity to experience positive emotions. Individuals whose reward response is dampened are less likely to experience pleasure in their lives and are more prone to states of anxiety and depression. They are less resilient.

Neurotransmitters associated with the reward response include dopamine, glutamate, GABA [Gamma Amino Butyric Acid which facilitates a calming effect]. At this point, it's important to note that a behavior that elicits a reward response is not always health-promoting. Dopamine, for example, rewards carbohydrate binging as much as it does exercise.

The reward response, just like the fight:flight response can drive behaviors that bypass or diminish input from the pre-frontal cortex, which is responsible for reasoning, judgement, and emotional control.

Stressful environments are hard to over-ride, but if we change our patterns of behavior, the brain has plasticity and can learn new tricks to conform with new behavior...

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Now that we know the good news - that a brain CAN learn new tricks because it has plasticity and is able to morph. The Science of Mind further demonstrates that the brain is designed for adaptation at any time in life.  

Up your Game: Change your Brain - Brain Derived Neurotrophic Factor [BDNF] aka a healthy "Miracle Grow" is decreased in Depression, Alzheimer's, Epilepsy, Schizophrenia and OCD. A healthy increase in BDNF comes with Exercise, Caloric restriction combined with plant-based nutrition, Coffee [and other phytonutrients], DHA-omega 3, Curcumin-turmeric, EGCG [green tea], Meditation, Reduction in gut permeability. 

Fight-Flight and the Sympathetic Tone? Get “Para” as much as you can...

Many age-related diseases come as a consequence of over-stimulation of our sympathetic nervous system, e.g. fight-flight. We have within us a built-in system to counter this response: the parasympathetic system. Turned on by meditation and relaxation techniques, this system has a calming and protective effect of decreasing heart rate, reducing brain distraction and anxiety-provoking neurotransmitters while improving metabolism. Cultivating behaviors that enhance parasympathetic tone – meditation, positive relationships, mindfulness, or listening to a beautiful piece of classical music – will serve as potent antidotes to sympathetic overdrive.

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Medical evidence linking meditation with many positive health outcomes is unequivocal.

The Buddhist practice to displace a negative mindset and cultivate a positive mindset is an excellent health promoting strategy.  

Evidence links positive emotional states/traits with better health outcomes.

Mind Body Stress Relief [MBSR] leads to a Reduction in Inflammatory Biomarkers. Emotional wellness increases. Inflammatory gene expression patterns down regulates; NF-kappa B * - the master switch of inflammation - gets turned off; and C-reactive protein is reduced. 

NF-κB - keep it turned off... 

NF-κB is a nuclear transcription factor that is triggered by diet, stress, environmental toxins, visceral fat, infections, intestinal barrier integrity disruption, oxidized LDL, free radicals, vitamin D deficiency, altered microbiome, LPS, inflammation from other sources. It up-regulates expression of 400+ genes involved with cytokine production, cell proliferation, apoptosis, angiogenesis. Exercise, meditation, Vitamin D, Spices [e.g. turmeric] and many plant flavonoids have shown to inhibit NF-κB in vitro and in vivo. Nrf2 is the antidote to NF-κB

Nrf2 - keep it turned on. Activation of Nrf2 is a critical intracellular defense:  Exercise, Meditation, EGCG, Resveratrol, Coffee, Sulfurophane, Curcumin all boost Nrf2

Mindfulness does a body good - Contrary to popular misconception...Mindfulness does not need to be carried out in a silent sanctuary with incense burning and soft background recordings of babbling brooks.

Mindfulness practices - meditation, prayer, yoga, relaxation response, guided imagery, biofeedback, and gratitude journals - are not deliberate attempts to detach from the busy world around us. They are the opposite, intentionally heightening awareness of each and every passing moment. 

The health benefits of mindfulness include: decreased cortisol, fight:flight response and blood pressure; increased parasympathetic tone [the antidote to stress]; improved mood, concentration, pain tolerance, and resilience; decreased cardiovascular risk; and enhancedneuro-plasticity .

Motion is the Lotion - Activity and Movement neutralizes the fight:flight response. Muscle acts as a metabolic engine to decrease insulin resistance, drop cortisol levels and increase endorphins and dopamine. Movement enhances strength, resilience, balance, concentration and mood. It also decreases inflammation, cardiovascular, diabetes and cancer risk and profoundly enhances longevity and quality of life. 

Meaning-Maker - Create meaning in your work, love and play. Meaning cannot be willed. It comes from Experience, Discovery, and Awareness. Meaning comes from a healthy reward response, bonding and social attachment, and the parasympathetic tone that diminishes fear and fight:flight mode.

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For more "news to use" from Dr. Pettus and the science to go with it, visit The Health Edge: Translating the Science of Self-Care. Not all research slides are shown in this article. To download complete lecture, follow this link to BHS Creating Health Wellness Series.

ENVIRONMENTAL TOXINS: What CAN we do about them?

Lecture by Mark Pettus transcribed by Carolann Patterson

ENVIRONMENTAL TOXINS: How do they get inside of us; what do they do to us; and how can we undo the damage they cause?

Learning objectives for this lecture will be to

i. Review some common sources of environmental toxins that pervade daily living.

ii. Examine how the growing burden of environmental toxic exposure affects health and quality of life.

iii. Examine lifestyle, behavioral, and supplement strategies that can reduce our toxic burden and optimize our capacity for detoxification.

The Precautionary Principle

We as physicians must act on facts…and on the most accurate interpretation of them, using the best scientific information.  That does not mean that we must sit back until we have 100% evidence about everything. When the state of the health of the people is at stake…we should be prepared to take action to diminish those risks even when the scientific knowledge is not conclusive” Horton. Lancet. 1998;352(9124):251

America does not apply The Precautionary Principle as do other parts of the world - especially in Europe and Canada. In America, THOUSANDS of chemicals are permitted to be used in food and countless other products until proven 100% unsafe and dangerous. Other countries approach it from the opposite angle: when a chemical is proven 100% safe it is then permitted to be used. If it happens that it is already in the system and considered to be unsafe it is more readily removed than would be the case in the US.  

Exposure to environmental toxins

Since WWII, more than 85,000 new synthetic chemicals have been released into the environment. As a species we are exposed to 6 million lbs mercury and 2.5 billion lbs of other toxic chemicals each year. Most have not been tested for potential toxicity in adults [few in children]. Over 4 billion lbs of pesticides are used annually in the US. Current law allows 350 pesticides to be used on the foods we eat. The average home contains 3-10 gallons of hazardous materials. Traces > 280 synthetic chemicals can be found in the average newborn.

Our Toxic Load is being passed on

The Environmental Working Group commissioned five laboratories in the U.S., Canada, and Europe to analyze umbilical cord blood collected from 10 minority infants born in 2007 and 2008. Collectively, the laboratories identified up to 232 industrial compounds and pollutants in these babies, finding complex mixtures of compounds in each infant. This research was the first ever to detect BPA in US cord blood as found in 9 out of 10 cord blood samples. Environmental  Working Group [EWG.org] -Neonatal Toxicity Study.

The research demonstrates that industrial chemicals cross the placenta in large numbers to contaminate a baby before the moment of birth. Of 10 babies born in US hospitals, 287 chemical compounds are identified in their cord blood, with an average of 200 chemicals per infant. In total, the nine EWG subjects with chemical traces in the cord blood carried:

  • 76 chemicals linked to cancer in humans or animals [average 53]
  • 94 chemicals that are toxic to the brain and nervous system [average 62] – nb: a more sensitive part of the body, Parkinson’s, Alzheimer’s
  • 86 chemicals that interfere with the hormone system [average 58] – nb: endocrine disruptors, puberty is now 2 years earlier, PCOS poly-cystic-ovarian-syndrome is an epidemic in, infertility is close to epidemic, sperm counts are down and 1:8 women develop breast cancer]
  • 79 chemicals associated with birth defects or abnormal development [average 55] – nb: associated with Autism
  • 77 chemicals toxic to the reproductive system [average 55]
  • 77 chemicals toxic to the immune system [average 53] nb: autoimmunity epidemic linked to toxic exposure 40-50 million adults with thyroid disease, rheumatoid arthritis, psoriasis, MS. 

Pesticide Levels in Children

Some foods have more “residue” from pesticides. Switching your Dirty Dozen to 100% organic will yield 90% reduction in pesticide residue levels in urine.

Some foods have more “residue” from pesticides. Switching your Dirty Dozen to 100% organic will yield 90% reduction in pesticide residue levels in urine.

What are the Main targets of chemical toxins? Chemical compounds clearly affect the:

  • immune system [allergies/asthma, chronic infections, auti-immunity]
  • Nervous system
  • Endocrine-hormonal system
  • Generational [coding and programming that is passed on to children who are born with their systems on alert and “switched on“].

The Effects of Toxins

  • Fatigue
  • Muscle aches / joint pain
  • Brain fog
  • Headaches
  • Sinus congestion and allergies
  • Digestive problems
  • Skin problems
  • PMS and hormone imbalances
  • Weight gain

 Plausible evidence links toxic exposure with risk of:

  • Immune: Autoimmune diseases, allergies, asthma, chronic dermatitis, and multiple chemical sensitivities [MCS]
  • Mitochondrial and Metabolic: Chronic fatigue, fibromyalgia, PD, autism spectrum, obesity, insulin resistance
  • Endocrine and reproductive disorders: weight gain, PMS, PCOS, Infertility, Endometriosis, Fibroids
  • Digestive disorders: IBS, nausea and vomiting
  • Neurological disorders e.g. Parkinson’s, ALS, Alzheimer’s disease, autism spectrum, and multiple sclerosis
  • Behavioral health disorders e.g. depression, anxiety, attention deficit and hyperactivity
  • Diabetes and cardiovascular diseases
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Mitochondria are our “powerhouses.” There are 53 trillion contained in every cell. They have their own DNA - their own “book of life” - and can run themselves.  We get our mitochondrial DNA from our mothers. Mitochondria from the father are loaded in the tail of the sperm and exclusively designed for one thing: to be the first to get to the egg. Once there, the tail falls off and all mitochondria then come from the mother. 

Sick mitochondria are driving many complex diseases:

  • Parkinson’s, Autism, ALS, MS, Dementia
  • Fibromyalgia
  • Chronic fatigue
  • Complex pain syndromes
  • Congestive heart failure
  • Pre-diabetes/diabetes

There are many things that can be done to restore mitochondria health by following the same protocol as Anti-Inflammatory diet and lifestyle. To learn more, link here to The Health Edge podcast on mitochondria.

Chemicals Cause Damage:

  • Mitochondrial toxicity – reduced function of the mitochondria and reduced function in cells/organs that contain mitochondria
  • Oxidative damage [ATP ‘our energy.” Fats are more efficient than carbs for energy production. They improve metabolism and decrease oxidative damage]
  • Neurotoxicity – solvents diminish neural functioning and Pesticides are neurotoxins by design

Some people retain more toxins than others for the following reasons:

  • Genetic differences in Phase One and Phase Two enzymes [polymorphism] nb- this is less about a “bad” gene and more about “typos” in the genes that we are given at birth
  • Nutrient deficiencies [in Mg – Magnesium; Se - Selenium, and Vitamin B6] prevent detoxification. Many of us are also deficient in Vitamins A, E, and K all of which are powerful antioxidants that aid detoxification.
  • High sugar/Low protein diets
  • Stress, emotional stuffing, trauma – allostatic overload impairs one’s ability to detoxify
  • Heavy metal presence [esp Hg – Mercury]
  • Increased exposure to toxins
We enter the world with genetic pre-dispositions towards certain conditions, but that does not mean you will get it

We enter the world with genetic pre-dispositions towards certain conditions, but that does not mean you will get it

We enter the world with genetic pre-dispositions towards certain conditions, but that does not mean you will get it.

Inheriting “typos” can lead to poor detoxification.

Glutathione S-Transferase pi-1 is responsible for Phase II detoxification of xenobiotics*, carcinogens, steroids, heavy metals, and products of oxidative stress. GSTP1 is located primarily in the brain and lungs.

GSTP1 polymorphisms are associated with either higher or lower enzyme activity, depending on specific environmental exposures. There is an increased risk of toxic burden, oxidative stress and various cancers especially if “GSTM1 Absent” or exposed to cigarette smoke. *Xenobiotic: a foreign chemical substance found within an organism that is not naturally produced by or expected to be present within that organism; substances which are present in much higher concentrations than are usual.

Treatment options to Boost GST activity:

  • Eat cruciferous vegetables [broccoli, bok choy] and alliums [garlic] to increase GST activity and reduce cancer risk
  • Eat a diet rich in antioxidants [colorful foods] and consider supplementation
  • Ensure availability of GSH cofactors [methionine-rich foods, NAC, L-glutamine, glycine, Mg, B6
  • Limit Glutathione depletion with alpha lipoic acid, milk thistle and taurine
  • Minimize exposure to xenobiotics, including polycyclic aromatic hydrocarbons and toxic metals
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Pharmaceuticals are in our Drinking Water

At least one pharmaceutical was detected in tests of finished drinking water supplies for 24 metropolitan areas, according to an Associated Press survey of 62 major water providers. Only 28 tested finished drinking water. Tests results vary widely. Some water systems said tests had been negative, but the AP found independent research showing otherwise.

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Phthalates are in the Products we use...and in our Urine...

Phthalates are used in many common products easily released into the environment. Exposure is airborne, from food and from direct contact. They disrupt endocrine function [EWG's list of endocrine disrupters] and are associated with cancer e.g., breast

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Environmental Toxins are prevalent in many products:

  • Persistent Organic Pollutants “POPS” : e.g. PCBs, dioxin, DDT, organochlorine pesticides, petrochemical fertilizers, herbicides
  • Perfluorooctanoic acid “PFOA”: water repellant in Scotch Guard, Gortex, carpeting, upholstery and PTFE in Teflon
  • Polybrominated compounds PBDEs : flame retardants in TVs, computers, etc. “21st century PCBs”
  • PCBs : in meat, fish, dairy
  • Bisphenol A “BPA”: polycarbinated plastics, canned foods, cash register receipts
  • Atrazine agricultural pesticide and herbicide seeps into drinking water

Toxic Chemicals are in Beauty Products:

The average woman uses 12 products daily, containing 168 unique ingredients. The average man uses 6 products daily, containing 85 unique ingredients. Get to know what you are putting ON your body, not just IN your body:

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  • Phthalates and Parabens: found in hair and skin care products
  • Fragrancefound in shampoos, deodorants, skin and body care
  • DiethanolamineI: DEA
  • TriethanolamineTEA - found in many cosmetics
  • Diazolidinyl Urea, Imidazolidinyl Urea, and Quarternium-15: found in skin and hair products…all release formaldehyde and are linked to sensitivities
  • Sodium Lauryl Sulfate: [SLS]
  • Sodium Laureth Sulfate: [SLES] found in makeup, shampoos, conditioners and toothpaste. When combined with DEA and TEA they form nitrosamines which are carcinogenic
  • Triclosan: a synthetic antibacterial in skin cleaners and household products is a hormone disrupter. The EWG Dirty Dozen Endocrine Disrupters are listed here

A useful site for to help you get to know the cosmetics you use: 

Explore switching to natural cosmetic products:

MERCURY is found in Fish

Mercury is environmentally ubiquitous with levels 30x higher last 2 generations. It enters the air and rain from coal and oil-fired power plants, incinerators, waste and manufacturing plants that use mercury to produce chlorine-containing plastics, PVC piping, pesticides, etc. It enters water and soil from natural deposits, volcanic activity, mining ore, and disposal of wastes e.g. batteries. Methyl mercury is formed in soil and water by algae and bacteria that is then ingested by fish. It is also found in fungicides. Elemental mercury and amalgams used in dental fillings, batteries, electrodes, barometers, fluorescent light bulbs, red tattoo dye, skin-lightening creams and thermostats. Federal Toxic Release Inventory states that over 6 million lbs of toxic waste in the form of mercury compounds in toxic waste are generated by industry, most of which is released directly into the environment.

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High levels found in: Bluefish, Grouper, Marlin, Tuna [yellowfin, blue, albacore], Tilefish, Sea bass, Mahi, Swordfish

Low levels found in: Arctic cod, Anchovies, Catfish, Crab, Flounder, Haddock, Herring, Mackerel, Non-farmed salmon, Trout, Tilapia, Oysters, Tuna [skipjack and chunk light]

MERCURY causes Negative Health Effects

  • Damages enzymes and other proteins by binding sulfhydryl groups, e.g., metallothionein, hemoglobin, glutathione
  • Promotes oxidative stress by formation of lipid peroxides, H2O2, and hydroxyl radical
  • Depletes glutathione and selenium
  • Penetrates nerves and binds to cysteines on Ach receptors
  • Damage to brain and kidneys
  • Cognitive dysfunction, depression, irritability, tremors, changes in vision and hearing
  • Probable carcinogenic

Chemical Additives are in Food. Read labels and steer clear of the ones pictured below:

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MSG and Glutamate

  • Glutamic acid is a non-essential amino acid found in plant and animal protein. 
  • Glutamate is the most abundant neurotransmitter in the brain.
  • Glutamate activates or excites cells to “communicate” important messages important for growth, development, learning and memory…essentially a brain stimulant.
  • MSG or monosodium glutamate is a synthetic chemical added to processed foods to make them more palatable.
  • The scientific literature regarding the health effects of MSG indicates controversy over the potential of MSG to cause various adverse reactions—from headaches and migraines, altered mood and cognition to endocrine disruption.
  • Possible Genetic susceptibility and “leaky” blood brain barrier
  • MSG goes by many names, read labels carefully. See image below for other names to watch out for.

HERE’S WHAT YOU CAN DO TO MINIMIZE YOUR EXPOSURE AND REDUCE-REPAIR IMPACT

Switch out THE DIRTY DOZEN to Organic and Stick to THE CLEAN FIFTEEN when not buying Organic

Follow the Principles of Healthy Detoxification:

  • Minimize your exposure to toxins by eating organic foods, moderating processed foods with refined grain flour, sugar, avoiding large game fish
  • Drink filtered water
  • Keep your bowels moving at least once a day through use of flax seeds and magnesium citrate [400mg/day]
  • Eat only organic animal products
  • Eat 6-8 servings of colorful vegetables and fruits including cruciferous veggies [broccoli, cauliflower, Brussel sprouts, kale] and allium family [garlic, onions, leeks, watercress, green tea, cilantro, berries, etc]
  • Eliminate nicotine and moderate alcohol intake [no more than 1 drink/day]
  • Exercise: Interval cardio 20-30” twice week; yoga; tai chi; Resistance 20” twice/week; Walk a lot and use stairs
  • Eliminate white flour and sugar and HFCS
  • Minimize char-broiled meats [heterocyclic amines]
  • Don’t be afraid to sweat e.g. sauna, steam
  • Mercury and dental amalgams
  • Home testing for mold
  • Reduce toxic thought-behavioral patterns e.g. Mindfulness practice, CBT
  • Apply chelation protocols for heavy metals

Reduce your toxic burden:

  • Buy and eat organic whenever possible
  • Consider glass or ceramic containers instead of plastic
  • Decline stain protection treatments for upholstery or floor coverings
  • Ask about VOCs (volatile organic compounds) in paints, new carpeting, furniture
  • Avoid polycarbonate plastics with “7” and “3” stamped on bottom.  Consider aluminum instead
  • Switch to stainless steel or hard-anodized aluminum pots and pans when Teflon cookware wears out
  • Vacuum/dust at least once per week: Air purification ionizers
  • Carbon Filter water

Practice Mind-Body Detoxification

  • Mindfulness about the dietary and lifestyle choices you make
  • Meditation
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Enhance Blood and Lymph Circulation through:

  • Aerobic exercise
  • Yoga
  • Massage and body work
  • Sauna and heat therapy
  • Skin exfoliation and brushing

 

Talk to your doctor or nutritionist to find out what SUPPLEMENTS are right for you to help you detoxify:

  • Multivitamin with mineral supplementation
  • Milk Thistle
  • Curcumin/turmeric and rosemary
  • Probiotics
  • Magnesium citrate [400-800 mg/day]
  • N-Acetyl Cysteine [NAC, 1200-2400mg]
  • SAMe, pronounced Sam-MEE [400-800]
  • Vitamin D [2,000-5,000 units/day to level 30+]
  • Co-Q-10 [200-400mg]
  • Alpha lipoic Acid [400-1000 mg]

 Explore Helpful websites such as these:

Use Helpful APPS such as these:

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CREATING HEALTH #4: Gastrointestinal Balance

Lecture by Mark Pettus transcribed by Carolann Patterson

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Gastrointestinal Balance: Do you have THE GUTS for Health?

   

 

 

LIFE is comprised of tightly integrated relationships between our Environment [what do we eat, how do we move, what toxins are in our life, how much sleep do we get, how do we resolve conflict and manage stress?]; Gene Epigenome [our unique "Book of Life" which sets our body's on and off switches]and ouMicrobiome [90% of our body is microbial]. We are not locked in to our genes and patterns - everything is modifiable.

Healthy choices in our Environment lead to healthy changes to our gene Epigenome and greater balance in our Microbiome. Everything is connected and overlapping. This approach is central to a Functional approach to your good health. 

How does a Functional-Systems Biology Model differ from the way we are currently looking at our health? Instead of looking at "the leaves" of disease to determine treatment, Functional Biology turns the model on its head and shifts analysis to begin at the roots, to find the root causes. Once we discover the root causes we can change our biology by changing our behavior. Our DNA is more malleable than we think. We are NOT locked in to our genetic legacy. 

Disease [how things appear] - Pre-Diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Alzheimer’s, Cancer, Autism, ADD, Hypertension.

 

Core Metabolic Imbalances [what drives them] - Inflammation-Immunomodulation, Fight-Flight (HPA axis), Microbiome (Gut-Immune), Detoxification, Hormonal, Insulin resistance 

 

Root Causes [what are their origins] - Gene-Epigenome Environment, Nutrition, Movement Stress Response, Environmental-toxins, Conflict Management Sleep, Social Connection, Traumatic events, Mindfulness, Meaning in Work, Love & Play

We don't get sick overnight. Disease is the accumulation of unhealthy choices, life patterns and events, and exposure to toxins over time. When we determine the root causes of Long Latency Disease [found in the roots], we can prevent disease from happening or make it disappear. 

Our intestines are so much more than just a tube for digestion and absorption.  The gut contents are an inner world that is “outside” the cellular body. Its surface is a frontier of 100 square meters and is only one cell layer thick. Your gut flora are an organ [the microbiome] that contains 10 times more microbial cells than the body has mammalian cells. Our microbiome has 100x the DNA than all of human DNA combined. From a cellular perspective, we are 10% human and 90% microbial. 

Our gut is one cell layer thick. Most of our immune system is attached to the gut on the outside. It is poised and ready to attack threats.

Our gut is one cell layer thick. Most of our immune system is attached to the gut on the outside. It is poised and ready to attack threats.

The most sophisticated immunologic component in our body resides in the gut. A profound neuroendocrine connection exists within the Gut which is considered to be "the second brain" where 90% of serotonin in your body is produced. Our gut is one cell layer thick. Most of our immune system is attached to the gut on the outside, poised and ready to attack threats.

Digestive Disease impacts MILLIONS of Americans:

  • 60-70% Americans suffer from Digestive Disease
  • GERD effects 45-60 million
  • 7-10% Americans experience heartburn at least daily
  • 20% [60 million] experience at least once-monthly
  • Irritable bowel disease [IBS] effects 30-45 million
  • Gallstone disease, 20-25 million
  • Diverticular disease, 20-40 million
  • Celiac is estimated at 3 million, approximately 1:100 [up from 1:133 from 2003 Alessio Fasano study] 
  • Gluten sensitivity is seen in as much as 5-8% of Americans
  • Crohn's Disease, 750,000-1 million
  • Colerectal Cancer is approximately 260,000  

Is your gut trying to tell you something? Yes.

100 million people experience various GI problems e.g. IBS, bloating, gas, reflux, constipation, diarrhea, and crampy pain. Americans spend $3 billion/year on OTC antacids, laxatives, acid blockers and fiber supplements [and some of the most popular prescription drugs used to alleviate digestive symptoms only exacerbate the cause, more on that below]. It is a common reason to seek medical care and a frequent reason for diagnostic testing...so yes, your gut is definitely trying to tell you something. The question is: WHAT is it telling you?

Problems with your gut health can promote and worsen the following conditions:

  • Allergy
  • Asthma
  • Autoimmunity
  • Arthritis
  • Metabolic Bone disease
  • Skin problems
  • Mood disorders
  • Dementia
  • Cancer
  • Inflammation

The Microbiome…it's an evolving story

The microbiome has evolved with humans. These "bugs" have allowed us to survive. The microbiome provides important functions in digestion, immunity, metabolism and detoxification. From a cellular perspective, our body is 10% human and 90% microbial. The gut microbiome in each person contains 100-150 times as many genes as the human gene pool and over 99% of the genetic diversity in our bodies is due to microbial colonization. 70% of the immune system is located in the gut epithelium [outer layer].

Gut microbes can drive appetite. Low Microbial Diversity in the gut drives obesity. Studies show that colonizing germ-free mice with the intestinal microbiome from obese mice led to an increased total body fat despite lack of change to diet.

Dirt is Good for Diversity. Increased diversity within the microbiome is seen with decreased hygiene. Early and diverse exposure to germs is key to a “healthy microbiome.” Reduced microbiome diversity is seen in obesity, IBD, and autism spectrum. 

Diet is a powerful factor that can shift the gut microbiome. There is an increased carbohydrate digesting microbiome in populations with higher carbohydrate [CHO] intake. 

SIBO - Small Intestinal Bacterial Overgrowth

SIBO is the root cause of many GI and systemic problems and is typically associated with carbohydrate intolerance and bloating after eating. It is also associated with:

  • Nausea, diarrhea, constipation

  • Contributes to food allergies
  • Intestinal permeability-systemic inflammation
  • Present in 75% of people with IBS, fibromyalgia, CFS [Chronic Fatigue Syndrome]
  • Eradicating SIBO often resolves symptoms of IBS
  • Breath test is available 

IBS - Irritable Bowel Syndrome

IBS is the most common GI functional disorder diagnosed by gastroenterologists and affects about 5-10% of the population with female predominance of 2-3:1. Its symptoms include abdominal pain, altered bowel function, bloating, mucosal inflammation, exaggerated stress response, increases in plasma pro-inflammatory cytokines. Stress [including early life stress] plays a major role in the onset and exacerbation of symptoms in IBS. It is closely linked to Dysbiosis [alterations, loss of diversity in microbiome], food sensitivities and SIBO [as many as 75%]. It is associated with:

  • GERD
  • Interstitial cystitis [inflammation of the bladder]
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Disrupted sleep
  • Rosacea
  • Migraine headaches
  • Restless leg syndrome [RLS]

GERD [Reflux] - do we have it all wrong?

GERD has been thought to stem from too much acid and our approach has been to block acid production [a case of treating the "leaves" not the "root cause"], but with Reflux, there already is LOW stomach acid. Many who have GERD also have SIBO. The diagram below outlines how it works: Low stomach acid leads to bacterial overgrowth + maldigested carbs [from poor quality simple sugars] which create increased gas and pressure, pushing up towards the esophagus while also increasing IAP [Intra-Abdominal Pressure]. As SIBO breaks down the simple sugars [FODMAPS] it produces the gas that increases IAP that allows stomach acid to reflux into the esophagus. 

Reflux is not a result of excess stomach acid. It is driven by LOW stomach acid. Prolonged use of PPI's - Proton Pump Inhibitors, such as Prilosec and Nexium - to alleviate symptoms of Reflux increases low levels of acid needed to properly digest food.

Reflux is not a result of excess stomach acid. It is driven by LOW stomach acid. Prolonged use of PPI's - Proton Pump Inhibitors, such as Prilosec and Nexium - to alleviate symptoms of Reflux increases low levels of acid needed to properly digest food.

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LPS - Lipopolysaccharide

Bacteria produce an endotoxin called lipopolysaccharide [LPS] from shedding their cell walls and induce inflammation. Researchers have found that gut-derived bacterial LPS enters the bloodstream and triggers insulin resistance that typically accompanies type II diabetes. Chronic high-fat [from bad fat] raises LPS levels and sets the stage for metabolic disease. LPS induces Leptin Resistance [the hormone that tells us we’re full].

Intestinal Permeability - Uncontrolled Trafficking of Molecules. How does the barrier break down?

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  • Dietary choices [reference Ian Spreadbury]
  • SIBO
  • Food allergies, lectins
  • Dysbiosis [alteration in the gut, ANTIBIOTICS are the biggest contributor]
  • ACID SUPPRESSION [PPI's not wise for long-term. We need acid to protect us and break down food]
  • STRESS response [causes alterations in the gut]
  • Environmental toxins
  • Medications

...Antibiotics on top of antibiotics - STAT food is neither ethical, nor healthy:

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DIET - no lecture is complete without reference to Ian Spreadbury's research:

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Ian Spreadbury points to the single greatest difference between ancestral and modern life: acellular carbohydratesWheat just ain't what it used to be. 

WHEAT can be viewed as a Triple Threat from:

  • Amylopectin - A high glycemic carb, a simple sugar that propagates an overgrowth of bacteria and yeast
  • Gluten [for some]/gluteomorphins are an opiate-like substance 
  • Fructans - FODMAPs - simple sugars

Ingesting acellular carbohydrates [not from vegetables or legumes] increases inflammation and leads to:

  • Insulin-fueling lipogenesis
  • Insulin resistance in muscle and liver
  • Inhibited capacity to burn fat
  • NF-κB goes up [bad]
  • Increased LPS - Lipopolysaccharides elicit a variety of inflammatory responses and may be a part of the pathology of Gram-negative bacterial infections [bad]
  • Cytokine up-regulation [bad]
  • Leptin resistance [hungry and less energy to move]
  • Poor health and many symptoms [including Periodontal disease]
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STRESS and the GUT 

The Vagus Nerve is the largest nerve. It's a super-highway, central to all our systems and travelling in both directions between the brain and the gut.

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HEALTHY GUT and HEALTHY BRAIN = BALANCE

Mindfulness and balance are associated with healthy gut microbiome.

Depression, auto-immune, fibromyalgia [etc] are associated with STRESS, an UNhealthy gut and intestinal dysbiosis. 

Host genes shape the gut microbiota. 90% of our bodies is not human: it's microbial. Microbes are essential to our health and most of them live in the gut sending out messages to support digestion, immunity, metabolism. When the microbiome is disrupted and out of balance [dysbiosis] messaging to the brain and throughout our body gets mixed up. Big time.

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LEAKY GUT and GLUTEN

Gluten attacks the intestinal tract. Boston Mass General's Alessio Fasano is a gastroenterologist and pioneering researcher whose team discovered Zonulin, the molecule which regulates intestinal permeability, a.k.a. Leaky Gut.

Gluten triggers Zonulin. Over-production of Zonulin has been linked to a series of autoimmune diseases, including Type 1 Diabetes, Celiac Disease and Multiple Sclerosis.

Fasano's research in 2003 demonstrated the prevalence of Celiac Disease in the U.S. to be far higher than previously thought, at a rate of 1 in 133 persons. Currently, 1:100 Americans have Celiac Disease.

Gluten causes Celiac Disease and from this we know that Environment can impact our immune system. It may not just be gluten but other molecules, too, that play a role in digestive disease. WHEAT can be viewed as a Triple Threat from its contents - Amylopectin [a high glycemic carb, simple sugar that propagates an overgrowth of bacteria and yeast]; Gluten [gluteomorphins are an opiate-like substance]; and Fructans [FODMAPs - simple sugars].

glutenleakygut.jpg

GLUTEN aggrovates the gut and causes Inflammation

When the mucous layer in the intestines is reduced, opportunists can move close to the gut lining, inciting inflammation. Fermentation of plant-based fiber seems to keep the mucous layer intact. So does the presence of peace-keeping microbes such F. prausnitzii.

F.prausnitzii colonizes the mucous layer and produces by-products such as Butyrate [saturated fat is good-health promoting and down-regulates immune response]. Theses short-chain fatty acids seem to have an anti-inflammatory effect by reducing regulatory T cells which in turn control aggressive aspects of the immune system. The absence of F.prausnitzii and other microbes that perform similar functions often correlates with diseases such as IBS and obesity. Some of its relatives - clostridial clusters - have similar properties. [see image below]

fprausnitzii.jpg

Celiac and Gluten Sensitivity are associated with the following inflammatory problems:

  • Thyroid disease
  • Neurologic diseases
  • Osteoporosis
  • Decreased fertility
  • Recurrent UTIs
  • Autoimmune disease
  • Skin disorders e.g. eczema, rosacea
  • RLS – restless leg syndrome
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The following changes in our modern food supply are linked to chronic complex disease:

  • Sugar and refined grain flours, processed - high glycemic foods with high “carbohydrate density”
  • Fructose from sugar and HFCS [a dose response]
  • Increased processed-seed oils [Omega-6] relative to Omega-3 EFA intake
  • Food sensitivities such as gluten, grains or dairy
  • Insufficient vegetables [phytonutrients-epigenetics]
  • Insufficient fiber [microbiome]
  • Foods contaminated with environmental toxins such as game fish (mercury), non-organic fruits and vegetables with pesticide residues, BPA in plastics, Genetically Engineered foods
The Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. African and European results were exactly opposite. Firmicutes are common in depression and obesity and are dominant in the European diet and far less present in the African diet.

The Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. African and European results were exactly opposite. Firmicutes are common in depression and obesity and are dominant in the European diet and far less present in the African diet.

The New Frontier will be found in the elegant inter-connections between the gut and all parts of the body. There are a growing number of examples connecting health problems to the microbiome, such as the emerging role of the gut in chronic heart failure. "Lack of mucosal integrity with consecutive local and systemic inflammation and dysfunction in transport proteins may worsen the clinical symptoms of chronic heart failure". [Curr Opin Clin Nutri Metab Care, 2008; 11:632-639]

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REVERSE. It is possible to reverse and un-do the damage caused by disease in the gut by changing our behavior and following the Recommendations of The 5R Model to:

  • Remove
  • Replace
  • Repair
  • Reinoculate
  • Rebalance

REMOVE. 

  • Elimination of disease causing microorganisms [dysbiosis] e.g. SIBO, yeast, parasites. Rx with appropriate agent e.g. Diflucan, Nystatin, Xifaxin. See FODMAPs example below
  • Foods that one may be intolerant to [elimination diet: start with gluten and dairy]
  • Medications that may negatively influence an optimal GI environment [such as PPIs, H2 blockers, NSAIDs, antibiotics, steroids]
  • Stress: how we interpret and respond

 Common FODMAPs include:

  • Fructose: A simple sugar found in many fruits, vegetables and added sugars
  • Lactose: A carbohydrate found in dairy products like milk
  • Fructans: Found in many foods, including gluten grains like wheat, spelt, rye and barley
  • Galactans: Found in large amounts in legumes
  • Polyols: Sugar ALCOHOLS like xylitol, sorbitol, maltitol and mannitol. They are found in some fruits and vegetables, and often used as sweeteners.
fodmaps.jpg

REPLACE. 

  • Stomach acid using apple cider vinegar, Swedish bitters, Betaine HCL tablets 30-60 minutes before meals
  • Digestive enzymes [plant-based], Pancreatic enzymes e.g. pancreas, Similase, GB digestion
  • Choleretics [increase the secretion of bile from the liver], Ox Bile, dandelion root

REPAIR.

  • Nutrient support with whole-foods, minimally processed, e.g. elimination diet or FODMAPS
  • Zinc carnosine [protective]
  • DGL-Deglycerinated Licorice, Slippery Elm
  • Turmeric-Curcumin [will turn off your NfkB and that's a good thing]
  • Glutamine [amino acid] 1,000 mg three times/daily
  • Gelatin rich bone broths that are amino acid nutrient dense e.g. chicken, beef. Recommended reading: Nourishing Broth by Sally Fallon and Kayla Daniels PhD.

RE-INOCULATE.

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  • Administer probiotics from the following three families that have been found to be beneficial for GI function: Bifidobacteria, Lactobacilli, and Saccharomyces.  Ther-biotic by Klaire
  • Administer prebiotics (food that promotes beneficial bacterial growth) such as bananas,    plantains, onions, asparagus and garlic, most vegetable-based fiber
  • Fermented foods like sauerkraut, cabbage, kimchi, beets, yogurt, kefir

RE-BALANCE. 

  • Rest and relaxation-response
  • Adequate sleep
  • Meditation
  • Yoga
  • Tai chi
  • Cognitive behavioral therapy
  • Health coaching

For more "news to use" and the science to go with it, visit The Health Edge: Translating the Science of Self-Care. Not all research slides are shown in this article. To download complete lecture, follow this link to BHS Creating Health Wellness Series.

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Balance.

CREATING HEALTH Lecture #3: Inflammation

Lecture by Mark Pettus transcribed by Carolann Patterson

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INFLAMMATION: ARE YOU PLAYING WITH FIRE?

Learning Objectives from today's lecture:

  1. Explore the root causes of inflammation that fuel chronic-complex disease
  2. Examine the connection between inflammation and brain health
  3. Examine the mechanisms that link many common environmental triggers with increased inflammation
  4. Consider lifestyle changes that can reduce-reverse inflammation to improve longevity and quality of life

The proposition for this lecture: how the outside gets inside

  1. Health and disease are byproducts of complex individualized gene-environment interactions that may go back more than a generation before our conception and continue throughout our lives.
  2. Your DNA i.e., your “Book of Life” still has a Stone Age imperative, not often adapted for 21st century environmental inputs e.g. the foods in our modern food supply.
  3. This incompatibility creates a distorted metabolic trajectory e.g. inflammation that forms the basis of chronic complex disease and diminished quality of life.
  4. Through mindful living that aligns conscious choosing with what are are most designed to be in relationship with, our biology can be transformed to promote-restore optimal function and health throughout the life continuum.

Nutrigenomics studies the effects of food and food constituents on gene expression and focuses on the molecular-level interaction between nutrients and genome. It is where we look beyond “food as calories” and see food for what it is: informationMolecules of food have the power to influence life-sustaining pathways. Depending on the quality of a certain food, it will send information that will either trigger inflammation or reduce it.

Does the stress of our present diet create an epigenetic change in our health? Absolutely... 

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This is the shape of things to come…and this is the route we are taking to get there…

  1. Poor Quality Carbs - information from food leads to...
  2. Excess Insulin - It is impossible to burn fat with excess insulin [leads to...]   
  3. Fat storage [leads to...]
  4. Down-regulation of insulin receptors [leads to...]
  5. Insulin Resistance and then on to Leptin Resistance and then on to Eat More + Do Less = NO GOOD

It is not simply a matter of poor food choices that lead to Inflammation and then on to Insulin Resistance. All of the following factors eventually lead to Insulin resistance: Visceral fat, Changes in food consumption, Stress, Sleep disruption,  Altered gut-permeability/microbiome, Social Isolation, Hormonal imbalances, Toxin excess. 

INFLAMMATION IS AT THE CENTER OF IT ALL

INFLAMMATIONCTR.JPG

Inflammation is connected to every chronic complex disease...and it's got everyone's attention. Scroll through the titles listed below to find articles related to Inflammation and Stroke; Inflammation, Atherosclerosis and Coronary Artery Disease; Inflammation and Cancer; Inflammation and Depression and the Brain; Inflammation and Obesity; Obesity and Periodontitis.

CRP. C-Reative Protein is a marker for inflammation. We can easily test for CRP levels. When tested for CRP, cancer patients' survival rates are higher when there is Low CRP. See graph below: 

Slide courtesy Jeanne Wallace PhD

Slide courtesy Jeanne Wallace PhD

Inflammation effects cancer prognosis and reaction to chemotherapy: Patients with higher CRP experience poor prognosis; toxicity of chemotherapy; cachexia; and fatigue...

CRPandChemo.jpg

NF-κB is Inflammation’s “Master Switch” - keep it turned off

NF-κB is a nuclear transcription factor that is triggered by diet, stress, environmental toxins, visceral fat, infections, intestinal barrier integrity disruption, oxidized LDL, free radicals, vitamin D deficiency, altered microbiome, LPS, inflammation from other sources. It up-regulates expression of 400+ genes involved with cytokine production, cell proliferation, apoptosis, angiogenesis. Exercise, meditation, Vitamin D, Spices [e.g. turmeric] and many plant flavonoids have shown to inhibit NF-κB in vitro and in vivo. 

Nrf2 is the antidote to NF-κB.

Nrf2 activation is a critical intra-cellular defense: keep it turned on. Exercise, Meditation, EGCG, Resveratrol, Coffee, Sulfurophane, Curcumin all boost Nrf2

FOOD AND INFLAMMATION

Changes in our diet trigger inflammation. Watch out for the following inflammation boosters:

  • SUGAR and REFINED grain flours, PROCESSED poor quality carbs with high “carbohydrate density”FRUSCTOSE from sugar and High Fructose Corn Syrup
  • Not enough vegetables and plant-based fiber to strengthen and balance your microbiome [we need 6-9 servings per day]
  • Increased processed seed oils [they are too high in Omega-6 polyunsaturated fatty acids. Excess Omega-6 fatty acids build up in our cell membranes and contribute to inflammation]
  • Insufficient healthy saturated fat [e.g. coconut oil and grass-fed-pasture-raised butter, whole milk, cream, eggs, red meat]
  • Sensitivity to GLUTEN and DAIRY
  • ENVIRONMENTAL TOXINS - contaminated foods such as game fish [mercury], non-organic fruits and vegetables [pesticide residues], food stored in BPA in plastics…and that’s just the short list

SUGAR

Obesity and Diabetes: The Twin Epidemics. Rates of Obesity and Diabetes have risen drastically in the past century. In 1890, one in thirty [adult 60 year old men] was obese. In 2000, 1 in 3 [adult 60 year old men] was obese. In the 1930's, one in 50,000 adults was diabetic. In 2000, one in 9 adults is diabetic [Johnson et al, American Journal Clinical Nutrition, 2007].

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Inflamed About Obesity, Michael Lehrke & Mitchell A Lazar: Two studies find that adipocytes and macrophages have more in common than previously thought. The work bolsters the notion that the inflammatory response might link obesity to afflictions such as diabetes. The epidemic of obesity stems from a clash between genes that allowed our ancestors to survive extended periods of famine and the caloric excess and sedentary lifestyle of our modern environment. Obesity is a major risk factor for diabetes and atherosclerosis, afflictions associated with a constellation of insulin resistance, hypertension and lipid abnormalities that is now defined as Metabolic Syndrome [Nature Medicine, Vol 10, No. 2, February 2004]

What is metabolic syndrome? Metabolic syndrome is not a disease in itself. Instead, it's a group of risk factors- high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat at the following levels [Source AHA]:

  • Waist Circumference > 35” in women and > 40” in men
  • BMI > 30 (= obese)
  • Elevated blood pressure: > 130/85
  • High triglycerides: > 150 mg/dL
  • low HDL: < 40 mg/dL men, < 50 wome
  • Elevated fasting glucose: >100 mg/dL

Visceral Adipose stores [mid-section weight gain, belly fat] is linked to Insulin Resistance; Dyslipidemia [high TGA and low HDL]; Elevations of Blood Pressure; and increased risk of chronic complex disease. It is the outward signal that internal fat surrounds organs and can penetrate the liver, causing the liver to respond as though it is Hepatitis. 

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The Quality of carbohydrates you eat matters. 

Different carbohydrates produce unique genomic responses. NF-κB is the Inflammation Master Switch: keep it turned off...

High Glycemic Carbs [NF-κB turned on = bad]. 

Low Glycemic Carbs [NF-κB turned off = good]. 

... and stay away from those seemingly innocent rice cakes and pretzels!

GLUTEN

Gluten attacks the intestinal tract. Boston Mass General's Alessio Fasano is a gastroenterologist and pioneering researcher whose team discovered Zonulin, the molecule which regulates intestinal permeability, a.k.a. Leaky Gut.

Gluten triggers Zonulin. Over-production of Zonulin has been linked to a series of autoimmune diseases, including Type 1 Diabetes, Celiac Disease and Multiple Sclerosis.

Gluten is the primary cause of Celiac Disease. Fasano's research in 2003 demonstrated the prevalence of Celiac Disease in the U.S. to be far higher than previously thought, at a rate of 1 in 133 persons. Currently, 1.4% of Americans have Celiac Disease.

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Primary source of Gluten is Wheat, and Wheat is NOT what it used to be...

GLUTEN MIND and GLUTEN MOOD 

Inflammation is a systemic process. Inflammatory triggers such as Gluten cause inflammatory manifestations in all parts of the body, not just at the "point of entry" e.g. the stomach and can disrupt coordination/balance, cause joint pain and brain fog and... 

  • Celiac Disease is caused by Gluten and associated with many neuro-psychiatric diagnoses e.g. ADHD seen in approx. 60%!
  • Celiac Disease is associated with white matter changes on MRI…similar to that seen with MS
  • Gluten increases insulin resistance in individuals who are sensitive
  • Brain wave patterns in ADHD improve consistently with gluten restriction
  • Gluten sensitivity enhances zonulin that increases intestinal permeability
  • Gluten sensitivity can alter blood flow to frontal lobes

From Gut to Brain: Gluten sensitivity is linked to:

  • Dementia
  • Depression
  • Headaches
  • Movement disorders
  • ADHD
  • Pain 

The intestines are only one cell layer thick. What causes Intestinal Permeability?

  • Food sensitivities
  • Dysbiosis – Too much bad and not enough good bacteria. Gut microbiome needs diversity to balance
  • Acid suppression [Causes overgrowth of bad bacteria. Prolonged acid suppression is not good for you Short-term use only e.g Prilosec]
  • Stress response
  • Environmental toxins
  • Medications e.g. regular steroids and NSAID use [irony: anti-inflammatory drugs such as Tylenol and Ibuprofen promote inflammation]
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A-cellular carbohydrates [not from vegetables or legumes] cause increased inflammation which leads to:

  • Insulin-fueling lipogenesis
  • Insulin resistance in muscle and liver
  • Inhibits capacity to burn fat
  • NF-κB goes up [bad]
  • Increased LPS - Lipopolysaccharides elicit a variety of inflammatory responses and may be a part of the pathology of Gram-negative bacterial infections [bad]
  • Cytokine up-regulation [bad]
  • Leptin resistance [hungry and less energy to move]
  • Poor health and many symptoms [including Periodontal disease]
acellularcarbohydrates.jpg

The Host Genotype Affects the Bacterial Community in the Human Gastrointestinal Tract

Host genes shape the gut microbiota. 90% of our bodies is not human: it's microbial. Microbes are essential to our health and most of them live in the gut sending out messages to support digestion, immunity, metabolism. When the microbiome is disrupted and out of balance [dysbiosis] messaging in our body gets mixed up. Big time.

The F-Word: FIBER [and F. prausnitzii]

When the mucous layer in the intestines is reduced, opportunists can move close to the gut lining, inciting inflammation. Fermentation of plant-based fiber seems to keep the mucous layer intact. So does the presence of peace-keeping microbes such F. prausnitzii.

disruptedmicrobiome.jpg

Speculative interpretation of current research is that gut colonization is most beneficial before the age of 3 and is strengthened by these three key factors at birth to age 3:

  1. Vaginal delivery
  2. Breast-feeding
  3. Minimal or no use of antibiotics and anti-bacterial products [both contribute to a less diverse ecosystem and microbiome]

Diversity of gut colonization relies on:

  1. One organism preventing overgrowth of another 
  2. Cross-talk influencing the immune system

Late colonization/infection + poor microbial diversity + genetics = sickness

Scientific America explains why our progeny may not be inheriting their fair share... "Because the critical issue is the inter-generational transfer of microbes and its timed assembly, three periods are relevant: before pregnancy, during pregnancy and in the child's early life.

For all three periods, antibiotic use is relevant because it may directly change maternal microbes prior to transfer or the child’s microbes afterward. Elective cesarean sections mean that the child misses the birth canal transit, and anti-bacterials in soaps and foods directly affect microbiota composition. Infant formulas have not been constructed with the benefit of millions of years of mammalian evolution, because breast milk contains nutrients that specifically select for the growth of preferred co-evolved organisms and inhibit opportunists and pathogens.

The aggregate of modern assaults on the early-life microbiome suggests that our progeny may not be inheriting their fair share. Exceeding the developing microbiome’s plasticity predictably leads to consequences, as growing evidence evinces.

Studies have linked C-sections and exposures to prenatal and postnatal antibiotics to increased risk of obesity, diabetes, celiac disease, asthma and allergies, among other ailments that have their roots in development."

PSYCHOBIOTICS

The brain responds to the gut. Researchers have learned which strains of gut bacteria affect the nervous system and have mapped out the pathways they use to influence the brain.  Gut flora can improve mood; some can produce neurotransmitters such as norepinephrine, serotonin, and dopamine; while other microbes such as L. helveticus and B. longum operate through the neuro-endocrine system and can lower cortisol.

A specific strain of Lactobacillus reuteri can increase the level of oxytocin, the hormone that kicks in when you cuddle, hug, or have sex. Lactobacillis acidophilus [found in yougurt, sauerkraut, and kimchi] is critical to regulating pain. B infantis and L reuteri and other strains attack inflammation by suppressing pro-inflammatory cytokines. They also send signals to increase Leptin [The “I am Full” hormone].

Watch this space – Psychobiotics might just be the next happy pill because of their links to:  

  • Protection of intestinal barrier function
  • Influence on local and systemic antioxidant status
  • Direct neurochemical production e.g. Gamma Amino Butyric Acid
  • Indirect influence on neurotransmitter function
  • Experimental evidence of links to depression, anxiety, and autism
  • Stress-induced alterations in microbiota
  • Direct activation of neural pathways between gut and brain
  • Regulation of immune response - inflammatory cytokines
  • Can influence production of Brain Derived Neurotrophic Factor [BDNF]*
  • Loss of microbiome “heritage” a contributor to many modern diseases

[Psychobiotics: a novel class of psychotropic. Biol Psychiatry. 2013 Nov 15;74(10):720-6. doi: 10.1016/j.biopsych.2013.05.001. Epub 2013 Jun10Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry Eva M Selhub1*†, Alan C Logan2† and Alison C Bested3 Journal of Physiological Anthropology 2014, 33:2]

*BDNF - Brain Derived Neurotrophic Factor

Up your Game and Up your Brain. Your Brain Derived Neurotrophic Factor [BDNF] is Known as "Miracle Grow." BDNF is decreased in Depression, Alzheimer's, Epilepsy, Schizophrenia and OCD.

BDNF increases with Exercise, Coffee [and other phytonutrients], DHA-omega 3, Curcumin-turmeric, EGCG [green tea], Meditation, Reduction in gut permeability. 

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Evidence for increased inflammation in:

  • MCI/Alzheimer’s disease
  • Depression
  • Pain
  • PD
  • MS
  • ADD and ADDHD
  • Brain fog i.e., trouble with concentration, focus, memory
  • Anxiety and Panic
  • Autism spectrum

What is happening in the brain doesn't necessarily originate there.

The contemporary convergence:

Gene-Epigenome + Environment + Microbiome = 

OUTCOME [how the outside gets inside]

 

Sugar triggers inflammation. Diabetes and pre-diabetes prevention and glucose control in midlife may protect against late-life cognitive decline. Higher glucose levels are associated with an increased risk of dementia. Studies show higher levels of fasting plasma glucose correspond to a higher rate of shrinkage of memory center [Neurology 2012;79:1019-1026].

High glucose is reversible and highly preventable.

High intake of energy from carbohydrates and low intake from fat may have inverse implications for development of Mild Cognitive Impairment [MCI]. In a study of 1,230 individuals age 70 and older, individuals with higher carbohydrate intake had nearly four times the risk of developing Mild Cognitive Impairment. Those individuals with the highest fat intake compared to the lowest fat intake were 42% less likely to have MCI.

MOTION is the LOTION:

Exercise training increases the size of the hippocampus and improves memory. "A physical activity program of an additional 142 minutes of exercise per week on average modestly improved congnition relative to controls in older adults with subjective and objective memory impairment" JAMA, September 3, 2008, Vol 300, No 9.

A six-month exercise intervention influences the genome-wide DNA methylation pattern in human adipose tissue. Studied followed 24 healthy men with low level baseline activity levels before and after 6-month exercise program. There were 30 controls as genome-wide methylation patterns were examined in adipose tissue. Several patterns changed in exercise group demonstrating reduced lipogenesis and a “silencing” of genes associated with obesity, inflammation and impaired insulin signaling.

SLEEP WELL

Disrupted sleep and loss of entrainment is a major inflammatory risk

  • 15% of Americans experience insomnia
  • 1 out of 3 has sleep disruption on one or more nights each week
  • Major risk factor for many chronic complex diseases
  • Neuro-endocrine-immune disruption
  • Sleep hygiene
  • Obstructive Sleep Apnea
  • Avoid pitfalls of sleeping medications
  • Follow the Circadian Rhythm strategy [below] and work up to a healthy sleeping pattern:
entrainment.jpg

ALLOSTASIS

The process of achieving stability or balance through physiological or behavioral change in response to changes in one’s environment. Simply put: Ability to achieve stability through change. Here are some helpful tips that are at the heart of an an Anti-Inflammatory Lifestyle:

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  • Sleep well. Get your ZZZ's and your Zeitgebers [Time Givers] - Light, Ambient temperature, Social Interactions, Exercise, Meal Timing
  • Get your Vitamin D through supplements or sensible sun exposure each day. Vitamin D influences many things - Cardiovascular Disease, Cancer, Autoimmunity, Depression, CHF, Osteoporosis, Fall Risk, Pain Syndromes
  • Whole foods always trump processed foods
  • Reduce-eliminate sugar, fructose and refined-processed, grain-based flour [carbohydrate-dense foods] e.g. breads, pasta, bagels, chips, pretzels, muffins, donuts, and many cereal grains
  • Consider an elimination trial e.g. gluten, dairy, sugar
  • Eat lots of vegetables, plant-fiber, sweet potatoes, plantains, beans
  • Reduce processed seed-vegetable oils e.g. corn, safflower, sunflower, canola, peanut and introduce more healthy fats e.g. grass-fed butter, EVOO, coconut oil, lard, ghee, and an increase in O-3s fatty fish, nuts, seeds, avocados
  • Lean, red meat  (grass fed-finished ideal), eggs
  • Eat organic for “the dirty dozen” produce

Round off an anti-inflammatory lifestyle with these healthy practices...

  • Movement: Motion is the Lotion: walking, aerobic, resistance, yoga, tai chi
  • Mind-Body awareness
  • Prayer, Breathing techniques, Relaxation Response, Meditation
  • Mindfulness-based stress reduction; HRV-Heartmath
  • Sleep hygiene-entrainment
  • Laughter
  • Volunteer Work
  • Social connection
  • Cultivate meaning in work, love, and play
  • More time outdoors during sun season

Recommended Reading: 

The Wahls Protocol, by Terry Wahl, M.D.

For more "news to use" and the science to go with it, visit The Health Edge: Translating the Science of Self-Care. Not all research slides are shown in this article. To download complete lecture, follow this link to BHS Creating Health Wellness Series.

CREATING HEALTH Lecture #2: Understanding Metabolism

Lecture by Mark Pettus transcribed by Carolann Patterson

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How did the fat switch get turned on? and why isn't it turning off?

This week's Creating Health lecture focuses on Metabolism, Insulin Resistance and Metabolic Syndrome.

The learning objectives of the lecture will be to examine the drivers of Weight Gain, Insulin Resistance and Metabolic Syndrome; the relationship between macro-nutrient content, lipogenesis [the biologic imperative to store fat] and leptin-insulin resistance; and the relationship between Biology and Behavior.

Four essential clinical pearls will emerge from tonight's lecture. Take note! 

  1. Calorie restriction decreases metabolic rate, enhances hunger and reduces the drive to move. "Eat less-do more" is not a successful or sustainable strategy.
  2. Different macro-nutrients produce different effects in thermogenesis, hormone regulation, and satiety.
  3. Quality of calories is MUCH more important than quantity
  4. The biologic goal is to reduce leptin and insulin resistance.

Last week I showed the image of "McPaleo Man" to illustrate "Health as a byproduct of gene-environment compatibility." There is a growing incompatibility between ancestral gene programming and modern 21st century lifestyle.

Healthy living happens in the healthy choices we make that align our modern life with our genes. Just because we are genetically pre-disposed to a condition does not mean we are prisoners of our genes.

 

How does a Functional-Systems Biology Model differ from the way we are currently looking at our health?Instead of looking at "the leaves" of disease to determine treatment, Functional Biology turns the model on its head and shifts analysis to begin at the roots, to find the root causes. Once we discover the root causes we can change our biology by changing our behavior. Our DNA is more malleable than we think: we are NOT locked in to our genetic legacy.

Leaves: Disease [how things appear] - Pre-Diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Alzheimer’s, Cancer, Autism, ADD, Hypertension

Stem: Core Metabolic Imbalances [what drives them] - Inflammation-Immunomodulation, Fight-Flight (HPA axis), Microbiome (Gut-Immune), Detoxification, Hormonal, Insulin resistance 

Soil: Root Causes [what are their origins] - Gene-Epigenome Environment, Nutrition, Movement   Stress Response, Environmental -toxins, Sleep   Social Connection, Traumatic events, Conflict Management   Mindfulness, Meaning in Work, Love & Play

Let's set the stage with International Data from World Health Organization & US DHHS, NIH, NIDDK  

Global Problem [2005]

  • 1.6 billion adults overweaight [age 15+]
  • 400 million adults obese
  • 20 million children under 5 overweight

Current Global Trends - by 2015

  • 2.3 billion adults will be overweight
  • 700 million will be obese

US Data: Fast Facts from the National Health and Nutrition Examination Survey [2009-2010], National Institute of Diabetes, Digestive & Kidney Diseases [NIDDK]

  • More than 2 in 3 adults is overweight or obese
  • More than 1 in 3 adults is obese
  • More than 1 in 20 adults is extremely obese
  • About 1/3 of children adolescents (6-19) is overweight or obese
  • More than 1 in 6 children is considered obese
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How do we get FAT?

The prevailing view of "how do we get fat" oversimplifies. While there is some truth, it is not entirely accurate when it states:

  • Obesity occurs when a person consumes more calories from food than he or she burns. National Institute of Health, 2008
  • Overweight is the result of caloric imbalance (too few calories expended for the amount of calories consumed) and is mediated by genetics and health. US Surgeon General, 2008

Weight gain is more than just "calories in, calories out" and it is not caused by genes. We get fat through the choices we make:

  • Not exercising at all or exercising the “wrong” way [i.e, continuous tread mill isn't effective]
  • Working indoors, not being outdoors [hunting-gathering]
  • We move less - Walking less, driving more
  • Poor diets, loaded with processed food [See what American eats in the Top 20 list below]
  • Eating poorly, unethically raised chickens and meats [their stressful environment passes on to us]

Top 20 Sources of Calories in the American diet [2013] - illustrates dietary choices in America  

We consume more calories than we ever did before and they are not quality calories.

We consume more calories than we ever did before and they are not quality calories.

  • Grain-based desserts (138)
  • Yeast breads (129)
  • Chicken & chicken mixed dishes (121)
  • Soda/energy/sports drinks (114)
  • Pizza (98)
  • Alcoholic beverages (82)
  • Pasta & pasta dishes (81)
  • Tortillas, burritos, tacos (80)
  • Beef & beef mixed dishes (64)
  • Dairy desserts (62)
  • Potato/corn/other chips (56)
  • Burgers (53)
  • Reduced-fat milk (51)
  • Regular cheese (49)
  • Ready-to-eat cereals (49)
  • Sausage, franks, bacon & ribs (49)
  • Fried white potatoes (48)
  • Candy (47)
  • Nuts/seeds & nut/seed mixed dishes (42)
  • Eggs & egg mixed dishes (39)

In addition to poor dietary choices, the ongoing dietary recommendation to reduce fat intake is not making Americans skinnier, or healthier. In fact, just the opposite. The charts below show the most significant change noted in the growing gap between increased carbohydrate consumption and decreased fat consumption and its correlation to growing obesity rates:

Don't blame butter for obesity. Crisco oil replaced butter, lard and tallow, thanks in part to Ancel Keys' research [see below]. Proctor & Gamble's Crisco was the leading sponsor of the American Heart Association campaign to reduce fat. Studies later revealed substituting polyunsaturated vegetable oils for saturated fats increased cardiovascular risks and deaths from all causes.

The New York Times poses a provocative question: “Are we fat because we eat too much or do we eat too much because we are fat?” 

The pendulum is starting to swing towards how certain foods we eat interfere with our biology, producing excess Insulin and Leptin.

There is no obesity gene. There is no diabetes gene. The growing public health problem of obesity and diabetes is not driven by genes. The quality of the food we choose to eat impacts our weight. Food composition affects metabolism.

Different foods produce different changes

  • in thermic effect [this is your metabolism. Fats produce higher metabolic rate];
  • in direct hormonal responses [Fat lowers insulin/carbs raise insulin. Fat lowers Leptin/Carbs raise Leptin];
  • in gene expression patterns [Epigenetic response - foods impact our Book of Life. Environmental factors need to change so that the On/Off switch can turn off];
  • in the microbiome [drivers of hunger have little to do with calorie counting].

Less Carbs and More Fat, please. TEE [Total Effect of Exercise] differed by approximately 300 kcal/day. People on the low-carb + high-fat diet burned 300 kcal/day more than those in the low-fat + high-carb group, an effect corresponding with the amount of energy typically expended in 1 hour of moderate-intensity physical activity.  Just goes to show: 

A calorie is not a calorie…poor quality food causes a metabolic shift so that our behavior becomes a consequence of our biology. If we improve the quality of the food we eat, we change the outcome. Poor dietary choices lead to Obesity, Diabetes and Metabolic Syndrome...

What is Metabolic Syndrome? Metabolic syndrome is not a disease in itself. It is a group of risk factors - high blood pressure, high blood sugar, unhealthy cholesterol levels and abdominal fat associate with the following readings [Source: A.H.A]:

  • Waist Circumference > 35” in women and > 40” in men
  • BMI > 30 (= obese)
  • Elevated blood pressure: > 130/85
  •  High triglycerides: > 150 mg/dL
  •  low HDL: < 40 mg/dL men, < 50 women
  • Elevated fasting glucose: >100 mg/dL

The National Health and Nutrition Examination Survey (NHANES) 2003-2006, studied more than 3400 adults over age 20 and discovered the overall prevalence of Metabolic Syndrome in 34% of those studied. Metabolic Syndrome increased with advancing age and weight and there is a higher prevalence of Metabolic Syndrome in Black and Mexican American females.

What are the consequences of Metabolic Syndrome? Metabolic Syndrome is prevalent in 34% of Americans aged 20+ and can lead to the following: 

  • Type II Diabetes
  • CVD/CAD
  • Dementia
  • Stroke
  • PCOS and infertility
  • Fatty Liver [NAFLD] see below
  • Breast, colon, prostate & other cancers
  • Psoriasis, rheumatoid arthritis, gout

NAFLD [Non-Alcoholic Fatty Liver Disease] was not described until 1980 and has grown to become one of the most common diseases in America present in 45% of all Latinos; 33% of all Caucasians; and 25% of all African Americans. 5% of total cases progress to NASH [Non-alcoholic SteatoHepatitis, liver inflammation and damage caused by a buildup of fat in the liver]. 25% of NASH cases progress to Cirrhosis [chronic liver damage leading to liver failure]. NAFLAD is 100% preventable.

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Among adults with type 2 diabetes, there was an estimated 1.6-fold increased prevalence for cancers of all sites among men and a 1.8-fold increase among women who reported being diagnosed with diabetes 15 or more years ago compared with those reporting diabetes diagnosis less than 15 years ago. Diabetes Care Jan 2013.

For breast cancer, 1.5–2.4 risk comparing women with highest levels of insulin to normal levels. Journal of the National Cancer Institute.

 

Time covers

That's Ancel Keys on the left. He was an expert on Nutrition in the 1950's and advised the nation that "Fat is Bad." 64 years later butter can take its revenge...and so can John Yudkin...

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This is John Yudkin. At the same time Keys was administering nutritional "liposuction" to an entire nation, Yudkin was banished for calling attention to sugar as THE issue, not fat. Yudkin could not get published until 1972 and his book Pure White and Deadly was largely forgotten until Robert Lustig's ground-breaking lecture Sugar: The Bitter Truth brought it to the forefront when hailing Yudkin's work as "prophetic".  Forty years after his book was finally published, we're wising up to the bitter truth about sugar...

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Consuming fructose-sweetened, not glucose-sweetened beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. "Fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose."

“Dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults.” Stanhope KL et al. Journal of Clinical Investigation. 2009 May 1; 119(5): 1322–1334

 

 America sure stand outs. The US is THE world leader in...

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We've covered Sugar and Fat, let's move on to Carbohydrates [CHOs]

Ian Spreadbury points to the single greatest difference between ancestral and modern life: acellular carbohydrates. Wheat just ain't what it used to be. 

Carbohydrate density isn't the lightest subject, but the grid below illustrates the carbohydrate choices we make. Stay away from those Rice Cakes!

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Leptin - tells you you're full

Leptin is the appetite hormone. Many obese people appear to become resistant to Leptin. A healthy Leptin function signals satiety in the brain [hypothalamus] and promotes a “readiness” to move.

Disrupted Leptin signalling causes Leptin Resistance which leads to weight gain, hard-to-control hunger, and a deep desire to minimize activity. Inflammation is associated with Insulin Resistance. Insulin Resistance is associated with Leptin Resistance.

Fructose wasn't always available everywhere in the world 24/7. It was only available at harvest and was necessary "survival" trigger to induce Insulation Resistance in order to store fat through the winter. Fructose stimulates weight gain. We have evolved to be rewarded for caloric-dense sugary fat foods as part of survival, an adaptation challenged in modern times.

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Kalle et al. Am J Clin Nutr; 2007:851:1417-27

Kalle et al. Am J Clin Nutr; 2007:851:1417-27

Different carbohydrates produce unique genomic responses:

High-Glycemic Carbs [macronutrients]: Dozens of genes switched ON as 62 genes regulate increased inflammation, stress, and immune responses.   

Switch to Low-Glycemic Carbs [beans, legumes]: Same genes are silenced. Genes regulating insulin production are switched OFF

 

The Microbiome…an evolving story

The microbiome has evolved with humans to allow survival. It provides important functions in digestion, immunity, metabolism and detoxification. These "bugs" have allowed us to survive. From a cellular perspective, our body is 10% human and 90% microbial. The gut microbiome in each person contains 100-150 times as many genes as the human gene pool and over 99% of the genetic diversity in our bodies is due to microbial colonization. 

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Gut microbes can drive appetite. Low Microbial Diversity in the gut drives obesity. Colonizing germ-free mice with the intestinal microbiome from obese mice led to an increased total body fat despite lack of change to diet.

Dirt is Good for Diversity. Increased diversity within the microbiome is seen with decreased hygiene. Early and diverse exposure to germs is key to a “healthy microbiome.”  

 

Increased carbohydrates [CHO] digesting microbiome in populations with higher CHO intake. Reduced microbiome diversity is seen in obesity, IBD, autism spectrum. 

Diet is a powerful factor that can shift the gut microbiome. 

70% of the immune system is located in the gut epithelium.

 

Now that we've explored why we get fat, how can we get "Un-Fat"?

Move More - Motion is the Lotion! 

  • HIT [High Impact Training], Resistance training, and dance
  • Muscle as a metabolic engine
  • Cortisol, ­endorphins and dopamine
  • Positive Epigenetic effects on reducing  inflammation, increasing insulin sensitivity and energy efficiency
  • Enhanced strength, resilience, balance, concentration, mood
  • Decreased cardiovascular disease, diabetes, cancer risk
  • Longevity and quality of life profoundly enhanced

 Stress Less 

  • Meditation, prayer, relaxation response, guided imagery, yoga, tai chi, biofeedback, gratitude journal 
  • HRV-HeartMath
  • Decreased cortisol, flight-fight response, BP
  • Increased parasympathetic tone
  • Improved mood, concentration, pain tolerance, resilience
  • Positive epigenetic effects on inflammation, insulin sensitivity and energy efficiency e.g. mitochondrial health
  • Decreased cardiovascular risk
  • Enhanced neuro-plasticity [our brains are bendy]

Sleep. It's not a luxury. It's a Necessity.

We used to be a dark planet. Now we've got our lights on all the time. We're sleeping less. Sleep loss leads to weight gain. In animals, disruption of circadian rhythm precedes obesity. In humans, night shift work increases BMI by 15% and risk of obesity by 40%

  • Disrupted Sleep-Loss of entrainment [see below for best strategy]
  • 15% Americans experience chronic insomnia
  • 1 out of 3 has sleep disruption on one or more nights each week
  • Major risk factor for many chronic complex diseases
  • Neuro-endocrine-immune disruption
  • Sleep hygiene
  • Obstructive sleep apnea
  • Avoid pitfalls of sleeping medications
Zeitgebers "Time Givers" are external cues that drive circadian rhythms. Light, ambient temperatures, social interactions, exercise and meal timing are all known "Time Givers"

Zeitgebers "Time Givers" are external cues that drive circadian rhythms. Light, ambient temperatures, social interactions, exercise and meal timing are all known "Time Givers"

Try new strategies to enhance metabolic efficiency and to reduce insulin-leptin resistance. Approach it from all angles:

  • Quality of calories trumps quantity of calories
  • Cut – reduce sugar-fructose in all its forms
  • For obesity, insulin resistance and diabetes, eliminate poor quality carbs and introduce healthy fats
  • Whole grains trump refined grain flours, and carbohydrate-dense processed foods 
  • Reduce omega-6 containing oils, replacing them with healthy fats e.g. extra virgin olive oil, fatty fish e.g. salmon, mackerel, sardines; grass-fed butter and coconut oil; lard, ghee, avocados, nuts and seeds
  • Pasture-raised eggs are nutrient dense and a great value
  • Consume pasture-raised meats, shellfish, organ meats
  • [Organic] Dairy is good provided you are not intolerant and don't have allergies. Fermented yogurt, kefir
  • Coconut Oil: Lauric acid; MCTs [medium chain triglycerides], gut permeability improved
  • Gut health-microbiome: Elimination trial; pre-probiotics; digestive enzymes
  • Motion is the lotion
  • Meditation: Lower stress response e.g. meditation, HRV
  • Circadian rhythm/entrainment – sleep strategies

Recommended Reading - keep up to date on latest research

For more "news to use" and the science to go with it, visit my website The Health Edge: Translating the Science of Self-Care. To download complete lectures follow this link to BHS Creating Health Wellness Series.

CREATING HEALTH Lecture #1: Exploring the Causes of the Causes

Lecture by Mark Pettus transcribed by Carolann Patterson

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CREATING HEALTH - Exploring the Causes of the Causes is the first of eight lectures created to form "a wellness road map." The Creating Health lecture series is about how you function. How you function determines how you feel. In eight weeks we will explore the key metabolic underpinnings of how we function. We will learn how our biology becomes our biography.

The #1 cause of death and diminished quality of life are the choices we make.  Healthy living does not happen at the doctor’s office.  Good Health requires that we transform perceptions of self-care and what we as humans are capable of. It’s not the hand you’re dealt. It's how you play your cards. 

Every choice we make has the power to transform our DNA. Lifestyle choices, our thoughts, the food we eat can all alter the microbiome [that is what lives inside us]. For better or worse, our choices lead to Wellness or Disease that takes shape as fatigue, depression, pre-diabetes, diabetes, obesity, and more...

How did the outside get inside?

Yogi Berra, my favorite yogi, once said “The future ain't what it used to be.” In a medical sense, this translates to the need to deconstruct our ways of thinking about self-care so that we may learn and acknowledge the impact of our choices. What we bring into our lives and what we put into our bodies matters.

In his short story Dubliners James Joyce said “Mr. Duffy lived a short distance from his body.” It's a perfect quote to illustrate how in this modern age we have so little time to examine who we really are. This dynamic leads to a total disconnect between the Mind, Body and Spirit. Now, more than ever, we need to be more mindful about all that is around us and learn more about the choices we make in order to understand our good health, and bad.

Albert Einstein said it best with Reality is an illusion, albeit a persistent one” to explain that reality constantly shifts and changes so that truths become...less true with time [and research]. When we apply this message to self-care, one of the most significant changes to surface through research is that Your DNA in NOT Your Destiny, a key theme that will resonate throughout the Creating Health lectures.

A proposition for Creating Health 

'Creating Health' is different from 'Preventing Disease,' 'Early Detection,' and 'Managing Disease.' It works from the starting point that the choices we make have the power to optimize our biology. Good choices yield kick-ass performance in our lives. Creating Health assumes that Good Health is more than a healthy blood pressure, cholesterol reading, and heart rate. It's about looking at our health in new ways and from many angles in order to create a new definition of self-care that reduces or eliminates the bad and fills up on the good. 

Here are some key "take-away" points from the Creating Health lectures: 

  • All health and disease are byproducts of complex individualized gene-environment interactions that may go back more than a generation before conception and continue throughout our lives and into the next generation. [yep, if Grandpa smoked then it has a bearing on you] 
  • Your genes i.e., your “Book of Life” have a Stone Age imperative, not often compatible with 21st century environmental inputs.
  • This incompatibility creates a disrupted biology e.g. inflammation that forms the basis of chronic complex disease and diminished quality of life. Our environment is no longer suited for "the Book of Life" to adapt to environmental toxins, stress, and modern day:night rhythms. 
  • Epigenetics is the relationship between our choices and how our genes function.
  • You can reduce-eliminate inflammation by aligning your lifestyle choices with your genes. Simply put: You can Create Health through the choices you make by getting to know what choices are best suited to your genes. 

There's been an explosion of knowledge.

Epigenetics research has doubled; microbiome research has doubled in the past year; and we're shifting away from Nature vs Nature to Nature via Nurture. To provide some context, here is a list of the different "moving pieces" on the playing field:

  • Ancestral 'Book of Life" - Evolutionary Biologic Lens
  • Functional – Systems Biology Model
  • Personalized Lifestyle Medicine
  • N = 1  (the quantified-self), measuring as much as you can about yourself, lots of Data Analysis
  • Food as Medicine, what you eat is a 'promoter' or 'disrupter'

If you change something in your environment, evidence will determine what is best for you.  Each of us has a unique "Book of Life." Changing variables - such as your intake of gluten, sugar or alcohol; your exposure to environmental toxins; or the positive addition of exercise, yoga and meditation - will alter your ability to thrive. 

Mark Twain had another way of defining Reality: “It’s not what we don’t know that gets us into trouble, it’s what we know that ain't so.”  What did we once know that turned out not to be so? …Smoking is not bad for your health; If you live long enough you will get hypertension; My doctor told me I am feeling poorly because I am just getting old…

Daniel Boorstin refers to the illusion of knowledge - “The greatest obstacle to discovering the shape of the earth, the continents, and the oceans was not ignorance but the illusion of knowledge.”  So what does that say about the current state of our health? It signals that we need to re-examine what we think we know and discover new "truths" to treat mounting health issues as outlined below.

The Current State and the Stats:

Doctors, health care providers, and care-givers are constantly "mopping up," putting out fires and helping patients gain traction. It's increasingly difficult to get to the source of many health problems. In the end, what gets treated is more often the symptoms, not the cause. This section references statistics to demonstrate the state we're in:

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The Growing Burden of Chronic Complex Disease

  • 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year
  • In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness
  • Obesity has become a major health concern. 1 in every 3 adults is obese and almost 1 in 5 youth between the ages of 6 and 19 is obese
  • About one-fourth of people with chronic conditions have one or more daily activity limitations
  • Diabetes continues to be the leading cause of kidney failure, non-traumatic lower-extremity amputations, and blindness among adults, aged 20-74
  • You can reduce-eliminate inflammation by aligning your lifestyle choices with that which your genes are best suited for.

Health Patterns of Our Children and Young Adult

  •  Infants come into the world with over 200 measurable environmental toxins
  • Asthma: in 1980, 1 out of 30 kids were diagnosed. In 2010, 1 out of 10 kids
  • Obesity- rates have tripled in the age 12-19 adolescent group over the last 25 years
  • Allergies: according to JACI, the rate of serious peanut allergies has tripled over the last 10 years
  • Behavioral: Rates of attention deficit-hyper activity disorder [ADHD] diagnosis increased an average of 3% per year from 1997-2006, ever increasing to an average of 5.5% per year from 2003-2007. In 2007, almost 10% of America's children aged 4-17 years of age are or have been diagnosed with ADHAD.
  • Children aged 2 to 19 consume seven trillion calories of sugar-sweetened beverages a year. It’s a $24 billion industry just for kids alone. 
  • Obesity prevalence among men would rise from 32% in 2008 to approximately 50% and from 35% to between 45% and 52% among women
  • 7.8 million extra cases of diabetes
  • 6.8 million more cases of coronary heart disease and stroke
  • 539,000 additional cases of cancer
  • Annual spending on obesity-related diseases would rise by 13-16%, leading to 2.6% increase in national health spending

Environments are changing across the globe with the rise of Diabetes, now a pan-species epidemic. 

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Growth beyond maturity-macroeconomics. Global Deaths from Infectious Disease by 2020 will be Less than 20 MILLION. More than 50 MILLION deaths will be caused by chronic disease.

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Diabetes

Today one in four Americans over 60 years old has type 2 diabetes. By 2020, one in two Americans will have pre-diabetes or diabetes. From 1983 to 2008, world-wide diabetes incidence has increased 7 fold from 35 to 240 million. Remarkably, in just the last 3 years from 2008 to 2011, we have added another 110 million to the diabetes roll call. Increasingly, small children as young as eight are being diagnosed with type 2 diabetes (formerly called adult onset diabetes). They are having strokes at 15 years old and needing cardiac bypasses at 25 year old. The economic burden of caring for these people with pre-diabetes and diabetes will be $3.5 trillion over 10 years.

We're a Drugged Culture. There is a tremendous role for pharmaceuticals and behavioral health drugs, especially when patients are in free-fall, but we can deconstruct the ways we think about them and how we use them...

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We're More Medicated than ever before...

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We're More Stimulated than ever before...

 

The one thing that distinguishes man from other creatures is man's desire to take medications,” William Osler - 1910

How does a Functional-Systems Biology Model differ from the way we are currently looking at our health? Instead of looking at "the leaves" of disease to determine treatment, Functional Biology turns the model on its head and shifts analysis to begin at the roots, to find the root causes. Once we discover the root causes we can change our biology by changing our behavior. Our DNA is more malleable than we think. We are NOT locked in to our genetic legacy.

plant.jpg

Disease [how things appear] - Pre-Diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Alzheimer’s, Cancer, Autism, ADD, Hypertension

Core Metabolic Imbalances [what drives them] - Inflammation-Immunomodulation, Fight-Flight (HPA axis), Microbiome (Gut-Immune), Detoxification, Hormonal, Insulin resistance 

Root Causes [what are their origins] - Gene-Epigenome Environment, Nutrition, Movement   Stress Response, Environmental -toxins, Sleep   Social Connection, Traumatic events, Conflict Management   Mindfulness, Meaning in Work, Love & Play

 

What are the conditions of your ‘soil’?

  1. What am I getting too much of that is undermining my health and how can I reduce it?
  2. What do I need more of that I am not getting enough of to improve my health and how can I bring more of it in?
  3. What would my great grandparents have done when confronting ____?

Health as a byproduct of gene-environment compatibility

McPaleoMan.jpg

An Ancient Design in Modern Times The social and cultural context in which we live has moved forward at lightning speed into the 21st century.  Our genetic endowment and the survival edge it brings with it, is still primitive.  Our design has maintained many of the Stone Age imperatives, but life in the fast lane has not. We are not well adapted for this and we we will eventually break down. Here's a THEN and NOW to show how things have shifted: 

  • THEN: Targeted fight-flight [quick turn off and on]
  • NOW: Anxiety, fear, PTSD, depression, all chronic, complex diseases [always on]
  • THEN: Energy Conservation [quick turn off and on]
  • NOW: Obesity and Metabolic Syndrome [does not turn off, we are always saving for a rainy day that will never come]
  • THEN: Immunity [quick turn off and on]
  • NOW: Autoimmunity and allergy [constant hyper-vigilant state]
  • THEN: Promotion of clotting
  • NOW: Heart attack and stroke [hyper-vigilant clotting]

!Kung People in the Kalahari Desert, Botswana have been around for 2.5 Million years living as foragers [Hunter gatherers] and eating everything - leaves, roots, berries, meat, fish - everything but processed food. Their diets exceed RDAs 2-10 fold [O’Keefe Mayo Clinic Poc 2004 Jan; 79(1):101-8]

Robert Sapolsky has studied the lives of baboons for decades. He is well known to the baboon tribe and is able to study them closely. Baboons are highly social. They groom one another and communicate threats. With the growth of African safari retreats and hotels came...DUMPSTERS. The primates had access to those dumpsters, and the food in those dumpsters. Naturally, they ate as much of it as they could. Sapolsky's primates became Junk Food Monkeys with:

  • Increased weight with increased BMI
  • Metabolic Syndrome
  • Insulin resistance with elevated fasting and post-prandial insulin leves
  • Increased TGAs
  • Decreased Movement
  • Less Socialization and less play
  • Less fertility
  • Earlier Death

Westernized Lifestyle

A recent study [noted below] provides compelling evidence that changes in lifestyle associated with Westernization play a major role in the global epidemic of type 2 diabetes. Prevalence of type 2 diabetes is 5 times higher in Arizona Pima Indians compared to Mexican Pima's. The researchers concluded that "the much lower prevalence of type 2 diabetes and Obesity in the Pima Indians in Mexico than in the US indicates that even in populations genetically prone to these conditions, their development is determined mostly by environmental circumstances, thereby suggesting that type 2 diabetes is largely preventable."

Pictured above: Mean body mass indices in hunter gatherers and non-westernized Populations show the BMI not exceeding normal limits in Australian Aborigines, Pygmies, !Kung, Innnuit, Yanomamo, Kren-Akore, Massai, Evenki and New Guineans. Recommended Reading: Jared Diamond, The World Until Yesterday - What Can We Learn from Traditional Societies? Diamond explores the introduction of grains and mono-commodities [corn, wheat] and its impact on growth and health [ie. lower height and greater number of cavities].

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In 1890, Barnum & Bailey's Fat Man Freak Show – Chauncey “Human Freight Car” Morlan was RARE. Now, one in three adults is obese. Obesity may be the shape of things to come and "the new norm," but bigger is definitely not better. Research shows that the stress of our present diet and life choices create epigenetic change in our health. 

Epigenetics

What else do we know that “ain’t so”? We now know that You are not a prisoner of your DNA. Case in point: TWINS. While genes of identical twins may be the same, their epigenome changes throughout life. Your epigenome is your “Book of Life’s” memory of prior environmental events and conditions.

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Recommended reading: A Life Decoded, by J. Craig Venter explores what we have learned from the human genome project. The genome has far fewer genes than expected [23k]; the variation of the genes is far greater than expected with 3 million SNPs; there are no specific "disease genes"; our phenotype results from genes + environment that work through our epigenome.

 

 

 

 

Who's Randy Jirtle and what's an Agouti mouse? The Agouti mouse has a genetic mutation that interferes with the ability to feel full. They can't exercise and are depressed and overweight. Dr Jirtle administered maternal supplements [methylating agents] to pregnant Agouti mice and guess what? Their offspring [and their offspring in turn] were smaller and a different color and experienced lower risk of cancer, diabetes and obesity and they had a prolonged lifespan. The offspring were 'social superstars,' highly active and able to navigate the maze with ease and speed.  Dr. Jirtle's research is a game-changer. See charts below for more details

MTHFR Polymorphism and Depression. DNA Methylation is essential for normal functioning of an organism. Patients who have the MTHFR C-T genotypes have a greater likelihood of having depression compared to those without the SNP. 

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Representative clinical conditions suggested to have epigenetic origins

  • Type 2 DM and Metabolic Syndrome
  • Coronary artery disease
  • Autoimmune Diseases
  • Cancer
  • Allergic Disorders
  • Depression
  • Neurologic: Alzheimer’s, PD, ALS, Autism

Epigenetics and Nutrigenomics: Getting beyond 'food as calories' and thinking of food as medicine. Food has an impact on the methylation and a body's on/off switches. For example, Green Tea and EGCG produce epigenetic effects that repair genes.

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NRf2 Activation is a critical intracellular defense, as it protects us from inflammation and is linked to Caloric Reduction; EGCG [in green tea];Resveratrol; Coffee; Sulfurophane; Curcumin/Turmeric [and brocolli, kale and cauliflower, too]

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Brain Derived – Neurotrophic Factor (BDNF)

BDNF is decreased in depression, Alzheimer’s, epilepsy, schizophrenia and OCD. BDNF expression increases with Exercise; Caloric restriction; DHA - Omega 3; Curcumin/turmeric; EGCG and Meditation.*

*Results of the MIDAS trial: Effects of docosahexaenoic acid on physiological and safety parameters in age-related cognitive decline. Karin Yurko-Mauro, Deanna McCarthyMIDAS Investigators. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, July 2009 (Vol. 5, Issue 4, Supplement, Page P84).

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 Xenohormesis

Plant based foods are nutrient dense.Things that the plant produces to protect itself are good for us, too.

Plants transfer the protective benefits to those eating them.

The converse principal holds true for foods raised in stressful, unethical environments.

 

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Michael Skinner wrote in Scientific American [2013] “the ability of environmental factors to promote a disease state not only for the individual but also subsequent progeny for successive generations is termed transgenerational inheritance...Epigenetic changes in methylation of the genome of germ cells after specific environmental toxin exposure that become permanently programmed allow transmission of epigenetic transgenerational phenotypes."

Trauma in pregnant mothers can carry over into the offspring of survivors...

Traumas Heirs
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Project Ice Stormdata provide first evidence in humans supporting the conclusion that PNMS results in a lasting, broad, and functionally organized DNA methylation signature in several tissues in offspring. We can infer that the epigenetic effects found in Project Ice Storm are due to objective levels of hardship experienced by the pregnant women.

  • FTO genotype did not predict obesity in people born before 1942
  • Higher risk when born after 1972
  • Greatest risk when born after 2000
  • As it turns out, it’s not just about who you are but in addition, when you are!

Get Moving! Acute exercise remodels promoter methylation in human skeletal muscle

Examined methylation patterns in skeletal muscle of sedentary men and women before and after 45 minutes of moderate-intense exercise revealed Methylation patterns changed significantly in genes coding for PPAR gamma and IL-6 suggesting more favorable gene expression patterns as they relate to inflammation and insulin signaling. Barres R et al. Cell Metab Mar 2012

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SCIENTIFIC AMERICAN – November 2014 The Neuroscience of Meditation [How it changes the brain, boosting focus and easing stress]

Meditate more. Stress Less. Mindfulness Based Stress Reduction [MBSR] and Reduction in Inflammatory Biomarkers

  • Randomized controlled trial of 40 individuals
  • Half received training in MBSR technique
  • Treatment group scored better on emotional wellness
  • Down regulation of inflammatory gene expression patterns
  • Diminished NF-kappa B expression
  • C-reactive protein reduced
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Change of Scenery [Change of 'genery'] - where you live and how you live change your gene expression:

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Environmental Programming of Gene Activity - Bonding and the Glucocorticoid Receptor Gene

Social Connection is critical to the methylation patterns. Child abuse disrupts methylation patterns and cortisol signalling function. Whereas bonding with children creates a different epigenetic pattern [of love].

Stamatis Moraitis left America after being told he had six months to live. He moved with his wife back to his ancestor's home on the isle of Ikaria. Almost four decades after the lung cancer diagnosis, he outlived the doctors who predicted his imminent death back in the 1970's. Ikaria is located in The Blue Zone, a geographical area known for the longevity of its inhabitants. The BBC made this heart-warming video of Stamatis in his olive orchard. Living there in the sunshine with healthy food and social connections kept Stamatis Moraitis busy, and very much alive.

"The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease.”  Thomas A. Edison

Click here to Download Mark's lecture notes and to listen to The Health Edge podcasts.

Mark Pettus Bio

Mark C. Pettus M.D., FACP, ABHM

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Director Medical Education, Wellness, and Population Health Berkshire Health Systems; Associate Dean Medical Education University of Massachusetts Medical School; Clinical Associate Professor of Medicine University of Massachusetts Medical School

Dr. Mark Pettus is a board certified Internist and Nephrologist practicing for over 25 years.  He received his A.B. from Boston University and his M.D. from the University of Massachusetts Medical School.  His postdoctoral training was at Harvard Medical School.  He completed his renal fellowship at The Massachusetts General Hospital in Boston. 

Dr. Pettus is an alumnus of The Advanced Program for Conflict Resolution, Negotiation, and Mediation at The Harvard School of Public Health and is also board certified in Holistic Medicine.  

Dr. Pettus currently serves as the Medical Director of Education and Population Health at Berkshire Health Systems in western Massachusetts. In addition he serves as The Associate Dean of Medical Education at The University of Massachusetts Medical School, where he graduated 30 years ago.  In that capacity he oversees undergraduate and graduate medical education at Berkshire Health Systems, a major affiliate of the medical school. 

He was formerly Chief of Medicine at St. Peter's Hospital in Albany, NY; a Clinical Associate Professor of Medicine at the University of Massachusetts Medical School; and former Medical Director of The Kripalu Institute for Integrated Healing in Lenox, MA. 

Dr. Pettus is Board Certified in Internal Medicine, Nephrology and Integrative-Holistic Medicine and is the author of two books, The Savvy Patient: The Ultimate Advocate For Quality Health Care and It’s All in Your Head: Change Your Mind, Change Your Health. His extended bio can be found on here and you can click here to Download Mark's lecture notes and to listen to The Health Edge podcasts.