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Popular Heartburn Drugs May Increase Stroke Risk

SimaNovember 16, 2016March 27, 2018Leave a comment

Uh oh - once again a drug taken for a common problem (heartburn) is linked to an unexpected negative health effect (higher risk of strokes). Millions of Americans take proton pump inhibitors (PPIs) to treat acid reflux and heartburn. They are among the most prescribed drugs in the United States, are frequently taken for long periods of time, and are available over the counter. But according to preliminary research presented at a 2016 American Heart Association conference, these medications may also increase the risk of ischemic stroke. Ischemic strokes, which are the most common type of stroke, occur when a blood clot cuts off blood flow to the brain.

Earlier research has linked proton pump inhibitors to increased risk of dementia in older patients, disruption of gut microbes, increased risk of C. difficile infections, and kidney disease. Stomach acid seems to play a role in the normal balance of microbes in the digestive system. When someone takes PPIs it lowers their amount of stomach acid, and so disrupts the gut microbial community (and these changes last for at least a month after discontinuing the drug).

The research was conducted in Denmark among a quarter-million patients who suffered from stomach pain and indigestion, and were taking one of four PPIs: Prilosec, Protonix, Prevacid or Nexium. Overall, they found that ischemic stroke risk increased by 21% among patients who were taking a PPI. The researchers found either no increased risk or minimal increased risk of stroke when taking low doses of PPIs. But at the highest doses of PPIs, they found that stroke risk increased from 30% (Prevaacid) to a high of 94% (Protonix). Another group of medications used to treat heartburn - called H2 blockers - were not linked to increased stroke risk.

Hey, what this research suggests is that not everything should be treated with pills. Medical professionals agree: the safest and best way to reduce heartburn is by making some lifestyle changes. Eat smaller meals (and not right before bedtime), lose weight if needed, don't eat very fatty meals, drink less alcohol, and don't smoke. From EurekAlert:

A popular group of antacids known as proton pump inhibitors, or PPIs, used to reduce stomach acid and treat heartburn may increase the risk of ischemic stroke, according to preliminary research presented at the American Heart Association's Scientific Sessions 2016.

"PPIs have been associated with unhealthy vascular function, including heart attacks, kidney disease and dementia," said Thomas Sehested, M.D., study lead author and a researcher at the Danish Heart Foundation in Copenhagen, Denmark. "We wanted to see if PPIs also posed a risk for ischemic stroke, especially given their increasing use in the general population." Ischemic stroke, the most common type of stroke, is caused by clots blocking blood flow to or in the brain.

Researchers analyzed the records of 244,679 Danish patients, average age 57, who had an endoscopy -- a procedure used to identify the causes of stomach pain and indigestion. During nearly six years of follow up, 9,489 patients had an ischemic stroke for the first time in their lives. Researchers determined if the stroke occurred while patients were using 1 of 4 PPIs: omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid) and esomeprazole (Nexium).

For ischemic stroke, researchers found:Overall stroke risk increased by 21 percent when patients were taking a PPI. At the lowest doses of the PPIs, there was slight or no increased stroke risk. At the highest dose for these 4 PPI's, stroke risk increased from 30 percent for lansoprazole (Prevacid) to 94 percent for pantoprazole (Protonix). There was no increased risk of stroke associated with another group of acid-reducing medications known as H2 blockers, which include famotidine (Pepcid) and ranitidine (Zantac).

Authors believe that their findings, along with previous studies, should encourage more cautious use of PPIs. Sehested noted that most PPIs in the United States are now available over the counter. Doctors prescribing PPIs, should carefully consider whether their use is warranted and for how long: "We know that from prior studies that a lot of individuals are using PPIs for a much longer time than indicated, which is especially true for elderly patients."

The FDA Has Already Stopped Testing For These Pesticides In Foods

SimaNovember 14, 2016October 27, 2017Leave a comment

An article points out what we should all be concerned with, but is being ignored - pesticide residues of glyphosate (found in Monsanto's Roundup) and 2,4-D in foods. Glyphosate is the most used pesticide in the world, and both glyphosate and 2,4-D pesticide residues in food are set to really increase with the introduction of genetically modified crops resistant to both pesticides (The farmers can spray the pesticides against weeds repeatedly and the crops won't die - they're resistant to the pesticides, so the crops and foods will contain pesticide residues.). Both pesticides are linked to a variety of health problems.

The FDA, under pressure, started analyzing some foods this year for glyphosate residues, but has already stopped due to "problems". When and if they resume is unknown. It is important to know that pesticide residues at varying levels have been found in many foods (here, here, and here). What this chronic low level exposure does to humans is unknown. The only way to avoid or minimize pesticide exposures is to eat organic foods (here, here, and here).

When reading the following excerpts, note that there are no standards for glyphosate residues in honey in the United States. Research by a FDA chemist and a chemist at the University of Iowa found residues of glyphosate at varying levels with a high of 653 parts per billion in one sample (in honey from Iowa) - which is more than 10 times the limit of 50 ppb allowed in the European Union. Other honey samples tested detected glyphosate residues from under 16 ppb to over 123 parts per billion ppb (in honey from Louisiana). I mention this because pesticide residues are an important issue - because we don't know what chronic exposure to mixtures of low levels of pesticides in foods does to us. To babies and children, to pregnant women, to the elderly, to all of us. The following article excerpts are by journalist Carey Gillam, from The Huffington Post:

FDA Suspends Testing for Glyphosate Residues in Food

Government testing for residues of an herbicide that has been linked to cancer has been put on hold, slowing the Food and Drug Administration’s first-ever endeavor to get a handle on just how much of the controversial chemical is making its way into U.S. foods. The FDA, the nation’s chief food safety regulator, launched what it calls a “special assignment” earlier this year to analyze certain foods for residues of the weed killer called glyphosate after the agency was criticized by the U.S. Government Accountability Office for failing to include glyphosate in annual testing programs that look for many less-used pesticides. Glyphosate is the most widely used herbicide in the world, and is the key ingredient in Monsanto Co.’s branded Roundup herbicide line.

Glyphosate is under particular scrutiny now after the World Health Organization’s cancer experts last year declared the chemical a probable human carcinogen. Several private groups and nonprofits have been doing their own testing, and have been finding glyphosate residues in varying levels in a range of foods, raising consumer concerns about the pesticide’s presence in the American diet.

The FDA’s residue testing for glyphosate was combined with a broader herbicides analysis program the FDA set in motion in February of this year. But the glyphosate testing has been particularly challenging for the FDA. The agency was finally forced to put the glyphosate residue testing part of the work plan on hold amid confusion, disagreement and difficulties ....FDA spokeswoman Megan McSeveney confirmed the testing suspension and said the agency is not sure when it will resume.....Alongside the testing for glyphosate, the FDA laboratories have also been analyzing foods for 2,4-D and other “acid herbicides,” documents obtained from the FDA show. The category of acid herbicides includes five of the top 10 active ingredients used in homes and gardens. Usage of 2,4-D is expected to triple in the coming year, according to the FDA.

McSeveney said glyphosate residues were only being analyzed in soy, corn, milk and eggs and the popcorn samples, while the other foods are being tested for residues of other herbicides. Earlier this year, one of the agency’s senior chemists also analyzed glyphosate residues in honey and oatmeal and reported his results to the agency. Some honey samples contained residue levels well over the limit allowed in the European Union. The United States has no legal tolerance for glyphosate in honey, though the Environmental Protection Agency (EPA) said recently it may set one because of the FDA findings.

With the testing on hold, it is not clear when the agency might have final results on the glyphosate residue analysis. McSeveney said preliminary results showed no violations of legal tolerance levels allowed for glyphosate in the foods tested. She did not provide details on what, if any, levels of residue were found. Tolerance levels are set by the EPA for a variety of pesticides expected to be found in foods. When residue levels are detected above the tolerance levels, enforcement action can be taken against the food producers.

Though FDA annually tests domestic and imported foods for residues of other pesticides, it never tested for glyphosate before. It has not routinely tested for 2,4-D either, a fact also criticized by the GAO. The FDA testing for 2,4-D residues comes as the use of 2,4-D with food crops is expected to start rising due to the commercialization of new formulated herbicide products that combine glyphosate and 2,4-D. Safety questions have been raised about the combination. But the EPA gave a green light on Nov. 1 to a Dow AgroSciences’ herbicide combination of glyphosate and 2,4-D. The new products are intended to counter widespread weed resistance to glyphosate, and be used with new types of genetically engineered herbicide-tolerant crops.

Probiotics Beneficial In Alzheimer’s Disease?

SimaNovember 11, 2016March 27, 2018Leave a comment

Interesting preliminary research that suggests that daily intake for 12 weeks of several beneficial bacteria species (Lactobacillus acidophilus, L. casei, L. fermentum, and Bifidobacterium bifidum) resulted in improved mental (cognitive) functioning in 52 people with Alzheimer's Disease. Could this be true - daily probiotics to improve mental functioning in those with Alzheimer's?

Many more studies need to be done, but this is definitely interesting. The nice thing in this study was that the patients were randomly assigned to the groups, and it was "double-blind" so no one knew who got just plain milk and who drank probiotic milk in the study (so no biases to distort results). There were also metabolic and inflammation improvements in those taking the probiotics. From Medical Xpress:

Probiotics improve cognition in Alzheimer's patients

For the first time, scientists have shown that probiotics—beneficial live bacteria and yeasts taken as dietary supplements—can improve cognitive function in humans. In a new clinical trial, scientists show that a daily dose of probiotic Lactobacillus and Bifidobacterium bacteria taken over a period of just 12 weeks is enough to yield a moderate but significant improvement in the score of elderly Alzheimer's patients on the Mini-Mental State Examination (MMSE) scale, a standard measure of cognitive impairment.

Probiotics are known to give partial protection against certain infectious diarrheas, irritable bowel syndrome, inflammatory bowel disease, eczema, allergies, colds, tooth decay, and periodontal disease. But scientists have long hypothesized that probiotics might also boost cognition, as there is continuous two-way communication between the intestinal microflora, the gastrointestinal tract, and the brain through the nervous system, the immune system, and hormones (along the so-called "microbiota-gut-brain axis"). In mice, probiotics have indeed been shown to improve learning and memory, and reduce anxiety and depression- and OCD-like symptoms. But prior to the present study there was very limited evidence of any cognitive benefits in humans.

Here, the researchers, from Kashan University of Medical Sciences, Kashan, and Islamic Azad University, Tehran, Iran, present results from a randomized, double-blind, controlled clinical trial on a total of 52 women and men with Alzheimer's between 60 and 95 years of age. Half of the patients daily received 200 ml milk enriched with four probiotic bacteria Lactobacillus acidophilus, L. casei, L. fermentum, and Bifidobacterium bifidum (approximately 400 billion bacteria per species), while the other half received untreated milk.

At the beginning and the end of the 12-week experimental period, the scientists took blood samples for biochemical analyses and tested the cognitive function of the subjects with the MMSE questionnaire, which includes tasks like giving the current date, counting backwards from 100 by sevens, naming objects, repeating a phrase, and copying a picture.

Over the course of the study, the average score on the MMSE questionnaire significantly increased (from 8.7 to 10.6, out of a maximum of 30) in the group receiving probiotics, but not in the control group (from 8.5 to 8.0). Even though this increase is moderate, and all patients remained severely cognitively impaired, these results are important because they are the first to show that probiotics can improve human cognition. Future research, on more patients and over longer time-scales, is necessary to test if the beneficial effects of probiotics become stronger after longer treatment.

Treatment with probiotics also resulted in lower levels of triglycerides, Very Low Density Lipoprotein (VLDL), high-sensitivity C-Reactive Protein (hs-CRP) in the blood of the Alzheimer patients, and likewise a reduction in two common measures (called "Homeostatic Model Assessment", HOMA-IR and HOMA-B) of insulin resistance and the activity of the insulin-producing cells in the pancreas. "These findings indicate that change in the metabolic adjustments might be a mechanism by which probiotics affect Alzheimer's and possibly other neurological disorders," says Salami. "We plan to look at these mechanisms in greater detail in our next study." [The original study.]

Tobacco Use Is Most Preventable Cause of Cancer

SimaNovember 11, 2016March 27, 2018Leave a comment

The CDC (Centers for Disease Control and Prevention) released a report this week stating that tobacco use is the most preventable cause of cancer, and that 40% of US cancer cases are linked to its use. It is estimated that currently there are more than 36 million smokers in the US. For in depth information, go to the CDC Cancer and Tobacco Use page. They also point out that tobacco smoke has at least 70 chemicals that cause cancer (carcinogens), and that exposure to secondhand smoke also causes cancer and thousands of deaths each year. From Medical Xpress;

Tobacco linked to 40 percent of US cancers

Tobacco use remains the most preventable cause of cancer, and 40 percent of diagnosed US cancer cases may have a link to its use, health authorities said Thursday. Lung cancer, acute myeloid leukemia, and tumors of the mouth and throat, voice box, esophagus, stomach, kidney, pancreas, liver, bladder, cervix, colon and rectum are all caused by tobacco use, according the report by the US Centers for Disease Control and Prevention.

The CDC Vital Signs report found that every year from 2009 to 2013, about 660,000 people in the United States were diagnosed with a cancer related to tobacco use. About 343,000 people died each year from these cancers. "Three in ten cancer deaths were due to cigarette smoking," said the report. Lung cancer is the top cause of tobacco related smoking, followed by colon cancer and pancreatic cancer.

Vitamin D and Breast Cancer

SimaNovember 10, 2016December 28, 2018Leave a comment

Vitamin D deficiency has been implicated in a variety of cancers (here, here, and here). Now a study found that vitamin D levels are linked to the long-term outcome in women with breast cancer. Researchers found that after 7 years, women with the highest levels of vitamin D had about a 30 percent better likelihood of survival from breast cancer than women with the lowest levels of vitamin D, The study put women into one of three groups based on their levels of vitamin D (as measured in the blood 2 months after the initial breast cancer diagnosis): deficient - levels below 20.0 ng/mL; insufficient - 20.0 to 29.9 ng/mL; and sufficient - greater than or equal to 30.0 ng/mL. They found that almost half of the women were vitamin D deficient, and another third were insufficient.

The researchers said the findings "provide compelling observational evidence for inverse associations between vitamin D levels and risk of breast cancer progression and death". In other words, the higher the vitamin D levels, the better the outcome. NOTE: Good vitamin D levels can usually be obtained with one 1000 IU supplement of vitamin D3 per day. Or expose bare skin to sunlight - after all, it is called the "sunshine vitamin". From Medical Xpress:

Higher vitamin D levels associated with better outcomes in breast cancer survivors

Women with higher vitamin D levels in their blood following a breast cancer diagnosis had significantly better long-term outcomes, according to new research from Kaiser Permanente and Roswell Park Cancer Institute....Vitamin D is a nutrient best known for its role in maintaining healthy bones; conversely, vitamin D deficiency has been associated with the risk for several cancers.

Common sources of vitamin D include sun exposure, fatty fish oils, vitamin supplements, and fortified milks and cereals. While the mechanisms for how vitamin D influences breast cancer outcomes are not well understood, researchers believe it may be related to its role in promoting normal mammary-cell development, and inhibiting the reproduction of and promoting the death of cancer cells.

"We found that women with the highest levels of vitamin D levels had about a 30 percent better likelihood of survival than women with the lowest levels of vitamin D," said Lawrence H. Kushi, ScD....principal investigator of Kaiser Permanente's Pathways study of breast cancer survivorship. The current study included 1,666 Pathways study members who provided samples between 2006 and 2013....had a diagnosis of invasive breast cancer in 2006. Participants provided blood samples within two months of diagnosis and answered questions about diet, lifestyle and other risk factors, with follow-ups at six months and at two, four, six and eight years.

"With the extremely rich data sources from a large sample size, we were able to prospectively analyze three major breast cancer outcomes—recurrence, second primary cancer and death," said Song Yao, PhD, associate professor of oncology at Roswell Park Cancer Institute and the study's lead author....In addition to lower overall mortality among all breast cancer survivors studied, the researchers found even stronger associations among premenopausal women in the highest third of vitamin D levels for breast-cancer-specific (63 percent better), recurrence-free (48 percent better) and invasive-disease-free survival (42 percent better), during a median follow up of seven years. [Original study]

Emulsifiers in Processed Food Linked to Cancer?

SimaNovember 9, 2016March 27, 2018Leave a comment

An earlier post discussed how emulsifiers (which are added to most processed foods to aid texture and extend shelf life) can alter the the community of microbes that live in our gut (gut microbiota) in such a way as to cause intestinal inflammation. Now the same researchers found that regular consumption of emulsifiers alter intestinal bacteria in a manner that promotes low-grade intestinal inflammation and possibly colorectal cancer.

The emulsifiers used in the study were the commonly used carboxymethylcellulose and polysorbate-80, but some others are soy lecithin, carrageenan, and polyglycerol ester. Processed foods often contain several emulsifiers, and while food regulations limit the amount of each emulsifier present in a particular food product to 1% to 2%, they don’t restrict the number of emulsifiers allowed. The study was done in mice, but the researchers tried to model the level of exposure of humans who eat a lot of processed food. From Science Daily:

Common food additive promotes colon cancer in mice

Emulsifiers, which are added to most processed foods to aid texture and extend shelf life, can alter intestinal bacteria in a manner that promotes intestinal inflammation and colorectal cancer, according to a new study. The findings, published in the journal Cancer Research, show regular consumption of dietary emulsifiers in mice exacerbated tumor development....There is increasing awareness that the intestinal microbiota, the vast, diverse population of microorganisms that inhabits the human intestines, play a role in driving colorectal cancer.

The microbiota is also a key factor in driving Crohn's disease and ulcerative colitis, the two most common forms of inflammatory bowel disease (IBD). IBD is known to promote colon tumorigenesis and gave rise to the term "colitis-associated cancer." Low-grade inflammation, a condition more prevalent than IBD, was shown to be associated with altered gut microbiota composition and metabolic disease and is observed in many cases of colorectal cancer. These recent findings suggest dietary emulsifiers might be partially responsible for this association.

Previous reports by the Georgia State research team suggested that low-grade inflammation in the intestine is promoted by consumption of dietary emulsifiers, which are detergent-like molecules incorporated into most processed foods that alter the composition of gut microbiota. The addition of emulsifiers to food seems to fit the time frame and had been shown to promote bacterial translocation across epithelial cells. Viennois and Chassaing hypothesized that emulsifiers might affect the gut microbiota in a way that promotes colorectal cancer. They designed experiments in mice to test this possibility.

In this study, the team fed mice with two very commonly used emulsifiers, polysorbate 80 and carboxymethylcellulose, at doses seeking to model the broad consumption of the numerous emulsifiers that are incorporated into the majority of processed foods. Researchers observed that consuming emulsifiers drastically changed the species composition of the gut microbiota in a manner that made it more pro-inflammatory, creating a niche favoring cancer induction and development. Alterations in bacterial species resulted in bacteria expressing more flagellin and lipopolysaccharide, which activate pro-inflammatory gene expression by the immune system.

Exposure To Harmful Chemicals During Pregnancy Shows Up In the Newborn

SimaNovember 8, 2016October 9, 2017Leave a comment

An important study was recently published that documents that when pregnant women are exposed to potentially harmful chemicals in the environment around them (environmental pollutants), many of these chemicals also get transferred to the fetus. Many of the 59 chemicals looked for were detected in the newborn babies' umbilical cords (thus the chemicals had crossed the placenta to the fetus during the pregnancy). Some chemicals were measured in higher levels in the umbilical cord than in the mother (as measured in her blood), while only cadmium appeared in mothers, but not in the umbilical cord (thus there was some protection for the fetus from that particular chemical).

This study did not look at the effects on the fetus and newborn from exposure to all these toxic chemicals - it just found that out of 59 chemicals tested for, the median number was 25 in maternal blood and 17 in umbilical cord blood. Eight of the 59 chemicals analyzed were detected in more than 90 percent of both the maternal and cord blood samples - and these included lead and mercury.

The researchers pointed out that no human studies have examined the developmental and reproductive health effects on the fetus and baby from being exposed to multiple chemicals simultaneously during pregnancy - which of course can have bigger risks and negative effects than being exposed to only one chemical at a time. Other studies have already shown that there are negative health effects (adverse neurodevelopmental effects) from a number of these chemicals, such as PCBs, PBDEs, Pb (lead) and Hg (mercury). Bottom line: No one really knows what these mixtures of chemicals do to the developing baby, but it is known that these chemicals have potential health risks. From Futurity:

Mom’s exposure to toxic chemicals shows up in newborn

Low-income and Latina pregnant women in a recent study had widespread exposure to environmental pollutants. In addition, many of the toxins showed up at even higher levels in their newborns. The study is the first in the United States to measure exposure to 59 toxic chemicals in pregnant women and their newborns.

“Pregnant women in the US are exposed to many harmful industrial chemicals that have been linked to premature birth, low birth weight, and birth defects, but estimates of how efficiently pollutants are transferred from mother to fetus have varied widely,” says Tracey Woodruff, professor of obstetrics, gynecology, and reproductive sciences and the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco. “Our findings have found that many chemicals do indeed accumulate in the fetal environment and are absorbed at greater levels by fetuses than by the pregnant women themselves. This may have significant consequences for the growing fetus, since many of these chemicals are known to affect development.”

Researchers measured polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), perfluorinated compounds (PFCs), mercury, and lead, among other chemicals. These industrial pollutants are common in the environment, and in previous studies many have been detected in greater than 99 percent of US pregnant women, according to National Health and Nutrition Examination Survey (NHANES) data.

“Contrary to previous research, we found evidence that several PCBs and OCPs were often higher in umbilical cord samples than in maternal blood samples,” says Rachel Morello-Frosch, professor of environmental science, policy and management at the University of California, Berkeley. The study also found that concentrations of mercury and certain PBDEs were often higher in umbilical cord samples than in maternal samples, and for most PFCs and lead, cord blood concentrations were generally equal to or lower than maternal concentrations, which is consistent with previous research.

Almost 80 percent of the chemicals detected in maternal blood samples were also detected in the umbilical cord blood samples, indicating that they passed through the placenta and entered the fetal environment, where they can pose a health risk to the developing baby. For those chemicals detected in at least 20 paired maternal and umbilical cord samples, 77 percent had significant correlations between maternal and umbilical cord concentrations.

The women in the study were participating in the Chemicals in Our Bodies Study, also referred to as the Maternal and Infant Environmental Exposure Project. Of the women participating in the current study, 95 percent had a combined annual household income of less than $40,000, two-thirds were Latina, and a third were born in Mexico, where they may have had less exposure to environmental toxics like the PBDEs found in flame retardants that have been widely used in the US. This demographic is often not well-represented in larger biomonitoring studies, such as NHANES, that form the basis of most of what is known about pregnant women’s exposure to environmental toxics nationally.

The study also provides a first indication of how several different classes of environmental chemicals found in a pregnant woman’s blood are also present in the newborn....From 2010 to 2011, researchers collected maternal blood samples from 77 pregnant women at Zuckerberg San Francisco General. Once they delivered their babies, researchers collected umbilical cord blood samples from 65 of these women. Of those samples tested for all 59 chemicals, the median number was 25 in maternal blood and 17 in umbilical cord blood. Eight of the 59 chemicals analyzed were detected in more than 90 percent of both the maternal and cord blood samples.

Low Vitamin D Levels and Bladder Cancer

SimaNovember 8, 2016December 28, 2018Leave a comment

Another study finding a link with low levels of vitamin D and a health problem - this time an increased risk of bladder cancer. Vitamin D is frequently called the "sunshine vitamin" because sunlight is the best source of vitamin D (our body makes vitamin D3 from sunlight exposure on our bare skin). If you take vitamin D supplements, look for vitamin D3 (rather than D2). From Medical Xpress:

Low vitamin D levels linked to increased risk of bladder cancer

Vitamin D deficiency is associated with an increased risk of developing bladder cancer, according to a systematic review of seven studies presented today at the Society for Endocrinology annual conference in Brighton. Though further clinical studies are needed to confirm the findings, the study adds to a growing body of evidence on the importance of maintaining adequate vitamin D levels.

Vitamin D, which is produced by the body through exposure to sunshine, helps the body control calcium and phosphate levels. Vitamin D can also be obtained from food sources such as fatty fish and egg yolks. Previous studies have linked vitamin D deficiency with a host of health problems including cardiovascular disease, cognitive impairment, autoimmune conditions, and cancer.

In this work, researchers from the University of Warwick and University Hospital Coventry and Warwickshire, Coventry and the investigated the link between vitamin D and bladder cancer risk. They reviewed seven studies on the topic which ranged from having 112 to 1125 participants each. Five out of the seven studies linked low vitamin D levels to an increased risk of bladder cancer.

In a separate experiment, the researchers then looked at the cells that line the bladder, known as transitional epithelial cells, and found that these cells are able to activate and respond to vitamin D, which in turn can stimulate an immune response. According to lead author of the study Dr Rosemary Bland, this is important because the immune system may have a role in cancer prevention by identifying abnormal cells before they develop into cancer. "....our work suggests that low levels of vitamin D in the blood may prevent the cells within the bladder from stimulating an adequate response to abnormal cells," said Dr Bland.

Probiotics For Burn Wounds?

SimaNovember 3, 2016June 26, 2018Leave a comment

Could certain beneficial bacteria (probiotics) help prevent or deal with infections in burn wounds? Infection of burn wounds are a common complication and can even result in sepsis and death. This can occur even with the use of topical antibiotics (creams, gels) and antibiotics. The following study examined the use of the probiotic Lactobacillus plantarum on burn wounds in mice, and found that it had excellent results in dealing with the pathogenic bacteria Pseudomonas aeruginosa. The researchers (from the University of Pittsburgh Medical Center) weren't sure exactly how the L. plantarum worked against the pathogenic bacteria, but it worked. They were enthusiastic about probiotics being used in the future in burn wound treatment and called it local probiotic bacteriotherapy.

The pathogenic bacteria Pseudomonas aeruginosa is frequently involved with burn wound complications.The frequent use of antibiotics has led to the development of many multi-drug resistant strains. The bacteria also frequently develops biofilms, which are very hard to treat. Biofilms are communities of bacteria sticking to one another and coated with a protective slime. Thus a probiotic alternative to antibiotics would be very desirable in the treatment of wounds, especially if it can deal with the most common pathogenic bacteria and suppress biofilm formation or eliminate them.

Lactobacillus plantarum works not only against Pseudomonas aeruginosa, but also against other kinds of pathogenic bacteria such as Escherichia coli. The following study builds on an earlier study that applied Lactobacillus plantarum on human burn wounds (which is described in the last paragraph below). Excerpts from a research article by A. Argenta et al in PLOS ONE:

Local Application of Probiotic Bacteria Prophylaxes against Sepsis and Death Resulting from Burn Wound Infection

OBJECTIVE: To determine if local prophylactic application of probiotic bacteria to burn wounds will prevent death in a mouse model of burn wound sepsis. BACKGROUND: Infection remains the most common complication after burn injury and can result in sepsis and death, despite the use of topical and systemic antibiotics. Pseudomonas aeruginosa is a frequently implicated pathogen. Local application of probiotics directly to burn wounds is an attractive novel intervention that avoids the pitfalls of standard antibiotic therapies.

METHODS: A burn-sepsis model was established using a sub-eschar injection of bioluminescent P. aeruginosa; infection was tracked using a charge-coupled camera. Full-thickness burn injuries were placed on the dorsums of adult mice; the injured sites were then treated with vehicle (burn wound control), probiotics (Lactobacillus plantarum only), pathogenic bacteria (Pseudomonas aeruginosa only), or probiotics plus pathogen (Lactobacillus plus Pseudomonas). Animals were monitored until death/moribundity or for one week, then sacrificed. Harvested tissues were subjected to imaging and molecular assays.

RESULTS: Control and probiotic-only animals showed no mortality (100% survival) at one week. Pseudomonas-only animals showed > 90% mortality within 40 hours of infection. In contrast, animals treated with probiotics plus Pseudomonas showed less than 10% mortality. Use of bioluminescent Pseudomonas bacteria demonstrated that probiotic therapy inhibited septicemic accumulation of the pathogen in remote organs. In addition, probiotic therapy successfully suppressed the infection-dependent induction of TNF-α and interleukins 6 and 10 in the liver. CONCLUSION: Local probiotic therapy shows great potential as a valuable adjunct in the management of complicated burn injury.

Infection following burn injury remains the most common complication in burn wound patients of all age groups and is the most cited reason for mortality, accounting for up to 60–75% of burn related deaths....Burn wounds, classically considered to be sterile immediately upon injury, become colonized and infected within one week after insult, often while the patient is under direct hospital care.... It has also been recently recognized that numerous bacteria (and fungi) exist within burn wounds in the form of biofilms .... they are highly resistant to both conventional antibiotics and to natural host immune responses, as well as being recalcitrant to detection by standard microbiological culture.

One of the most frequently implicated pathogens in infection-related burn complications is Pseudomonas aeruginosa. Part of normal gut flora, P. aeruginosa is also prevalent in nature and has been identified on many hospital surfaces,....Because P. aeruginosa adapts rapidly, widespread and sometimes indiscriminate use of antibiotics has led to multi-drug resistant strains. Moreover, P. aeruginosa is well-known to be capable of biofilm formation, which further limits effectiveness of conventional antibiotic therapy.

Our results clearly indicate that local application of probiotic bacteria can be effective in reducing mortality from burn wound infection and can successfully suppress the systemic hyperinflammatory response such an infection typically provokes. It appears therefore that Lactobacillus is somehow able to contravene against the normally invasive Pseudomonal biology. The mechanisms by which this occurs are as yet unclear, but include several possibilities.

Furthermore, one study examined 56 burn patients, half of whom received oral probiotics [Lactobacillus acidophilus and Lactobacillus casei] half of whom did not. The investigators noted significantly fewer deaths in the treated group among patients with large (41–70%) total body surface area (TBSA) burns, and suggested that probiotic food additives may be clinically beneficial in these patients [35] It is unclear whether local probiotic therapy to the wound as employed here would confer a similar benefit versus gut-derived pathogens, but given that the probiotic bacteria themselves appear to translocate it is possible that it could be used in combination with oral therapy.

Locally applied probiotic bacteriotherapy offers an attractive if counterintuitive means to address the problem of burn wound infection. Probiotic bacteria may be active against a range of pathogens simultaneously, including drug-resistant organisms. They have demonstrated activity against fungal pathogens as well, for example, in their use as a treatment of Candidal vulvovaginitis [43]. They are unlikely to facilitate emerging antibiotic resistance and would be potentially effective even against pathogens in biofilm configuration.... They are inexpensive and could be easily applied topically to a burn injury site.

Thus far, the use of topical probiotics in burn patients is limited to a single report. Peral et al. applied topical L. plantarum soaked into gauze sponges to a cohort of second and third degree burn injured patients, divided into early and late treatment groups, and compared outcomes to a similar cohort of patients treated with silver sulfadiazine cream [45]. No systemic antibiotics were used, and the majority of patients had TBSA burns of <15%. The numbers of patients were too small to achieve statistical significance, but the investigators found little to no difference in the two cohorts overall in the rate of healing or in the bacterial counts in the healing wounds on subsequent biopsy. Importantly, no adverse outcome occurred in the 38 patients (with varying depth and time of injury) that could be related to the use of Lactobacillus, including no difference in subsequent skin graft take. These extremely preliminary data give promise that an appropriate regimen of local probiotic bacteriotherapy for burn injured patients can be safe and at least as effective as silver sulfadiazine. [The 2009 Peral et al study]

Lactobacillus plantarum Credit: Nature

Why Eat More Than Ten Servings of Fruits and Vegetables Daily?

SimaNovember 2, 2016November 28, 2016Leave a comment

Eating lots of fruits and vegetables (more than 10 servings a day!) is linked to better cognitive functioning in both normal weight and overweight adults (both young and older adults), and may delay the onset of cognitive decline that occurs with aging and also dementia. Overweight and obese older adults with a daily fruit and vegetable consumption of less than 5 servings generally had worse cognitive functioning. Higher levels of physical activity and higher daily fruit and vegetable consumption were both associated with better cognitive functioning. Cognitive functioning generally refers to a person’s ability to reason and think, the mental processes needed to gather and process information, and all aspects of language and memory.

The York University researchers found that fruit and vegetable consumption, physical activity, and BMI or body mass index (normal, overweight, obese) all appear to interact in how a person mentally functions (cognitive functioning), especially as they age. The ideal goal as one ages is to preserve the mind. It appears that eating lots of fruits and vegetables daily (10 or more servings), being physically active (this includes daily walks), and being a healthy weight help with this goal. It helps to also be highly educated (or read books?) so that the brain has a "cognitive reserve",

Why is daily fruit and vegetable consumption (FVC) good for cognitive functioning and the brain? Studies find that daily consumption of fruits and vegetables is strongly associated with a reduced risk of cardiovascular disease, cancer, diabetes and age-related declines. They appear to be "protective" against cognitive decline. The study researchers point out that fruits and vegetables contain high quantities of vitamin C and E, fiber, micronutrients, flavonoids, beta-carotenes and other classes of phytochemicals. These are important in various ways: "they modulate detoxifying enzymes, stimulate the immune system, modulate cholesterol synthesis, and act as antibacterial, antioxidant or neuroprotective agents." NOTE: A serving of fruit is generally 1 medium fruit or 1/2 cup of fruit. A serving of vegetables is 1 cup of raw leafy greens or 1/2 cup of other vegetables. From Medical Xpress:

Healthy living linked to higher brain function, delay of dementia

It's tempting to dip into the leftover Halloween treats, but new research out of York University has found eating plenty of fruits and vegetables, combined with regular exercise, leads to better cognitive functioning for younger and older adults, and may delay the onset of dementia. York U post-doctoral fellow Alina Cohen and her team, including Professors Chris I. Ardern and Joseph Baker, looked at cross-sectional data of 45,522 participants, age 30 to 80+, from the 2012 annual component of the Canadian Community Health Survey.

What they found was that for those who are normal weight or overweight, but not obese, eating more than 10 servings of fruit and vegetable daily was linked to better cognitive functioning. When moderate exercise was added, those eating less than five servings, reported better cognitive functioning. Higher levels of physical activity were linked to the relationship between higher daily fruit and vegetable consumption and better cognitive performance. Those with higher body mass indexes, low activity levels and fruit and vegetable consumption were associated with poorer cognitive functioning.

More details from the original study in the Journal of Public Health: Physical activity mediates the relationship between fruit and vegetable consumption and cognitive functioning: a cross-sectional analysis

Results: Higher BMIs, lower PA [physical activity] and FVC [fruit and vegetable consumption] were associated with poorer cognitive functioning. Additionally, PA statistically mediated the relationship between FVC and cognitive function (Sobel test: t = −3.15; P < 0.002); and higher education levels and daily FVC were associated with better cognitive function (P < 0.001). Conclusion: Higher PA levels were associated with better cognitive functioning in younger and older adults. Also, higher daily FVC and education levels were associated with better cognitive scores.

Individuals who were normal weight or overweight and reported a FVC of >10 servings per day reported better cognitive functioning scores than those who reported <10 servings, as well as those individuals with obesity . As well, both active and inactive individuals who reported a FVC of >10 servings per day had better cognitive scores than those who consumed fewer servings. However, in those who were moderately active, individuals with a daily FVC of <5 or 5–10 servings reported better cognitive functioning than those with a daily FVC of 10 or more servings; this may have resulted because of underestimations of the number of servings of fruits and vegetables actually consumed... Thus, increasing FVC and PA levels as well as having a healthy BMI may aid in the delay of cognitive decline.

Results also indicated that higher education levels along with a daily FVC of five or more servings were associated with better cognitive functioning. Education may be assisting in the process of delaying cognitive decline by increasing cognitive reserve, the ability of the human brain to cope with damage by using different brain processes to retain the ability to function well. Cognitive reserve is developed through intellectual stimulation and translates into a higher volume of connections between neurons and stronger rates of cerebral blood flow.