stig@bengmark.sewww.bengmark.comwww.synbiotics.se

VÄLJ HÄLSA”Hedra Din Moder till hälsa (Dina tarmbakterier) på det att det må gå Dig väl

och Du må länge leva på jorden” 2 Mosebok 2:12

Stig Bengmark MD PhD London University, UK

ULLA OCH BO LUNDEVALLHJÄRNFONDEN

KAROLINSKA INSTITUTETS ADHD – TEAMStockholm 26.04.2018

DIFFERENT LIFESTYLE – DIFFERENT DISEASE PATTERNClayton P, Rowbotham J Int. J. Environ. Res. Public Health 2009;6:1235-1253

INCREASED LIFE EXPECTANCY: 47 78 YEARS but an TZUNAMI OF CHRONIC DISEASES on its way

Fontana L Biochimica et Biophysica Acta 2009;1790:1133–1138

Cardiovascular disease (CVD), cancer, and diabetes account for about 70% of deaths in the US and Europe.

About 80% of adults over 65 yrs have at least one chronic disease &

50% have two or more chronic diseases.

IMPORTANT TO REMEMBER:

40% of cancer & up to 80% of all heart disease, stroke and type 2 diabetes are preventable with elimination of unhealthy diets, physical inactivity, and use of tobacco

Increase of chronic diseases 1850 – 2005 parallel to:100 % increase in consumption of animal fats 1500 % production of milk/cow -2 l/d => 30 l/d & intake of milk products10000 % increase in intake of refined sugar ( 0,5 kg =>48 kg/p/y)

FORECAST FOR USA + UK (375 mill) 5 % OF GLOBAL POPULATION

Wang YC et al Lancet 2011;378:815-825

Chronic Diseases will further increase by 2030: 76 mill more obese adults 6–8.5 mill additional cases of diabetes 6-7 mill additional cases of cardiovascular disease 492 000 – 669 000 additional cases of cancer Loss of 26–55 mill quality-adjusted life years Increased costs of preventable diseases by $ 50–68 billion/year

THIRD MILLENIADISEASES

increases in incidencein recent 27 years

(1990 – 2017)USA

Lear R. The Root Cause in the dramatic rise of Chronic Disease

https://app.box.com/s/iyjuzrxtkx3gpblu4vmt0wjrgsxykuzc

Chronic fatigue syndrome 11027 percent

Bipolar disease in youth 10833 percent

Fibromyalgia 7727 percent

AUTISM 2094 percent

Celiac Disease 1111 percent

ADHD 819 percent

Lupus 787 percent

Hypothyroidism 702 percent

Osteoarthritis 449 percent

Sleep Apnea 430 percent

Diabetes 305 percent

Alzheimer’s disease 299 percent

Mental Depression 280 percent

Asthma 142 percent

PROGNOSIS ALZHEIMER USA – 2050Hebert LE et al Arch Neurol 2003;60:1119-1122

FORCEFULLY ”HITTING BACK”ANTIBIOTIC-RESISTANT MICROORGANISMS

– a great threat to global healthA UK government commission estimates 700,000 deaths linked to drug-resistant infections & premature deaths in 2017 & forecasted to increase to 10 mill. by 2050

An increase of app 15 X

Predicting the World’s GDP to be:

0.5% smaller already by 2020

1.4% smaller already by 2030

LEADING BURDENS TO GLOBAL ECONOMY – 2012 - WHO Add by 2050: Antibiotic resistance ($ 100 trillion)

OBESITY

$ 2.1 trillion

$ 2.1 trillion

$ 2.0 trillion

ALCOHOLISM $ 1.4 trillion

CLIMATE CHANGE

Global GDP 2017: $ 78 trillion

ANTIBIOTICS DYSBIOSIS DISEASES

Highest number of

PRESCRIPTIONS

Louisiana Mississippi, Alabama, Arkansas, Tennessee, Indiana, West Virginia

OBESITY - THE GLOBAL TZUNAMI- strongly associated to modern agriculture & mass-produced cheap processed foods

EPICENTRE: Louisiana Mississippi, Alabama, Arkansas, Tennessee, Indiana, West Virginia

Soon to lead”the league of unhealth”

GLOBAL STROKE INCIDENCE

Thrift AG et al Int J Stroke 2014;9:6-18

NEGATIVE EFFECTS ON HEALTH – a result of industrial revolution?

PLANT BREEDING including GMO

ANIMAL BREEDING

ARTIFICIAL INSEMINATION

SUPPLEMENTING CHEMICALS: herbicides (to kill weeds), insecticides(to kill bugs), fungicides (to eliminate funguses), soil fumigants (to disinfect), desiccants (drying agent), harvest aids (to speed up hardening), and plant growth regulators (also called plant hormones, aimed to increase growthof plants: cells, tissues and organs)

INDUSTRIAL PROCESSING: separation, condensation, drying, freezing, irradiation, burning, roasting, curing, microvawing, emulsifying, toasting , supplementing salt & other food additives

HOME PROCESSING: baking, cooking, microvawing, frying, wooking, grilling etc.

FOOD ADDITIVES – commonly used: antibiotics, acidity regulators, thickeners, stabilizers, emulsifiers, acidity regulators, anti-caking agents, glazing agents, flavourenhancers, gases, sweeteners

Modern techniques aimed to increase food productivityare increasingly associated with UNHEALTH:

GUIDE TO PESTICIDES

PLANT BREEDING – NEGATIVE EFFECTShttp://www.nutritionsecurity.org/PDF/Food%20Nutrition%20Decline.pdf

FRUCTOSE IN FRUITS Dr Mercola 2010 http://articles.mercola.com/sites/articles/archive/2010/06/19/richard-johnson-interview-may-18-2010.aspx

Agrawal R, Gomez-Pinilla F J Physiol 2012;590:2485–2499

FRUCTOSE & MEMORY LOSS

PLANT FOOD & MICROBIOTA & HEALTHDuranti S et al Genes & Nutrition 2017;1218:18

TREATMENTS

PROCESSED FOODS – THE VILLAIN

Excess of refined foods; fats, sugars, bioactive peptides, hormones, chemicals (pharmaceuticals)

Destabilizes the immune system

Increases proxidant actions

Stimulates overexpression of NF-κB, COX-2, LOX, iNOS

Reduced microbiota - Creates dysbiosis

Reduces resistance to disease www.bengmark.com

DERANGED MICROBIOTA – CHD Sabatino A et al. Nephrol Dial Transplant, 2015;30:924–933

Reduced intake of dietary fibres - Prescribed restriction of potassium intake leads to reduced intake of fruits and vegetables

Too much proteins available for proteolysis - Increased production of protein-bound uremic toxins

Prolonged intestinal transit time - often comorbidities; heart disease, diabetes, cerebrovascular, malnutrition, constipation

Increased intestinal permeability - Leaky gut intestinal ischemia, uremia

OBS 1. Chemicals, drugs especially antibiotics, phosphate binders & most other drugs induce dysbiosis

OBS 2. aggressive ultrafiltration per se induces leaky gut

FOOD INTAKE & INFLAMMATION Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc. High intake of heat- and storage-inducedproteotoxins: glycated (AGEs), lipoxidatedmolecules (ALEs),processed carbohydrates induces: Dysbiosis: reduced numbers & diversity Leakage of various body membranes; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood-brain barrier etc.

PLANT FOOD PREVENT CHRONIC INFLAMMATIONAune D. et al Int J Epidemiol 2017;46:1029-1056

Eating 800 g fruit and vegetables a day –

or 10 portions – is associated with: 28 % reduced risk of cardiovascular disease

24 % reduced risk of heart disease

33 % reduced risk of stroke 13 per cent reduced risk of total cancer 31 % reduction in premature death

RECOMMENDATION for optimal health 1 – 1 ½kg/person/day

Louis Camille Maillard 1878 – 1936Demonstrated a strong association between chronic disease, especially chronic renal disease and exposure to chemicals between amino acids and sugars, later called AGEs.

This work was considered a major contribution, and the reaction was named after him – Maillard reaction.

He was in 1914 awarded several prices, including the Highest price of the French Academy of Medicine.

ed2011- Available as 103 at http://bengmark.com/research-articles/

2017 Available as 119 at http://bengmark.com/research-articles/

HEAT-INDUCED TOXINS (AGEs & ALEs) IN FOODS

“smoking with the stomach”Dys-functioning, glycated PROTEINS (AGEs) and lipoxidatedfats/oils (ALEs) induce about 50 times more inflammation in the body compared to non-heated proteins and fats/oils accumulate in tissues (amyloid) weakens immune system impair DNA repair mechanisms reduce antioxidant defense induce inflammation & infection accelerate development of various diseases.

Bengmark S. Modified Amino Acid-Based Molecules; Accumulation and Health Implications. In Amino Acids in Human Nutrition and Health. Ed Mello JFD, CABI Allingford, UK, 2011

AGEs & INFLAMMATION-INDUCTIONBohlender JM Am J Physiol Renal Physiol 2005;289:F645-659

FOOD & HEAT-INDUCED TOXINS (AGEs & ALEs)MEAT, POULTRY, FISH: AGE content increases with exposure

to higher temperatures:

comp: Boiling 1000 vs Frying 9000 kU/servingGoldberg T et al. J Am Diet Assoc 2004;104:1287-1291

DAIRY:CHEESE, espec. hard cheeses

POWDERED MILK (espec. ice cream, baby & clinical nutrition formulas)

GRAIN PRODUCTS: Toasted bread, bread crusts & crisp breads

VEGETABLE OILS:ex.heated olive oil ca 8000 kU OTHERS: Egg yolk powder, lecithin powder, coffee, espec dark roasted,

hard-cured teas, roasted and salted peanuts, dark and sugar-rich alcoholic beverages - high in i.g. broth, Chinese soy, balsamic vinegar, Cola drinks etc

ACRYLAMIDE IN FOODS & UNHEALTHDas AB, Srivastav BB Toxicol Mech Methods 2012;22:163-169

Acrylamide has been studied extensively for more than 40 years, but the first detection of acrylamide in carbohydrate-rich foods was made as late as 2002

Acrylamide has a number of adverse effects on the human body - two major effects being NEUROTOXICITY & CARCINOGENICITY

Toasted bread contains several-fold more of acrylamide than untoasted Wheat: 11–161 vs < 5 mg/kg . Rye: 27–205 vs 7–23 mg/kg Granby K et al Food Additiv Contamin 2008; 25:921–929

DIET ”Smoking with the stomach”

AGEs IN VARIOUS MILK PRODUCTSBaptista J, Carvalho R Food Res Int 2004;37:739-747

Fresh milk

2 years storage in room temperature

STORAGE IN ROOM TEMPERATURE 1-2 YEARS

1 year storage in room temperature

ACRYLAMIDE IN FOODS & UNHEALTH Das AB, Srivastav BB Toxicol Mech Methods 2012;22:163-169

Acrylamide – a strong inducer of acute and chronic diseases among other effects NEUROTOXICITY

NEFROTOXICITY & CARCINOGENICITY It was first in 2002 that acrylamide was known to be produced when carbohydrate-rich foods is heated

INSTANT FOODS RICH IN ACRYLAMIDE Semla M et al Physiol Res.2017;66:205-217

INSTANT FOODS rich in snacks, chips, crisps, coffee, particularlyinstant coffee & coffee substitutes

HEAT-INDUCED ACRYLAMIDE SYNTHESIS Tareke C et al J. Agric. Food Chem. 2002;50:4998-5006

AGE/ALE & PREMATURE AGING Nagai R et al J Clin Biochem 2014;2014:55:1-6

AGE – ALE & OPHTALMIC DISEASES Smuda M et al Biochemistry 2015;54:2500-2507

AGEs & PREMATURE AGING Nagai R et al J Clin Biochem 2014;2014:55:1-6

DISEASES WITH ELEVATED AGEs/ALEs• ADHD

• Aging

• Allergy & Autoimmune diseases

• Alzheimer´s disease & Parkinson´s disease

• Amyotrophic lateral sclerosis

• Atherosclerosis

• Cardiovacular diseases & Stroke

• Cataract

• Chronic kidney disease

• Chronic liver diseases

• Chronic pulmonary disorders

• Creutsfeldt-Jakob disease

• Diabetes

• Familial amyloidotic polyneuropathy

• Fibromyalgia

• Glaucoma

• Hormone deficiencies

• Macula degeneration

• Nephropathies

• Neuropathies: Epilepsia, Huntington´s disease

• Obesity

• Osteoporosis

• Paradontosis

• Polycystic Ovary Syndrome

• Rheumatoid diseases

• Ruptured Achilles tendon

• Sepsis

HEATING POISONS (AGEs) IN RENAL DISEASEAgalou S et al. Biochem Soc Trans 2003;31:1394-96

Plasma conc of free AGEs in hemodialysis patients such asNε-carboxymethyl)lysine (CML) increased app. 8-fold &Nε-(carboxyethyl)lysine (CEL)

increased 22-fold

LOW AGE DIET, EXERCISE & HEALTH Marcias-Cervantes et al Nutrition 2015;31:446-451

Improvement on Low AGE diet + exercise

SPICES – EFFECTS ON HB-GLYCATIONwild caraway = vild kummin Naderi Gh et al Indian J Pharm Sci. 2014; 76: 553–557.

HEATING OF FOODS – NEGATIVE EFFECTSBenlloch-Tinoco M et al. Food Chem 2015;187:254–262

PHa: pheophytin APhb: Pheophytin B

CHLOROFYLL:Microg/cupParsley 380Spinach 240Cress, garden 160Green beans 80Arugula 80Leeks 80Endive 50Sugar peas 50Chinese cabbage 40

BETACAROTENE:PeppersLettuceKaleCarrotsSpinachMustard GreensTurnip GreensChinese Cabbage

LUTEIN:SpinachKaleCarrotsBroccoliPeppersSweetcornTomatoes

Fresh Microvawed Conventionally heated

Lutein/Zeaxanthin micrg/100 gKale 21.9

Collard greens 16.3

Spinach 12.6

Cress leaf 12.5

Swiss chard 11.0

Chicory leaf 10.3

Parsley 10.2

Mustard greens 9.0

Beat greens 7.7

Okra 6.8

Red pepper 6.8

Endive 4.0

Avocado 4.0

Celery 3.6

COOKING & LOSS OF IODINERana R, Raghuvanski RS J Food Sci Technol. 2013;50:1212-1216.

%loss

Cookingin

water

SIX DANGEROUS METABOLIC MANIFESTATIONS 0FTEN OCCURING IN THE SAME CHRONICALLY ILL PERSONS

Abdominal obesity High blood pressure Elevated blood sugar Elevated blood triglycerides Low blood HDL cholesterols Fatty liver & fat-infiltrated skeletal muscles High blood uric acid

Suggested in 1923 by Eskil Kylin, Swedish Physician, Eksjö, Jönköping and Stockholm.

Today strongly associated withconsumption of ”Western-type” foods

Waist circumference men: < 102 cm women: <88 cm Fasting glucose 3,9 - 5,9 mmol/LTriglycerides: < 1,7 mmol/LLow-density lipoprotein cholesterol(LDL), men: < 2,5 – 3,0 mmol/LSystolic blood pressure: (SBP) < 130 mmDiastolic blood pressure: (DBP) < 85 mm

NORMAL VALUES

METABOLIC SYNDROMERE-NAMED around 1980 as Insulin Resistance Syndrome – IRS

recoined to METABOLIC SYNDROME - MS.

Affects 20 – 25 % of the world’s adults

Affected in 2000 32% of U.S. adults

10 years later 34 %

& Continues to increase

DISCRETE PERSISTANT CHRONIC INFLAMMATION - A MOTHER OF DISEASE

Bengmark S. J Clin Nutr 2004;23:1256-1266

CALORIE-CONDENSED FOODS & UNHEALTH Cani PD, Delzenne NM Curr Pharm Des. 2009;15:1546-1558

CALORIE-CONDENSED & PRO-INFLAMMATORY FOODS

Alcohol Bread & Pasta, Pastries Butter Cheese Chips Fast food & takeaways

Fried food Jam and marmaladeMilk & Latte Potatoes & other tubers – EATEN WARM – NOT COLD Red meat Tomato ketchup Soft drinks

Jon Brower Minnoch, USA, 1941 -1983, 635 kg - The ever world´s heaviest person

Celebratingbirthday

THE QUARTET OF DEATHBengmark S. Hepatobiliary Surg Nutr 2015;4:278-288 - www.bengmark.com

Excessive body weight Hypertension Impaired glucose homeostasis Atherogenic dyslipidemia

LIFESTYLE CAUSES OF DEATH Danaei G Plos Med 2009,6(4),e

2017: ”Obesity replacing smoking as leading cause of global death”

DISEASE, GENES ENVIRONMENTexample cancer Anand P et al Pharm Res 2008;25:2097-2116

Environment 90-95 %

DIET app 1/3

Genes 5 %

PALEOLITHIC LIFESTYLE & HEALTHless fat, less protein, less sugar, less calories

Robbins J: Healthy at 100: The Scientifically Proven Secrets of the World's Healthiest and Longest-Lived Peoples

Read: http://thepdi.com/hunza_health_secrets.htm

17 % fat intake

10 % protein

1800 calories per day

0 % processed –99 % plant foods

A TZUNAMI OF PROSTATE CANCER -JAPAN

The age-adjusted death rate in ChDs such as prostatic cancer rose in Japan during the period 1948 - 98

25-foldparallel to increases in intake of :

egg 7 Xmeat 9 X dairy 20 X

Ganmaa D et al Medical Hypotheses 2003;60:724-730

”WARNING SIGNALS” - CHRONIC INFLAMMATION

Unexplained fatigue, sleep problems, frequentheadache, hair loss, gray hair, dandruff, acne, skin rashes, dry eyes, frail nails, dry mouth or increased salivation, reduced sex functions, irregular menstruations, obstipation or diarrhea, osteoporosis, overweight, frequent infections, mental depression, easy breathless, sweaty feet, sweaty hand palms etc. www.bengmark.com

Sweden 2017: Individuals with loweducation and low incomehave 60 % more diseaseminus 9-10 years life span affects also their children

USA: Garbutt JM et al. Clin Pediatr. 2012;51:840-847

CHRONIC DISEASES - Classrelated!

SOCIOECONOMIC STATUS & OUTCOME, – USAShea S et al. Plos One 2016; 11: e0165651.

EARN MORE – LIVE LONGER Chetty R et al JAMA 2016;315:1750-1766

”No election is won by poking

one's nose into people's fridges”

Citation from Swedish conservative government minister.

"Health is not a political issue

– only healthcare is.“

Citation from Swedish socialist government minister.

DYSBIOSIS-INDUCED METABOLIC DISORDERS Cani PD et al Diabetes 2008;57:1470-1481

LPS concentration 10 to 50 X higher than those obtained during septic shockMitaka C. Clin Chim Acta 2005; 351:17-29

Bifidobacteriumspp.

LPS = ENDOTOXIN – THE VILLAIN

ENDOTOXIN - THE VILLAIN & ASSOCIATED DISEASES:• Alzheimer Jaeger LB et al. Brain BehavImmun. 2009; 23: 507–17

• Cognitive impairment Lee JW et al. J Neuroinflammation 2008; 5: 37

• Arterio-/Coronary Diseases Heo SK et al Immunol Lett 2008;120:57-64

• Diabetes type 1 Nymark M et al Diabetes Care 2009 32(9): 1689–1693

• Diabetes type 2 Andreasen AS Intensive Care Med. 2010;36:1548-1555

• Cancer Hsu RY et al Cancer Res. 2011;71(5):1989-1998

• Chronic Liver diesases Nolan JP Hepatology 2010;52:1829-1835.

ADHD, allergy, ALS, autism, autoimmune diseases, bipolardisease, cataracts, chronic fatigue, syndrome, chronic kidney disease, chronic lung disease - COPD, fibromyalgia, glaucoma, gulf warsyndrome, HIV, iritis, maculardegeneration, minimal encephalopathy, multiplesclerosis, nephropathies, obesity, osteoporosis, paradontosis, Parkinson, polycystic ovarysyndrome, rheumatoid disease, stress, schizophrenia, stroke, uveitis, etc

Brix S et al J Allergy Clin Immunol 2015;135:277-280

Endotoxin in lungs

POSTPRANDIAL HYPERGLYCEMIA & HYPERLIPIDEMIA – THE INDUCER OF CHRONIC DISEASES Ceriello A, Genovese S. Rev Endocr Metab Disord 2016;17:111–116

DAILY BLOOD GLUCOSE VARIATIONS Freckmann G et al J Diabetes Sci Technol. 2007; 1: 695–703

Normal:72-108 mg/dL = 4-6 mmmol/lfasting, max 157 = 8.7 after meal.

POSTPRANDIAL INFLAMMATION & ENDOTOXEMIA Erridge C et al Am J Clin Nutr 2007;86:1286 –1292

POSTPRANDIAL HYPERLIPIDEMIA IN METABOLIC SYNDROMEAlcala-Diaz JF et al. Plos One 2014;9:e96297

INDUCERS OF POSTPRANDIAL INFLAMMATIONLópez-Moreno J et al. J Agric 2017;65:7756-7763

Rich in: Saturated Fat Monosaturated Fat + Omega-3 Fats

(animal fat) (sunflower oil 85 % olive oil 75 %, canola oil 58 %) (tallow 50 %, lard 40 %)

LFHCC = COMPLEX CARBOHYDRATES

Medium chain fatty acids – MCFAs - protect from lipotoxicity and subsequent

insulin resistance MCFA TOP SOURCES: Coconut oil and palm kernel oil

Dietary long-chain fatty acids – LCFAs - impair insulin sensitivity & lipid metabolism – LCFA TOP SOURCES: C14, C16, C18 – mainly dairy and meat:

C14, C16, C18 – mainly from dairy and meat

FATTY ACIDS – CHAIN LENGTH & METABOLISMWein S. Diabetes Metab Res Rev 2009;25:185-194

SATURATED FATTY ACID METABOLISMMCFA: Coconut Oil 85,2, Palm kernel oil 81,5, Palm Oil 45,3,

Olive Oil 14.5 (70 % monosaturated) LCFA: Animal fats

FAT UTILIZATION 72 HRSSoeters P et al Am J Physiol Endocrinal Metab 2012;303:E1397-1407

MINIMIZE POSTPRANDIAL INFLAMMATION 1. Avoid being overweight.

2. Exchange long-chain fatty acids, incl. olive oil, to medium-chain fatty acids.

3. Avoid foods and drinks containing sugar, high-fructose corn syrup, white flour.

4. Reduce the numbers of meals & keep servings modest.

5. Eat high-fiber, low GI foods: whole grains, nuts. legumes, vegetables, fruits.

6. Eat daily salads of leafy greens dressed with vinegar &

7. Drink vinegar mixed with water at your meals.

8. Consume daily nuts, & eat vegetables, berries & fruits.

9. Eat lean protein at all meals – peas, beans, nuts, almonds or lean meat or fish.

10. Obtain 30 min or more of daily physical activity of at least moderate intensity.

POSTPRANDIAL METABOLISM – IMPACT OF VINEGAR Mitrou P et al Eur J Clin Nutr 2015;69:734-739

VinegarVinegar

INSULIN TRIGLYCERIDES

Best - Number 1

Worst

LONG-CHAIN & MEDIUM CHAIN FATTY ACIDS - EFFECTS OF HEATINGGrootveld M et al – data under publication

LONG-CHAIN & MEDIUM CHAIN FATTY ACIDS & INFLAMMATIONYu S et al . Microbiol. Biotechnol.2017;27:1617-1627

BENEFITS OF MEDIUM CHAIN TRIGLYCERIES - MCTs - SUPPLY• Reduces inflammation & insulin

resistence Geng S et al Eur J Nutr 2016;55:931-940

• Provides antifungal, antibacterial and antiviral properties Nguyen VTA et al. J Lipids 2017;2017:7170162

• Promotes heart health Kamisah Y et al. Pharm Biol. 2015;53:1243-1249

• Promotes brain function BMC Neurosci 2008;9(suppl 2):16

• Supports healthy thyroid function Positive Med, September 16, 2015

• Protects against dementia Nafar F et al Neurochem Int 2017;105:64-79

• Inhibits cancer cell growth Lappano R Cell Death Discover 2017;3:17063

• Boost energy & Promotesmetabolism & digestion Otsuka H et al. Tohoku J Exp Med.2016;240:323-328

• Promotes weight loss Chamma CM et al. Food Funct 2017;8:778-787

• Control Crohn’s disease

• Maintain healthy skin

• Control Candida

• Maintain oral health.

THE MICR0BIOTA-OBESITY CONNECTIONMoran CP, Shanahan F Best Pract Res Clin Gastroenterol 2014;28:585–597

”THE BATTLE FIELD” POSTPRANDIAL INFLAMMATION GENERAL INFLAMMATION CHRONIC DISEASES

Myles IA Nutrition Journal 2014;13:61

”Everything in excess is opposed to Nature. All disease begins in the gut” HippocratesHippocrates

”You are what

you eat”

METABOLIC SYNDROME & DYSBIOSISTremellen K, Pearce K Med Hypotheses 2012;79:104-112

DIFFERENT MICROBIOTA IN OBESE vs LEANAngelakis E et al Future Microbiol. 2012;7: 91–109

GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606-613

↓ FFA oxidation

↑ Endotoxin/s

↓ SCFA production

↓ Incretin secretion *

↓ Butyrate production

↑FFA oxidation

↓ Endotoxin/s

↑ SCFA production

↑ Incretin secretion

↑ Butyrate production

* Incretin = hormonedownregulatingblood glucose

MICROORGANISMS:

Yellow = beneficialGreen = pathogenic

BREAKING THE VICIOUS CIRCLEINFLAMMATION

INFECTION &DISEASE

Treatment alternatives: Antibiotics: Reduces infections but Deranges Microbiota & Creates DysbiosisIntestinal Intestinal Reconditioning: Pro/Synbiotics restoresMicrobiota & REDUCES DEGREE OF CHRONIC INFLAMMATION

CLUSTERING & RISK PROFILE Qvarnstrom M et al J Clin Periodontol 2010; 37: 805–811

ANTI - OBESITY FOODS Omega-3: inhibiting lipid synthesis & increasing thermogenesis(krill oil, flax seed)

Conjugated Linoleic Acid: increasing oxidation (mushrooms)

Phenolic compounds & Other Antioxidants; Catechin (blackberries, dark chocolat), Saponins (beans & legumes), Anthocyanins (eggplant/brainfood, black current, green bananas, cranberries, blueberries, asparagus) Isoflavones(soy beans)

Dietary minerals: Increasing adipocyte metabolism, reducing storage of fat & fecal fat excretion. (Soy/tofu, spring greens, spinach, watercress, broccoli, kale, chickpeas, almonds, sesame seeds, dried figs, currents).

Dietary fibres; promoting secretion of anorexigenic/appetite reducing peptides (pectin, resistant starch, inulin, betaglucan)

Pro- and Synbiotics

PLANT FOOD PREVENTS CHRONIC DISEASESAune D. et al Int J Epidemiol 2017 E-pub Feb 22.

RECOMMENDATION for optimal health 1 – 1 ½kg/person/day

Eating 800 g fruit and vegetables a day –

or 10 portions – is associated with: 28 % reduced risk of cardiovascular disease

24 % reduced risk of heart disease

33 % reduced risk of stroke 13 per cent reduced risk of total cancer 31 % reduction in premature death

ADVANTAGES OF RAW FOOD VEGAN DIET Fontana L et al . Rejuvenation Res. 2007;10:225–234

Consuming a low-calorie low-protein vegan diet, composed of unprocessed and uncooked plant derived foods

Recruited from The St. Louis Vegetarian Society and a Raw Food online magazine (Raw Food News, www.rawfoods.newsmagazine.com).

SBP=Systolic blood pressure, DBP=Diastolic blood pressure, HOMO-IR=homeostatic model assessment - a method used to quantify insulin resistance and beta-cell function, hsCRP=high sensitive c-reactive protein – indicator of inflammation

”Couch potatoes”

“HARMONY

LIFESTYLE&

HEALTH

EXERCISE FOOD

REGULAR EXERCISE REDUCES MORBIDITY & MORTALITYGebel K et al JAMA Intern Med 2015;175:1863-1864

WHO’s guidelines suggest that “significant health benefits can accrue

through accumulation of at least 150 minutes of moderate activity per week”

661 000 persons followed during 14 years:No exercise – the highest mortality150 min/w moderate exercise, low speed - 20 %

150 min/w moderate exercise, more speed - 31 %

450 min/w moderate exercise, more speed - 39 %

1500 min/w moderate exercise, high speed - 20 %

“GOOD FOR MICROBIOTA - GOOD FOR HEALTH

Avoid toxic substances: Alcohol, tobacco, pesticides, drugs, AGE & ALEs, casein, gluten, zein, refined sugars, flour etc

Avoid processed foods Eat fresh greens

HEALTHY FOODS – NEW TREND

Dennis Burkitt 1911 - 1993Suggested that Western diseases, rare in Africa are primarily the result of diet and lifestyle.

Reported an association between low fibre in diet higher risk of colorectal cancer as well as other diseases such as CHD and diabetes

GI PERISTALSIS – UK vs UGANDAAppr GI transit time: UK: 100 hrs vs Uganda: 20 hours Appr stool weight: UK 60 g/day vs Uganda 600 g/day Burkitt DP et al Lancet 1972;300 (7792):1408-11

British geriatric patients: GI transit time: >14 days in > half of the patientsBrocklehurst JC, Khan MY. Gerontol Clin 1969;11:293-300

1. JORDÄRTSKOCKETESTET. Jordärtskocka är liksom lök, vitlök, purjolök, sparris,

kronärtskockor och banan rika på de mycket nyttiga men svårsmälta fiber som

kallas fruktaner. Om Du kan äta en rå medelstor jordärtskocka utan att få

tarmbesvär då kan man vara ganska säker att Du har en hyggligt fungerande

tarmflora.

2. MOUNT EVEREST-testet. Om man har en bra fungerande tarmflora så är normalt

att två gånger om dagen fylla toaletten med en större avföring. Moderna

toalettstolar är inte byggda för ”paleolitisk” avföringen. Om man producerar

tillräckligt med avföring så kommer toaletten bli lätt överbelastad – en liten

”alptopp” skall sticka upp över vattenytan och vattnet ”resa sig” något vid

spolning.

3. MAJS/BLÅBÄRSTESTET. ”Paleolitisk” avföring tar cirka 20 timmar att ta sig från

mun till anus. Lunchen ”kommer ut” mellan 8 och 9 nästa morgon och

kvällsmålet mellan 12 och 13 nästa dag. Det kan man mäta genom att se när majs

eller blåbär kommer ut igen.

DAVID JP BARKER 1838 – 2016The thrifty epigenotype hypothesis -Barker, D.J.P. Maternal Nutrition, Fetal Nutrition, and Disease in Later Life".

Nutrition, 1992;13: 807-813Curr Opin Nephrol Hypertens 1997; 6:106-110

We know that “disorders of adult life, including coronary heart disease, stroke and diabetes, arise through interaction between influences in our adult lifestyle and genetically determined susceptibility.”

“Recent research, however, suggest that growth in utero may also play an important role” “Even brief periods of … may permanently change/`reprogramming´ the body…and lead to persistent changes in blood pressure, cholesterol metabolism, insulin response to glucose, and in a range of other metabolic, endocrine and immune parameters.”

FOOD INTAKE & INFLAMMATION Low intake of fresh plant foods; GREENS, vegetables, fruits, SPICES High intake of proteotoxins in certain foods: casein, gluten, zein (corn) etc. High intake of heat- and storage-inducedproteotoxins: glycated (AGEs), lipoxidatedmolecules (ALEs),processed carbohydrates induces: Dysbiosis: reduced numbers & diversity Leakage of Various body membranes; leaky gut, leaky airways, leaky skin, leaky vagina, leaky eye cavity , leaky nose, leaky placenta, leaky blood-brain barrier etc.

PROCESSED MEAT & RISK OF CANCEROesophageal cancer Salehi M et al Nutr Rev 2013;71:257-267, Huang W et al Cancer Causes Control 2013;24:193-201

Stomach cancer Larsson SC J Natl Cancer Inst 2006;98:1078-1087

Pancreatic cancer Larsson SC, Wolk A Br J Cancer 2012;31;106:603-607

Colorectal cancer Chan DS et al Plos One 2011;6:e20456

Bladder cancer Wang C, Jiang H Med Oncol 2012;29:848-855

Lung cancer Yang WS et al Ann Oncol 2012;23:3163-3170

Ovarian cancer Kolahdooz F et al Am J Clin Nutr 2010;91:1752-1763, Wallin A et al Br J Cancer 2011;104:1196-1201

PROCESSED MEAT AND HEART DISEASEMicha R et al. Circulation 2010;121(21):2271-2283

USA: Metaanalysis of 20/1598 totally including 1218380 individuals with 23889 cases of CHD, 10797 cases of diabetes mellitus and 2280 cases of stroke.

Conclusion: Processed, but not unprocessed, meat is associated with 42% higher risk of CHD and 19% higher risk of diabetes mellitus (P<0.001). Processing promotes: vascular dysfunction and atherosclerosis, reduce insulin secretion, impair glucose tolerance.

USA: 37 698 men and 83 644 women (2.96 million person- years) followed for > 28 years.

20 % by eating processed meat: cured, bacon, sausages, paté meatballs, hamburgers etcPan A et al Arch Intern Med 2012;172:555-563

EU: 448,568 men and women, age 35-69 studied during 13 years:

A daily piece of steak is associated with a 13 % greater chance of dying during the study (13 years)

An extra daily serving of processed red meat linked to a 20 % higher risk of death during the study.

72 % increased risk of dying in heart disease &

11 % increased risk of dying in cancer Rohrmann S et al BMC Medicine 2013;11:63

FISH INTAKE & HEALTH

Vegetarians have a 22 % lower risk to get colorectal cancers; in the colon 19 %, in the rectum 29 % comp to non-vegetariansOrlich MJ Frazer GE et al JAMA Intern Med. 2015; 175:1727

Meta-analysis shows that fish consumption is associated with a 63 % reduction in mortality such as prostate cancerSzymanski KM et al Am J Clin Nutr 2010;92:1223-1233.

DAIRY-INDUCED INFLAMMATIONDietary proteins of cow´s milk induce inflammation: release inflammatory mediators

increase intestinal permeability &

induce leakage of large molecules; albumin, hyaluronan etcJalonen T J Allerg Clin Immunol 1991;88:737, Isolauri E Gastroenterology 1993;105:1643, Bengtsson U et al. J Clin Exp Allerg 1996;26:197, Allerg ClinImmunol 1997;100:216

ESTROGENS IN MILK Malekinejad H et al J Agric Food Chem 2006;54: 9785-9791

Background: The dramatic increase in testicular, breast, prostate, ovarian, and corpus uteri, and large bowel cancers.

60-80% of the intake of estrogens originates in the Western world from milk and other dairy foods.

The daily intake of total estrogens through milk

is 372 ng/L

“which is dramatically more than currently recognized.”The content is twice as high in 3.5 % fat milk than in non-fat milk & extremely high in butter!

DIET AND BREAST CANCERCarroll KK Cancer Res 1975;35:3374-3383

THE JAPANESE EXPERIENCEThe age-adjusted death rate in ChDssuch as prostatic cancer rose in Japan

during the period 1948 - 98

25-foldParallel to increases in intake of :

egg 7 Xmeat 9 X dairy 20 X

Ganmaa D et al Medical Hypotheses 2003;60:724-730

PROSTATIC CANCER&

MILKCONSUMPTION

Ganmaa D et al Int. J. Cancer 2002,98,262–267

BOVINE MILK &

CORONARY HEART DISEASE

Artaud-Wild SM et al. Circulation1993;88:2771-2779

PROSTATIC CANCER DEVELOPMENT IN EASTASIA Zho Y et al Asian J Androl 2015;17:48–57

BREAST CANCER: INCIDENCE & MORTALITY - 2030 Chajès V, Romieu I Maturitas 2014;77:7– 11

EARLY MILK CONSUMPTION & RISK OF PROSTATIC CANCERTorfadottir JE et al Am J Epidemiol 2012; 175:144-53

Iceland: 8,894 men born 1907 to1935 followed a mean 24.3 years & 1123 diagnosed with prostatic cancer 2,268 participants reported their milk intake in early, mid-, and current life.

Daily milk intake in adolescence associated with a 3.2-fold risk of advanced prostate cancer (95% CI: 1.25, 8.28) suggesting that

frequent milk intake in adolescence increases risk of advanced prostate cancer later in life.

DAIRY & RISK FACTORS IN PROSTATIC CANCERAune D et al Am J Clin Nutr 2015;101:87-117

USA: In a Physicians Health Study, 21,660 men were followed for 28 years. 2806 men developed prostatic cancer & 305 died.

Total intake of dairy products was associated with increased incidence of prostatic cancer (HR = 1.12)

Larger intake of skim/low-fat milk was associated with greater risk of nonaggressive prostatic cancer &

Larger intake of whole milk with fatal prostatic cancer & progression to fatal disease after diagnosis (HR = 2.17)

DAIRY INTAKE AND RISK OF CANCERLu W et al. Nutrition Journal 2016;15:91

Studies of 11 population-based cohort studies involving 778,929 individuals demonstrated that

low total dairy intake reduced relative risk of all cancers &

increase of whole milk significantly elevated risk of increased prostate cancer mortality with the RR of 1.43 (95 % CI 1.13–1.81, p = 0.003).

BOVINE MILK & CHRONIC DISEASESAllergy Rautava S, Isolauri EJ Pediatr

Gastroenterol Nutr. 2004 Nov;39:529-535

Breast cancer Outwater JL et al Med Hypotheses 1997;48:453-461, HjartåkerA et al Int J Cancer 2001;93:888-893

Colorectal cancer ManousosO et al Int J Cancer 1999;83:15-17, Ma et al J Nat Cancer Inst;2001:93:1330-1336

Chronic constipation Iacono G et al N Engl J Med 1998;339:1100-1104

Coronary heart disease Briggs RD et al. Circulation 1960;21:538-542, Marshall T BMJ 2000;320:301-305

Diabetes type 1 Gimeno SGA, De Souza JMP Diabetes Care 1997;20:1256-1260, Virtanen SM et al Diabet Med 1998;15:730-738

Malabsorption O´Keefe SJD et al Am J ClinNutr 1991;54:130-135

Ovarian cancer Larsson SC et al Am J ClinNutr. 2004;80:1353-1357, Ganmaa D, Sato A

Med Hypotheses. 2005;65:1028-1837

Parkinson disease Park M et al. Neurology2005;64:1047-1051

Testicular and prostate cancerGanmaa D et al. Med Hypotheses 2003;60:724-730, Qin LQ et al Nutrition and Cancer 2004;48:22-27

HORMONAL ENVIRONMENTAL ”DISRUPTORS”

Up to 80 % of milk come from pregnant cows & contains significant amounts of: Pituitary hormones: PRL, GH, TSH, FSH, LH, ACTH Steroid hormones: estrogen, progesterone, testosterone Hypothalamic hormones: TRH, LHRH, GnRH, GRH Gastrointestinal peptides Halogenated aromatic hydrocarbones Advanced glycation & lipoxidation end products(AGEs/ALEs)

FREE ESTROGENS IN DAIRY pg/gWolford ST, Argoudelis CJ J Dairy Science 1979;62:1458-1463

E1 2 - 17β E3

Whole milk 3.7 6.4 9.0

Skimmed milk 20.2 3.4 8.2 Whey 3.6 1.5 3.0

Cottage cheese 34.9 10.8 6.1

Butter 539.4 82.3 86.8

Compare 1266 322 51 Malekinejad H et al J Agric Food Chem 2006;54: 9785-9791

MEJERIFRIA – MJÖLKALTERNATIVwww.bengmark.com

METABOLIC SYNDROME IN COWSHostettler-Allen RL et al J Anim Sci 1994;72:160-173

Modern feeds of dairy cows, less forage-based and rich in starch & carbohydrates (corn, maize grains, barley, molasses & dextrose)

are likely to induce, also in cows Insulin resistance, observed in calves

fed on intensive milk- and lactose diet

"Cow's milk in the past has been oversold as the perfect food, but we are now seeing that it isn't the perfect food at all and the government really shouldn't be behind any efforts to promote it as such.“ Benjamin Spock, M.D., Los Angeles Times, November 18, 1992

“I would call milk perhaps the most unhealthful vehicle for calcium that one could possibly imagine, which is the only thing people really drink it for, but whenever you challenge existing dogma...people are resistant.“ Neal Barnard, M.D., Director of the Physician's Committee for Responsible Medicine www.pcrm.org

BENEFITS OF PRE- & PROBIOTICSDruarte C et al Adv Nutr 2014;5:S624-S633

FECAL TRANSPLANTATION Rao K, Safdar N J Hosp Med 2016;11:56-61

FLORA IN WESTERNERS Lb plantarum, a dominating LAB, observed in only 25 % of omnivorous Americans & in 65 % of vegetarian Americans Finegold SM et al. Human intestinal microflora in health and disease Academic Press, London, UK, 1983. pp 3-31

Benefial & common colonic LACROBACILLI present inonly in about 50 % or less of healthy Scandinavians: Lb plantarum 52 % Lb rhamnosus 26 % Lb paracasei ssp paracasei 17 %

Ahrné S et al. J Appl Microbiol 1998;85:88-94

MICROBIOTA & OBESITYMillion M et al. Int J Obesity 2012;36:817-825

L. plantarum 0 (0%) 8 (18.2%) 0.0004

L. paracasei 10 (14.7%) 17 (38.6%) 0.004

L. reuteri 6 (8.8%) 1 (2.3%) 0.16

L. rhamnosus 3 (4.4%) 4 (9.1%) 0.27

L. ruminis 3 (4.4%) 4 (9.1%) 0.27

L. salivarius 5 (7.4%) 2 (4.5%) 0.43

Obese (n=68) Controls (n=44) P-value

ENDOTOXIN & OBESITY Fei N, Zhao L. ISME J. 2013;7:880-884

A Chinese man weighing 175 kg lost 51.4 kg after

23 weeks on VEGAN TYPE FOOD & recovered from hyperglycemia and hypertension.

The endotoxin-producing Enterobacter cloacae B29 -found to constitute 35% of the gut bacteria - decreased to non-detectable.

The Enterobacter cloacae inoculated in germfree mice induced obesity & insulin resistance.

Most lactobacillus strains are not probiotics” Suzuki C et al Int J Food Microbiol 2008 ;123:159-165

Strains IL-6 (ng/ml) IL-12 (ng/ml) TNF-α (ng/ml)

S63 138 37 20

P79 100 23 10

H-17 118 3 12

H45 4 2 0.33

O 62 4 2 0

G50 10 2 16

1257 0.29 1 0.23

ATCC19435 21 5 0

O19 0 0 0

O20 0 0 0

LPS 170 8 4

MMUNE IMODULATION –studied in 46 strains of lb. Lactis

THE GREAT Pswww.bengmark.com

Lb Plantarum Lb Paracasei Pediococcus pentosaceus

Lb paracasei – the master? the strongest inducer of Th1 & repressor of Th2 cytokines when more than 100 strains are compared Fujiwara D et al. Int Arch Allergy Immunol 2004;135:205–215

FERMENTATION ABILITYThe ability of 712 different LAB to ferment oligofructans (inulin, phleins) studied:

16/712 able to ferment the phleins &

8/712 able to ferment the inulin type fibreOnly four species had the ability:

Lactobacillus plantarum (several)Lactobacillus paracasei subsp. paracasei

Pediococcus pentosaceus & Lactobacillus brevis Müller M, Lier D. J Appl Bact 1994;76:406-411

Included in Synbiotic 2000

CONTROL OF PATHOGENSThe ability of 50 different LAB to control 23 different pathogenic Clostridium difficile tested:

27 were totally ineffective

18 antagonistic to some

5 effective against all:

2 strains - Lb paracasei s. paracasei

3 strains - Lb plantarumNaaber P et al. Med Microbiol 2004;53:551-554

RESEARCH BACKGROUND: THE 1986 EXPERIENCE

1986: Review of 81 extensive liver resections

Prophylactic antibiotic (ampicillin, cephalosporin, tetracyclines) given to 57/81 patients

No antibiotics to 24/81 patients

Morbidity: 33% (17 % major)

ALL INFECTIONS WERE IN ANTIBIOTIC TREATED PATIENTS

NO INFECTIONS WERE SEEN IN THE PATIENTS WHO DID NOT RECEIVE ANTIBIOTICSEkberg, PhD thesis, Lund University 1986 Henrik Ekberg 1951 – 2012 (61 år)

CHOICE OF LACTIC ACID BACTERIA TO SYNBIOTIC 2000

The abilities of 535 Lactobacillusstrains to control inflammation and infection were studied355 harvested from humans &180 from plants www.bengmark.com

SYNBIOTIC 2000 - UNIQUE PROPERTIES4 of 535 studied LAB selected because:

All induce several Bioactive Proteins & cross-react with stress proteins All transcribe NF-B – to the largest extent L plantarum and L paracaseiAll produce both pro-inflammatory (IL-1, IL-8) and anti-inflammatory (IL-10) cytokines, to the largest extent L plantarum, and to less extent Leuconostoc mesenteroidesLjungh Å, Microb Ecol Health Dis 2002;3, Suppl 4:4 Kruszewska D et al Microecol. Ther. 2002;29:37

SYNBIOTICS 2000 ORIGINALwww.synbiotics.se, synbiotic2000@gmail.com40 BILLION LACTIC ACID BACTERIA:• 109 of Pediococcus pentosaceus 5-33:3

• 109 of Leuconostoc mesenteroides 32-77:1

• 109 of Lactobacillus paracasei sbsp. paracasei

• 109 of Lactobacillus plantarum 2362

10 GRAM BIOACTIVE FIBRES:• 2.5 g of betaglucan

• 2.5 g of inulin

• 2.5 g of pectin

• 2.5 g of resistant starch

https://synbiotics.se

SYNBIOTIC 200040 billion Lactic acid bacteria:

Pediococcus pentosaceus 5-33:3

Leuconostoc mesenteroides 32-77:1

Lactobacillus paracasei sbsp. Paracasei F19

Lactobacillus plantarum 2362

10 gram bioactive fibers:

2.5 g of betaglucan

2.5 g of inulin

2.5 g of pectin

2.5 g of resistant starch

Price per dose: SEK 50,00

Discounts:

More than 15 doses 10 per cent

More than 30 doses 20 per cent

http://synbiotics.se

SYNBIOTIC 1515 billion Lactic acid bacteria:

Pediococcus pentosaceus 5-33:3

Leuconostoc mesenteroides 32-77:1

Lactobacillus paracasei sbsp. Paracasei

Lactobacillus plantarum 2362

10 gram bioactive fibers:

1.5 g of betaglucan

1.5 g of inulin

1.5 g of pectin

1.5 g of resistant starch

Price per dose: SEK 18,50Discounts:

More than 90 doses 10 per cent

More than 180 doses 12.5 per cent

https://supersynbiotics.se/produkt/synbiotic15/

SYNBIOTIC 2000 FORTE400 billion Lactic acid bacteria:

Pediococcus pentosaceus 5-33:3

Leuconostoc mesenteroides 32-77:1

Lactobacillus paracasei sbsp. Paracasei F19

Lactobacillus plantarum 2362

10 gram bioactive fibers:

2.5 g of betaglucan

2.5 g of inulin

2.5 g of pectin

2.5 g of resistant starch

Price per dose: SEK 500,00

Discounts:

More than 10 doses 10 per cent

More than 20 doses 20 per cent

http://synbiotics.se

SYNBIOTIC 2000 INHIBITS GROWTH OF MULTIRESISTANT BACTERIAProfessor Val Edwards-Jones, University of Manchester, UK

Multi-resistant Acinetobacter baumanii Multi-resistant Klebsiella

SYNBIOTIC 2000 IN LUNG INJURYIlkgul O et al Br J Int Care. 2005;15:52-57

Placebo Only fibres Synbiotic 2000

SYNBIOTIC 2000 IN LIVER TRANSPLANTATION Rayes N et al. Am J Transplant 2005;5:125-131

50 to 85 % of transplant patients develop nosocomial infections within 30 days.Compared effects of daily supply of Synbiotic 2000 and Only fibres daily from the day before surgery & during following 14 postopoperative days

30 day-infection rate: Synbiotic 2000 1/33 - 3 %Only fibres 17/33 - 51 %

SYNBIOTIC 2000 IN LIVER TRANSPLANTATION

Isolated bacteria: Synbiotic 2000 Fibres onlyEnterococcus faecalis 1 11Escherichia coli 0 3Enterobacter cloacae 0 2Pseudomonas aeruginosa 0 2Staphylococcus aureus 0 1

Total 1 18

Rayes N et al. Am J Transplant 2005;5:125-131

SYNBIOTIC 2000 IN PANCREATECTOMYINFECTIONS: Synbiotics 2000 5/40 - 13 %Control (Only fibers) 16/40 - 40 % p< 0.05

Synbiotic 2000 Control Wound infections 4 6

Peritonitis 0 5

Pneumonia 0 4

Urinary 1 1

Sepsis 0 2

Cholangitis 0 1

Empyema 0 1

Total 5 20Rayes N et al. Ann Surg 2007;246:36-41

SYNBIOTICS IN ACUTE PANCREATITISOláh A et al Hepato-gastroenterology 2007;54:36-41

Isolated Microorganisms: SYNBIOTIC 2000 Fibres OnlyPseudomonas aeruginosa 1 4Enterococcus faecalis 1 2Enterobacter spp 1 1Streptococcus spp 2 -Staphylococcus aureus 1 1Enterococcus faecium 1 -Candida spp - 2Staphylococcus haemolyticus - 1Serratia spp - 2Klebsiella spp - 1Escherichia coli - 1Stenotrophomonas maltophilia - 1

Citrobacter freundii - 1

Total 7 17

SYNBIOTIC 2000 IN MULTIPLE TRAUMAKotzampassi K et al. World J Surgery 2006;30:1848-1855

102 patients supplied 15 days posttrauma with either Synbiotic 2000 Forte or placebo The treated patients demonstrated reduced: Mortality Rate of infection (P = 0.01) Rate of SIRS & severe sepsis (P = 0.02) Numbers of days on mechanical ventilation (P= 0.001) ICU stay (P = 0.01)

SYNBIOTIC 2000 IN CHRONIC LIVER DISEASE Qing-Liu et al. Hepatology 2004; 39:1441-1449

One month supply of Synbiotic 2000 reduces: Mucosal pH

PPM flora: E. coli (p<0.001) Staphylococcus (p<0.01) & Fusobacterium (p<0.05)

Endotoxin, ammonia/s, ALT/s, bilirubin/s

&

improves: Albumin/s and prothrombin

Degree of disease at Child classification &

Degree of encephalopathy at psychometric testing

SYNBIOTIC 2000 FORTE IN INTESTINAL PARALYSIS INDUCED BY BRAIN TRAUMA

Zhang L Probiotics Antimicrob Proteins 2017; 9:172-181

Traumatic brain injury (TBI) markedly reduced contractile activity of the intestinal smooth muscle (P < 0.01), impaired ICC networks and densities (P < 0.01) & reduction of defecation/obstipation (P < 0.01)

Application of Synbiotic2000™ Forte improves contractile activity of the small intestine (P < 0.01) & maintains contractile activity (P < 0.01)

SYNBIOTICS AND ATHLETIC PERFORMANCE

Study at the Olympic Training Centre in Barcelona. Six swimmers (4 women and 2 men) ingested regularly Synbiotic 2000 Original

One of 2 men improved the Spanish record in 200 meters butterfly

Three of 4 women improved the Spanish records: 100 meters butterfly, 200 meters butterfly, 200 freestyle, 4x200 freestyle relays

Dr Pedro Pujol, FACSM Depart Physiol University of Barcelona

SYNBIOTICS 2000 -REDUCTIONS IN INFECTIONS/POSITIVE BLOOD CULTURESLiver transplantation, 66 patients1

Patients with postop. infections 16 => 1 = 94 per cent

Patients with pos. blood cultures 11 => 1 = 91 per cent

Pancreatdoudenectomy for cancer, 80 patients2

Patients with postop. infections 16 => 5 = 69 per cent

Patients with pos. blood cultures 27=> 5 = 82 per cent

Severe pancreatitis – 62 patient3

Patients with infections 15 => 9 = 40 per cent

Patients with pos. blood cultures 17 => 7 = 59 per cent

Severe trauma, treated with Synbiotic 2000 Standard – 52 patients4

Patients with infections 23/30 (77 %) => 17/35 (49 %)

Severe trauma, treated with Synbiotic 2000 Forte – 72 patients5

Patients with post-trauma infections 13 => 5 = 62 per cent Patients with pos. blood cultures 13 => 5 = 62 per cent

SYNBIOTICS 2000: REDUCTIONS IN USE OF ANTIBIOTICS, ARTIFICAL RESPIRATION, TIME IN ICUs & IN HOSPITAL

Liver transplantation – 66 patients1

Days on Antibiotics 3.8 => 0.1 = 3.7 = 97 per cent

Days in ICUs 10.2 => 8.8 = 1.4 = 14 per cent

Days in Hospital 27.9 => 27.8 = 0.1 = 13 per cent Pancreatdoudenectomy for cancer - 80 patients2

Days on Antibiotics 10 => 2 = 8 = 80 per centDays in ICUs 6 => 2 = 4 = 67 per cent

Days in Hospital 22 => 17 = 5 = 23 per cent

Severe acute pancreatitis – 62 patients3

Days in Hospital 19.7 => 14.9 = 4.8 = 24 per centSevere trauma treated with Synbiotic 2000 Forte – 65 patients5

Days on Artificial Respiration 24 => 19 = 5 = 21 per cent

Days in ICUs 41.3 => 27.7 = 13.6 = 33 per cent

COMMUNICATION BETWEEN THE GUT, GUT

MICROBIOTA & THE BRAIN

endocrine, neurocrine &

inflammation-relatedcommunications

Mayer et al J Neurosci2014;34:15490-15496

PSYCHO-NEUROLOGICAL DISORDERS & GUT CONNECTION• ADHD Pärtty A et al Pediatr

Res 2015;77:823-828.

• Autism Kraneveld AD et al. Int Rev Neurobiol 2016;131:263-287

• Alzheimer Alam MZ et al CNS Neurol Disord Drug 2013 E-pub

• Anxiety Luna RA, Foster JA CurrOpin Biotechnol 2015,32:35–41

• Chronic fatigue syndrome FrémontM et al Anaerobe 2013;22:50-56

• Encephalopathy Liu Q et al Hepatology 2004;39:1441-1449

• Mental Depression Dinan TG, CryanJF Neurogastroenterol Motil2013;25:713-719

• Myalgic encefalomyelitis FrémontM et al Anaerobe 2013;22:50-56

• Multiple sclerosis Ochoa-Repáraz J et al Gut Microbes 2010;1:103–108

• Parkinsons Disease Cersosimo MG et al J Neurol 2013;260:1332-1338

• Schizophrenia Severance EG Schizophren Res 2013;148:130-137

DIET, MICROBIOTA ANXIETY &

DEPRESSION

Luna RA, Foster JA Current Opinion in Biotechnology

2015, 32:35–41

DIET, MICROBIOTA ANXIETY &

DEPRESSION

Luna RA, Foster JA Curr Opin Biotechnol

2015,32:35–41

DYSBIOSIS IN EPILEPSIAErasistratus linked epilepsy to bowel dysfunction in the 3rd century BC.

Ketogenic diet observed to be effective in seizures. Peterman MG. JAMA 1925;84:1979–83.

Ketogenic antiepileptic effects likely due to diet-induced NPY Mainardi P, Albano C. Med Hypotheses 2008;70:536-539

NPY release stimulated by nutrients in the gut. Fu-Cheng X et al. Pflugers Arch1995;431:66–75

Neuropeptide Y (NPY) is a potent & selectively inhibitor of excitatory synaptic transmission in the hippocampus Schwarzer et al Neuroscience 1995;69:831–45

Fats - potent activators of NPY release in distal gut. Lin HC et al Peptides 2000;21:1561–1563

”Every man is the architect

of Her/His own health”

HEALTH: TWELVE COMMANDMENTS1. Limit/eliminate sugars, especially fructose, and sugar-like foods: bread, pizza, pasta, polished rice, warm cooked potato &

tubers. Cool before eating.2. Limit/eliminate diary products. 3. Limit red meat to 300 g/week. Avoid processed meat, pig meat, beef from supplement-fed animals and farmed fish.

Focus on wild fish, game meat and beef from grass-fed animals.4. Limit/eliminate intake of long-chain fatty acids and processed oils. Focus on plant fats such as cocos and avocado.5. Eliminate foods containing inflammation-inducing proteins: casein (diary), gluten (wheet, rye, barley) och zein (corn).6. Limit/eliminate heat-induced inflammation-inducing proteins – glycated and lipoxidated products - foods heated above

120-130 degree C. 7. Avoid exposure to microbial toxins such as endotoxin, pesticides and other poisons. 8. Limit your sodium & chloride salt intake - increase the intake of iodine. Avoid fluoride, bromide and reduce chloride.9. Limit/eliminate as much as possible exposure to chemicals including pharmaceutical drugs. 10. Focus on plant foods rich in proteins, fibres, antioxidants. Use grains such as amaranth, durrah, teff, quinoa, various

seeds, peas, beans, lentils, almonds and nuts. Germinate/sprout seeds,peas, beans, lentils, almonds and nuts for 12-24 hours.

11. Let the majority of your food (about 80 %) be fresh raw vegetables and fruits with low glycemic index, and anti-inflammatory spices and teas such as puerh, yerba & oliveteas. Supplement Vitamin D, omega3, turmeric and probiotics– the four corner stones of anti-inflammation. Supplement also iodine as KJ or Kelp.

12. Practise daily fasting as Peak fasting (intake of calories 6/24 hours) either as SKIPPING BREAKFAST (no food before noon) or SKIPPING DINNER (no food after 14 pm)

PALEOLITHIC DIET“Much support that our genes, adapted during million of years to the lifestyle of our prehistoric ancestors badly tolerate the dramatic changes, especially in food habits, which have occurred”.

Eaton BS, Konner M. Paleotlithic nutrition: a

consideration of its nature and current

implications. N Engl J Med 1985;312:283-289

Contained more of: (X = times more) Minerals 2 X Fibers 4 to 10 XAntioxidants 10 XOmega-3 FA 50 X Lactic acid bacteria >1010 X

Contained less of:(X = times less)Protein 2 XSaturated FA 4 XSodium 10 X

DIET & LONGEVITYRobbins J: Healthy at 100: The Scientifically Proven Secrets of the

World's Healthiest and Longest-Lived Peoples

Read: http://thepdi.com/hunza_health_secrets.htm

80/10/10 DIET80 % raw greens

10 % vegetable fats (Medium-chain fatty acids as coconut fat & avocado)

10 % vegetable proteins(beans, peas, lentils, almonds, nuts, whole grains)

STORAGE & UTILIZATION OF ENERGYEASY ACCESS 1 – GLYCOGEN

Skeletal muscles 500 gr (2500 cal)Liver 100 gr (500 cal)

EASY ACCESS 2 – TRIGLYCERIDES Visceral fats up to 6 kg = app 55000 cal

DEPOT FAT – TRIGLYCERIDES Subcutaneous, slow release, examples: App 30 % fat (app 70 kg) = 190 000 calApp 50 % fat (90-100 kg) = 315 000 cal

App 90 % fat (635 kg) = 540 000 cal

PRESENT POOR EATING – POOR IMMUNITY PALEO

THE FRONT DOOR – SHORTCUT 1

app 60 % are Sugar and Suger-like substanceswhich enters the body in upper jejunum via mainlythe arterial system < 15 %

THE BACK DOOR – THE DANGEROUS ROUTE

app 30 % animal fats & vegetable oil enters via the the body via the lymphatic system and remains in circulation for hours > 10 %

THE MAIN DOOR

< 20 % raw greens, vegetables, fruits are Foods for Microbiota and reaches the large intestine

after 2-3 hours, enhancing immune system & preventing inflammation app 80 %

PREVENTING DYSBIOSIS IS KEY TO DISEASE & INFECTION CONTROLBrandtzaeg P et al Gastroenterology 1989;97:1562-84

A striking local preponderence (70-90 %) of IgA immunocytes in the gut: plasma cells, plasma blasts

The gut content is constantly tested by recognition cells such as dentritic cells (DC) &

Programming/tuning the immune system

Each DC commands about 1200 T-cells

If deranged microbiota - DYSBIOSIS & LEAKY GUT will induce INFLAMMATION & facilitate INFECTION & DISEASE

Per Brandzaeg 1936 - 2016

DENDRITIC CELL & IMMUNE REGULATIONVan Baarlen P et al PNAS 2009;106:2371–2376

THE DENDRITIC CELL IN ACTION Kraehenbuhl JP, Corbett M. Science 2004;303:1624-1625

HIGH FAT DIET & MICROBIAL TRANSLOCATIONAmar J et al EMBO Mol Med 2011;13:559-572

Live intestinal bacteria found in large numbers in blood, adipose tissue (MAT) & mesenteric lymph nodes (MLN) after only one week on high fat diet (HFD)

CASEIN & GLUTEN IMPAIRS LACTOBACILLUS GROWTHWithout casein and gluten With casein and gluten

Dubos RJ, Schaedler RW J Exp Med 1962;115:1161-1172

GLUTEN & SURFACE MOLECULE EXPRESSIONSClass II, CD86, CD40, CD54 Nikulina M et al J Immunol 2004;173:1925-1933

100 µg/ml gluten matches the effects of 10 ng/ml LPS = ENDOTOXIN

GLUTEN-RELATED DISORDERSBiesiekierski JR, Iven J. Unit Eur J Gastroenterol . 2015;3:160

NCGS = non-coeliac gluten sensitive

A NEW ENTITY – NONCELIAC GLUTEN SENSITIVITY (NCGS) Sapone A et al. BMC Medicine 2011, 9:23

Often seen in diffuse often ignored distresses: lack of energy, mental depression, encephalopathy/‘foggy mind’, abdominal pain, bloating, diarrhea, eczema and/or rash, various headaches, numbness in the legs, arms or fingers, joint pain, fatigue etc.

Gluten-free diet

Increases energy, enthusiasm, well-being &

Improves clinical signs.

Prevents & improve chronic diseases

Freedom of symptoms of several chronic diseases including a few with THERAPY-RESISTANT EPILEPSY & NON-ALZHEIMER DEMENTIA

GLUTEN SENSITIVITY & CHRONIC DISEASESRuuskanen A et al. Scand J Gastroenterol. 2010;45:1197-1202Glutenoids affects genetic markers: HLA-B8, HLA DQ2, HLA DQ8, increase systemic inflammation

ADHD

arthritis

Addison´s disease allergy

Autoimmune disorders

Autism

Bipolar disease

Dermatitis herpetiformis

Diabetes mellitus

EpilepsiaGraves´disease, infections

Inflammatory bowel diseases – IBD

Irritable bowel syndrome – IBS

Mental depression

Myasthenia gravis

Obesity Osteoporosis

Pernicious anemia

Polymyalgia rheumatica

Psoriasis

Schizophrenia

Scleroderma

Sepsis

Sjögren’s syndrome

Thyreotoxicosis

Vitiligo

NON-CELIACS & DYSFUNCTIONAL FLORATiellström B et al Scand J Gastroenterol. 2007;42:1204-1208

Children with celiac disease (CD) known to have an aberrant gut microflora.

Non-CD relatives have compared to healthy controls impaired intestinal microbial metabolism significantly lower level of:

acetic acid &

total SCFAs

increased level of i-butyric acid

free tryptic activity (FTA)

Healthy controls

Relatives to individualswith celiac disease

GLUTEN-FREE DIET in TYPE 1 DIABETESMatteo-Rocco P et al. J Clin Endocrinol Metab 2003;88: 162–165

Gluten-free diet tried in 15 patients with diabetes type 1 but no gluten intolerance

Insulin sensitivity increased significantly in 12/14 subjects after six months on gluten-free diet (P 0.04) &

Decreased again in 10/13 subjects after another 6 months on “normal” diet (P=0.07)

GLUTEN-FREE DIET in IRRITABLE BOWEL SYNDROME Biesiekierski Jr et al. Am J Gastroenterol 2011;106: 508-514

EXCLUSION DIET (wheat + 15 other foods) IN ADHDPelsser LMJ et al Lancet 2011;377:494-503

Crossover study 100 children, aged 4-8 yrs, 9 weeks treatment + 4 weeks ”return” to previous diet

Total Inattention

Hyperactivity Connor scale

WHEAT: NEW & ANCIENT & IBSSofi F et al. Br J. Nutr. 2014;111:1992-1999

Abdominal pain Bloating

Stool consistancy Tiredness

Nausea

AMYLASE-TRYPSIN INHIBITORS - STRONG TRIGGERS OF INFLAMMATION http://medicalxpress.com/news/2016-10-links-protein-wheat-inflammation-chronic.html

Amylase-Trypsin Inhibitors (ATIs) – 1-3 % of wheat proteins –have extra strong inflammation-inducing abilities.

A potent microflora should have ability de break down ATIs.

ATIs known to induce among others:

Coeliac disease

Asthma

Multiple Sclerosis

Rheumatoid arthritis

Inflammatory bowel disease

Non-coeliac sensitivity

Systemic lupus erythematosus

Autoimmune encephalomyelitis etc Catassi C et al Nutrients 2017, Epub Nov.. 2017 Nov; 9(11): 1268.

PROTEIN – ATIs (amylase-trypsin inhibitors) TRIGGERS INFLAMMATIONhttp://medicalxpress.com/news/2016-10-links-protein-wheat-inflammation-chronic.html

ATIs – a non-gluten protein - app 4 % of wheat proteins – have strong inflammation-inducing abilities.

A potent microflora should have ability de break down ATIs.

ATIs known to induce:

Coeliac disease

Asthma

Multiple Sclerosis

Rheumatoid arthritis

Inflammatory bowel disease

Non-coeliac sensitivity

Systemic lupus erythematosus

Autoimmune encephalomyelitis etc

ATIs – THE REAL VILLAINS Schuppan D, Zevallos V. Dig Dis. 2015;33:260-263

AMYLASE INHIBITORS INDUCE INFLAMMATIONJunker Y et al J Exp Med. 2012;209:2395-2408

LPS = Endotoxin

PROLAMINS & TRYPTOPHAN/CORTEXChoi S et al Physiol Behov 2009;98:156-162

An up to 8-fold decrease in cortex tryptophan & similar decrease in serotonin observed after feeding:

Marked reductions; Zein (corn)

Significant reductions: Casein (dairy) & Gluten (wheat, rye, barley)

Small reductions: Lactalbumin (dairy)

Small increases: Vegetable protein (soy)

ANCIENT GRAINS

Amaranth – Aztec culture, high protein & mineral content

Quinoa – Inca culture, high protein & mineral content

Sorghum (durrah, jowari, milo) - 5th in world, versatile, low energy, most cost-effective

Millet – 6th highest in world, versatile, mild flavor

Teff – staple in Ethiopia, tiny seed, high mineral content

SORGHUM (durrah, jowari, milo) – A SUPER GRAIN!Dykes L, Rooney LW Cereal Foods World 2007;52:105-111

Many thousend top athletes agree, among them the two best tennis players of the world –Novak Djokovic & Andy Murray -abstaining from gluten, lactose and processed carbohydrates, insisting that this gives themmuch greater energy.

“CONTENT

FOOD&

HEALTH

AMOUNT TIME

SATURATED FATTY ACID METABOLISMMCFA: Coconut Oil 85,2, Palm kernel oil 81,5, Palm Oil 45,3, Olive Oil 14.5 (70 %

monosaturated) LCFA: Animal fats

MEDIUM-CHAIN FATTY ACIDS LONG-CHAIN FATT ACIDS

PORTAL VEIN, THORACIC DUCT, HEPATIC ARTERYPORTÅDERN, STORA LYMFGÅNGEN, LEVERARTÄREN

POSTPRANDIAL LIPIDEMIA & INFLAMMATIONKhor A et al Nutr Res. 2014;34:391-400

Postprandial inflammatory activity is a strong risk factors for atherosclerosis (& other chronic diseases) Ebenbichler CF Curr Opin Lipidol 1995;6:286–290

Increased content of endotoxin in blood (eqv to smoking 3 cigarettes) & Erridge C et al Am J Clin Nutr 2007;86:1286 –1292 &

Cascades of inflammatory and oxidative stress

Ceriello A et al. Diabetes 2004;53:701–710 &

Release of tumor necrosis factor-α, a key proinflammatory cytokineErridge C et al Am J Clin Nutr 2007;86:1286 –1292 &

Increased numbers of & activates leukocytes Alipour A et al Arterioscler Thromb Vasc Biol 2008;28:792–797 &

Inflammatory reaction potentiated by simultaneous intake of sugar Ceriello A et al. Diabetes 2004;53:701–710

POSTPRANDIAL METABOLISM – EFFECT OF VINEGARMitrou P et al Eur J Clin Nutr 2015;69:734-739

INSULIN TRIGLYCERIDES

POSTPRANDIAL INFLAMMATION & ENDOTOXEMIAErridge C et al Am J Clin Nutr 2007;86:1286 –1292

FAT UTILIZATION 72 HRSSoeters P et al Am J Physiol Endocrinal Metab 2012;303:E1397-1407

DAILY FASTING – IMPORTANT FOR BODY RENOVATION

DAILY FASTING – IMPORTANT TO:

Burn off the excess body fat

Reduce & eliminate toxins & poisons body

Eliminate bad proteins

Regenerate body organs & restore functions

BENEFITS OF DIURNAL FASTING Reduces oxidative stress/inflammation

Normalizes "the hunger hormone“ – ghrelin

Normalizes insulin and leptin sensitivity

Normalizes fat, sugar and protein metabolism

Boosts mitochondrial energy efficiency

Minimizes damage to cellular proteins, lipids & nucleic acids

Reducing disease and premature aging

Improves various biomarkers of disease

MICROBIOTA & DIURNAL RHYTMFeehley T, Nagler CR Nature 2014;514:176-177

DIURNAL RHYTHM &

MICROBIOTIC FUNCTIONS

Liang X et alCell. 2014;159:469-70

DIURNAL RHYTHM MICROBIOTIC FUNCTIONS

&FECAL

TRANSPLANTATION

Liang X et al. Cell. 2014;159:469-70

DAILY FASTING REDUCES OBESITY & IMPROVES HEALTHHatori M et al Cell Metabolism 2012;15: 848-860

MICROBIOTA, METABOLISM & DIURNAL RHYTMThaiss CA et al Cell. 2014;159:514-529

DIURNAL CONTROL OF GENE ACTIVITYPlikus MV et al J Biol Rhythm 2015;30:163-182.

GUT MICROBIOTA & DERANGED METABOLISMVrieze A et al Diabetologia 2010;53:606-613

↓ FFA oxidation

↑ Endotoxin/s

↓ SCFA production

↓ Incretin secretion *

↓ Butyrate production

↑FFA oxidation

↓ Endotoxin/s

↑ SCFA production

↑ Incretin secretion

↑ Butyrate production

* Incretin = hormonedownregulatingblood glucose

MICROORGANISMS:Yellow = beneficial

Green = pathogenic

INTERMITTENT FASTING & WEIGHTHatori M et al Cell Metabolism 2012;15: 848-860

NA=normal diet, free access, FA= free access to fat diet, NT & FT=time-restricted normal or fat diet

SKIPPING BREAKFASTvs.SKIPPING DINNER

human study – 17 participants

Nas et al Am J Clin Nutr 2017 E-pub

Fat oxidation

Carb Oxidation

Energy expenditure

Control

DIURNAL CHRONOBIOTICS PREVENTS & DELAYS ALZHEIMERS DISEASELaundry G, Liu-Ambrose T Front. Aging Neurosci 2014 Dec 8;6:325.

BLT = Bright light therapy

DAILY FASTING –AVOIDING LATE

NIGHT EATING AND SKIPPING

BREAKFAST – long-term effects

Zilberter T, Zilberter EYFront Public Health 2014;2:59

INFLAMMATION IN OBESE PREGNANT WOMENBasu S et al Obesity 2011;19:476-482

MCP1 IL-8 IL-6 TNFα Leptin CD14 TLR4 TRAM2

The thrifty epigenotype hypothesis -Barker, D.J.P. Maternal Nutrition, Fetal Nutrition, and Disease in Later Life".

Nutrition, 1992;13: 807-813Curr Opin Nephrol Hypertens 1997; 6:106-110

We know that “disorders of adult life, including coronary heart disease, stroke and diabetes, arise through interaction between influences in our adult lifestyle and genetically determined susceptibility.” DAVID JP BARKER 1838 – 2016

“Recent research, however, suggest that growth in utero may also play an important role” “Even brief periods of … may permanently change/`reprogramming´ the body…and lead to persistent changes in blood pressure, cholesterol metabolism, insulin response to glucose, and in a range of other metabolic, endocrine and immune parameters.”

David Barker 1838 - 2016

Maccaferri S et al Dig Dis 2011;29:525–530

LEAKY BARRIERS

• Gastrointestinal tract

• Airways

• Skin

• Oral cavity

• Vagina

• Nose

• Eye cavity

• Placenta

• Blood brain barriers

INFLAMMATION IN OBESE PREGNANT WOMENBasu S et al Obesity 2011;19:476-482

MCP1 IL-8 IL-6 TNFα Leptin CD14 TLR4 TRAM2

LEAKY PLACENTAA shocking 9/20 (43 %) of umbilical cord blood, cultivated from healthy neonates, born by cesarean section,

demonstrate positive growth: Enterococcus faecium, Propionibacterium acnes, Staphylococcus epidermidis & Streptococcus sanguinisJiménez E et al. Curr Microbiol 2005;51:270–274.

ATHEROSCLEROSIS & BACTERIAL DEBRISNicolaou G et al J Atheroscler Thromb 2012;19:137-1498

Bacteria & bacterial debris in human atheroma, in the pastconsidered harmless,

seems to contribute to disease progression via TLR- dependent lipid bodyformation in macrophages

PRENATAL INFECTION OF FETUS AND DISEASE LATER IN LIFEYang Y et al. LifeSciences 2018;194:111-118

Bygren LO et al Acta Biotheor 2001 ;49:53-59

ALLERGY, ADHD & GUT RECONDITIONINGErika Isolauri & Seppo Salminen

2001 – Mothers from families with high burden of allergies received during the last 2-4 weeks of pregnancy and the baby during first 6 mo Lactobacillus GG

Kalliomäki M et al. Lancet 2001;357(9262):1076-1079.

2003 – 14/53(26 %) in the probiotic group and 25/54 (46 %) in the placebo group developed atopic eczema

Kalliomäki M et al Lancet 2003;361(9372):1869-1871

2015 - Probiotic-treated individuals showed no ADHD or Aspergersyndrome - 0/40 = 0 %

in contrast to placebo group - 6/35 17.1%) - about every 6th child

Pärtty A et al Pediatr Res. 2015;77:823-828.

THE MARCH from AGRICULTURE AQVA- & HORTICULTURE-based dietPresident Bill Clinton – now a vegan

radically changed diet, lost 20 lbs. in weight

& improved his health, Clinton tells CNN.

After experiencing periodic heart problems leading up to the 2004 surgery, the former junk food lover now calls himself a vegan,

shunning meat, eggs, dairy and almost all oil

saying: "I like the vegetables, the fruits, the beans, the stuff I eat now“

"I feel good, and I also have … more energy."

PLANT-BASED DIET & CORONARY ARTERY DISEASEEsselstyn CB Prev Cardiol. 2001;4:171–177

SAFE: grains?, legumes, lentils, vegetables, fruits, nuts and seeds

NOT SAFE: oils, dairy foods, meat, poultry, & fish (frequently containing unacceptable levels of PCBs, dioxin, and mercury)

VITAMIN K IN FOODS micrg/100 grThyme, dried 1715

Sage, dried 1700

Parsley raw 1640

Amaranth leaves 1160

Kale raw 817

Mustard greens, raw 497

Spinach, raw 483

Basil, fresh 413

Beat greens, raw 400

Turnip greens, raw 251

Lettuce, raw 174

Broccoli raw 102

THE DILEMMA: PHARMA & MICROBIOTA ARE INCOMPATIBLE! Antibiotics destroys about 90 % of microbiota functions: bile acid metabolism, eicosanoid and steroid hormone synthesis etc

Caetano L et al. Antimicrob Agents Chemother. 2011;55:1494-1503

Chemotherapeutics reduces microbiota 100-fold;

decrease anaerobic bacteria up to 10,000-fold &

increase in PPMs 100-fold

Van Vliet MJ et al. Clin Infect Dis 2009;49:262-270

Pharma as proton pump inhibitors (peptic ulcer) during pregnancy increase the risk of offspring getting asthma

Andersen AB et al. Aliment Pharmacol Ther 2012;35:1190-1198

Anti-hypertensives induce gastrointestinal dysbiosis & reduce mucosa protection, espec. mucus production

Nonzee V et al J Med Assoc Thai 2012;95:96-104.

INFLAMMATION INVOLVES ABOUT 1200 GENESaffect a wide range of effector molecules; pro-inflammatory cytokines,

chemokines, Matrix metalloproteinases (MMPs) and metabolic proteins

BIOLOGICALS aimed to targetsingle genes; anti- TNF-α, anti- IL-1β, anti-HER2, IL-12/IL-23, IFN-γ, IL-17A, IL-2 and IL-6, and inhibitors of NF-КB etc.

• Uni-targetting

• Immediate powerful effects

• Limited by multiple toxicity

• Negative effects on microbiota

• Sometimes short-lasting effects

• Substancial adverse effects

• Indicated in aggressive diseases

ECO-BIOLOGICALS: utilizes the antiinflammatory effects of microbes and plants; greens, vegetables, fruits & spices to support microbiota

• Multi-targetting

• Slower and weaker effects

• GRAS – e.g. no toxicity

• Positive effects on microbiota

• Long-lasting effects

• No adverse effects

• Indicated for prevention & early disease

MINIMIZE POSTPRANDIAL INFLAMMATION 1. Avoid long-chain fatty acids including olive oil.

2. Avoid highly processed foods and drinks containing sugar, high-fructose corn syrup, white flour

3. Keep servings modest & reduce the numbers of meals.

4. Avoid being overweight.

5. Eat daily salads of leafy greens dressed with vinegar + drink vinegar mixed with water at your meals.

6. Eat richly anti-inflammatory spices such as turmeric, chili pepper & cummin

7. Consume anti-inflammatory spices, nuts, & eat vegetables, berries & fruits.

8. Choose high-fiber, low GI foods - whole grains, legumes & vegetables & fruits.

9. Eat lean protein at all meals – peas, beans, nuts, almonds or lean meat or fish.

10. Obtain > 30 min of daily physical activity of at least moderate intensity.

ROLE OF NUTRITION TO CONTROL INFLAMMATION IN CKD & HEMODIALYSISKhor BH et al Nutrients March 2018 Epub

REDUCTION OF INFLAMMATION

CHRONIC (RENAL) DISEASE BY CONSUMPTION OF SPECIFIC NUTRIENTS

Effects on markers such as C-reactive protein (CRP),

interleukin-6 (IL-6), & tumour necrosis factor-α (TNF-α).

Khor BH et al Nutrients, March, 2018 Epub

VITAMIN E

OMEGA-3

TRIPPLE-HELIX FOR ANTIINFLAMMATION1. TWELVE COMMANDMENTS2. GUT RECONDITIONING – SYNBIOTIC 20003. ANTIINFLAMMATORY TURMERIC COCKTAIL

HEALTH: TWELVE COMMANDMENTS 1. Limit/eliminate sugars, especially fructose, and sugar-like foods: bread, pizza, pasta, polished rice, warm cooked potato &

tubers. Cool before eating.2. Limit/eliminate diary products. 3. Limit red meat to 300 g/week. Avoid processed meat, pig meat, beef from supplement-fed animals and farmed fish.

Focus on wild fish, game meat and beef from grass-fed animals.4. Limit/eliminate intake of long-chain fatty acids and processed oils. Focus on plant fats such as cocos and avocado.5. Eliminate foods containing inflammation-inducing proteins: casein (diary), gluten (wheet, rye, barley) och zein (corn).6. Limit/eliminate heat-induced inflammation-inducing proteins – glycated and lipoxidated products - foods heated above

120-130 degree C. 7. Avoid exposure to microbial toxins such as endotoxin, pesticides and other poisons. 8. Limit your sodium & chloride salt intake - increase the intake of iodine. Avoid fluoride, bromide and reduce chloride.9. Limit/eliminate as much as possible exposure to chemicals including pharmaceutical drugs. 10. Focus on plant foods rich in proteins, fibres, antioxidants. Use grains such as amaranth, durrah, teff, quinoa, various

seeds, peas, beans, lentils, almonds and nuts. Germinate/sprout seeds,peas, beans, lentils, almonds and nuts for 12-24 hours.

11. Let the majority of your food (about 80 %) be fresh raw vegetables and fruits with low glycemic index, and anti-inflammatory spices and teas such as puerh, yerba & oliveteas. Supplement Vitamin D, omega3, turmeric and probiotics– the four corner stones of anti-inflammation. Supplement also iodine as KJ or Kelp.

12. Practise daily fasting as Peak fasting (intake of calories 6/24 hours) either as SKIPPING BREAKFAST (no food before noon) or SKIPPING DINNER (no food after 14 pm)

ANTI-INFLAMMATORY TURMERIC COCKTAIL for consumption once or twice daily

1 heapful tablespoon turmeric powder 159,277

1 heaped teaspoon Ceylon Cinnamon 267,536

OBS! Not Saigon cinnamon (toxic) 15,170

¼ teaspoon or more chilipepper powder

¼ teaspoon or more grounded cloves 314,446

Spread on sallad or mix with fruit dessert, yoghurt or juice or mix

with ½ - 1 tablespoon apple cider vinegar in a glass of waterhttp://bengmark.com/anti-inflammatorisk-kryddblandning-till-cocktailshots/

Containing antioxidants µmol TE/100g

Available at http://bengmark.com/research-articles/

AVAILABLE @: www.bengmark.comwww.synbiotics.sewww.facebook.com/stig.bengmark

Videos:www.ihcanconferences.co.uk/antioxidantsapril2017/Podcast: https://goo.gl/wTRvwhwww.ihcanconferences.co.uk/a

460 – 370 BC

Let us not wallow in the past!

THANK YOU!