INFLAMMATION DUE TO TOXINS - kidneyfl.org€“1150... · • FDA does not require any safety...

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THE GUT AND THE BRAIN AND TOXINSANDREW W. CAMPBELL, M.D.

INFLAMMATION DUE TO TOXINS

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WHAT WAS IT LIKE BEFORE?

• How did we live?

• How did we get our food?

• What did we eat?

• How did we cook our food?

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WHAT HAS CHANGED?• New strains of wheat, rice, soy, corn, and 150

more.

• Americans eat more GM foods that the rest of the world combined

• Dairy: rBGH (butter, cheese, cottage cheese, ice cream, sour cream, yogurt, etc.)

• Concentrated Animal Feed Operations: CAFO’s

• DES in cattle

• Ractopamine: converts fat into meat. Beta agonist-increases protein synthesis. Banned in China, Europe, Russia.

• Artificial coloring, preservatives, additives, sweeteners.

GMO’S

• GMO’s have non‐plant genes inserted into their DNA.

• These genes are taken from bacteria or viruses.

• Main crops in the U.S. are genetically modified (GM): soy, corn, cotton, canola, sugar beets, alfalfa: up to 94%

• All are used for as food for humans and animals.

• Cottonseed and canola are made into food grade oils.

• All are engineered to be herbicide tolerant for glyphosate (Roundup).

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GMO’S

• Zucchini, yellow squash, papaya, etc. have virus genes inserted into them to provide resistance to infections from plant viruses.

• Apples and potatoes are engineered with double stranded RNA, which suppresses the gene that causes foods to oxidize and discolor (turn brown).

SAFETY OF GMO’S

• FDA does not require any safety studies or labels.

• FDA policy allows GMO makers to determine on their own if their foods are Generally Recognized as Safe (GRAS).

• There are no safety testing standards.

• There have been no human clinical trials.

• There have been no post‐market surveillance on health outcomes related to GMO consumption.

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SURPRISE!

• Michael Taylor oversaw the GMO policy for the FDA.

• He was a political appointee, former outside attorney for Monsanto.

• Later he was the company’s vice‐president for government and regulatory affairs.

• Lastly, he was the Deputy Commissioner for Foods at the FDA.

GLYPHOSATE

• AKA Roundup: the active ingredient used on GE crops.

• Most used pesticide in the U.S.: we use more than the rest of the world combined : more than 900 million pounds.

• Glyphosate residues are found on the main foods of Western diet: corn, soy, sugar, canola, wheat, etc.

• These residues inhibit cytochrome P450 enzymes which our bodies need to detoxify xenobiotics, allowing them to accumulate.

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Glyphosate and Celiac Disease

Glyphosate and Deaths due to Intestinal Infections

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Glyphosate and Thyroid Cancer

WHAT HAS CHANGED IN OUR ENVIRONMENT?

• We use 4 billion pounds of pesticides annually

• Only 10% have been studied for toxicity

• Many of these chemicals cannot be easily excreted and remain in our blood, adipose tissue (fat cells), muscle, bone, semen, brain, lungs, and other organs.

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PESTICIDES IN PRODUCE: 12 MOST CONTAMINATED.

• Peaches

• Apples

• Sweet Bell Peppers

• Celery

• Nectarines

• Strawberries

• Cherries

• Pears

• Grapes

• Spinach

• Lettuce

• Potatoes

PESTICIDES IN PRODUCE:12 LEAST CONTAMINATED

• Onions

• Avocados

• Sweet Corn (frozen)

• Pineapples

• Mango

• Asparagus

• Sweet Peas (frozen)

• Kiwi fruit

• Bananas

• Cabbage

• Broccoli

• Papaya

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ULTRA‐PROCESSED FOODS

• • Breads and breakfast cereals.

• • Cake, ice cream, and other sweets.

• • Soft drinks and fruit drinks.

• • Frozen and packaged meals.

• • Pizza.

• • Salty snacks.

• • Milk‐based drinks.

• • Packaged baked goods.

• • Chicken and fish nuggets.

• • Instant noodles and soups.

• • Packaged cheeses.

• • Bottled dressings and sauces.

Dr. Ari Vojdani

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Dr. Ari Vojdani

HOW MUCH SUGAR IS IN FOODS1. Coke 12 oz can: 10 teaspoons

2. Coke 20 oz bottle: 17 teaspoons

3. Coke 1 liter bottle: 28 teaspoons

4. Mountain Dew: 20 oz bottle: 20 teaspoons

5. Vitamin Water, B‐Relaxed Jackfruit and Guava flavor: 8 teaspoons

6. Sobe Mango Melon 20 oz: 10 teaspoons

7. Arizona Lemon Ice Tea 24 oz can: 18 teaspoons

8. Snapple Lemon Iced Tea 16 oz: 15 teaspoons

9. Minute Maid Lemonade 20 oz: 17 teaspoons

10. Minute Maid Orange Juice 16 oz bottle: 12 teaspoons

11. Nesquick Chocolate Milk 16 oz bottle: 15 teaspoons

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INFLAMMATORY FOODS AND BEVERAGES1. Sugar

2. Flour and anything made with flour

3. White rice

4. MSG: monosodium glutamate

5. High fructose corn syrup

6. Artificial sweeteners

7. Artificial colorings

8. Artificial flavorings

9. Casein

10. Any beverage from a plastic bottle

CHICKEN: MEAT FOR THE PRICE OF BREAD

• Antibiotics: 15,400 tons are used each year

• 80% of all antibiotics sold

• Chicken farmers use more than than those who raise cattle or pigs

• The main function is to make broiler chickens fatten up more quickly and to act as a prophylactic against the cramped conditions in which they are raised

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• A chicken’s weight at slaughter is today double that it was 70 years ago and does so in ½ the time

• Animals receive antibiotics in feed and water, creating antibiotic‐resistant bacteria in their gut, which then spreads to the soil and water

• Each year salmonella causes 1.2 million cases of food poisoning according to the CDC

• Death rate is highest among children under five


• Grass fed beef costs 30% more than grain fed beef.

• Pork costs 40% more than the usual.

• Chickens cost 200% more.

• In 2016, the average American ate more than 92 pounds of chicken; in 1960 it was 26 pounds.

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CHRONIC INFLAMMATION

• Much of Western‐style diets consist of pesticide‐sprayed, high‐glycemic, highly processed, low‐fiber, high in saturated fat and sugars, food‐like substances in plasticized containers. The habitual consumption of these high‐fat meals that are common, readily accessible, and at low cost throughout the industrialized world, is one of the prime contributors of postprandial endotoxemia, leading to chronic inflammation via intestinal permeability.

DYSBIOSIS AND LEAKY GUT

Changes in gut microbiota – dysbiosis, gut inflammation, increased levels of lipopolysaccharide (LPS), increased intestinal permeability, metabolic endotoxemia, and development of obesity, all lead to metabolic dyshomeostatis, and chronic diseases.

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LPS AND CHRONIC INFLAMMATION

• Intestinal dysbiosis leads to intestinal permeability, aka: ”leaky gut syndrome”.

• This constitutes a key pathophysiological link for the transport of microbiome derived toxins across the GI tract and BBB resulting in a progression from systemic inflammation to CNS inflammation.

LEAKY GUT LEADS TO OBESITY

• According to the NIH, 68.8% of Americans are obese, with a BMI greater than 30kg/m2.

• Public Health England: 66% of adults and 25% of children between two and 10 years old are overweight or obese

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OBESITY INCREASES THE RISKS OF

• Heart disease

• Stroke

• Type 2 diabetes

• Reduced cognitive function

• Alzheimer’s disease

• Early death

WHAT HAS CHANGED IN OUR ENVIRONMENT?

• The U.S. manufactures 5 trillion pounds (that’s 5 with 12 zeros) of chemicals per year.

• There are 70,000 different chemicals

• Only 1,500 have been studied for toxicity

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CHEMICALS

• We are exposed to gasoline fumes and diesel fumes

• Fragrances from candles, plug‐ins, sprays, trees we hang from the car rear‐view mirror

• New car smell: fire retardant chemicals –

• Cars, all airline interiors, curtains, bedding materials, clothes – especially for children.

CHEMICALS

• Home: carpeting and artificial flooring ‐ all synthetic materials and fibers that release formaldehyde into the area for months and years.

• Building materials: plywood, gypsum, foam insulation, adhesives‐all made with chemicals.

• Toothpaste, perfumes, cologne, soap, shampoos, cosmetics: these contain nanoparticles.

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BISPHENOL‐A: BPA

• Endocrine disruptor

• Neurotoxic

• Used also in dentistry as a composite and sealant

• Linked to cardiovascular disorders, diabetes, and obesity

BPA

• Harvard Study, JAMA 2011: 75 volunteers

• 12 ounce portion of vegetarian canned soup x 5 days

• Matched group: fresh vegetarian soup without canned ingredients

• 48 hour washout

• 2 groups were reversed

• Urine: in the group eating canned soup x 5 days:

• 1221 % increase in BPA

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DETERGENTS

• Surfactants

• Chlorine

• Phosphates

• Fragrances

OUR BODY AND OUR MICROBIOME

• The total number of cells that make up the human

body: 37 trillion

• The total number of cells that make up the

microbiome in the gut: 130 trillion

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THE MICROBIOME

• Total surface of the gut is the size of a tennis court.

• There are more nerve cells (neurons) in the gut than in the spinal cord.

• The microbiome is continually and persistently exposed throughout life to foods, liquids, and chemicals.

• The gut will process an average of 1 ton of food each year. Remember: we have 9,000 taste buds on our tongue.

MICROBIOME

• This rich bacterial community is kept in check by 1 thin layer of interconnected epithelial cells reinforced by tight junctions.

• The intestinal epithelium is exposed relentlessly on an ongoing basis to massive amounts of foreign materials (antigens).

• These are either beneficial or harmful.

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GENOME

• The human genome is made up of 23,000 genes

• The microbiome is made up of 8 million genes

• One ml of colonic fluid contains more bacteria than there are humans on the planet

THE BRAIN• It is the only organ almost completely surrounded and protected by bone: the skull

• The brain weighs 3 lbs or 2% of our body weight, yet uses 20 – 30% of the calories we consume.

• From the carotid and vertebral arteries, it receives the most oxygenated blood emerging from the heart.

• 60% of the weight of the brain is fat(beware of statins)

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THE BRAIN

• The brain uses 20% of of the oxygen absorbed by the lungs.

• The hourly blood flow through the brain is 13 gallons, or 20% of all the blood pumped by the heart.

• There are over 400 miles of blood vessels, mostly capillaries, that reach all 100 billion neurons in the brain.

• The brain differs from other organs in that it depends almost entirely on glucose as a source of energy.

THE BRAIN

• 100 billion neurons, with 1,000 synaptic connections per cell.

• The neurons in the visual cortex have around 12,000 synapses.

• The neurons in the prefrontal cortex have around 80,000 synapses.

• Each of these is firing every second.

• The transmission speed along the axon is 200 mph.

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THE BRAIN

Every person’s thoughts, memories, emotions, actions, and reactions are activated in the

neurons via neurotransmitters.

TRYPTOPHAN & SEROTONIN

• The Brain‐Gut Axis is a bidirectional communication network between the brain and the gut. For example:

• Tryptophan and its metabolite serotonin are fundamental to health.

• Tryptophan is an essential amino acid which must be supplied in the diet, and can cross the BBB, and participates in serotonin synthesis in the CNS.

• The vast majority of serotonin is in the gut.

• Serotonin affects mood, sleep, aggression, and sexual behavior. Serotonin is converted to melatonin.

• Tryptophan: egg whites, cod, chocolate, dates, red meat.

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IMMUNOLOGICAL EFFECTS BY THE MICROBIOME ON THE CNS

• There is a continuous stimulation of the innate immune system to produce cytokines due to LPS (endotoxins) from gram negative bacterial cell walls.

• This creates a state of immune activation (the gut contains about 1 gm of LPS).

• i.e. Excessive cytokine release is associated with disrupted sleep.


• Increased exposure to LPS results in increased intestinal permeability (leaky gut syndrome) caused by:

• Chemicals

• Stress

• Increased alcohol intake

• “Fast‐food” and Western diet.

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This is accompanied by:

• Depressed mood

• Increased anxiety

• Impaired long‐term memory for emotional stimuli

• Reduced visceral pain thresholds

ALZHEIMER’S DISEASE

• 65% of patients are women:

• More common than breast cancer.

• Monotherapies have failed.

• There is no known cure.

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ANNUAL COST COMPARISON FOR THE U.S.

• Cancer $ 77 Billion

• Heart Disease $ 102 Billion

• Alzheimer’s Disease $ 236 Billion

• By 2025: $ 1.1 trillion

PARKINSON’S DISEASE

• Second most common neurodegenerative disorder affecting 6.2 million.

• 60,000 new cases a year; 250 a day.

• Dx: clinical features

• Related to environmental factors: insecticides, pesticides and industrial chemical exposure.

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PARKINSON’S DISEASE

Nebraska has the highest rate in the U.S. as a result of high agricultural use of pesticides.

Cost of care exceeded $25 billion in 2013.

Several medications available.

BUT: Drug side effect are a serious problem.

ENVIRONMENTAL CONTRIBUTING FACTORS TO DEMENTIA

• Glyphosphate residue in our food supply.

• Glyphosphate is the active ingredient in the herbicide Roundup used on GE crops.

• More glyphosate is used in the U.S. than all other countries in the world combined.

• 880 million pound used annually.

• It is a potent mineral chelator leading to zinc deficiency which can contribute to AD and Parkinson’s.

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GUILLAIN‐BARRE SYNDROME

• Guillain‐Barre Syndrome (GBS) is the most common cause of acute neuromuscular paralysis in persons in developed countries.

• About 2/3 of GBS patients develop the syndrome following an infection, including: C.jenuni, CMV, EBV, Mycoplasma pneumonia and influenza.

• C. jenuni: gram (‐) bacteria & part of the natural microbiota of poultry.

• These infections occur more frequently in patients with intestinal dysbiosis.

MORE CHEMICALS THAT AFFECT OUR GUT AND OUR BRAIN

• One example of chemicals: nanoparticles

• 1 billionth of a meter

• Nanoparticles production per year:

• 15,600 tons of titanium dioxide

• 3,700 tons of zinc oxide

• 300 tons of cerium dioxide

• It is in treated drinking water, toothpaste, cosmetics, sunscreen, and other personal products.

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WHAT DO THESE NANOPARTICLES DO?

• Inflammation breaks down the gut barriers.

• Nanoparticles enter the gut, cause inflammation, leading to increased intestinal permeability (leaky gut syndrome).

• Nanoparticles can cross the epithelial lining of the gut via transcytosis.

• These nanoparticles can cross the blood‐brain barrier.

• They cause inflammation in the brain via loss of the blood brain barrier.

ObesityGut Dysbiosis, Gut

Inflammation, Gut Barrier Dysfunction

Lipopolysaccharide Pro‐Inflammatory Cytokines,

Gut‐Brain Axis (Vagal), Afferent Dysfunction

Systemic Inflammation

NeuroinflammationEfferent Gut‐Brain Pathway

Dysfunction (Vagal), Hippocampus/Cerebellum, Hypofunction/DysfunctionAmyloid Deposition, Tau

Phosphorylation, NeuroCognitive Impairment & Vulnerability to Alzheimer’s

Dementia

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SO WHAT CAN WE DO?• IMPORTANT POINTS:

• AVOIDANCE

• NITRIC OXIDE

• PROBIOTICS

• Take a vacation!

• In 2016, Americans forfeited 662 million vacation days.

PREVENTION AND TREATMENT

• The Lancet International Commission on Dementia Prevention, Intervention and Care reported that more than one third of global dementia cases may be preventable through addressing lifestyle factors that impact an individual's risk. These potentially modifiable risk factors have been identified at multiple phases across the life‐span, not just in old age.

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PREVENTION AND TREATMENTAlzheimer Study:

156 elderly with mild cognitive impairment and followed for 2 years in a randomized study (2013)

Neuropsychological testing before and after

MRI before and after

0.5 mg vitamin B12

0.8 mg folic acid

20 mg vitamin B6


• Results of the study:

• Decrease in grey matter atrophy

• Slowed cognitive decline

• Other studies came to the same conclusion:

• 321 elderly at Ewha Woman’s University in Korea (2013)

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PREVENTION AND TREATMENT:

• Gluten‐Free Diet for Parkinson’s Disease:

• Report of dramatic improvement in a patient with Parkinson’s disease who had silent celiac disease and was put on a gluten‐free diet.

DANCE AND AD

• People who routinely exercise can reverse the signs of aging in the brain.

• Dancing has the most profound effect.

• Learning to play a sound on a musical instrument alters the brain waves in a way that improves a person's listening and hearing skills over a short time frame.

• Wards off age‐related cognitive declines

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• Most of the foods we eat every day are produced or imported, labeled, and sold with almost no oversight.

• The seafood industry is rife with fraud and substitution.

• In any restaurant in any state, if you order grouper or red snapper, you will not get what you ordered. It will most likely be substituted for mercury‐rich tilefish.

PREVENTION AND TREATMENT• Avoid: Wheat, barley, rye and sugar

• Avoid statin drugs• Avoid flu vaccines (aluminum hydroxide)

• Avoid aluminium (foods and personal care)

• DO: Exercise 30 to 40 minutes daily

• DO: Reduce stress (Yoga, meditation, music, etc.)

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PREVENTION AND TREATMENT• Eat organic grass fed beef

• Eat healthy fats: avocado, walnuts, salmon, lamb, etc.

• Eat foods high in DHA

• Eat organic blueberries ½ cup daily

FLAVONOIDS

• Flavonoids have anti‐inflammatory and antioxidant properties.

• Flavonoids reduce the risk of dementia and preserve cognition.

• Individuals from 65 to 77 years of age.

• 1/2 drank concentrated blueberry juice.

• In 12 weeks improvement was noted in cognitive function, working memory, blood perfusion to the brain, and activation of the brain while performing cognitive tests.

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• EVOO: California’s McEvoy Ranch; Australia’s Cobram Estate.

• U.S. beef: naturally raised, grass‐fed. It cost 17% more to raise beef on grass than grain.

• Labels: USDA Organic; Niman Ranch; Certified Angus Beef Natural.

• Angus means nothing; eat Aberdeen Angus.


• Bison: free range, no fences, eating an entirely natural diet, no drugs. There are no bison feedlots.

• New Zealand lamb: all grass fed.

• Fruit Juice: almost all juices in the US contain apple juice concentrate from China, even the expensive ones in glass containers.

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• Beef: “no hormone administered”

• Pork and Chicken: “no antibiotics added”

• Most reliable for pork and chicken: USDA organic.

• Smart Chicken by Tecumseh Poultry

• Meaningless: pasture raised, pasture finished, no additives, no animal by‐products, free range, free roaming, green fed, humane, pesticide free.

• Also: free range carrots, stone ground eggs, and hand‐woven honey.


• Use coconut oil in foods

• Take gingko biloba

• Eat nutritious organic foods, whether it be vegetables, fruits, meat, poultry, etc.

• Line caught fish.

• Cinnamon: inhibits aggregation of tau protein particles (also help lower blood sugar)

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Loss of NO is Associated with Atherosclerosis

Consequences of NO insufficiency

HypertensionLack of energyAtherosclerosisThrombosisAlzheimer’s disease Sexual DysfunctionPeripheral Artery DiseaseMitochondrial Dysfunction

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PROBIOTICS

What about YOGURT?

PROBIOTICS

• $30 billion spent by consumers annually on yogurt.

• All commercial yogurts are made from pasteurized milk. Pasteurization kills off potential pathogens, as well as destroying all beneficial bacteria.

• Yogurt is also pasteurized after it has been allowed to ferment, then bacteria are added back to the product as a last step.

• Many commercial yogurts found in supermarket in the U.S. contain artificial coloring, chemical additives and sugars, including high fructose corn syrup and aspartame.

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PROBIOTICS

• A publication from Reading University with the Food Safety Authority of the United Kingdom, in essence the FDA in England, showed that less than 10% of the usual commercial strains of Lactobacilli and Bifidobacterium in probiotics are able to get to the colon.

DO YOU REALLY KNOW WHAT’S IN THAT PROBIOTIC?

A recent publication by UC Davis examined 16 probiotic products from local California stores to check if the strains claimed on the label

matched those that were found in the product. They found that only ONE out of 16 actually matched the label claim. In some products there was pill‐to‐pill variation in the same

bottle.

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THE KITCHEN SINK

• The vast majority of probiotics are trying to stand above the others by including more strains and more cfus.

• However, there is no scientific rationale for this. There are no studies that have shown that 200 billion CFU is more effective than 10 billion cfu and that 15 strains are more effective than 5 strains.

• Most probiotic studies are done on a single strain and at relatively low doses (2‐3 billion+). Quality of the strain is far more important than quantity.

• In probiotics, the ones you want to recommend and use are strains that have undergone DNA sequencing.

WHAT IS A TRUE PROBIOTIC?

• Most probiotics are not technically a “probiotic” but instead they are “dead bacteria therapy”. In some cases, some of these have been shown to have a transient effect in the gut as they move through.

• The “Probiotic Paradox” has been studied. They are Biological Response Modifiers or Metabolic Response Modifiers and not probiotics. They DO NOT go and live in the gut and cause a shift between good and bad bacteria; instead they have a temporary metabolic effect, in some cases favorable, but there is no real functional change in the health of the gut.

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• The Bacillus genus are spore forming bacteria; they survive the transit through the stomach and small intestines to reach the microbiome in the colon, where they germinate, proliferate, then re‐sporulate.

• Thus, they offer significant advantages over the more common Lactobacillus and Bifidobacterium, which are non‐spore forming.

WHAT IS A TRUE PROBIOTIC

• Studies have shown that orally ingested B. subtilis spores are immunogenic and can disseminate to Peyer’s patches and mesenteric lymph nodes.

• Bacillus indicus HU36 spores produce a number of carotenoids, including lycopene, lutein, beta‐carotene and astaxanthin.

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BENEFITS FROM BACILLUS SPORES

Studies in humans show the following benefits from Bacillus spores:

• Immune modulation for childhood allergies

• Immune stimulation of peripheral T‐and B‐lymphocytes

• Decrease in frequency of urinary tract infections and positive cultures

• Reduction in side effects related to anti‐H. pylori antibiotic therapy

BENEFITS FROM BACILLUS SPORES

Studies in humans show the following benefits from Bacillus spores, cont.:

• Effective treatment for small intestinal bacterial overgrowth (SIBO)

• Diminished duration of diarrhea in children 3 to 36 months of age

• Reduced incidence of irritable bowel syndrome diarrhea

• Improvement in pain scale in Rheumatoid arthritis patients

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1. Has DNA verification of the strains.

2. Safety of the product: either by safety studies on each strain used or clinical trials with the finished formulation that showed no adverse events.

3. If it is going to be labeled as a “probiotic” it has to show that it survives gastric passage and then can colonize the gut.

4. The finished product must have at least one human clinical trial to show that the product has effect.

REFERENCES

• Taylor A, Marcus I, et al. Metal Oxide Nanoparticles Induce Minimal Phenotypic Changes in a Model Colon Microbiota. Environmental Engineering Science. July 2015, 32(7): 602‐612.

• Zhang L, Nichols R, et al. Persistent Organic Pollutants Modify Gut Microbiota‐Host Metabolic Homeostasis in Mice Through Aryl Hydrocarbon Receptor Activation. Environ Health Perspect. 2015 Jul;123(7):679‐88.

• Lyte M. Microbial Endocrinology in the Microbiome‐Gut‐Brain Axis: How Bacterial Production and Utilization of Neurochemicals Influence Behavior. PLoS Pathog, 2013; 9(11): e1003726.

• Emeran A. Mayer, Rob Knight, et al. Gut Microbes and the Brain: Paradigm Shift in Neuroscience. The Journal of Neuroscience, 12 November 2014, 34(46): 15490‐15496.

• Galland L. The gut microbiome and the brain. J Med Food. 2014 Dec;17(12):1261‐72.

• O’Mahony S, G. Clarke G, et al. Serotonin, tryptophan metabolism and the brain‐gut‐microbiome axis. Behavioural Brain Research, Volume 277, 15 January 2015, Pages 32–48.

• Campbell A. Pesticides: Our Children in Jeopardy. Alt Ther Health Med. 2013, Vol. 19,1.

• Campbell A. Our Other Vital Organ. Alt Ther Health Med, 2015, Vol. 21,2.

• Campbell A. The Gut, Intestinal Permeability, and Autoimmunity. Alt Ther Health Med, 2015, Vol 21,1.

• Campbell A. The Brain: What Can Affect It and What Can Improve It. Alt Ther Health Med, 2014, Vol 28,3.

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REFERENCES

• FDA (2013) Summary Report on Antimicrobials Sold or Distributed for Use in Food‐Producing Animals.

• Gibson GR, Rouzaud G, et al. An evaluation of probiotic effects in the human gut: microbial aspects. Final Technical report for Food Standards Agency (FSA) project ref 2005;G01022.

• Lewis Z, et al. Validating bifidobacterial species and subspecies identity in commercial probiotic products. Pediatric Research (2016)79,445–452.

• Adams C, The probiotic paradox: live and dead cells are biological response modifiers. Nutr Res Rev. 2010 Jun;23(1):37‐46.

• Hong, H.A., Duc, L.H., Cutting, S.M. (2005) The use of bacterial spore formers as probiotics. FEMS Microbiol. Rev. 29, 813‐835.

• Casula G, Cutting S,. Bacillus Probiotics: Spore Germination in the Gastrointestinal Tract. Applied and Environmental Microbiology, May 2002, p. 2344–2352.

• Mazza, P. 1994. The use of Bacillus subtilis as an antidiarrhoeal microorganism. Boll. Chim. Farm. 133:3–18.

• Khaneja, R., Perez‐Fons, L, et al. S., (2010) Carotenoids found in Bacillus. Journal of applied microbiology 108: 1889‐1902.

• Perez‐Fons, L., S. Steiger, et al. (2011) Identification and the developmental formation of carotenoid pigments in the yellow/orange Bacillus spore‐formers. Biochimica et biophysica acta 1811: 177‐185.

REFERENCES

• Campbell, AW. The Blood‐Brain Barrier. Altern Ther Health Med. 2016 Mar; 22(2):6‐7.

• Campbell AW.: The brain: what can affect it and what can improve it. AdvMind Body Med. 2014 Summer;28(3):4‐5.

• Kanoski SE, Davidson TL (2011) Western diet consumption and cognitive impairment: links to hippocampal dysfunction and obesity. Physiol Behav103: 59‐68.

• Campbell AW.: Healthcare for our Aging Population. Adv Mind Body Med, 27(4) Fall 2013.

• Amar J, Burcelin R, Ruidavets JB, Cani PD, Fauvel J, et al. (2008) Energy intake is associated with endotoxemia in apparently healthy men. Am J ClinNutr 87: 1219‐1223.

• James BD, Leurgans SE, Hebert LE, Scherr PA, Yaffe K and Bennett DA. Contribution of Alzheimer disease to mortality in the United States. Neurology. 2014; 82:1045‐50.

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REFERENCES

• Casula G, Cutting S,. Bacillus Probiotics: Spore Germination in the Gastrointestinal Tract. Applied and Environmental Microbiology, May 2002, p. 2344–2352.

• Mazza, P. 1994. The use of Bacillus subtilis as an antidiarrhoeal microorganism. Boll. Chim. Farm. 133:3–18.

• Gabrielli, M., Lauritano, E., et al. (2009) Bacillus clausii as a treatment of small intestinal bacterial overgrowth. Am J Gastroenterol 104: 1327‐1328.

• Hun, L., (2009) Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. Postgrad Med 121: 119‐124.

• Marseglia GL, Tosca M, et al. Efficacy of Bacillus clausii spores in the prevention of recurrent respiratory infections in children: a pilot study. Ther Clin Risk Manag. 2007 Mar;3(1):13‐7.

• Mandel DR, Eichas K, et al. Bacillus coagulans: a viable adjunct therapy for relieving symptoms of rheumatoid arthritis according to a randomized, controlled trial. BMC Complement Altern Med. 2010 Jan 12;10:1.

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