Pea & Rice ProteinFormulated to reduce insulin resistance
P < 0.001Gannon et al., 2003 Am J Clin Nutr
Higher levels of protein improves A1c levels
1. Abou-Samra R, Keersmaekers L, Brienza D, Mukherjee R, Macé K. Effect of different protein sources on satiation and short-term satiety when consumed as a starter. Nutr J. 2011;10:139.
2. Diepvens K, D Haberer D, Westerterp-Plantenga M. Different proteins and biopeptides differently affect satiety and anorexigenic/orexigenic hormones in healthy humans. Int J Obes (Lond). 2008;32(3):510-518.
Multiple studies demonstrate that pea protein promotes satiety 1,2
It’s not that diabetes, heart disease, and obesity runs in your family. It’s that NO ONE runs in your family.
The influence of diabetes mellitus on clinical and structural outcomes after arthroscopic rotator cuff repair
• Sustained hypoglycemia increased the possibility of anatomical failure at the repaired cuff
• An effective glycemic control associated with better rate of healing after rotator cuff repair
Nam Su Cho, Seong Cheol Moon, et al. Am J of Sports Med, 43(4):991-7
Inhibition of MMPs
• Patients with metabolic syndrome, type-2 diabetes, hypertension, dyslipidemia and obesity have a generalized elevation of MMPs
• Research demonstrated that patients with the metabolic syndrome and type-2 diabetes have an increased risk of expressing disc herniation
• AGEs associated with hyperglycemia have been identified as promoters of disc herniation
Hopps E, Caimi G. Matrix metalloproteinases in metabolic syndrome. Eur J Intern Med, 2012;23(2):99-104Jhawar BS, Fuchs CS, et al. Cardiovascular risk factors for physician-diagnosed lumbar disc herniation. Spine J, 2006;6:684-91Sakellaridis N, Androulis A. Influence of diabetes mellitus on cervical intervertebral disc herniation. Clin Neurol Neurosurg, 2008;110:810-2Tsusu M, et al. Effect of AGEs on human disc herniation: intervertebral disc hernia is also effected by AGEs. Kurume Med J, 2002;49(1-2):7-13Jazini E, et al. Alterations in magnetic resonance imaging T2 relaxation times of the ovine intervertebral disc due to non-enzymatic glycation. Spine, 2012;37(4):E209-15
Mediterranean Diet for Diabetes
• Adhering to Mediterranean-style diet may help reduce risk for type-2 diabetes, even when people don’t lose weight or increase exercise levels
NYTimes.com
Lifestyle Changes Staves Off Diabetes, Death
• 6-year lifestyle intervention decreased incidence of diabetes, cardiovascular mortality, and all-cause mortality in adults with impaired glucose tolerance
The Lancet Diabetes & Endocrinology online
• During 23 years of follow-up, individuals in the intervention group had a 45% lower risk of developing diabetes
• Had a 41% decrease in cardiovascular mortality
Environment: Blood Sugar Balance & PMA
• Reduce Stress Related Insulin Production:• Two minutes after you experience stress, your body starts
producing cortisol. This triggers insulin production that lowers your blood sugar, which in turn increases your cravings for high GI foods. “I eat when I’m stressed.”
• Blunt Cortisol production with Adaptogenic Herbs (licorice, ashwaganda, rehmannia) Whey protein, or breathing techniques.
Protocol
Acid / Alkaline Balance
pH Balance & Premature Aging
APO –ENZYMES(Inactive)
ACTIVE ENZYME
COMPLEX
ENZYMECO-FACTORS
(vitamins, minerals, etc)
pH Balance & Premature Aging
APO –ENZYMES(Inactive)
MUCH LESSACTIVE
ENZYME COMPLEX
ENZYMECO-FACTORS
(vitamins, minerals, Etc)
Acidic pH < 7.0(Salivary)
pH Balance & Premature Aging
APO –ENZYMES(Inactive)
MUCH MOREACTIVE
ENZYME COMPLEX
ENZYMECO-FACTORS
(vitamins, minerals, Etc)
Alkaline pH > 7.0 (Salivary)
Key Concept
Even if the
nutrient cofactors
are available to
catalyze the
enzymatic
reactions, the
enzyme activity
will be greatly
diminished if the
body pH is not
optimal
With all the vitamins that I take,
why do I still feel lousy?
• pH balance and acid buffering are critical to human health and slowing the aging process
Whole Body Alkalization
5.8 & belowDangerous Range. Seek assistance of a licensed professional
6.0 – 6.2Unhealthy Range. Consider proper dietary changes
6.4 – 6.8Moderate Range. Consider slight dietary adjustments
7.0 – 7.4Optimal Rangefor a 24-hour period
8.0 – 9.0Too Alkaline. While not common, this is unhealthy
pH Balance & PMA
Salivary pH as a marker of plasma adiponectin concentrations in women
Conclusion:
• Results suggest that salivary pH is significant correlate of plasma adiponectin levels in women
• Salivary pH – a simple, inexpensive and noninvasive measure, could be promising avenue
Tremblay M, et al. Diabetol Metab Syndr. 2012
Most People Over 40 Are Acidic
• Most people’s diet and lifestyle are acidic
• Foods – dairy, meats, trans-fats, cooked oils, refined sugars, coffee, and carbonated drinks
• Stress, drugs, alcohol, stimulants are acidic
Most People Over 40 Are Acidic (cont’d)
• Research conducted at University of San Francisco Department of Medicine revealed:a) As we get older, our bodies accumulate acid wastes
b) Significant decreasing alkaline reserves from age 20 to 90
c) Alkaline reserves remain fairly constant until 40, at which point they decrease significantly
d) Most adult degenerative diseases (obesity, diabetes, CVD, osteoporosis) appear at age 40
e) Believed that examination of alkaline reserves warranted consideration for these diseases
J. Gerontology A Biol Sci Med Sci. Jan 1996, 51(1):B91-9
Smart Evaluations: Total ORACFN
Free Radical “Most Wanted” List: Nutrients to counteract
Hydroxyl• Most reactive of the ROS• Incapable of elimination by
body’s endogenous enzymes
Linked to DNA damage & cancerTurmeric, garlic, basil, oregano, cinnamon
Peroxyl Associated with CVD/atherosclerosisBroccoli sprout, onion, tomato, carrot, spinach, kale, Brussel sprouts
PeroxynitriteChronic inflammation & breakdownof vital proteins (collagen)
Acerola, quercetin, acai, mangosteen
Singlet oxygen Linked to cholesterol problems & CVDBlackcurrant, blueberry, cherry, acai, blackberry, raspberry
Super oxide anionToxic-free radicals leading to DNA damage & mitochondrial diseases
Apple, elderberry, blue corn
Whole Body Alkalization (cont’d)
• Acid/alkaline balance – helps entire internal biochemical environment
Formulation with combination of select phytonutrients, vitamins and minerals demonstrated to increase total functional ORAC
Daily organic superfruit and greens
Potassium citrate
Glutamine
Project Implementation
Incorporating Natural Approaches
for Detoxification and
Anti-Aging
The Hidden LoadWhat’s invisible ishurting us!
More than 287
toxic chemicalshave been found in newborn cord blood
“Specific genes are turned on and off at certain time intervals, and any disruption of this finely-tuned DNA methylation regulation may persistently alter
gene expression. The fetal epigenome is most susceptible during this developmental period to epigenetic modifiers in the maternal environment. An error during such a crucial time might lead to an abnormal phenotypic outcome
in the offspring.
Kanherkar, et al. Epigenetics across the human lifespan. Frontiers in Cell and Developmental Biology September 2014 (2):49
Exposure to Toxins
• Polybrominated diphenyl ethers (PBDEs): used as flame retardant
• Bisphenol A (BPA): packaging plastics
• Perfluorooctanoic acid (PFOA): non-stick cookware
• Acrylamide: a) carbs at high temperature; b) coffee
• Mercury: seafood
• Methyl tert-butyl ether (MTBE): a) second-hand smoke; b) gasoline additive
Association between urinary Bisphenol A concentration and obesity prevalence in children and adolescents
Conclusion: Urinary BPA concentration was significantly associated with obesity in this cross-sectional study of children and adolescents
JAMA 2012:308(11):1113-1121
Bisphenol A may cause
testosterone reduction by adversely
affecting both
testis and pituitary systems similar to estradiol
Toxicol Lett. 2010 Apr 15;194(1-2):16-25. Epub 2010 Feb. 6
Cash Register Receipts – A Source of BPA
http://dx.plos.org/10.1371/journal.pone.0110509
BPA is an Ovarian Toxicant
• “I think more scientists working today agree that BPA is an ovarian toxicant” – Dr. Flaws
• Review research published in Environmental Health Perspectives: ovarian toxicity among the most consistent and strongest effects found “in both animal models and in women”
BPA alternative disrupts normal brain-cell growth, is tied to hyperactivity
University of Calgary: Thinks it’s research is first to show that bisphenol-S – ingredient in many products bearing “BPA-free” labels – causes abnormal growth surges of neurons in an animal embryo
Health & Science
BPA substitute can trigger fat cell formation: Chemical used in BPA-free products exhibits similar endocrine-disrupting effects
The Endocrine Society, Mar 22, 2016
Reduce Your Exposure
Detox Your Body
26 Seconds.
Is all it takes
for the chemicals in your
personal care products to enter your bloodstream.
What’s in YOUR products?
Phase II Pathways
• Sulfation – toxins attach with sulfur compounds. Primary cortisol pathway
• Glucuronidation – glucuronic acid combines with toxins. Primarily aspirin pathway
• Glutathione conjugation – the attachment of glutathione to toxins to detoxify fat soluble toxins
• Acetylation – acetyl co-a is attached to toxins
• Amino acid conjugation – conjugation of toxins with amino acid xenobiotics
• Methylation – involves conjugating methyl groups to toxins. **estrogen**
Phase II Detox Pathways
Phase II System Inhibitors Sulfation NSAIDs, tartrazine (yellow foods dye),
molybdenum deficiency
Glucuronidation Aspirin, probenecid (drug used to treat gout)
Glutathione conjugation Selenium deficiency, vitamin B2 deficiency, glutathione deficiency, zinc deficiency
Acetylation Vitamin B2, B5 or C deficiency
Amino acid conjugation Low protein diet
Methylation Folic acid or vitamin B12 deficiency
Phase II Detox Pathways
Phase II System Required Nutrients InducersSulfation Cysteine, methionine,
molybdenumCysteine, methionine, taurine
Glucuronidation Glucuronic acid Fish oils, cigarette smoking, BCP, limonene-containing foods
Glutathione conjugation Glutathione, vitamin B6 Brassica family foods, limonene-containing foods
Acetylation Acetyl-CoA None found
Amino acid conjugation Glycine Glycine
Methylation S-adenosyl-methionine Lipotropic nutrients (choline,methionine, betaine, folic acid, B12)
10-Day
1) Nutritional Detox Powder
Regulating nutrients:
• L-Cysteine
• Magnesium
• Support optimal function of Phase I and Phase II enzymes
Antioxidants for support of Phase II:
• Comprehensive vitamin profile, including vitamins A, C, E and a broad spectrum of B vitamins help neutralize reactive intermediary compounds
• Pantothenic acid supports the production of ATP to power the reactions
10-Day Detox
2) A capsular formulation to support detoxification: supports detoxification. Provides bifunctional support to enhance the activities of several liver detox enzymes while promoting balanced activity of Phase I and Phase II detox pathways
3) Eating plan: a modified elimination diet rich in vitamins, minerals, and phytonutrients reduces the allergen and toxin load, helping the body to detoxify efficiently:
a) Listing of foods to choose from for Days 1 – 10b) Sample recipes/menu plan for each dayc) 3 meals a day
Take a Probiotic to Detoxify the Body
• Two new studies: taking a probiotic can help body detoxify
• Nutrition journal: 1) Probiotics help detoxify body of heavy metals, free radicals, and
dangerous bacteria by enhancing natural antioxidant status in body
2) Probiotic also significantly increased glutathione status (the number one internal antioxidant in the body) and decreased malondialdehyde
Asemi, A., Jazayeri, S. et al. Effect of Daily Consumption of Probiotic Yogurt on Oxidative Stress in Pregnant Women. Annals of Nutritional Medicine, 2012. 60(1), 62-28Ejtahed, H. Mohtadi-Nia, J. et al. Probiotic Yogurt Improves Antioxidant Status in Type-2 Diabetic Patients. Nutrition, 2012. 28, 539-543
10-Day Detox Protocol
• Nutritional Detox Powder: 2 scp. BID
• A capsular formulation to support detoxification: 2 caps BID
• Modified elimination diet
• Probiotic – lactobacillus acidophilus, NCFM, b. lactis Bi-07: 1 cap daily• 15 or 60 billion live organisms
Detox
Daily bifunctional support for detoxification:
• Supports the balance between Phase I and Phase II
• Provides nutrients used to support multiple Phase II detoxification pathways
• Silymarin and other traditional herbs provide antioxidant activity and supports overall liver function
Formula for Balanced Clearance of Toxins Through Phase I and Phase II
Ellagic acid induces transcription of the rat
glutathione S-transferase-Ya geneGarfinkel L, Garfinkel D.
Induction of glutathione S-transferase (GST) enzymes
can increase detoxification of carcinogens and reduce
carcinogen-induced mutagenesis and tumorigenesis. To
determine if the anticarcinogen ellagic acid induces
cellular enzymes which detoxify carcinogens, we
examined the effect of ellagic acid on the expression of
glutathione S-transferase-Ya. Rats fed ellagic acid
demonstrated significant increases in total hepatic GST
activity, hepatic GST-Ya activity and hepatic GST-Ya
mRNA. To determine if the observed increase in GST-Ya
mRNA was due to ellagic acid inducing transcription of
the GST-Ya gene, transfection studies were performed
with plasmid constructs containing various portions of
the 5' regulatory region of the rat GST-Ya gene. The
transfection studies demonstrated that ellagic acid
increased GST-Ya mRNA by inducing transcription of
the GST-Ya gene and demonstrated that this induction is
mediated through the antioxidant responsive element of
the GST-Ya gene.
Comparative chemopreventive mechanisms of green tea, black tea and selected polyphenol extracts measured by in vitro bioassaysSteele VE, Kelloff GJ, Balentine D, Boone CW, Mehta R, Bagheri D, Sigman CC, Zhu S, Sharma S.
Black tea extracts (hot aqueous, polyphenols and theaflavins) and green tea extracts (hot aqueous, polyphenols, epicatechin, epicatechin gallate, epigallocatechin and epigallocatechin gallate) were tested in nine standardized cell culture assays for comparative cancer chemopreventive properties. Most black and green tea extracts strongly inhibited neoplastic transformation in mouse mammary organ cultures, rat tracheal epithelial cells and human lung tumor epithelial cells. Nearly all tea fractions strongly inhibited benzo[a]pyrene adduct formation with human DNA. Induction of phase II enzymes, glutathione-S-transferase and quinone reductase, were enhanced by nearly all tea fractions, while glutathione was induced by only a few fractions. Ornithine decarboxylase activity was inhibited by nearly all the green tea fractions, but none of the black tea fractions..
Bifunctional Modulators support balance between Phase I and Phase II
Decrease of plasma and urinary oxidative
metabolites of acetaminophen after
consumption of watercress by human
volunteers.Chen L, Mohr SN, Yang CS.
To investigate the effect of the consumption of watercress
(Nasturtium officinale R. Br.), a cruciferous vegetable, on
acetaminophen metabolism, the pharmacokinetics of
acetaminophen and its metabolites were studied in a
crossover trial of human volunteers. A single oral dose of
acetaminophen (1 gm) was given 10 hours after ingestion
of watercress homogenates (50 gm). In comparison with
acetaminophen only, the ingestion of watercress resulted in
a significant reduction in the area under the plasma
cysteine acetaminophen (Cys-acetaminophen)
concentration-time curve and in the peak plasma Cys-
acetaminophen concentration by 28% +/- 3% and by 21%
+/- 4% (mean +/- SE; n = 7; p < 0.005), respectively.
Carcinogenesis. 2000 Jan;21(1):63-7● Carcinogenesis. 2000 Jan;21(1):63-7 ● Clin Pharmacol Ther. 1996 Dec;60(6):651-60
Inhibit overproduction of Phase I enzymes and up-regulate production of Phase II enzymes with:
• Decaffeinated green tea catechins
• Ellagic acid
• Watercress glucosinolates
AntioxidantsThe missing piece to support glutathione
Help reduce free radical formation
Function in the regeneration of glutathione
Aid in phase II detoxification
Antioxidant functionDetoxifying function
GSH
GSHGSSG
G R
Neutralized counterparts
G P x
Free radicals, H2O2
organic peroxides
NADP+ NADPH
GSH
X
G S T
Further breakdownand excretion
GSH = glutathione; = glutathione disulfide; = xenobiotics
GST = glutathione S-transferase; GPx = glutathione peroxidase; GR = glutathione reductase
GSSG
x
X
Glutathione: Antioxidant and detoxifying function
Niacinamide
Selenium
N-acetyl-L-cysteine
Broccoli extract
Vitamin C
Provide your patients with a powerful formula for balanced daily detoxification
• Bifunctional detoxification support:
• Methylated vit. B12, folic acid with nutrients to balance phase I and phase II
• Antioxidant protection and detoxification support:
• Vit. C, selenium, niacin (niacinamide), n-acetyl-L-cysteine (NAC), broccoli extract
• Kidney detoxification and kidney health:• Vit. B6, B12, Folate, cordyceps, Chinese salvia, NAC
• Once daily convenient packet
Heavy Metals: A Global Problem
Cadmium inhaled from polluted air and eaten in food raised in contaminated soil
Lead exposure comes from numerous sources, including drinking water, contaminated soil, household dust, and lead-based paint in older homes
Body’s natural mechanism for eliminating heavy metals
Metallothionein
Binds to heavy metals
in the cell
Transports heavy metal
out of the cell to the liver
Liver
Conjugated with glutathione (phase
II detoxification) transformed to mercapturate
Mercapturate
Excreted via urine or stool
Metallothionein
Support metabolism of heavy metals but do not facilitate excretion of certain healthful minerals (calcium, magnesium, selenium, zinc)
Metabolic Detoxification The importance of metallothionein for support of heavy metal metabolism
PhytonutrientsMetal-
activated transcription
factor-1
Metallothionein-1
Spent hops (Humuluslupulus), pomegranate rind extract (Punica granatum), prune skin extract (Prunus
domestica), watercress plant extract (Nasturitum
officinalis)
Heavy-Metal Detox – On-Going Care
1) 3 formulas in one packet to provide on-going liver and kidney detoxification
2) Supports the genetic expression of enzymes involved in the metabolism of heavy metals (3 tabs BID)
3) Minimum 30 days
Promoting Weight loss without Supporting Detox is Malpractice!
Persistent Organic Pollutants
DETOXFat Loss Patients!Weight Loss May Push
Toxins Into Bloodstream
“Serum concentrations of most POPs were higher in those with long-term weight loss”Int J Obes (Lond). 2010 Sep 7
Juicing and other fasting programs can actually deprive your body of essential nutrients needed to support detoxification.
Detoxification – 21st Century Model
• Body’s innate process of removing or altering metabolic wastes and acquired toxins
• Enables the body to perform its life processes unencumbered by detrimental elements and disruptive molecules
• Body’s natural innate processes to “recycle” or “take out the trash”
Healthy, Lean, Strong
91 year-old Betty Calman shows off the peacock pose
Are You Kidding Me?
• Tampons and pads are regulated by the FDA as medical devices
• Medical devices are not required to disclose ingredients
• Tampons – made from cotton, rayon, pulp fiber
• 94% of cotton in U.S. = GMO!
Are You Kidding Me? (cont’d)
• These materials may contain toxic disinfection by-products:a) From chlorine bleaching
b) Dioxins, furans, DBP
c) Pesticides from non-organic cotton
• FDA recommends that tampons be free of dioxine, etc…
• It is not a requirement
• Studies have shown the toxins are present in brands studied
FYI
• Feminine-care products are classified as “cosmetics” by FDA
• Means no specific tests are required to demonstrate their safety
• Avoid fragranced tampons
• Use “unscented” products
• Chlorine-free or unbleached tampons/pads
• Use organic – chemical-free (non-GMO particles)
Try This…
• Burn an organic tampon/pad – it burns slow and clean
• Burn a commercial brand (undisclosed ingredients)
Creates black smoke and thick residue
Indicates the pad has dioxins
Post Detox…
Environment
MicrobiomeEpigenetics
Us
GI Tract: Food sensitivitiesLeaky gut syndromeYeast/FungusDysbiosis ( Good bacteria)
Body Composition: Obesity
Insulin: Blood sugar problemsPre-diabetes/DiabetesInsulin resistance
Liver: Liver dysfunctionToxins/Chemical overload
Musculoskeletal System:Arthritis/Joint painSoft-tissue injuryCytokine, MMPS
Brain: SatietyInflammatoryNeurodegeneration
Dr. Rob’s Gut Matrix
The Gut’s the Body’s
Second Brain
Gut bacteria linked to age-related diseases
• Research suggests that treating a leaky gut may promote longevity
• Alterations in intestinal microbiota linked with aging and measures of frailty in elderly
Clark RI, Salazar A, et al. Distinct shifts in microbiota composition during drosophila aging impair intestinal function and drive mortality. Cell Rep. 2015;12:1656-67
Section VI: GI Treatment
4R Program
Section VI: GI Treatment
4R Program
Section VI: GI Treatment
4R Program: REMOVE
Pathogens, parasites, yeast
Food Allergens
Gastric irritants
Section VI: GI Treatment
4R Program
Stomach Acid
Digestive
Enzyme
Stomach Acid
Digestive
Enzyme
: REPLACE
Section VI: GI Treatment
4R Program
Beneficial bacteria
: REINOCULATE
Beneficial bacteria
Section VI: GI Treatment
4R Program
Nutrients
Heal GI lining
Nutrients
Heal GI lining
: REPAIR
1. Remove
• Removing offending substances from the diet
• Food allergens and other materials that negatively influence the intestinal environment:–Can cause localized irritation
–Trigger release of damaging chemicals into general circulation
–Affecting other tissues or organ
1. Remove (cont’d)
• Concentrated aromatic oils:• Thyme oil• Oregano oil• Sage leaf• Lemon balm leaf
• For upper respiratory issues/sinusitis
• Aromatic oils = open the bronchial
• Thyme oil – health of GI/upper respiratory
• Sage/lemon balm – herbs that complement and stabilize the fragile essential oils
1. Remove (cont’d)
Concentrated berberine formula for intestinal support
• Berberine HCL
• Oregon grape• Coptis root
• Chinese herbs, ginger, licorice, skullcap
• For healthy intestinal environment
• Dyslipidemia, dysbiosis
• Best suited for train-wreck patient
• B=bowel issues
2. Replace
I. Low-gastric acidity:• A formulation featuring betaine HCI combined with pepsin to
complement the natural production of digestive agents in the stomach.
II. Pancreatic enzyme insufficiency:• A formulation that features a comprehensive enzyme complex that
helps promote healthy digestive function. Containing protease, amylase and lipase.
• L. acidophilus NCFM and B. lactis Bi-07 (60 billion live organisms) – designed to relieve recurring bowel distress and related functional discomforts, such as occasional bowel urgency
• Helps relieve abdominal discomfort, bloating, cramping, bowel irritation, and occasional urgent bowel movements
3. Reinoculate – Probiotics (cont’d)
Xanthohumol strong clinical data
CardiovascularAnti-inflammatory/
Polyphenols/Antioxidant
ArthritisAnti-inflammatory
NFkB inhibition
Digestive HealthAnti-inflammatory
Polyphenols
Brain HealthAnti-inflammatory
Anti-oxidant/polyphenolsMitochondrial biogenesis
Xanthohumol
Excellent science: >250 publications in preclinical science
Next generation SKRM designed for enhanced bioavailability
Xanthohumol modifies kinases in favor of antioxidant protection
Bioavailable form of curcumin: CurQfen®
• Curcumin shows potent anti-inflammatory activity and research suggests it may help reduce inflammation-signaling molecules, such as NF-B, TNF-, COX-2, and PGE2
1
• Curcumin also shows potent antioxidant activity and research suggests it may help improve overall redox status through influencing antioxidants Nrf2, HO-1, and NQO12
• Delivery of significant concentrations of biologically active free curcuminoids has always been regarded as a major limitation for the efficacy of curcumin supplementation2
• CurQfen is a unique, patented blend of a stable curcuminoid and galactomannan compound (from fenugreek) designed for great bioavailability and more reliable clinical outcomes
1. Vecchi Brumatti L, Marcuzzi A, Tricarico PM, Zanin V, Giradelli M, Bianco AM. Curcumin and inflammatory bowel disease: potential and limits of innovative treatments. Molecules. 2014;19(12):21127-21153.
2. Rajasekaran SA. Therapeutic potential of curcumin in gastrointestinal diseases. World J Gastrointest Pathophysiol. 2011;2:1-14. 35. González-Reyes, S. Guzmán-Beltrán S, Medina-Campos ON, Pedraza-Chaverri J. Curcumin pretreatment induces Nrf2 and an antioxidant response and prevents hemin-induced toxicity in primary cultures of cerebellar granule neurons of rats. Oxid Med Cell Longev. 2013;2013:801418
3. Krishnakumar IM, Abhilash M, Gopakumar G, Dinesh K, Balu M, Ramadasan K. Improved blood–brain-barrier permeability and tissue distribution following the oral administration of a food-grade formulation of curcumin with fenugreek fibre. Journal of Functional Foods. 2015;14:215-225.
CurQfen: formulated for greater curcuminbioavailability
• In a randomized, crossover study of 50 subjects
• Single dose of 400mg of
• Curcumin levels were measured over 12 hours
• CurQfen group demonstrated 45.5 times more bioavailability when compared to standard curcuminoids
AKAY research in collaboration with Amala Cancer Research Institute in India and SMO connect clinical research services Pvt Ltd, India
Dr. Rob’s GI Restoration Protocols Remove & Replace – 30 Days
Ingredients Dosage
Berberine HCL, Oregon grape, Coptis root, Chinese herbs, ginger, licorice, skullcap
3 TID
Thyme oil, oregano oil, sage leaf, lemon balm leaf (If pt. has respiratory symptoms)
1 sg TID
Betaine HCL, pepsinTitrate up to a warming dose
Protease, amylase, lipase 1 tab w. each meal
Modified elimination food plan
EPA/DHA 4 g.
Dr. Rob’s GI Restoration Protocols Reinoculate & Regenerate – Next 30 Days
Ingredients Dosage
Medical food for inflammation and GI support 2 scp. BID
Specialized Pro-resolving Mediators 250 mg. daily
D3 5000 (check 25-OH D3 levels)
L. Acidophilus NCFM/b. Lacti Bi-07 (60 billion) 1 ca. daily
Modified elimination food plan 30-60 days
Include digestive enzymes if score indicatesIf autoimmune disease – may take up to 90 days
Retest
Paradigm shift
• SPM represent a paradigm shift in how we regulate the inflammatory response
Specialized Pro-Resolving Mediators (SPM)
α-linolenic acidEssential fatty acidsMust be acquired through diet
Inefficient multi-step conversion
EPA
DHA
Conditionally essential fatty acids support:• Cell membrane integrity• Brain and eye health•Healthy triglycerides levels•Heart health
SPMs
Unique role in supporting the resolution of the immune response and inflammation – necessary for healthy aging and active living•Neutrophil activity is curtailed•Macrophages remove dead neutrophils, bacteria and debris• Tissue is remodeled • Return to homeostasis (cells’ previous normal conditions)
Multi-step process, and production affected by certain health conditions*
Inefficient Conversion to meet needs in the face of inflammation,
particularly in an already compromised
host
Serhan CN. Nature. 2014;510:92-101
Advantages of pro-resolving mediators
• Brings biochemical precursor and products to site of action
• They play a role in inflammation and resolution
SPMs
• Signal for the activated immune cells to be killed- Apoptosis
• Signal macrophages to engulf those dead cells
• Signal promotes a molecular switch to change the role of macrophages to a resolving one
• Net result: suppresses further immune recruitment and promotes tissue repair
SPMs (cont’d)
• Act through specific cellular receptors that initiate intracellular signals
• Signals microbial phagocytosis and clearance
• SPM receptors “G-protein coupled receptor”
• Receptors span the cell membrane
• Receptor binding causes specific cell behaviors
Cell Behaviors Mediated by SPMs Tissue-Level Outcomes of SPM Actions
• Inhibit neutrophil recruitment• Reduce vascular permeability• Reduce endothelial cell proliferation and migration
(limit revascularization --- is this really the case?)• Promote lymphocyte removal of phagocytic cells
(efferocytosis or phagocytosis)• Reduce leukocyte infiltration• Reduce cytokine levels
Halt of inflammation
Promote tissue repair
Regenerate original structure and function and return to homeostasis
Resolvins protects from local inflammation and osteoclast mediated bone destruction
Conclusion: Indicates that resolvins directly interacts with human neutrophils and that an abnormality of neutrophil function in human disease can be modified with exposure to resolvins
FASEB Journal, Dec 22, 2005;p1-17
Resolvins mediate bone preservation
Conclusion: Results indicate that resolvins modulates osteoclast differentiation and bone remodeling by direct actions on bone
Journal of Immunology, 2013;190:689-94
Resolvins modulates osteoclast differentiation and bone resorption
Conclusion: indicated resolvins inhibits osteoclast (OC) growth and bone resorption by interfering with OC differentiation. This leads to a direct action in bone remodeling.
British Journal of Pharmacology, Sept 2008;p1214-1223
Clinical Uses and Advantages
Health Conditions Associated with Chronic Inflammation that
may benefit from SPM supplementation
Obesity
Metabolic Syndrome
Diabetes
Aging and age-associated diseases
Vascular disease such as cardiovascular disease and peripheral vascular
disease
Digestive disorders including Inflammatory Bowel Disease (IBD)
Autoimmune conditions
Arthritis
Without resolution, even a reduced inflammatory response can become chronicM
agn
itu
de
Time
Initiation
Serhan CN. Nature. 2014;510:92-101.Spite et al. Cell Metab. 2014;19(1):21-36.
SPMs act to resolveinflammation. Without resolution, even a reduced inflammatory response can become chronic, and full healing and return to homeostasis cannot occur
SPMs
Resolution
Balance between initiation and resolution is critical
So, are we ready for Monday morning??
“But I’ve heard…”
• “There’s lots of probiotics products out there and as long as it’s from a reputable company it’s going to be good.”
• “If 10 billion CFUs is good, then 20 billion is twice as good.”
• “Probiotics should always be refrigerated.”
• “Probiotics don’t need to be refrigerated.”
• “Probiotics should be taken on an empty stomach to reduce their destruction by stomach acid.”
• Patients should keep their open probiotics in the freezer.”
• “I just tell my patients to take yogurt.”
Obesity and Pollutants Contribute to Whole-Body Inflammation
University of Ottawa, Canada, literature review conclusion: obesity and environmental pollutants combined to increase inflammation in the body
Obesity Reviews, 15:19-28, 2014
Obesity GorillaPonders New Diet
Simple strategies first!
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