by Deanna Minich, PhD, CNS, IFMCP
You’ve likely seen, or heard, the detox debate. Experts, celebrities, and news outlets have reported the importance of detoxing or doing a cleanse. Over time, it’s thought that an accumulation of environmental toxins weighs us down, saps our energy, and prevents us from living our best lives. As a result, the best way to reduce the “toxin burden” is to bring in everyday strategies to remove them and to have dedicated times of year to do a bit more for a whole-self reset.
Of course, there’s also the school of thought that suggests that our bodies are built for detoxing, and we don’t need a special diet or product to clear out the system. Detox is just a waste of time, they say. Well, there is no doubt that the body does regular cleansing through breathing, urinating, defecating, crying, secreting, and exfoliating, but are we always doing it efficiently?
With all the current data on pharmacogenetics and even nutrigenomics, we now know that every individual is different when it comes to the efficiency of toxin removal. So how would you know if you are one of the “chosen ones” who needs a detox? Let’s look at the body systems from physical, emotional, and mental perspectives, as they may provide the clues.
Let’s begin by looking at what “detox” means. Over the last two decades, this word has taken on a much more dynamic meaning. In the United States, we encounter over 80,000 different chemicals,1 and an estimated 4 billion pounds of chemical pollutants from plastics, pesticides, solvents, heavy metals, etc. enter into our environment, finding their way into the air, soil, food, water supplies, our clothing, and eventually, into our bodies.2 Every year, the toxic load continues to increase. Scientists now estimate that everyone of us carries at least 700 contaminants within our bodies!3
While it is true that the human body is well-equipped to rid itself of these potentially harmful chemicals, the sheer volume of what we’re now exposed to can overburden our natural detoxification processes and allow the toxins to accumulate in our tissues.
One of the first indicators that we may be harboring a toxic burden is to look at changes in the body’s immune system, such as increased susceptibility to colds, flues, and becoming sick.4 Additionally, generalized joint and muscle aches and pains, food, environmental or chemical sensitivities, headache, lethargy, weakness, and even abdominal pain could be signs that you need to help your body relieve some of the accumulated toxins.
When we look at detoxification, we don’t just want to look at the removal of physical toxins that weigh down our bodies. We can also be burdened in other areas of life, including emotional and mental aspects that can arise from many areas in life—from the company we keep to physical and psychological stressors to sleep habits.
In addition to emotional toxicity, we may also experience mental toxins. Perhaps the most pervasive are the limiting thoughts that invade our minds throughout the day like, “Nobody cares what I think,” “I’m just not good at new things,” or “I can’t say no.” Years ago, I heard we have up to 80,000 thoughts each day, and most of them are negative. Regardless of the exact number, it’s probably reasonable to think that most people are not thinking positively most of the time. These types of mental toxins could add up to mental stress, leading to an inability to concentrate and even sleep. And, without proper sleep,6 we may not be allowing for the flux of toxins out of the brain.
Steps for daily detox
No matter where the toxic burden originates from, there are simple steps to take to help your body detox.
1. National Resources Defense Council. https://www.nrdc.org/issues/toxic-chemicals. Accessed October 17, 2018.
2. http://scorecard.goodguide.com/env-releases/us-map.tcl. Accessed November 5, 2018.
3. Onstot J et al. Characterization of HRGC/MSUnidentified Peaks from the Analysis of Human Adipose Tissue. Volume 1: Technical Approach. Washington, DC: U.S. Environmental Protection Agency Office of Toxic Substances; 1987.
4. Sears ME et al. J Environ Public Health. 2012;2012:356798.
5. J Environ Public Health. 2012;2012:356798.
6. Inoué S. Behav Brain Res. 1995;69(1-2):91-96.
7. Ishii H et al. http://www.clinexprheumatol.org/article.asp?a=2136. Accessed 10/17/18.
8. Guan Y et al. Evid Based Complement Alternat Med. 2015:824185.
Nobody likes uninvited guests. This includes toxins and pollutants such as heavy metals and pesticides from the air, water, and soil that bombard our bodies every day. Over time, these “guests” can build up and can contribute to mild issues such as brain fog, tiredness, aches, and skin complaints.1,2 This is when it is important to understand the three phases of your body’s natural detoxification processes. Here’s what that looks like:
Phase I: Reaction
In the first phase of metabolic detoxification, your body reacts to toxins by using enzymes (known as P450 enzymes)3 that act to turn the toxins into free radicals. This is a good thing: Free radicals are a natural occurrence that, when balanced, should not be an issue; it is when free radicals become imbalanced that they are considered an issue. Through this conversion process, toxins become water-soluble molecules that are easier for your body to get rid of via the kidneys (and eventually through the urine).3
Phase II: Neutralization
Welcome to the activation phase of detox! After Phase I, some toxins are rendered as more reactive than before. In Phase II, these products are attached to other water-soluble substances to increase their solubility and make them easier to eliminate through urine or bile.3 This process is called a conjugation reaction, and requires co-factors (metal ions or co-enzymes) to make it happen.3
Phase III: Transportation
Like a ferry that brings cars and people from Point A to Point B, the transporters of Phase III help ensure the water-soluble compounds created in Phases I and II are excreted from your cells. Before this occurs, Phase III neutralizes the compounds and binds them with dietary fiber. From here, it’s literally a flush when the toxins are excreted.3
1. Goldman RH et al. The occupational and environmental health history. 1981 Dec 18;246(24):2831-6.
2. Nelson et al. 2011.
3. Liska D. The Detoxification Enzyme Systems. Altern Med Rev.1998 Jun;3(3):187-98.
4. Infographic: The 3 Phases of Detoxification. Metagenics Institute. Available at: https://www.metagenicsinstitute.com/ce-education/clinical-tools/3-phases-detoxification. Accessed August 30, 2018.
Submitted by the Metagenics Marketing Team
Add These Detoxifying Foods to Your Shopping List
Detox is a hot topic nowadays. Many detox programs promise to cleanse your body harmful compounds, and others tout weight loss and additional health benefits. Unfortunately, many of these detox methods involve a major dietary overhaul or giving up solid foods altogether, which may actually be harmful to your body.1 Because your body is in constant detox mode, you can encourage this process, correctly and effectively, by simply eating the right foods.
Scientific research has found that the nutrients, enzymes, and antioxidants found in certain whole foods can help support the liver’s detoxification pathways, prevent the buildup of toxins, and support overall health.2-4
Chemicals and toxins are everywhere, but your body is built to fight back. Here are six of your top nutritional allies:
1. Cruciferous vegetables & leafy greens
Spinach, broccoli, and Brussels sprouts are among the folate- and chlorophyll-richgreens that support the body’s detoxification process by helping to detoxifythe blood and cleanse the intestines.2,4-7 All the more reason to go green!
Broccoli deserves some special attention for its high concentrations of glucoraphanin, which is converted in the body to sulforaphane—an active compound associated with many positive health benefits, including its role in inducing phase II detoxification enzymes and support for overall liver health.8-10
Used in many anti-inflammatory and detoxifying recipes, turmeric contains a powerful substance called curcumin, a polyphenol with anti-inflammatory and antibacterial properties. Science has found curcumin to play a role in modulating cellular response to oxidative
stress—demonstrating hepaprotective and therapeutic effects on liver health.11,12
Commonly used in bread products, oils, and dressings, sesame is flowering plant that maybe beneficial for detox. Sulfur-containing amino acids methionine and cysteine—both of which are found at high levels in sesame—are precursors to the production ofglutathione, a key antioxidant in the detoxification process.4
These pretty-colored veggies contain betanin, which can help repair liver cells and help support detoxification processes in the liver.13,14 It’s also great for digestion. Tell toxic chemicals to “beet” it!
No party spread is complete without it! Avocado has high concentrations of the antioxidant glutathione, which has been found to neutralize free radicals to support and protect the liver—i.e., your detoxification powerhouse.4,15,16
Why guacamole? Avocado in this form often uses other healthful ingredients, like cilantro. Also known as coriander, cilantro contains oils with antibacterial, antifungal, and antioxidative properties.17 Pass the guac, please.
Alongside its knack for warding off vampires, garlic may be beneficial for clearing out toxins. The sulfur-containing compound allicin, which gives garlic its unique and strong-smelling aroma, may enhance antioxidation and detoxification capabilities18,19 and has also demonstrated hepatoprotective effects against heavy metals in the liver.20
Incorporating more of these foods into your diet can help support detox processes. Add them to your shopping list today!
1. National Institutes of Health. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/detoxes-cleanses. Accessed November 15, 2018.
2. Guan YS. Evid Based Complement Alternat Med. 2015;2015:824185.
3. V Marco. Int J Food Sci Nutr. 2011;63 Suppl 1(S1):82-89.
4. Hodges RE. J Nutr Metab. 2015;2015:760689.
5. Suparmi S. J Toxicol. 2016;2016:8515089.
6. https://www.healthline.com/health/liquid-chlorophyll-benefits-risks. Accessed November 15, 2018.
7. Welzel TM. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1279-1282.
8. Kikuchi M. World J Gastroenterol. 2015;21(43):12457–12467.
9. Yoshida K. World J Gastroenterol. 2015;21(35):10091–10103.
10. Glade MJ. Nutrition. 2015;31(9):1175-1178.
12. García-Niño WR. Food Chem Toxicol. 2014;69:182-201.
13. Krajka-Kuźniak V. Br J Nutr. 2013;110(12):2138-2149.
14. Clifford T. Nutrients. 2015;7(4):2801–2822.
15. Kaplowitz N. Yale J Biol Med. 1981;54(6):497–502.
16. Sacco R. Minerva Gastroenterol Dietol. 2016;62(4):316-324.
17. Mandal S. Asian Pac J Trop Biomed. 2015;5(6):421-428.
18. Bayan L. Avicenna J Phytomed. 2014;4(1):1–14.
19. Wu CC. J Tradit Complement Med. 2012;2(4):323–330.
20. Nwokocha CR. Food Chem Toxicol. 2012;50(2):222-226.
Submitted by the Metagenics Marketing Team
Heavy metals, pesticides, and xenoestrogens
The industrial, chemical, and technological revolutions benefited us in many ways but have also led to a highly toxic world. If we could take a look inside the food and supplements that we put into our bodies, we would expect them to not contain heavy metals and pesticides. However, this simply is not realistic given our modern environment, where we are regularly exposed to toxins through water, food, air, personal care products, and other elements such as:
While this information may come as a surprise, we are not incapable of protecting ourselves from exposure to toxins. Here are four critical ways that we can protect ourselves:
1. Be aware of safety guidelines Action begins with awareness that we need to protect ourselves from daily exposure to toxins. Regulatory agencies such as the Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) publish information and set forth safety guidelines for heavy metal intake and other manageable exposures.5,6 Being aware of these safety guidelines is a great first step toward living a cleaner lifestyle.
2. Detox your home We think our homes are safe, but they are actually where we can be exposed to heavy metals and xenoestrogens—compounds that imitate the hormone estrogen. Xenoestrogens include brominated flame retardants (BFRs) commonly found in mattresses, carpet, electronics, and more. Older homes can also harbor lead paint. Aluminum has been found in pots, pans, and various personal care products. Even scented candles and air fresheners can contain xenoestrogens and other harmful compounds.7
Plastic containers are another place where xenoestrogens lurk. While convenient, plastic containers such as water bottles and bags include chemicals that mimic estrogen in the body. Two of these chemicals, bisphenol-A (BPA) and bisphenol-S (BPS), are especially detrimental in extreme temperatures, as high heat can cause both to break down and leach into foods and liquids.8 Use glass or stainless-steel containers instead of plastic to reduce exposure.
3. Shop smart One of the easiest ways to reduce toxin exposure is by shopping smarter at the grocery store. Look for organic varieties of produce listed on the Environmental Working Group “Dirty Dozen” list, as these items have been associated with high pesticide residue levels.9 For shoppers on a budget, produce listed on the “Clean 15” are identified as non-organic produce with the lowest pesticide levels.9
For animal products, select organic meats whenever possible and pick wild-caught seafood over farm-raised. Not all fish are created equal, and in the deep blue sea, smaller is better as they are gobbled up by larger fish, thereby beginning the cycle of contaminants compounding and building in potency until they reach your plate. Because large fish such as tuna and swordfish are higher on the food chain, they usually harbor greater concentrations of toxins and contaminants being dumped into oceans and lakes than their food source (e.g., smaller fish).
4. Drink filtered water. The tap water in your area could be harboring heavy metals, pesticide runoff, and environmental estrogens like fluoride, chlorine, and other chemicals. In a 2008 study across nine states, the US Geological Survey found municipal water to contain 85 man
made chemicals.10 However, adequate water is important for so many bodily processes—including detoxification—so purchase a quality water filter to stay hydrated while keeping toxins at bay.
Submitted by the Metagenics Marketing Team
by Ashley Jordan Ferira, PhD, RDN
Recent research from three well-known cohorts, The Nurses’ Health Study (NHS), NHS2 and Health Professionals’ Follow-Up Study (HPFS), reveals that higher magnesium intake is associated with lower risk of type 2 diabetes (T2D), particularly in diets with poor carbohydrate quality.1
Green leafy vegetables, unrefined whole grains, and nuts are richest in magnesium, while meats and milk contain a moderate amount.2 Refined foods, like carbohydrates (carb), are poor sources of magnesium. Diets with poor carb quality are characterized by higher glycemic index (GI), higher glycemic load (GL), and lower fiber intake. These poor carbs require a higher insulin demand.
The typical American diet is low in vegetables and whole grains, resulting in reduced magnesium intake. The Recommended Daily Allowance (RDA) for magnesium is 310-320 mg/day for adult women and 400-420 mg/day for adult men.3 Half of the US population fails to meet their daily magnesium needs, and hypomagnesemia exists in 1/3 of adults.4-5 Magnesium is needed for normal insulin signaling; current research has linked insufficient magnesium intake to prediabetes, insulin resistance and T2D.4 Increased magnesium intake has been inversely associated with T2D risk in observational studies.6
Collaborators from Tufts University, Harvard University, and Brigham and Women’s Hospital, sought to investigate the impact of magnesium intake, from both dietary and supplemental sources, on the risk of developing T2D in subjects who had diets with poor carb quality and raised GI, GL, or low fiber intake.1 They followed three large prospective cohorts, NHS, NHS2 and HPFS (totaling over 202,700 participants). Dietary intake was quantified by validated food frequency questionnaires (FFQ) every 4 years, and T2D cases were captured via questionnaires. Over 28 years of follow-up, there were 17,130 cases of T2D.
Major study findings included:1
Similar to the US population estimates, 40-50% of study participants had inadequate magnesium intake. A healthful, varied diet and supplemental magnesium (especially in diets that restrict or exclude carbohydrates, dairy or meat) are essential to ensure sufficient daily magnesium intake.
Why is this Clinically Relevant?
Link to Abstract
by Bianca Garilli, ND
Magnesium is the 4th most abundant mineral in the human body following calcium, sodium, and potassium. Intracellularly, magnesium is the 2nd most abundant cation behind only potassium.1 The number of essential roles magnesium plays in the body is extraordinary, with over 300 enzymes requiring magnesium as a co-factor for proper functioning.1
This essential element is involved in numerous critical physiological processes such as energy production (ATP metabolism, oxidative phosphorylation, and glycolysis), protein synthesis, muscle contraction, nerve function, blood glucose control, hormone receptor binding, blood pressure regulation, trans membrane ion flux, gating of calcium channels, cardiac excitability, and synthesis of nucleic acids (RNA and DNA).1
Unfortunately, magnesium is one of the most prevalent nutrient gaps in the US. The 2015 Dietary Guidelines Advisory Committee noted a substandard intake of magnesium as compared to the Estimated Average Requirement (EAR), which is the Dietary Reference Intake (DRI) used to assess population sufficiency vs. insufficiency for nutrients.2-3 A 2016 publication in Advanced Nutrition concluded, “Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less”.4 This is especially concerning when one considers the critical implications of long-term, frequently unrecognized magnesium deficiencies.
Deficiencies in magnesium can present with overt clinical manifestations such as nausea, vomiting, lethargy, weakness, personality changes, tetany and tremor, seizures, arrhythmia, and muscle fasciculations.5 In other cases, sub clinical deficiencies may be more difficult to recognize yet have equally serious effects if left untreated. Health concerns and disease processes resulting from an underlying, subclinical magnesium deficiency may contribute to low bone mineral density and cardio-metabolic implications such as metabolic syndrome, hypertension, arrhythmia, arterial calcification, atherosclerosis, heart failure, and increased risk for thrombosis.6
A sub clinical magnesium deficiency can also disrupt sleep and cause muscle cramping, two common symptoms often glossed over but which can be signs of a bigger problem if left untreated. The impact of magnesium on these two clinical manifestations will be explored further:
Magnesium and sleep
A double-blind randomized clinical trial composed of 43 elderly participants between 60-75 years of age with diagnosed insomnia was conducted.7 The experimental group was given 500 mg/day of elemental magnesium for 8 weeks (250 mg elemental magnesium from 414 mg of Mg oxide, twice daily), while the control group received a placebo for the same length of time.7 A statistically significant increase was seen in sleep time, sleep efficiency, and concentration of serum renin and melatonin, as well as a significant decrease in insomnia severity index (ISI) score, sleep onset latency, and serum cortisol level.7
For many individuals, sleep is disrupted by restless leg syndrome (RLS) or periodic limb movements (PLMS).8 A study supplementing 12.4mmol of oral magnesium in the evenings for 4-6 weeks found that the overall sleep efficiency improved from 75 to 85%.9 The Mg-supplemented group also experienced a significant reduction in PLMS associated with arousal (7 PLMS/hr vs. 17 PLMS/hr at baseline).9
Magnesium and muscle cramps
Muscle cramping is a common occurrence among women during pregnancy, in athletes, and in the elderly, for which magnesium is often recommended.10 There are only a few studies, however, that have reviewed the efficacy of magnesium for muscle cramping.10 In a Cochrane review, 7 trials (5 parallel, 2 cross-over design) were included, with 3 of these trials studying pregnancy-associated leg cramps in 202 females and 4 trials looking at idiopathic leg cramps in 322 participants.10 Results from the studies noted no significant improvement of muscle cramping in older adults, while results in pregnancy were mixed leading the authors to recommend further studies in this population.10 The authors of a review article in Scientifica note that the mixed findings may be explained by the potential that, “deficiencies of other elemental nutrients including calcium and potassium have also been implicated in muscle cramps and spasms. It may be that magnesium is potentially helpful in situations of magnesium deficiency but is not of use if the problem is related to deficiency of another nutrient.”1
Magnesium: Daily needs and sources
Magnesium is an essential macro-mineral required by the human body. The prevalence of deficiency from serum measurements ranges from 12.5-20% of the population.11 Due to the necessity of this cation for over 300 reactions in the human body and the high risk of deficiency, magnesium levels should be routinely monitored either through blood testing and/or a diet diary review. If found to be low, magnesium stores can be replaced through increasing daily intake of the mineral through nutrition as well as routine supplementation.
Foods groups high in magnesium content include green leafy vegetables, legumes, nuts, seeds, and whole grains.12 Specific foods with high magnesium levels include spinach, Swiss chard, beet greens, turnip greens, pumpkin seeds, summer squash, soybeans, sesame seeds, quinoa, black beans, cashews, sunflower seeds, brown rice and pinto beans.12
The Recommended Dietary Allowance (RDA) for magnesium varies by age, sex, and whether pregnant or lactating:13
*RDA not able to be determined; Adequate Intake (AI) reported
Supplementation with high-quality magnesium is another, targeted way to reach optimal levels and fill dietary gaps. Supplementation dosing and form can be personalized and taken orally via capsules, tablets, liquid, and even powder. Some of the different forms available in the market include Mg oxide, gluconate, chloride, citrate, sulfate, glycinate, and L-threonate.
Bianca Garilli, ND
Dr. Garilli is a former US Marine turned Naturopathic Doctor (ND). She works in private practice in Northern California as well as running a consulting company working with leaders in the natural and functional medicine world such as the Institute for Functional Medicine and Metagenics. She is passionate about optimizing health and wellness in individuals, families, companies and communities- one lifestyle change at a time. Dr. Garilli has been on staff at the University of California Irvine, Susan Samueli Center for Integrative Medicine and is faculty at Hawthorn University. She is the creator of the Veterans for Health Initiative and is the current President of the Children’s Heart Foundation, CA Chapter.
Broad health implications for general population, too
by Bianca Garilli, ND, USMC Veteran
Energy drinks have become a common sight in today’s fast-paced, “get the job done” world. In fact, according to the National Institutes of Health (NIH), next to multivitamins, energy drinks are currently the most popular dietary supplement consumed by American teens and young adults.1 These drinks are marketed as a means to improve energy, stamina, athletic performance, and concentration, as well as reducing fatigue.1-3 Energy drinks are sometime considered “functional beverages” while also falling under the umbrella of drinks or dietary supplements.1,3
The main ingredient in energy drinks is caffeine at levels 70-240 mg in a 475 ml drink or 113-200 mg if consumed as an energy “shot”.1 For comparison, a 355 ml can of soda contains around 35 mg of caffeine, while an 235 ml cup of coffee provides approximately 100 mg.1 In addition to caffeine, many energy drinks also contain other ingredients which might include: B vitamins, various forms of sugar, guarana, taurine, ginseng, glucuronolactone, yohimbe, carnitine, and bitter orange; it is important to note that some of these ingredients further increase the quantity of caffeine in the energy drink, while others may substantially spike blood glucose levels.1 There are currently no regulations in place requiring the amount of caffeine to be printed on energy drink labels.1
Sales of energy drinks have skyrocketed dramatically in the past years increasing to $9.7 billion in sales in 2015 in the US alone.3 Consumption of energy drinks may have negative health consequences, including higher levels of risk-seeking behaviors, poor mental health outcomes, adverse cardiovascular effects, and heightened risk for metabolic, renal, and dental conditions.3
With marketing campaigns geared towards teenagers and the young adult population, it’s not surprising to find that males between the ages of 18-34 are the highest consumers of these drinks.1 Moreover, one-third of teenagers consume energy drinks regularly, while 51% of college students report their consumption at least once per month.1,3
Energy drinks have a strong appeal to military service members as well, particularly with the drinks’ promises of reduced fatigue and enhanced mental and physical performance. Due to the specialized nature of their work, military personnel often seek ways to:
Statistics estimate that energy drink consumption by military personnel mirrors or exceeds that of the general public, yet the health consequences of long-term, high energy drink use in military troops has not been adequately researched.2 A recent study aimed to learn more about the associations between energy drink consumption and health outcomes in military personnel post-deployment.2 In particular, mental health variables including sleep problems, depression, anxiety, PTSD, alcohol misuse, aggressive behaviors, and overall fatigue were compared to the frequency and quantity of energy drink consumption in 627 male infantry Army soldiers 7 months post-combat deployment.2
Results from this study published in Military Medicine found that approximately 75% of soldiers reported consuming energy drinks with nearly 30% of those reporting at least daily use and 16.7% reporting high level consumption (≥ 2 drinks/day).2
Additionally, when compared to the low-frequency group (no consumption of energy drink or < 1 drink/week), the high-frequency group (≥ 2 drinks/day) had increased rates of sleep problems, depression, anxiety, PTSD, and alcohol misuse; they were also more likely to demonstrate aggressive behavioral characteristics.2 Similarly, the moderate-frequency group (at least once per week or 1 drink/day) showed greater depressive symptoms when compared to the low-frequency group.2
Although energy drinks are marketed to consumers as a means to reduce fatigue, the results from this study demonstrated that moderate and high energy drink users experienced heightened fatigued when compared to low or no use.2 The high use of energy drink may, in fact, be a hindrance to both the mission objectives and troop welfare. Authors of this study conclude that, “future research should examine whether energy drink use results in greater fatigue over time.”2
Realizing that mental health, aggressive behaviors, and PTSD are potential concerns among military personnel, the high prevalence of energy drink use in this population should be reviewed. Revised guidelines from military healthcare leaders on the consumption of energy drink would be prudent to support safe and appropriate utilization of these drinks within the military.
Why is this Clinically Relevant?
Link to article
You try to eat well to feel good and stay healthy. While it’s optimal to get your daily nutritional needs from the foods you eat, it’s just plain difficult. There is conflicting information out there on the benefits of supplements, but the Dietary Guidelines for Americans 2015-2020 say that supplements may be useful for providing the nutrients you may be lacking from diet alone.
Still on the fence? Consider these top five reasons to add a multivitamin to your daily regimen.
1. Healthy aging. As we get older, our bodies have a harder time absorbing nutrients from food. The National Institute on Aging notes that starting around age 50, people begin to require increased amounts of certain vitamins and minerals.1,2 In fact, according to a study published in the American Journal of Clinical Nutrition, researchers found that taking a daily multivitamin & mineral supplement may help improve micro nutrient deficiencies associated with aging.3
2. Making up for eliminated food groups. While some people have to cut certain foods like nuts or gluten out of their diets due to allergies, many eliminate particular foods or food groups from their diet voluntarily. This can cause vitamin insufficiency and deficiencies that would be helped with a multivitamin. Trying a paleo diet? You might risk a shortage of calcium or vitamin D by eliminating dairy or grains. Cutting back on red meat? A multivitamin will replace the iron and B12 you would normally get from diet.
3. Getting the RDAs you’re not getting from food. You’ve probably heard that the typical Western diet doesn’t include nearly enough fruits, vegetables, whole grains, legumes, or lean protein. Because of that, you don’t always reap the vitamin and mineral benefits that those foods naturally supply. Consequently, nationally US adults are routinely failing to meet their daily requirements for vitamin A, C, D, E, and K, as well as for calcium, magnesium and potassium from diet alone, and this is including fortified sources!4 Supplementing with a multivitamin is therefore a prudent way to strategically fill those gaps on a daily basis. After all, the goal should not simply be to avoid blatant vitamin deficiencies, like scurvy with vitamin C deficiency. Borderline vitamin and mineral insufficiency are just as important to avoid and address. Even the most health-conscious eater will benefit from multivitamin support to achieve micro-nutrient sufficiency across the board.
4. Getting that extra energy to get through the day. In today’s “go-go-go” society, one of the top complaints is a general lack of energy. Instead of reaching for that third cup of coffee, remember that your cells require certain vitamins and minerals to power your busy life; especially if you’re not getting a full eight hours of sleep or eating a balanced diet, a multivitamin can help provide the nutrients you need to feel energetic throughout the day.5
5. Managing stress. Daily life stressing you out? You’re not alone. But vitamins and minerals play significant biochemical roles in supporting and preserving your brain’s cognitive processes, and studies have shown that a daily multivitamin—particularly one with high doses of B vitamins—can help to reduce stress and support a healthy mood.6
Ready to add a daily multivitamin to your diet? Be sure to check with your healthcare practitioner to see if he or she has personalized recommendations for you and to ensure that any medications you’re currently on won’t interfere with their effectiveness or the effectiveness of the multivitamin ingredients.
Targeted probiotic in personalized therapeutic plan for patients with diabetes shows promise
by Bianca Garilli, ND and Ashley Jordan Ferira, PhD, RDN
Type 2 diabetes (T2D) is no longer a Western world phenomena, but rather a global epidemic, with research revealing an association between higher T2D rates and a country’s wealth or economic growth.1 As a clear example, in a publication titled “Prevalence of type 2 diabetes in the Arab world: impact of GDP and energy consumption”, it was observed that the higher a country’s gross domestic product (GDP), the higher the T2D prevalence.1 T2D rates in these regions include Kingdom of Saudi Arabia- 31.6%, Oman- 29%, Kuwait- 25.4%, Bahrain- 25%, and United Arab Emirates- 25%.1
Recognizing the worldwide impact of T2D, it is critical to identify underlying causes and practical, implementable tools for prevention and treatment. It is well documented that T2D is a chronic, inflammatory condition. Higher levels of lipopolysaccharides (LPS) have been observed in diabetic vs. non-diabetic individuals.2 LPS are Gram-negative bacterial fragments that are considered endotoxins, and can, if left untreated, overgrow in the gastrointestinal tract leading to increased gut permeability.3 A “leaky gut” environment increases the opportunity for these endotoxins to migrate out of the gut and into the circulation, ultimately contributing to systemic inflammation.3
Probiotics have been studied in various models to determine their effects on LPS growth and proliferation and whether targeted probiotic administration aimed at mitigating LPS effects can reduce systemic inflammation, in particular in the T2D population.4-5 The limitations of previous research included short-term duration (≤3 months) and the utilization of mono-strain supplementation.3
To augment the current literature on this topic, a longer study (6 months) was conducted in a randomized, double-blind, placebo-controlled fashion to examine the impact of probiotics on endotoxemia, inflammation, and cardiometabolic disease risk in Arab patients with T2D.3 In this study, 61 Saudi adults (35 females) aged 30-60 years completed the 6-month trial: 30 in the placebo group and 31 in the probiotic group.3 The placebo and probiotic groups were randomly allocated to powder sachets, to be dissolved in a glass of water twice daily, before breakfast and bedtime. The probiotic intervention provided 2.5 billion CFU/g BID and included the following strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19, and L. lactis W58.3
No additional therapeutics such as exercise or dietary recommendations were included during the course of the study in either group.3
In the probiotic group, significant changes in glycemic indices, lipid profile, inflammatory markers, endotoxin levels, and adipocytokine profile were observed at 6 months vs. baseline:3
The improvements in endotoxin load, inflammation, and cardiometabolic profile over time in the probiotics group are noteworthy, but they were not clinically significant when compared to the placebo group.3 Comparing the probiotic intervention to the placebo group: There was a significant and clinically relevant decrease in HOMA-IR (↓64.2%) in the probiotic group.3 HOMA-IR is correlated with most other cardiometabolic indices measured, so one could posit a potentially broader cardiometabolic benefit from the probiotic intervention, but this and other hypotheses should be explored in a future study with an adequately powered sample size.
Why is this Clinically Relevant?
Targeted probiotic - a cornerstone of root-cause approach to disease management and wellness
by Melissa Blake, BSc, ND
The use of probiotics has grown substantially over the last several years. Propelled by development in sequencing methods and analytical techniques, there has been a significant increase in knowledge and understanding about the importance of a healthy microbiome.1
The currently accepted definition of a probiotic states they are “live microorganisms which when administered in adequate amounts confer a health benefit on the host”.2 Is this relatively broad definition sufficient for clinicians to guide treatment? Can we assume that any live organism in relevant doses will achieve positive clinical outcomes? We’ve been talking about the use of probiotics for over a hundred years,6 but when it comes to probiotic therapy, what do we really know?
A brief history lesson
As early as the 1680's, long before the term probiotic was coined, Antonie van Leeuwenhoek was studying his oral and fecal microbiota. He noted striking differences in these microbes, as well as in samples collected from healthy vs. unhealthy people at both of these anatomical sites.3
The notion of natural, innate immunity furthered our understanding of gut bacteria. The concept, first discussed by scientist Élie Metchnikoff and for which he was awarded a Nobel Prize in 1908, encountered much resistance from the medical community.4 Metchnikoff insisted disease was more than the germ theory and highlighted the importance of a healthy host. The health of the host, he believed, was largely dependent upon having diverse intestinal flora.5 Metchnikoff’s research suggested that a diet rich in fermented dairy products, due to high content of Lactobacilli, had a positive influence on health and longevity.6 The concept of “probios” (pro-bios, conducive to life of the host) was born.
Research in gut microbiology has become a significant area of interest, including the establishment of the Human Microbiome Project (HMP) in 2008. The HMP has characterized the microbial communities found at several different sites on the human body: nasal passages, oral cavity, skin, gastrointestinal (GI) tract, and urogenital tract and has examined the role of these microbes in human health and disease.7 In 2012, the potential for a mammary microbiome was suggested and later confirmed in a study published in 2014, which identified widespread bacteria within the mammary glands, irrespective of lactation.8
The evidence continues to establish the diversity of the human microbiome, not only from one person to another, but also across specific body sites.9
The human microbiome
A balanced and diverse microbiota plays a role in human health during the lifecycle. Growing evidence supports a connection between maternal microbiome and pregnancy outcomes, including preterm birth, preeclampsia, gestational hypertension, and gestational weight gain, as well as having an impact on infant health.10
Infancy is a critical time in the development of commensal gut bacteria and is influenced by pre- and postnatal exposures, including the maternal microbiome, delivery method (C-section vs. vaginal birth), diet, and medical interventions.11 Such factors can negatively or positively influence the balance of an individual’s microbiome and may impact short- and long-term health outcomes.12
Modifications to the infant gut microbiota may impact childhood obesity risk,13 atopic disease,14 as well as various GI conditions.15 After initial colonization, factors such as age, gender, diet, environment, stress, and the use of antibiotics continue to influence the microbiome.
Changes in the GI and respiratory microbiome of adults have been implicated in the pathogenesis of chronic pulmonary diseases, including asthma and allergies.16 Dysbiosis has also been associated with psoriasis,17-18 psoriatic arthritis,18 and inflammatory bowel disease,19 suggesting a direct link between a balanced microbiome and the health of the GI and immune systems. Studies have also connected highly abundant levels of specific genera of bacteria with leanness and have shown they play a role in regulating blood sugar and insulin levels.20
Recent reports suggest that neuroinflammation is an important causal mechanism in cognitive decline. This inflammatory status could be triggered by changes in the gut microbiota composition.21 Evidence is connecting the dots between gut bacteria, altered intestinal permeability, and blood brain barrier integrity.22 A disruption in gut flora may, through several mechanisms, contribute to a “leaky brain”, making the brain more susceptible to circulating substances and contributing to cognitive dysfunction. Further research is warranted in this exciting area of scientific study.
As clinicians, we cannot erase the past or possibly impact all the factors that influence the microbiome of our patients. However, we can partner with our patients to help them make positive lifestyle changes. Diet and targeted probiotic therapy are powerful tools. Consumption of excess saturated fats and added sugar influences the microbiota composition, which may lead to an imbalanced microbial population in the gut.22 By modifying risk factors and targeting the microbiome, Functional Medicine practitioners have an opportunity to both prevent and manage disease with individualized nutrition and probiotic therapy at any age.
Evidence for an individualized approach
Convincing evidence of the human health implications of probiotics exists. Hundreds of well-controlled trials, systematic reviews, and meta-analyses have helped define the appropriate use of probiotics and their valuable benefits. The evidence suggests, however, that probiotic therapy is far from a one-size-fits-all approach. In fact, studies show clearly defined benefits are associated with specific strains of bacteria. Here we discuss several that have substantial evidence to support their targeted clinical uses in specific populations:
Lactobacillus acidophilus NCFM
Although we have much more to learn, advancements in our understanding of the human microbiome continue to provide exciting approaches to Functional and personalized medicine. Probiotic therapy is a cornerstone of a root-cause approach to wellness and disease management.
Dr. Melissa Blake is a clinical specialist on the Medical Information team at Metagenics. She completed her pre-medical studies at Dalhousie University in Halifax, Nova Scotia and obtained her naturopathic medical training from the Canadian College of Naturopathic Medicine. Dr. Blake has over 10 years of clinical experience, specializing in the integrative and functional management of chronic diseases.