August 5, 2002 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Neurological complications of coeliac disease

While this is only a short abstract of a larger review article, it cements the fact that allergy to gluten containing grains (mainly wheat) can have a major impact on the rest of the body; in this case the neurological system. Chalk up effects on the GI system, skin and increased autoantibodies to thyroid. If patients are unsure, an elimination diet avoiding wheat for at least 2 wks can be used. The beauty of an approach like this is that no one I've ever recommended an elimination diet for has ever died... If you don't like this approach, serum transglutaminase levels can be used as a marker for coeliac disease.

Postgrad Med J -- Summaries: Pengiran Tengah et al. 78 (921): 393

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Can calprotectin simplify the diagnosis of irritable bowel syndrome?

Calprotectin is a marker for inflammation of the GI tract and is suggested in this study as a fecal marker to differentiate IBS from inflammatory bowel disease. While this is an easy and effective way to differentiate, I have a problem with this article referring to IBS as a non-organic disease. I would much rather have researchers refer to IBS as a functional disorder. By labeling it as a non-organic disease I envision a condition that is psychogenic in origin, which I do not feel that IBS is. It may be flared by stressful situations, but that hardly constitutes a psychogenic illness.

Entrez-PubMed

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Plant sterol ester spread lowers total, LDL cholesterol in children

As a single therapy for cholesterol lowering, 10% reduction is pretty substantial. As with any natural approach, addition of exercise, other dietary modifications and intake of beneficial fats (nuts, olive oil, fish oil...) could send that response rate much higher. This study addresses treatment in children and should be viewed as a primary approach. I always get very, very nervous about long term pharmacotherapy that has known hepatotoxic effects in children.

AJCN -- Abstracts: Amundsen et al. 76 (2): 338

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Total-body skeletal muscle mass

The "age related" loss of lean muscle mass, sarcopenia, is considered by some researchers as a hallmark of aging. Loss of muscle mass leads to increasing difficulty controling serum glucose; increased serum glucose leads to increased glcosylated proteins (irreversible changes to a protein from glucose attaching to the protein) ultimately leads to cell death and then organ death. A reliable method to assess skeletal muscle mass is still not available. Electroimpedence devices has shown some efficacy but have not gained much acceptance. A new technology that could increase the use of this marker could have a major impact on long term health. However, as with any test result, the physician ordering the test would have to know what steps to take to effect the sarcopenia...

AJCN -- Abstracts: Kim et al. 76 (2): 378

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Impaired functioning of MHTFR dependent on riboflavin status

Ahhhh....the plot thickens!! Sometimes I just have to sit back and laugh at the depravity of medicine when it comes to natural therapeutics...Unfortunately, most clincians have never heard of defects in the MHTFR genotype and its impact on folic acid need. Well, despite the lack of knowledge, science moves on--we are now finding other factors that also impact the conversion of folic acid to its active form (tetrahydrafolate) via the enzyme MHTFR; in this case riboflavin. However, the clinical impact SHOULD be negligible--most good diets and definately most good quality multivitamins will also supply healthy levels of riboflavin to counteract this negative association. As an interesting note...most prenatals from the pharmaceutical companies have low levels of riboflavin (gram for gram probably outweighed by the food colorings and processing chemicals...)

AJCN -- Abstracts: McNulty et al. 76 (2): 436

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The ability of fish oil to suppress TNF alpha production

This is the future of medicine (like great-great-great grandchildrenish future...) where genetic differences are known to effect response rates to various interventions. TNF alpha upregulates the immune system and TNF alpha blockade is one of the big new classes of disease modifying drugs for Crohn's and rheumatoid arthritis. Here we see that different genetic polymorphisms in production of TNF alpha respond differently to fish oil supplementation. Genetic tests are already available for many known single nucleotide polymorphisms (SNiPS) that effect treatment response. Keep in mind that 6 g of fish oil is a high dosage.

AJCN -- Abstracts: Grimble et al. 76 (2): 454

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Cross-Talk Between Iron Metabolism and Diabetes

Iron supplementation is always a difficult issue. Here we see a connection with iron depletion and lowered risk of diabetes. Considering that iron is known to be a pro-oxidant and there is an inflammatory component to type 2 diabetes, this is not a great surprise. However, iron is essential for healthy oxygen transport in red blood corpuscles and iron deficiency anemia causes its own set of problems. As a side note, one of the pharmaceutical prenatals is now putting stool softeners in with the iron because iron is known to constipate patients. The brain dead formulators at this company have not yet realize that the constipation comes from poor absorption of cheap iron. Don't improve quality of the iron...just add another substance to counteract the effects... (care to guess which approach is cheaper??)

Diabetes -- Abstracts: Fernández-Real et al. 51 (8): 2348

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Prasterone on corticosteroid requirements of women w/ SLE

This study uses DHEA (an adrogen secreted by the adrenal cortex) to lower the necessary dose of prednisone in patients with lupus. I would like to see a similar study done on patients with adrenal support designed to balance out DHEA levels. Interestingly, this study may in reality be an attempt to correct some of the imbalances created by the prednisone in the first place. Chronic corticosteriod use is known to suprress adrenal cortex function which would in turn lower DHEA levels...

Entrez-PubMed

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