Health Benefits of Tai Chi Chuan

Attention: Click here to view a mobile-friendly version.

Tai Chi is often described as “meditation in motion,” but it might well be called “medication in motion.” As you move, you breathe deeply and naturally, focusing your attention — as in some kinds of meditation — on your bodily sensations.

Tai Chi on Balancing

Tai chi moves, which involve gradual shifts of weight from one foot to another combined with rotating the trunk and extending the limbs, offer a series of challenges to improve your balance. 

In 136 patients who’d had a stroke at least six months earlier, 12 weeks of Tai Chi improved standing balance more than a general exercise program that entailed breathing, stretching, and mobilizing muscles and joints involved in sitting and walking.^[1,2]

Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls.^[14]

Tai Chi on Pain Improvement

In a randomized controlled trial, 20 patients with functional class I or II rheumatoid arthritis (RA) were randomly assigned to Tai Chi or attention control in twice-weekly sessions for 12 weeks.  The results show that Tai Chi appears safe and may be beneficial for functional class I or II RA. It improved pain and functional status in adults with RA.^[20]

A pragmatic randomized controlled trial of tai chi exercise for people with low back pain. It showed that a 10-week tai chi program improved pain and disability outcomes and can be considered a safe and effective intervention for those experiencing long-term low back pain symptoms.^[21]

Tai Chi on Cognitive Performance

In a meta-analysis of 20 studies on tai chi and cognition,^[8] tai chi appears to improve executive function—the ability to multitask, manage time, and make decisions—in people without any cognitive decline. In those with mild cognitive impairment, tai chi slowed the progression to dementia more than other types of exercise and improved their cognitive function in a comparable fashion to other types of exercise or cognitive training.

In one study,^[9] researchers had nearly 400 Chinese men and women with some cognitive impairment perform either tai chi or a stretching and toning program three times a week. After a year, the tai chi group showed greater improvements, and only 2% of that group progressed to dementia, while 11% from the traditional exercise group did.

In another study,^[10] tai chi outperformed walking. Following 40 weeks of either tai chi, walking, social interaction, or no intervention, researchers compared MRI images and discovered that brain volume increased the most in the tai chi group. In addition, that group also performed better on cognitive tests.

Tai Chi Better Immune Function Test

When we consciously and mindfully focus on our breathing, a rhythmic pattern of healthy heart rate variability (HRV) and healthy immune function result.^{[3, 4]} And that mean a longer and healthier life. For cancer and fibromyalgia patients, you can also slow your heart rate by deep breathing to reduce pain.^[5-7]

A UCLA study found that practicing tai chi chih can significantly boosts the immune systems of older adults against the virus that leads to the painful, blistery rash known as shingles.^[17]

Tai Chi Helps Reduce Stress and Anxiety

When learned correctly and performed regularly, tai chi can be a positive part of an overall approach to improving your mental health by:^[16]

• Decreasing stress, anxiety and depression
• Improving mood
• Improving overall well-being

When tai chi was combined with a standard depression treatment for a group of older people with depression, researchers found better improvement in the level of depression, as well as improved quality of life, better memory and cognition, and more overall energy, in comparison to another group in which the standard depression treatment was combined with a health education class.^[12]

Tai chi Can Be an Adjunct to Standard Care of COPD Patients

Based on a randomized controlled trial of tai chi, scientists concluded that tai chi may be a suitable exercise option for patients with COPD as an adjunct to standard care.^[19]

Tai chi provides people mild to moderate aerobic activity, and lower-extremity, unsupported upper-extremity, and core-strength training. It also contains elements of breathing and respiratory muscle training and stress management that are important aspects of COPD management. Further, studies suggest that tai chi is safe, accessible, enjoyable, and has a high adherence rate.

 

Tai chi Can Be an Effective Approach for the Management of Blood Pressure and Long-term Glucose Control  

A new study showed that Tai Chi exercise was more effective in improving blood pressure and HbA1c level than general aerobic exercise. It suggested that Tai Chi might be an effective approach for the management of blood pressure and long-term glucose control in older persons with depressive symptoms.^[22]

References

1. The health benefits of tai chi
2. Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors
3. Breathe Deeply to Activate Vagus Nerve (Travel to Health)
4. Shingles and Its Remedies (Travel and Health)
5. "Ultra-Longevity" by Mark Liponis, MD
6. Breathe Deeply to Activate Vagus Nerve (Travel to Health)
7. Fibromyalgia misconceptions: Interview with a Mayo Clinic expert
8. The Impact of Tai Chi on Cognitive Performance in Older Adults: A Systematic Review and Meta-Analysis
9. Interim follow-up of a randomized controlled trial comparing Chinese style mind body (Tai Chi) and stretching exercises on cognitive function in subjects at risk of progressive cognitive decline
10. Changes in Brain Volume and Cognition in a Randomized Trial of Exercise and Social Interaction in a Community-Based Sample of Non-Demented Chinese Elders
11. Tai Chi Boosts Standard Depression Treatment
12. Complementary Use of Tai Chi Chih Augments Escitalopram Treatment of Geriatric Depression: A Randomized Controlled Trial
13. Yang-Style Tai Chi Chuan 24 Forms (Travel and Health)
14. Tai Chi and Postural Stability in Patients with Parkinson's Disease
15. A sharper mind: tai chi can improve cognitive function
16. Tai chi: A gentle way to fight stress (Mayo Clinic)
17. Practicing Tai Chi Boosts Immune System in Older Adults, UCLA Study Shows
18. Mayo Clinic Minute: Tai chi keeps seniors on their feet
19. Tai Chi Exercise for Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study
20. Tai Chi improves pain and functional status in adults with rheumatoid arthritis: results of a pilot single-blinded randomized controlled trial
21. Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial
22. Comparison of the effects of Tai Chi and general aerobic exercise on weight, blood pressure and glycemic control among older persons with depressive symptoms: a randomized trial
    

Vitamin Chart Infographic

Image Source: Miles Harrison Info Graphics

Low levels of both vitamin D and K2 are associated with poor outcomes in SARS-CoV-2 infections and both vitamins suppress the activation of NF-kB, the master gene switch for inflammation and production of MMPs.^[1]

Foods with Vitamin K2

Vitamin K is in many foods, but on average, most of what we consume is the K1 form found in plants. These eight vitamin K2-rich foods can help you achieve a better balance in your diet:

1. Natto
2. Eel
3. Cheese
4. Beef liver
5. Chicken
6. Butter
7. Sauerkraut
8. Egg yolk

References

1. Managing the Mortality & Morbidity of COVID19: The Case for Vitamin K2 Supplementation
2. Top Foods High in Vitamin K2

Eye Health: Age-Related Macular Degeneration (AMD) Prevention

Attention: Click here to view a mobile-friendly version.
 

In the aging human eye, oxidative damage and accumulation of pro-oxidant lysosomal lipofuscin cause functional decline of the retinal pigment epithelium (RPE), which contributes to age-related macular degeneration.

There’s a known decline in the of RPE cell function in age-related macular degeneration. These are the photoreceptor support cells in the retina that are critical for the process of light into sight conversion. The RPE dysfunction is caused by:^[11]  

• A build-up of metabolic waste products in the RPE called lipofuscin.
• An RPE oxidation burden that compromises important metabolic pathways.

The ensuing dysfunction, distress and sometimes death of the RPE cells results in age related macular degeneration.

However, researchers believe that the real causes of MD could be multifactorial:

• Hereditary or genetic predisposition
• Environmental
• Nutritional

But, age is the strongest known risk factor and the disease is more likely to occur after the age of 50.^[1]

Video 1.  Dietary Prevention of Age-Related Macular Degeneration (YouTube link)

How to Prevent MD?

There is currently no cure for the disease.^[1]  The good news is if you are predisposed genetically to AMD, you can take steps to lower your risk of developing the condition, says ophthalmologist Rishi Singh, MD.

To prevent MD, you can try:

• Stop smoking if you're a smoker.
• Eat a well-balanced diet with foods rich in a source of antioxidants  and carotenoids
• Carotenoids 
• Carotenoids protect eyes against age-related macular degeneration and also provide very mild sun protection, equal to about an SPF of 3.
• Lutein is a pigment in the macula that along with another pigment (Zeaxanthin), is believed to protect the macula from damaging effects of blue light.^[12] 
• Lutein and zeaxanthin are present in green leafy vegetables (e.g., spinach and kale) and corn.
• Within the central macula, zeaxanthin is the dominant component, whereas in the peripheral retina, lutein predominates.
• Lutein /zeaxanthin can decrease the risk for cataracts, macular degeneration, and the development of atherosclerotic plaques
• Carrots, sweet potatoes and pumpkins, which are high in beta carotene, which converts to Vitamin A
• Fats improve the absorption of lutein and zeaxanthin, so including them in your diet, such as some olive oil in a green salad or some butter or coconut oil with your cooked greens, is a good idea.^[9]
• Antioxidants
• Papaya, oranges and grapefruit, which are top sources of Vitamin C
• Eat Goji berries with nuts and seeds (see above video)
• Flavonoids in oranges
• Associate Professor Bamini Gopinath from the University of Sydney said the data showed that flavonoids in oranges appear to help prevent against MD.^[1]

• Take omega-3 fatty acids
• Wear sunglasses (especially at the time of skiing)
• UVA and UVB rays from the sun can cause oxidative stress and contribute to AMD, so it’s crucial to wear sunglasses that protect against ultraviolet light.
• Maintain normal blood pressure
• Maintain normal body weight
• Exercise regularly
• Central obesity causes inflammation
• Use of the supplements with that of AREDS (or the Age-Related Eye Disease Study) formulation daily
• AREDS recommends:
• 500 mg Vitamin C
• 400 IU Vitamin E
• 15 mg Beta Carotene
• 80 mg Zinc
• 2mg Copper
• Note that AREDS supplements is not a cure for MD; rather it is a treatment that helps to prevent progression and visual loss.
• You should consult your eye care provider before taking AREDS supplements (especially if you are a current or recent smoker).

References

1. An orange a day keeps macular degeneration away: 15-year study
2. 100 Questions & Answers About Macular Degeneration by Jeffrey S. Heier, MD. 
3. The Language of Life by Francis S. Collins 
4. Avocado 101
5. What are the warning signs of macular degeneration?
6. Your Lifestyle May Increase Your Risk of Age-Related Vision Loss (Cleveland Clinic) 
7. Cataracts and Macular Degeneration
8. Optometrist or Ophthalmologist: Which Is Best for Your Eye Care?
• “Optometrists can handle nearly all the medical aspects of ophthalmology. But they do not perform surgery,” Dr. Wagenberg explains.
9. Lutein, Zeaxanthin, and meso-Zeaxanthin: The Basic and Clinical Science Underlying Carotenoid-based Nutritional Interventions against Ocular Disease
10. Dietary antioxidants prevent age-related retinal pigment epithelium actin damage and blindness in mice lacking αvβ5 integrin
11. Eating Grapes Can Help to Prevent Macular Degeneration
12. Chronic blue light leads to accelerated aging in Drosophila by impairing energy metabolism and neurotransmitter levels

Discover the Diversity of Indian Cuisine

Attention: Click here to view a mobile-friendly version.

"India is, the cradle of the human race, 

the birthplace of human speech, 

the mother of history, the grandmother of legend, 

and the great grand mother of tradition. 

our most valuable and most instructive materials 

in the history of man are treasured up in India only."

-Mark Twain

People who eat according to the rules of a traditional food culture are generally much healthier than people eating a contemporary Western diet[4]. Therefore, the author of four New York Times bestsellers Michael Pollan recommends[5]us to:

Eat more like the French or the Italians or the Japanese or the Indians or the Greeks.

Indian Cuisine

India has one of the most varied cuisines in the world. Indians combine vegetables, legumes and grains with herbs, spices and dairy products to form the largest range of vegetable dishes in the world. The short list below provides you a glimpse of these varied cuisines:

• Chutney
• A condiment made from a combination of vegetables, fruits, herbs, and spcies
• Curry
• Meat, seafood, vegetables, fruits or legumes cooked in a spiced sauce
• Dhals
• These are vegetarian dishes using tamarind variously combined to lentils and spices. The result are highly flavored and tasty dishes.
• Dosa
• A thin and crisp rice-lentil vegetarian Crêpes.
• Idlis
• Idlis are one of the main tiffin items (eaten as break fast or snack in the evening).  They are a type of rice cake which are made by steaming a batter consisting of fermented black lentils (de-husked) and rice. The fermentation process breaks down the starches so that they are more readily metabolized by the body.
• Korma
• Korma is a dish made with yogurt, cream, nut and seed pastes or coconut milk; it is usually considered a type of stew.
• Masala
• One of many mixtures of two or more spices—whole or ground, toasted or raw, wet or dry
• Naan
• A rich, tender flat-bread baked on the wall of a clay oven
• Raita
• Salads of raw vegetables folded into plain yogurt; they are served as cooling accompaniments to spicy dishes
• Saag
• Saag or sag is a leaf-based (spinach, mustard leaf, Basella, etc) dish eaten with bread such as roti or naan, or rice. Saag can be made from spinach, mustard leaves, finely chopped broccoli, or other greens, along with added spices and sometimes other ingredients such as paneer.
• Sambar
• A stew made of lentils, vegetables, spices, herbs and tamarind
• Tandoori Dishes
• Tandoori is a cylindrical clay oven used in cooking and baking. Tandoori dishes include: tandoori chicken, tandoori vegetables, tandoori shrimp, etc. For example, tandoori chicken are pieces of cooked chicken marinated in yogurt and tandoori spices.
• Uttapam
• A rice-lentil vegetarian pancake
• Vindaloo
• An amalgamation of two Portuguese words vinho means wine or vinegar and alho means garlic. Spices, chiles, garlic and vinegar can be blended to form a vindaloo paste.

Final Words

Indian cuisine consists of a wide variety of regional and traditional cuisines native to the Indian subcontinent.  If you try to classify it roughly based on geography, it could be categorized into two main parts:

• South Indian Cuisines
• North Indian Cuisines

Besides that, you can have different ingredients used in the cuisine such as Gongura , Poppy_seed, etc.  Also, indian pickles are different. They use red chilli, salt and oil to preserve instead of vinegar.

References

1. Passages to India by Laxmi Hiremath (Costco Connection, January 2013)
2. Indian Food Diversity
3. Saag (Wikipedia)
4. Western Diets and Western Diseases
5. In the Defense of Foods by Michael Pollan
6. Map showing Coriander, Celery and Cardamom growing states in India
7. South Indian cuisine
8. North Indian cuisine
9. Indian cuisine
10. Cuisine of India in Calgary

Human-Beings Get Rich as They Grow Old

Attention: Click here to view a mobile-friendly version.

There is good news and bad news on aging:

The bad news is there is no "quick fix" or magic bullet when it comes to aging well. "Generally speaking, the better you treat your body throughout your life, the better your aging experience will be," said Dr. Mercola.^[1] For example, a lifestyle that includes exercise and a well-balanced diet will slow or minimize many problems related to aging. 

The good news is later life tends to be a golden age, according to psychologists. Most people get happier as they grow older.^[2] According to University of California psychologist Dr Susan Turk Charles, mental wellbeing generally improved with age, except for people with dementia-related ill health.

5 References

1. Dr. Mercola
2. People 'get happier as they age'
3. Why Do We Age and What to Expect?
4. Aging—Knowing the Basics

Health Effects of Spirulina

Spring means flower buds and blooming trees — and if you're one of the millions of people who have seasonal allergies, it also means sneezing, congestion, a runny nose and other bothersome symptoms. Seasonal allergies — also called hay fever and allergic rhinitis — can make you miserable.^[1]

Based on a study in 2008, it says that Spirulina is clinically effective on allergic rhinitis.^[4]  Spirulina represents a blue-green alga that is produced and commercialized as a dietary supplement for modulating immune functions, as well as ameliorating a variety of diseases.

In this article, we will discuss the pros and cons of consuming Spirulina for its claimed health benefits.

Pros

In below video, Dr Joseph Mercola has discussed all the benefits of Spirulina.  However, he does warn that you want to find your products from high quality organic sources and is pollutant-free.

Benefits of Spirulina (YouTube link)

Cons

On the other hands, Dr. Michael Greger still recommend us to stay away from Spirulina for multiple reasons:

• In 2008, hepatotoxins were detected in Spirulina supplements^[7]
• In 2009, a potent neurotoxin was found in Spirulina supplements^[6]

Note that Spirulina may not produce these toxins themselves.  However, it appears that they could be contaminated with other toxin-producing blue-green algae grown in the shared environment.^[11]

In below video Dr. Michael Greger has also mentioned some of the benefits of Sprirulina, which include:

• Good for your blood pressure and cholesterol^[3]
• Seems to work wonder with seasonal allergies^[4]

Conclusions

Both Dr. Mercola and Dr. Greger are my respected physicians.  If you follow Dr. Mercola's advice and take Spirulina as dietary supplements, do choose high quality products.  However, if you heed Dr. Greger's warnings, maybe you want to stay away from Spirulina.

To conclude this article, I'll quote with what Dr. Michael Greger said:

There’s no doubt that spirulina does some amazing things, but as with everything in life, it’s all about risk/benefit.

References

1. Seasonal allergies: Nip them in the bud
2. Cox PA, Banack SA, Murch SJ, Rasmussen U, Tien G, Bidigare RR, Metcalf JS, Morrison LF, Codd GA, Bergman B. Diverse taxa of cyanobacteria produce beta-N-methylamino-L-alanine, a neurotoxic amino acid. Proc Natl Acad Sci U S A. 2005 Apr 5;102(14):5074-8. Epub 2005 Apr 4.
3. Torres-Duran PV, Ferreira-Hermosillo A, Juarez-Oropeza MA. Antihyperlipemic and antihypertensive effects of Spirulina maxima in an open sample of Mexican population: a preliminary report. Lipids Health Dis. 2007 Nov 26;6:33.
4. Cingi C, Conk-Dalay M, Cakli H, Bal C. The effects of spirulina on allergic rhinitis. Eur Arch Otorhinolaryngol. 2008 Oct;265(10):1219-23. Epub 2008 Mar 15.
5. Mazokopakis EE, Karefilakis CM, Tsartsalis AN, Milkas AN, Ganotakis ES. Acute rhabdomyolysis caused by Spirulina (Arthrospira platensis). Phytomedicine. 2008 Jun;15(6-7):525-7. Epub 2008 Apr 22.
6. Food Chem Toxicol. 2009 Sep;47(9):2189-95. Epub 2009 Jun 9.First detection of anatoxin-a in human and animal dietary supplements containing cyanobacteria.Rellán S, Osswald J, Saker M, Gago-Martinez A, Vasconcelos V.
7. Y. Jiang, P. Xie, J. Chen, and G. Liang. Detection of the hepatotoxic microcystins in 36 kinds of cyanobacteria Spirulina food products in China. Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 25(7):885-894, 2008.
8. Infant Seizures Linked to Mother’s Spirulina Use
9. G. Moulis, A. Batz, G. Durrieu, C. Viard, S. Decramer, J.-L. Montastruc. Severe neonatal hypercalcemia related to maternal exposure to nutritional supplement containing Spirulina. Eur. J. Clin. Pharmacol. 2012 68(2):221 - 222
10. R. J. Marles, M. L. Barrett, J. Barnes, M. L. Chavez, P. Gardiner, R. Ko, G. B. Mahady, T. L. Dog, N. D. Sarma, G. I. Giancaspro, M. Sharaf, J. Griffiths. United States pharmacopeia safety evaluation of spirulina. Crit Rev Food Sci Nutr 2011 51(7):593 - 604
11. Microalgal food supplements from the perspective of Polish consumers: patterns of use, adverse events, and beneficial effects

Vegetarians: How to Get Enough Protein?

As a vegetarian, should you be concerned about protein deficiency?  The answer is probably NO for at least two reasons:

• People are actually more likely to suffer from protein excess than protein deficiency
• If you know what sources of plant protein to take 

How Much Protein Do You Really Need?

In [1], Dr. Michael Greger provides the following guidelines:

Adults require no more than 0.8 or 0.9 grams of protein per healthy kilogram of body weight per day, which is about your ideal weight in pounds multiplied by four and then divided by ten. So, someone whose ideal weight is 100 pounds may require up to 40 grams of protein a day. On average, they probably only need about 30 daily grams of protein, which is 0.66 grams per kilogram, but we round it up to 0.8 or 0.9 grams because everyone’s different and we want to capture most of the bell curve.

Adverse Effects of Protein Excess

People are actually more likely to suffer from protein excess than protein deficiency. “The adverse effects associated with long-term high protein/high meat intake” diets may include:^[1]

• Disorders of bone and calcium balance
• Disorders of kidney function
• Increased cancer risk
• Disorders of the liver
• Worsening of coronary artery disease

Considering all of these potential disease risks, there is currently no reasonable scientific basis to recommend protein consumption above the current recommended daily allowance.

Plant-Based Proteins

At Cleveland Clinic, it has pointed out the following 5 top sources of plant protein for your plant-based diet:^[2]

• Cooked Legumes
• 17g in 1 c.* lentils
• 16g in 1 c. chickpeas
• 12g in 1 c. black beans
• Soy
• 17g in 1 c. edamame
• 15g in 2 oz. tempeh
• 7g   in 3 oz. firm tofu
• Nuts and Seeds
• 9g in 1 oz. hemp seeds
• 8g in 1 oz. pumpkin seeds
• 7g in 2 T nut butters
• 6g in 1 oz. almonds
• 5g in 1 oz. chia seeds
• Cooked Grains
• 8g in 1 c. quinoa
• 4g in 1 c. oatmeal
• Cooked Vegetables
• 5g in 1 c. spinach
• 4g in 1 c. Brussels sprouts
• 2g in 1 c. broccoli

*: cooked cup (240 ml)

Complete Proteins

Did you know? Most plants are considered “incomplete proteins” because they lack some of the essential amino acids (total: 9). However, there are a few unique plants that are considered “complete proteins.” Listed below are plant-based foods that are considered complete proteins:

• AMARANTH:
• The highest source of iron among all gluten-free grains, amaranth is a complete protein and can be made into flour or toasted much like popcorn.
• QUINOA:
• An ancient cereal grain of Peru, quinoa cooks similar to rice but in half the time. This gluten-free grain contains healthy omega-3 and -6 fatty acids and is a complete protein.
• BUCKWHEAT:
• Buckwheat is actually a seed and not a grain. Unroasted buckwheat groats have a soft, mild flavor, while the roasted variety has an earthy, nutty flavor. A complete protein, the triangular seeds are frequently made into flour and is the primary ingredient in Japanese soba noodles.
• CHIA SEEDS:
• Chia seeds are complete proteins and the richest plant-based source of heart-healthy omega-3 fatty acids. Because chia seeds can absorb more than twelve times their weight in water, they are often used to add fluffiness in baked goods and are also used to replace eggs in vegan products.
• HEMP:
• A seed that can be eaten raw, ground into a meal or sprouted, Hemp contains omega-3s and is high in gamma linolenic acid (GLA), a healthy omega-6 fatty acid. This seed is a complete protein and can be easily made into a vegan milk by blending raw hemp seeds and filtered water.
• SOYBEANS:
• Soybeans (including edamame) and soy foods such as tofu, natto and tempeh are a complete protein. When choosing tofu, the firmer the tofu, the higher the protein content.
• SPIRULINA:
• Spirulina is a blue-green algae that grows in oceans and salty lakes in subtropical climates. A complete protein, spirulina is sold in supplement form and can help boost the growth of gut-friendly bacteria in the intestinal system.

Video 1. Increasing Protein Intake After Age 65 (YouTube link)

References

1. How Much Protein Do You Really Need?
2. Plant Proteins that Pack a Punch (Infographic)
3. The 17 Best Protein Sources For Vegans and Vegetarians
4. Plant Proteins that Pack a Punch (Infographic) 
5. 10 PLANT-BASED PROTEINS YOU SHOULD BE EATING
• 1 lentils, 2 hemp seeds, 3 chia seeds 4 quinoa 5 spirulina 6 nutritional yeast 7 seeds 8 nuts 9 beans 10 tempeh/organic tofu/edamame
6. Healthy Aging: Protein Consumption Advice for the Elderly (Travel to Health)
7. Study shows protein that reverses aging of skeletal muscle
8. Clean Protein or Toxic Blend? The Truth About Protein Powder

How Does the Gut Flora Influence Our Health?

It is now widely appreciated that humans did not evolve as a

single species, but rather that humans and the microbiomes

associated with us have co-evolved as a "super-organism,"

and that our evolution as a species and the evolution of our

associated microbiomes have always been interwined.

-William Parker, Duke University

When we are born, our body is sterile, meaning our skin, lungs, and intestines don't contain any bacteria at all. When we pass through our mother's birth canal, we are exposed to outside world. Over time our body gets colonized by a diverse and distinct brew of bacterial species determined by genetics and by bacteria surrounding us.

The gut is literally at the center of our body and plays a central role in our health, just as our "gut feeling" plays a central role in our instinct. In this article, we will look at gut flora and its links to our health.

Gut Flora

There are estimated 100 trillion microbes that make our GI tract their playground, which is more than 10 times of our human cells. It is believed that imbalances in gut flora are a big part of our autoimmune problems, causing both autoimmunity and making our symptoms and antibodies worse if we already have a diagnosed autoimmune disease.^[2-4]

The Gut/Immune Connection

Non-self antigen is a substance, like a bad bacteria, yeast, parasite, or virus, that is recognized as foreign and, hopefully, only these should be attacked by our immune system.

Approximately 70% of the immune system lives in our gut. Everyday we bring the outside world—in the form of food—into our body through the mouth. So our front line of defense is located in our gut. There are two important roles of our immune system's front line of defense:

• Recognizing what is foreign, followed by
• Sounding an alarm by telling other cells in the immune system to react if foreigners are found

Let's say that there was salmonella in something we ate for dinner last night. If things are working correctly, our dendritic cells (or antigen presenting cells—APC) recognize the salmonella as foreign and sound an alarm to the T cells and B cells (i.e. lymphocytes), which then attack the bacteria and clear it out of our system. While the dendritic cells respond immediately, it takes a bit of time, anywhere from hours to days, for the lymphocytes to mobilize to either make more killer cells or to make antibodies to attack foreigner.

When this process goes smoothly, there are signals and messages sent between the dendritic cells and T cells that keep the immune system balance. T regulator cells (Tregs) eventually help turn the alarm off when the immune system's job is done.^[17]

But if the Tregs are not working correctly, the killer cells and/or antibody-producing cells can get stuck in overdrive and become confused about what is foreign and what is not. This confusion can then cause autoimmune diseases.^[2-4]  In addition, these immune cells can release many inflammatory molecules, traveling around the body and causing inflammation in our joints, hands, blood vessels, and brain.

Healthy Gut Flora Can Make Our Immune System Happy

Because so much of our immune system is in our gut, it's critical to keep our gastrointestinal system healthy and in balance. It appears that gut flora play a huge role in early infancy in helping our immune cells develop properly and in the right balance. Good bacteria (for example, Lactobacillus acidophilus, bifidobacteria, etc.) that live in our intestines have the most important influence on the function of the T cells that are located there. They can provide the following potential benefits:

• Help the immune system learn the difference between self (including good bacteria) and non-self
• Develop tolerance to good bacteria^[2]
• Help accelerate our immune system's response to a foreigner
• Help regulate the balance between Th1 and Th2 responses
• Help the T regulator cells work better
• Stimulate the production of immunoglobulin A
• Immunoglobulin A is a protective antibody that's one of the main defenses in our gut
• Make short-chain fatty acids, which feed and strength all the cells that line our digestive tract, keeping them healthy^[3]
• Help form our intestinal lining (the protective barrier)
• Interact with our immune cells to directly protect us from harmful infections and maintain the function of that barrier so that unwanted foreign proteins and infectious agents cant't seep into the bloodstream.
• If this barrier is comprised, we can develop what is called leaky gut syndrome, a condition that can lead to autoimmune diseases.
• Help begin the process of metabolizing toxins, which means changing their form to make them less harmful.
• Make enzymes that improve digestion
• Help the body process vitamins such as B12 and K.^[12] So they can be better utilized and absorbed by the body.
• Help in converting inactive vitamin D into its active form
• A paper published in Nature Communications suggests that gut bacteria may play a vital role in converting inactive vitamin D into its active, health-promoting form.

Dysbiosis

Having enough friendly flora in our gut reduces the incidence of allergies and autoimmune diseases, and restoring and balancing these flora in the gut can treat and reverse these conditions. When the amount of healthy bacteria in our gut is too low, a condition called dysbiosis occurs.

There are five types of dysbiosis and we can have more than one kind of it at the same time:^[1]

1. Insufficient good bacteria
• This is the mildest form.
2. Small intestinal bacterial overgrowth (SIB)
• Occurs in the upper part of the small intestine when bacteria from the colon grow in the wrong place.
3. Immunosuppressive dysbiosis
• Toxins from harmful bacteria, yeast, or a parasite lower our levels of good bacteria and give off toxins that weaken or break down the gut lining and cause leaky gut syndrome.
• People often get this form of dysbiosis when they have an overgrowth of yeast in the body
4. Inflammatory dysbiosis
• When the body has an exaggerated response to our body's imbalance of good bacteria.
• Physical symptoms of this type of dysbiosis include muscle and joint pain in addition to digestive symptoms such as gas and bloating.
5. Parasites
• Can infect the digestive tract and put stress on the population of good bacteria.
• Parasites often cause diarrhea, cramping, and bloating.
• However, read [14] for a different perspective—the potential benefits of parasites.

Researchers at the University of Arizona College of Medicine recently reviewed the literature on this topic and found good evidence that dysbiosis plays a role in rheumatoid arthritis and, in animal studies, multiple sclerosis.^[1]

Conclusions

Scientists don't call the microbiome "the forgotten organ" for nothing. Recent research advances have seen a tremendous improvement in our understanding of the scale, diversity, and importance of the gut flora. For example, a simple birthing choice (i.e., natural birth vs caesarean section) could make a difference:^[15]

Each individual's community of gut microbes is unique and profoundly sensitive to environmental conditions, beginning at birth. Indeed, the mode of delivery during the birthing process has been shown to affect an infant's microbial profile. Communities of vaginal microbes change during pregnancy in preparation for birth, delivering beneficial microbes to the newborn.

At the time of delivery, the vagina is dominated by a pair of bacterial species, Lactobacillus and Prevotella. In contrast, infants delivered by caesarean section typically show microbial communities associated with the skin, including Staphylococcus, Corynebacterium, and Propionibacterium.

While the full implications of these distinctions are still murky, evidence suggests they may affect an infant's subsequent development and health, particularly in terms of susceptibility to pathogens.

Finally, if you have been diagnosed with any autoimmune disease, you may have dysbiosis and/or leaky gut syndrome. In that case, grab a copy of Dr. Blum's book^[1] and learn how to heal your gut.

References

1. Healing Your Gut (Chapter 8 of The Immune System Recovery Plan)
2. Denise Kelly, Shaun Conway, and Rustam Aminov. Commensal gut bacteria: mechanisums of immune modulation. Trends Immunol 2005 Jun; 26(6)
3. Laurence Macia et al. Microbial influences on epithelial integrity and immune function as a basis for inflammatory diseases. Immunol Rev 2012 Jan; 245(1): 164-76.
4. Hsin-Jung Wu and Eric Wu. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes 2012 Jan-Feb; 3(1):1-11.
• Figure 1. Commensal bacteria induce CD4+T cell differentiation.
• Figure 2. An autoimmune arthritis model that demonstrates the link between gut microbiota and an extraintestinal disease
5. S. Grenham et al. Brain-gut-microbe communication in health and disease. Front Physiol 2011;2:94.
6. How Your Gut Flora Influences Your Health - Mercola
7. How Many Microbes Are Hiding Among Us?
8. Exploring The Invisible Universe That Lives On Us — And In Us
9. Are Probiotics the New Prozac? (Dr. Mercola)
10. Consumption of fermented milk product with probiotic modulates brain activity. Gastroenterology. 2013 Jun;144(7):1394-401
• Four-week intake of an fermented milk product with probiotic (FMPP) by healthy women affected activity of brain regions that control central processing of emotion and sensation.
11. Navel gazing: healthy gut bacteria can help you stress less
12. Vitamins’ Old, Old Edge
13. The Belly Buttons Will be Revealed, Slowly
14. Can Parasites Heal the Gut? (Travel and Health)
15. Complex World of Gut Microbes Fine-Tune Body Weight (Science Daily)
16. Alcoholism linked to lack of intestinal bacteria
• 26 out of the 60 alcoholics suffered from leaky gut syndrome and generally had a low amount of intestinal bacteria -- specially their levels of Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, were detected as unusually low. 
• The leaky gut syndrome is linked to inflammation of the gut and diseases like Crohn disease.
17. Schmidt A, Oberle N, Krammer PH. Molecular mechanisms of tregmediated T cell suppression.Frontiers in Immunology. 2012;3:p. 51. 
• Treg exhibit multiple immunosuppressive mechanisms including: 
• The secretion of cytokines such as transforming growth factor beta (TGFβ) and interleukin-10 (IL-10) 
• The killing of CTL
• The inhibition of immune cells through a cell contact mechanism
18. Gut bacteria and vitamin D: What is the link?
19. Diet For A Better Microbiome?
20. Food for thought about the immune drivers of gut pain
21. Bouhnik Y et al. Effects of Bifidobacterium sp fermented milk ingested with or without inulin on colonic bifidobacteria and enzymatic activities in healthy humans. European Journal of Clinical Nutrition 1996 Apr; 50(4):269-73.
22. Gyawali R et al. The role of prebiotics in disease prevention and health promotion. Chapter 12 in Dietary Interventions in Gastrointestinal Diseases, 2019. Pages 151-67.
23. Mahboobi S et al. Effects of prebiotic and synbiotic supplementation on glycaemia and lipid profile in type 2 diabetes: A meta-analysis of randomized controlled trials. Advanced Pharmaceutical Bulletin 2018 Nov; 8(4):565-74.
24. Nowak A et al. Antigenotoxic activity of lactic acid bacteria, prebiotics, and products of their fermentation against selected mutagens. Regulatory Toxicology and Pharmacology 2015 Dec; 73(3):938-46.
25. An Update on the Effectiveness of Probiotics in the Prevention and Treatment of Cancer

Shingles Vaccination―Shingrix vs Zostavax

In 2017, shingles vaccination had been brought back to the front page:

New Shingles Vaccine Shows Efficacy for Older Adults

Basically, the excitements were all about the new shingles vaccine named Shingrix:

In October 2017, the U.S. Food and Drug Administration (FDA) licensed the Shingrix® vaccine for adults aged 50 years and older to prevent shingles. The CDC recommends two doses of Shingrix, two to six months apart for healthy adults aged 50 and older.

On Oct. 25, the Advisory Committee on Immunization Practices (ACIP) voted that Shingrix is the preferred vaccine for preventing shingles and related complications. It is also recommended for adults who previously received the current shingles vaccine (Zostavax®).

 

Why Older Adults Need to Get Vaccinated?

Before widespread use of the chickenpox vaccine, parents regularly updated their own immunity by getting exposed chickenpox from their children, or from other adults who were exposed by children. But, now that most children are vaccinated against chickenpox and don't contract it, older adults suffer from more severe cases of shingles.^[6]

Shingrix® vs Zostavax®

The previously released vaccine, Zostavax®, reduces the risk of shingles by over 50 percent. The now-preferred Shingrix vaccine series reduces the risk by over 90 percent.^[4]

• Zostavax
• Is a live vaccine given as a single injection, usually in the upper arm
• Approved in 2006 and is no longer being sold in the U.S. as of July 2020, other countries may still use it
• Has been shown to offer protection against shingles for about five years.
• Although Zostavax is approved for people age 50 and older, CDC recommends that Zostavax be given at age 60, when the risk of shingles and its complications is highest.
• Shingrix
• Is a nonliving vaccine made of a virus component. It's given in two doses, with two to six months between doses.
• Approved in 2017 
• Studies suggest protection against shingles with Shingrix may extend beyond five years.
• Recommended for people age 50 and older, including those who've previously received Zostavax.

Note that elderly individuals do not respond to immune challenge as robustly as the young.^[3]

What If You Already Had Zostavax®?

For those who have received Zostavax, the CDC recommends waiting at least eight weeks before getting Shingrix.

Scheduled two to six months apart, Shingrix is given as a series of two shots.

Side Effects

The most common side effects of either shingles vaccine are redness, pain, tenderness, swelling and itching at the injection site, and headaches.

Some people report a chickenpox-like rash after getting the shingles vaccine.

Although some people will develop shingles despite vaccination, the vaccine may reduce the severity and duration of it.

Precautions

As always, all vaccines could have possible side effects and might not be good for all adults.  Using current  shingles vaccine (Zostavax®) as an example, you can find those information in the "Vaccine Consent and Administration Record" of the attached form.

For more details on other precautions,  please read the below article:

Shingles and Its Remedies

References

1. New Shingles Vaccine Shows Efficacy for Older Adults
2. Shingles and Its Remedies
3. Causes, consequences, and reversal of immune system aging
4. Is the New Shingles Vaccine Really Worthwhile?
5. Shingles vaccine: Should I get it?
6. Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2021
7. Slow the Spread? Speeding It May Be Safer by Vivek Ramaswamy And Apoorva Ramaswamy
8. Slide show: Common skin rashes
9. Shingles associated with increased risk for stroke, heart attack

Health—Know Your Numbers

I have been a vegetarian since 2006.  As the chart shown below, my lipid panel has improved after my diet changes:

Based on my family physician's records, the following two problems were reported to me:

• Impaired fasting glucose (01/10/2005)
• Pure hyperglyceridemia (08/01/2006)

Without doubt, I had metabolic syndrome in the period of 2004-2006.

Metabolic Syndrome

Metabolic syndrome is related to insulin resistance.  It also reflects other health findings that accompany serious insulin resistance. Metabolic syndrome can be diagnosed by any three of the following:

• Increased waist circumference
• ≥  35 inches in women
• ≥  40 inches in men
• Fasting blood sugar 
• ≥  100 mg/dL
• Blood pressure 
• ≥  130/85
• Low HDL
• < 50 mg/dL for women 
• < 40 mg/dL for men
• High triglycerides
• > 150 mg/dL

Higher fasting triglyceride predicts higher risks of diabetes mortality in US adults (Source: [4])

2017 Physical Exam Report 

The chart shown above stopped at 2008.  So, how am I doing from then to now?  Yes, I still remain as healthy as before.  See below report for yourself.

How Can You Achieve It?

In a Scope article published by Stanford Medicine:^[1]

On the road to diabetes: How to halt disease progression and turn back to health

It has offered you some good advice.  But, as Dr. Michael Greger has been advocating, just switch to plant-based diets.  As for me, I have documented my personal journey from 2007 to now in many health-related articles published on below web sites:

• Travel to Health
• Travel and Health (In the process of migrating to a new Google site here)

Finally, as I humbly said on my web site:

The American travel writer Paul Theroux once wrote: "Tourists don't know where they've been, travelers don't know where they're going." 

Healthy pursuits are like traveling. We know there is a wonderland called wellness. But, there are no fixed routes to reach there. The pursuits need effort and determination. We cannot act like tourists who don't know where they've been. We must take notes of warning signs sent by our bodies.  

On the journey to wellness, there are many dangers to be avoided; there are many footsteps to be taken; unfortunately, there are no short-cuts. 

Travelers walking in the night follow North Star. Healthy pursuits work similarly. We know our goal; we know the signposts; we know the dangers on the road; we can adjust pace if we are tired; we can change travel plans due to the weather. But, We walk steadily and persistently. With my companionship, hopefully, your journey will be made easier. 

May all be fed. May all be healed. May all be loved.^[2]

References

1. On the road to diabetes: How to halt disease progression and turn back to health
2. Healthy At 100
3. Diabetes―the Silent Killer
4. Higher fasting triglyceride predicts higher risks of diabetes mortality in US adults

Diabetes―the Silent Killer

The onset of type 2 diabetes is gradual, with most individuals progressing through a state of prediabetes, a condition now striking approximately 1 in 3 Americans, but only about 1 in 10 even knows it.

Video 1.  How to Prevent Prediabetes from Turning into Diabetes (YouTube link)

Type 1 vs Type 2

• Type 1 diabetes
• Occurs when the pancreas doesn't produce enough of the hormones needed to alert the body to sugar
• Is now widely treated by supplemental insulin
• Type 2 diabetes (aka age-associated diabetes)
• Occurs when pancreas is able to make enough insulin but the body is deaf to it.
• The 9 percent of all adults globally with this disease need a drug (i.e., metformin) that restores their body’s sensitivity to insulin so cells take up and use the sugar that’s coursing through their bloodstreams. That’s important for at least three reasons:^[4]
• It gives the overworked pancreas a rest
• It prevents spikes of freely floating sugar from essentially caramelizing proteins in the body. 
• Recent results indicate high blood sugar can also speed up the epigenetic clock (i.e., aging).

Complications of Diabetes

Diabetes itself has few symptoms, but its consequences can lead to disability and death.

Complications develop because diabetes and its high blood sugar levels lead to a breakdown of multiple body systems that usually maintain a healthy energy balance. Among other problems, this breakdown creates inflammation throughout the body, especially in blood vessels.

A few of the complications include:^[1]

• Heart and brain 
• By irritating blood vessels, diabetes accelerates damage caused by cholesterol blockages in the lining of arteries that bring oxygen and nutrients to all tissues in the body. 
• In the arteries nourishing the heart, these cholesterol time bombs are more liable to burst open to cause a heart attack. 
• This blockage of critical oxygen causes the death of heart muscle tissue. The same thing frequently occurs in the arteries that feed the brain. The resulting stroke kills off brain tissue. 
• Unfortunately, lowering blood sugar is not be enough to prevent these difficulties.
• Some damage to arteries can’t be reversed and diabetes causes injury in other ways beyond blood sugar.
• Kidney
• Diabetes damages kidney blood vessels as well as the filtration system that creates urine. This stresses and overworks the kidney, making kidney failure more likely. Diabetes is the most common reason for kidney dialysis, where a machine is needed to filter the blood after the kidneys fail.
• Cognitive impairment 
• People with diabetes can have difficulties with thinking and memory. 
• As people with diabetes age, diabetes causes a faster decline then normal in mental functioning. 
• Researchers are still learning more about how diabetes affects the brain.
• Depression and fatigue
• Depression occurs twice as often in diabetes compared to other people. 
• Fatigue is also a common difficulty. 
• Both problems can occur soon after diagnosis and arise from high blood sugar levels and blood vessel inflammation as well as the stress and complexities of living with diabetes.
• Nerves
• Damage to leg nerves (peripheral neuropathy) occurs because diabetes damages the small blood vessels that provide nutrition to these nerves, which die off, leaving numbness or pain instead of normal sensation.
• Sexual dysfunction 
• Damage to key blood vessels as well as other diabetes complications frequently lead to sexual problems.
• Eye
• Several forms of eye disease, many related to faulty blood vessels, make blindnessa real threat in diabetes.
• Stomach and intestines
• In diabetes, the digestive system loses the ability to coordinate the passage of food from start to finish. 
• This produces problems ranging from poor emptying of the stomach to constipation.
• Skin
• Foot ulcers are rare in healthy individuals, but common for those with diabetes. 
• Loss of feeling in the feet from nerve damage makes injury more likely and then high blood sugar impairs healing. Problems with the feet and legs can require amputation.

Video 2.  How Not to Die from Diabetes (YouTube link)

This article was extracted from the fourth in a series of eight blog posts discussing pre-diabetes and Type 2 diabetes on the Scope published by Stanford Medicine.^[1] The first installments examined what happens inside the body in pre-diabetes, how to stop pre-diabetes from progressing and how doctors and patients can reframe their approach to diabetes. The next post will focus on treatments for diabetes that extend beyond medications to lower blood sugar.

References

1. Breaking down diabetes: The importance of complications
2. Dr Michael Greger on "How not to die from diabetes"
3. Breaking down diabetes: How to prevent complications
4. Lifespan: Why We Age—and Why We Don't Have To
• Like rapamycin, metformin mimics aspects of calorie restriction. But instead of inhibiting TOR, it limits the metabolic reactions in mitochondria, slowing down the process by which our cellular powerhouses convert macronutrients into energy. 
• Among beneficial effects, metformin helps people living healthier lives, inhibits cancer cell metabolism, increases mitochondrial activity, and removes misfolded proteins.
5. Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me