Tag Archive for: inflammation

How C-Reactive Protein Can Predict Cancer Risk

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High-sensitivity C-reactive protein (hs-CRP) is a measure of inflammation in the body. This blood test looks for inflammation that’s not apparent; with severe infection you have a fever, but other types of inflammation may go unnoticed. This is subtle because you don’t feel anything. On top of that, CRP hasn’t been shown to be diagnostic for any disease. It still may not be, but a recently published study demonstrated that there’s a chance that if CRP changes over time, that may be indicative of some forms of cancer.

The Study

The researchers examined the relationship between CRP trajectory patterns and new-onset cancers among 52,276 participants over eight years; CRP trajectories were developed from 2006 to 2010 to predict cancer risk from 2010 to 2019. The study was restricted to the population who participated in physical examinations in 2006, 2008, and 2010, and had their CRP measured each time.

If you can think of a variable, they tested for it, as well as collecting demographic information that allowed them to consider confounding variables in the statistical analysis. The subjects were tracked for the next eight years to find out who developed cancer and what type of cancer they developed.

The Results

During the extensive and complicated statistical analysis, four CRP trajectory patterns emerged:

A low-stable pattern (43,258 subjects)
A low-stable pattern was associated with a low risk of new cancers.

A moderate-increasing pattern (2,591 subjects)
Subjects in the moderate-increasing CRP trajectory pattern were associated with an elevated risk of any form of cancer, but especially lung, breast, leukemia, bladder, stomach, colorectal, liver, gallbladder, or extrahepatic bile duct cancer.

An increasing-decreasing pattern (2,068 subjects)
Subjects in the increasing-decreasing trajectory pattern were associated with an elevated risk of any form of cancer, but especially lung, breast, bladder, pancreatic, and liver cancer. This pattern was also associated with decreased risk of colorectal cancer.

An elevated-decreasing pattern (4,359 subjects)
Subjects with an elevated-decreasing trajectory pattern were associated with increased risk of leukemia and decreased risk of esophageal and colorectal cancer.

The Bottom Line

Here’s what we know now: inflammation is definitely one of the hallmarks of cancer. Regular assessment of CRP over many years may now be predictive as a risk factor for cancer but not diagnostic. There’s more research to go, but this study is a step in the right direction.

The good news is that it’s another risk factor that can be changed through lifestyle: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

Reference: Int J Cancer. 2022. 10.1002/ijc.34012

How Periodontal Disease Makes COVID-19 Worse

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Aging with a Vengeance is more than gaining muscle mass and losing fat around your waist; it also means that your immune system is robust. I think we often over-emphasize supplementation; while I think it’s necessary, it really should serve as support for other actions that are equally or even more important. For example, taking care of your teeth. By that, I mean regular checkups, brushing after meals, and flossing every day. Does that affect the immune system? You bet it does, and a recent study illustrates how significant that can be.

Researchers in Qatar conducted a study to see if people with periodontal disease had an increased risk of being in the intensive care unit (ICU), being put on a ventilator, or dying from COVID-19. Qatar Is a country of 2.3 million people with an advanced electronic medical records system; because dental records are a part of the medical records system, they were able to identify people with periodontal disease, sometimes called gum disease. In addition to the medical records on COVID-19 and how the subjects fared, they were also able to get data such as BMI, HbA1c, and CRP, among other health indicators.

As an observational study, researchers were able to find 568 people who were diagnosed with COVID-19 between February 2020 and the end of July. That number included 40 people with severe cases of COVID-19 that required hospitalization. The characteristics of those who had severe cases are similar to what we find in the U.S.: more were overweight or obese, had higher HbA1c levels, and had higher CRP levels.

Of those who had periodontal disease, 33 had severe cases of COVID-19; only seven people who had no periodontal disease had a severe outcome. When looking at the odds ratios, a person with periodontal disease had six times the risk of being admitted to the ICU, almost eight times the risk of being put on an ventilator, and a 17 times greater risk of death from COVID-19.

Why would having periodontal disease, an infection that appears to be limited to the teeth and gums, have such an overall effect? The reason is that it creates a state of higher inflammation that compromises the immune system. When exposed to the virus, the immune system is already stressed and the body does not have all the resources it needs to fight the infection.

The Bottom Line

Here’s my advice: if you’re overdue for your dental checkup, call and make the appointment, especially if your gums bleed regularly when you floss, if your gums seem inflamed, or if you have a very bad mouth odor. No excuses; gum disease should not be ignored.

I see many comments in social media about “all the talk being about vaccinations, masks, and social distancing.” “No one ever talks about diet and exercise, etc.” The reason, at least in my humble opinion, is that the last 50 years have clearly demonstrated that most people in the U.S. don’t eat well, don’t move enough, and eat more than they should.

Instead of criticizing people for their poor dietary and exercise habits, the current medical approach seems to be to meet people where they are. My hope is that by addressing some of the other issues related to health, such as periodontal disease and overall healthcare in our quest to age with a vengeance, all readers will see ways to make their immune system much more robust so it can do a better job of protecting them.

And if it has the side benefit of shutting up the naysayers that talk about long-term solutions only at the exclusion of the things that we know are working right now—such as vaccinations, masks, etc.—I’m good with that. As I said in May, not fear; respect.

What are you prepared to do today?

        Dr. Chet

Reference: J Clin Periodontol. 2021. DOI: 10.1111/jcpe.13435.

Spice Up Your Life and Be Healthier

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Before I get into this memo any further, keep in mind there were only 12 subjects in this study, and we don’t change our recommendations for an entire society based on a limited numbers of subjects. We just have to recognize that this is a preliminary study. Second, because they examined a large number of variables, the probability of getting a false positive increases.

As long as we keep those in mind, the results were really surprising. Adding spices to a high-fat, high-carbohydrate meal reduced the inflammation caused by that meal. While coconut curry chicken might not be your preference, I’d wager you’ve eaten a bacon cheeseburger with fries and a soft drink at some point. That can easily add up to a similar profile of a high-fat, high-carbohydrate meal. So let’s take a look at the spices.

The Spices

The spice blend included the following spices, but not all dishes contained all the spices. For example, the turmeric was used in the chicken dish while the cinnamon was used in the biscuit:

Turmeric
Ginger
Cinnamon
Oregano
Parsley
Basil
Coriander
Cumin
Red pepper
Rosemary
Black pepper
Bay leaf
Thyme

This is not a magic blend by any means, but each of these spices and herbs have different phytonutrient blends. The magic comes from those phytonutrients. Recall the image of the various sizes of measuring spoons. A teaspoon is 5 grams, a half teaspoon is 2.5 grams, and an eighth of a teaspoon is 0.625 grams. That illustrates how little of a spice you need per serving. Keep that in mind if you decide to spice up your meals.

What we don’t know is whether there’s any interaction between those spices and herbs that would impact the inflammatory hormones. We know that turmeric and ginger have been studied extensively. The researchers recommended testing each spice individually.

Two Observations

There are probably dozens of factors that need to be examined, but two stand out in my mind. First, we’ll need to find out the impact of cooking on each of the different herbs and spices. Does heat destroy the phytonutrients or does it enhance them? We have a partial answer from this study because the spices were put into the dishes as they were being prepared and not added as a topping.

Second, if you take supplements with phytonutrient blends in them, it may be wise to take them either before or while you’re eating so the phytonutrients will be available to help during the digestive process. I’ve always recommended taking your supplements whenever you can remember to take them, and I still stand by that because consistency is more important than timing. But if you can increase the potential benefits by taking them with meals, that’s a good idea.

The Bottom Line

The reason that I loved this approach to research is because it was practical. By that I mean, instead of assessing only one food or a specific group of foods, this study looked at what we would consider “bad foods” together with herbs and spices that are full of phytonutrients to see how they work together.

If you think about it, if saturated fat and refined carbohydrate were as bad as they’re thought to be for the risk of CVD or type 2 diabetes, those diseases would take effect much faster. But perhaps, cake with dark chocolate frosting or French fries with ketchup work with their phytonutrients to somewhat neutralize the bad effect of the food by itself. It doesn’t mean that we don’t bear responsibility; we should still eat as healthy as we can. But perhaps if we choose wisely, we may be able to enjoy some of the food that are perceived as not as healthy if we can spice them just right.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.

The Health Benefits of Spices

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Continuing our look at the research study on the effect of spices on markers of inflammation, there were some interesting results. The high-fat, high-carbohydrate meal was coconut curry chicken, a cornbread muffin, and a biscuit; that strikes me as an odd meal, but you do what you must for research. The only difference was the spices added to allow for comparative results.

Examining the effect of the 1,000-calorie, high-fat, high-carbohydrate meal, the researchers found an increase in the release of inflammatory hormones above baseline in all subjects. So that’s the first result: inflammation was increased after eating the test meal with no spices added.

Compare that to consumption of the same meal with six grams of spice blend: it significantly reduced IL-1β secretion at four hours after the meal compared with the meal with none of the spice blend. Also, IL-6, IL-8, MCP-1, and TNF-α secretion after the meal containing six grams of the spice blend was below baseline values for each cytokine (inflammatory hormone). These results suggest that spice consumption may reduce inflammation after a high-fat, high-carbohydrate meal for hours after eating. The paper is Open Access, so you can read it yourself at the link in the references.

Those are interesting results, and I’m guessing you really would like to know which spices were used in the study. I’m going to give you that spice blend and put this research in context in Saturday’s memo. But if you haven’t done our little experiment with the teaspoon, half teaspoon, and eighth teaspoon, please do it before then.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.

Can Spices Make You Healthier?

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I’d like you to do something before you read the rest of this memo. Go to your drawer that contains measuring spoons, and pull out the teaspoon, half teaspoon, and eighth teaspoon. Then measure out salt or sugar for each different volume and put it on a plate. Notice how little there is by the time you get to the eighth teaspoon. Keep that image in your mind for the remainder of the week.

Too often, nutrition research lacks a practical approach; researchers try to drill down into the details before they look at the larger response to any intervention. In other words, examining what people actually eat and cook, then changing something and seeing what happens. I don’t mean exaggerated results such as weight loss, but more subtle effects such as changes in triglycerides, cholesterol, blood sugar, and in this case, markers of inflammation.

This week we’re going to take a look at a recently published paper that took exactly that approach. Researchers selected a group of 12 overweight male subjects with at least one additional risk factor for cardiovascular disease and fed them a high-fat, high-carbohydrate, 1,000-calorie meal. They fed them the same meal on three different days: once without any specific spice blend, second with two grams of a spice blend, and the third time with six grams of the same spice blend. They tested the subjects to see what markers of inflammation were changed after each feeding. I’ll give you the results in Thursday’s memo.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.

What to Do About Aching Joints

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When we stop to consider what prevents us from moving as much and as freely as we would like, the main culprit would probably be our joints: knees for most, with hips a close second. Shoulders are up there, along with our feet and hands. One of my problem areas is my thumbs in the metacarpal joints of both hands.

Everything we’ve talked about so far leads us to our joints. The muscles attach to bones via tendons across joints, and that allows for movement. There are ligaments that hold bones in place, several types of cartilage that provide cushioning, even specialized fluid within joints. It’s the interaction of all those factors combined with the damage we’ve experienced and our genetics that results in the pain we may experience that inhibits motion. What do we do about it?

Without question, the most important is stretching and strengthening. I’ve written about that already, but it warrants a reminder. Maintaining the range of motion of each joint improves our mobility and ability to use our limbs properly. Our physical therapist has a saying, “Motion is lotion,” which is a way of saying the more you move, the easier it is to move. We should all move as much as we can without overdoing it. Here’s an example: Paula and I had to give up dance lessons because she has arthritis in her feet, and dancing was just too much stress on all the little joints in the foot. For all of us, the challenge is finding that happy medium between moving enough to keep everything going and moving so much it adds to the damage.

In terms of nutrients, all parts of the joints are connective tissue; the basic nutrient for every one is glucosamine. Our bodies are supposed to make as much as we need but often don’t. Any type of glucosamine can be beneficial. Chondroitin and hyaluronic acid are forms of glycosaminoglycans. In addition, vitamin C is also important for all connective tissue. There are many nutrients that may impact the inflammation in joints such as tart cherry juice and turmeric. But it begins with a good foundation, and that’s glucosamine.

Everything to date leads us to the final part of this series of living every day. I’ll cover that on Saturday.

What are you prepared to do today?

        Dr. Chet

Research Update: Gut on a Chip

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In the final research paper I’ll review, the headline that caught my attention was “Probiotics are not always ‘good bacteria’.” That’s something I really hadn’t seen before so I had to check it out.

In this case, I had to learn about a new technology called organ-on-a-chip. Over the past five years or so, researchers have tried to develop a three-dimensional approach to doing research on various organs including the gut. Essentially what they have done is develop what are called chips with living tissue on different sides of a membrane. As it relates to the gut, they have the epithelial layer, the actual absorbable tissue from the gut, on one side and the endothelial layer on the other side. They can then control fluids and nutrients to study what happens in healthy versus diseased conditions.

In the study that resulted in the headlines, the researchers examined what happened when probiotics were introduced into a damaged gut such as we would see in irritable bowel disease or Crohn’s. Using a mouse-model chemical that destroys the gut tissues, what they found was that once the chemical was removed, the inflammation was reduced and the gut was repaired.

If the probiotics were introduced before the gut damage, the destruction was ameliorated, thus preventing some damage. When the probiotic was introduced after the damage, the inflammation was reduced but the repair process was impeded.

Prior research has demonstrated that probiotics are beneficial in human trials for people with damaged epithelial cells or simply stated, the inner portions of the gut. It seems curious that it would slow repair in this gut-on-a-chip model; even so you might feel better because inflammation is reduced.

What should we do? The digestive system, just like any other organ system, is part of a total organism. On a chip, even with more than one component represented, it’s still not the entire organ and certainly is missing the effects of some other organs that may have an impact. The only way to know for sure is to duplicate the study in living beings, whether in rodents or humans.

Based on human trials, there’s no reason to change the use of probiotics if you have inflammatory bowel disease. Talk with your physician, but at this point there’s no reason to stop using probiotics.

The Bottom Line

Probiotic research continues at a rapid pace, and I believe that the ultimate “cure” for any disease or condition will be found there. It doesn’t mean we’ll live forever; it could mean we get to live healthier all the days we’re alive. I continue to take my probiotic as does everyone in the family, including my three-year-old grandson Riley. And don’t forget you can get even more good bacteria from vegetables and fermented foods.

What are you prepared to do today?

Dr. Chet

 

References:
1. https://doi.org/10.1016/j.jcmgh.2017.12.010.
2. www.pnas.org/lookup/suppl/doi:10.1073/pnas.1810819115/-/DCSupplemental.

 

Research Update on Probiotics and Healthy Skin

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There has been so much research on probiotics published that it’s hard to keep myself informed, and you as well. This week I’ll summarize three recent studies on probiotics. Let’s begin with research on probiotics and skin conditions.

Researchers examined the effects of three strains of probiotics on skin inflammation in mice: two strains of lactobacillus and one strain of bifidobacterium. Three groups of mice were given one of the probiotics for two weeks while two control groups were given a placebo. After two weeks, the skin of four groups of mice was chemically exposed to an irritant to cause inflammation while the fifth group was exposed to a control chemical.

The researchers examined both blood and skin of the mice for indicators of inflammation after seven days of exposure. The markers for inflammation were lower in the groups who took the preventive probiotics than either of the positive or negative controls. While this was a small study on mice, it did demonstrate that probiotics helped reduce the skin response to chemical irritation. This may be the first step in identifying a probiotic that could help conditions such as atopic dermatitis in the future.

Keep taking a wide-spectrum probiotic, especially if your skin has been less healthy than you want it to be. If you have a teen with skin problems, probiotics may make a big difference. Another research update on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Beneficial Microbes, 2018; 9(2): 299-309.

 

How to Reduce Disease-Related Pain

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The first two memos on pain were relatively easy: joints and nerves. From that point forward, it can get very challenging: Lyme disease, irritable bowel syndrome, shingles—the list of diseases that lead to pain could go on and on. To complicate matters, with the concern over opioid addiction, many people in pain don’t want to even try those medications. What do you do?

The key is to work with your physician and specialists to develop a strategy for pain relief. That will vary by disease. A medication that benefits the nerves for shingles pain may be helped by NSAIDS or other pain relievers, but NSAIDS may not be beneficial for someone with IBS; the absorption of the pain reliever may cause more bowel pain.


Two Strategies to Help

There are two things you can try that may directly or indirectly help with pain. The first is to reduce inflammation and as I mentioned on Tuesday, the supplements that may help are omega-3s, turmeric, and glucosamine. They can help reduce inflammation in more than joints.

The second would be to strengthen the immune system. Lyme disease is bacterial, shingles is a virus, and IBS is an attack on the lining of the intestines. While strengthening the immune system is not directly involved, it may assist the body in dealing with the cause and reduce the pain. To me, that means using probiotics, antioxidants such as vitamin C and E, and using herbs such as echinacea and garlic. As I said, it may not directly affect pain but may indirectly help the body cope with the condition.


The Bottom Line

The two strategies won’t work for every disease. Every form of cancer can result in different pain. Some diseases such as type 2 diabetes can impact the extremities and eyes in ways that require professional guidance. But in general, strengthening the immune system may help over the long term. That also means increasing the intake of vegetables and fruit and getting some exercise within the limitations of the condition. That’s a topic for another time.

What are you prepared to do today?

Dr. Chet

 

Immune Boost 1-2-3: Garlic

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The second part of our immune boost supplements is garlic. Garlic has been noted to have beneficial properties for over 5,000 years. Garlic thins the blood, thereby benefiting blood pressure, and helps lower cholesterol. Garlic does many things, but what benefits our immunity is its ability to boost the immune system while reducing inflammation.

There is little question that garlic helps the immune system. It’s been used as a dietary treatment to help the immune system recover from chemotherapy; it’s also been used in supplement form to help the immune system get and stay stronger. That’s an obvious way it helps with viruses and allergies, but it also acts as an anti-inflammatory. It’s important to remember that inflammation occurs whenever our body is under attack—not broken-leg inflammation but the release of negative hormones. Garlic helps reduce that type of inflammation.

Just as with echinacea, it’s important to begin as soon as the first tickle occurs. The quantity would be 600 mg taken three times a day. That gets our immune system starting to work better, but there’s one more thing we need. I’ll cover that on Saturday.

What are you prepared to do today?

Dr. Chet