Medical Articles by Dr. Ray

Jul

2020

Key Factors for Centenarians

By Ray Schilling | alcohol, Alzheimer’s disease, Cancer, Cardiovascular disease, Diabetes, diet, exercise, fasting mimicking diet, fish oil, food, heart attack, Mortality, olive oil, omega-3 fatty acids, Prevention, Processed food, stress, Stress management, Stroke

A study from Washington State University (WSU) showed some of the key factors for centenarians to survive. The publication of the study goes back to June 17, 2020. In general, it was common knowledge that genetics plays a role in 25% to 35% of centenarians for their survival. That is to say, the remainder is the result of lifestyle factors. It is important to realize that the environmental factors play a significant role in the survival of centenarians, said Rajan Bhardwaj, a second-year WSU medical student. He and his research team determined what allowed centenarians to reach an age of 100 or above. Briefly, they identified the following factors that were necessary.

Three factors identified by the Washington State University study

walkability of the neighbourhood, which encourages regular exercising
belonging to the higher socioeconomic class
a high percentage of working population in the neighborhood (a mixed population) was also important

In the discussion the authors of the WSU study said that “blue zones” of centenarians had been mentioned before in the literature. To clarify, these are areas in the world where more than the average of centenarians live. Dan Buettner used the term “blue zones” in a National Geographic article about where centenarians were located.

The blue zones

He wrote a book about the location of the 5 blue zones. Notably, they are located in Sardinia (Italy), the islands of Okinawa and a group of Seven Day Adventists in Loma Linda. California. In addition, the Nicoya Peninsula of Costa Rica, and the island of Icaria, Greece complete the 5 blue zones. Specifically, Dan Buettner described the following characteristics of the lifestyle of centenarians.

They engage in regular physical activity
Mostly eating a plant-based diet including legumes
Calorie intake is moderate
Moderate intake of alcohol, mostly wine
Having a purpose in life
Engaged in family life
Having an active spiritual life
Reducing stress
Engaged in social life

Other attributes of centenarians

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27^th Annual World Congress on Anti-Aging Medicine. In particular, the topic of his talk was “Positive Psychological Attitudes of Centenarians “. Dr. Hertoghe is an endocrinologist in Belgium. He took an interest in people above the age of 100. These people, he felt, are special people with a very optimistic outlook on life. Dr. Hertoghe went on to say that centenarians have a will to live. Indeed, they adapt to changes; they have a sense of purpose, and they stay active.

More positive attributes of centenarians

Other psychological features, by the same token, show that they have a positive mood and they avoid stress and anxiety. Another key point is that they have self-determination. It must be remembered also that they are very sociable, have close family ties, love their relationships and often have a strong religious faith. In addition, there is a connection between their basic values, beliefs and spirituality. Truly, centenarians insist on their freedom and they have a feeling of youth. For one thing, centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing some of the details that Dr. Hertoghe gave.

The will to live

For one thing, it takes courage to grow old, and all centenarians have this. They say “Life is worth living”. Essentially, they have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Surprisingly, their mortality was only 33.3%. Be careful what you wish for!

Adaptability

In other words, this describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. However, 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group had a 2%-4% lower mortality risk. They had a 36%-55% higher probability of not developing cognitive impairment. That is to say, they rated themselves to be in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. In essence, these high resilient centenarians had no short-term health decline.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48% in males. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%. Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

The fasting mimicking diet helps you to reach a longer life

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet. The FMD makes chemotherapy more tolerable.

Key Factors for Centenarians

Conclusion

As we reviewed the factors that lead to longevity, we learnt that engaging in regular moderate exercise is one of the key factors. But belonging to the higher socioeconomic class and living in a mixed neighborhood with people from all walks of life is also important. We also reviewed the blue zones according to Dan Buettner. Mostly eating a plant-based diet including legumes with moderate calorie restriction prolongs your life. Add to this moderate intake of alcohol, mostly wine, and having a purpose in life. Augment this further with being engaged in family life, having an active spiritual life and reducing your stress level.

Living longer is a matter of fulfilling these longevity factors

With all of this you are on your way to become a centenarian. A review by Dr. Hertoghe in a lecture given at an Anti-Aging Conference in Las Vegas in 2019 added more criteria centenarians have. He provided references regarding the will to live, being adaptable, remaining active and harboring positive emotions. The more of these factors you can adopt, the longer you will live. At the same time, you will avoid getting diseases like heart attacks, strokes or cancer, which leads to a longer and healthier life.

The above text contains parts of this blog. The part about the fasting mimicking diet was published here before.

Jul

2020

Fat Deposits Mean Higher Covid-19 Risk

By Ray Schilling | Diabetes, diet, food, heart attack, Infectious Disease, Inflammation, lifestyle, Mortality, Nutrition, Obesity, Stroke, sugar, Weight loss

A new study showed that fat deposits mean higher Covid-19 risk. This study was reviewed here.

The article is based on the June 10, 2020 publication of the British Medical Journal.

They did large population studies showing that obesity is an independent risk factor for severe disease and death from Covid-19. One study with 428,225 participants had 340 admitted to hospital with confirmed Covid-19 coronavirus. 44% of them were overweight and 34% were obese. Another study, the OpenSAFELY study used linked electronic health records. 17,425, 445 participants were included and 5,683 Covid-19 deaths occurred. In this study there were 29% overweight and 33% obese persons. The researchers noted a dose-response relationship between excess weight and severity of Covid-19. The researchers removed confounding factors like age, sex, ethnicity, and social deprivation.

Critical illness and death rates in overweight and obese people

They realized that critical illness caused by Covid-19 was increased compared to normal-weight people as follows.

Covid-19 risk 44% higher in overweight people
Covid-19 risk 97% higher in people with obesity

This means that the risk for serious illness from Covid-19 was 1.44-fold for overweight persons and 1.97-fold for obese persons compared to normal-weight controls. The OpenSAFELY study also looked at the death rates from Covid-19 for people with obesity. Two obesity categories were investigated: obesity with a BMI of 30-34.9 and BMI of greater than 40 compared to normal-weight controls. Here are the death rates.

BMI of 30-34.9: 1.27-fold increased risk
BMI of greater than 40: 2.27-fold risk

Possible mechanisms explaining fat deposits mean higher Covid-19 risk

The researchers mentioned three possible mechanisms why overweight and obese people may have higher Covid-19 disease and death rates than normal-weight controls.

First, angiotensin converting enzyme-2 is found with higher frequency in fat cells of overweight and obese persons. Researchers are aware of the fact that the Covid-19 coronavirus uses this enzyme to enter body cells. It may also be the reason that fat cells become reservoirs that can shed virus for much longer than in normal-weight people with less fat cells. They pointed out that others have seen this also and found it with other viruses. In the case of influenza A, obesity prolonged viral shedding by 42% compared to normal-weight controls. And with H1N1 influenza obesity was an independent risk factor for hospitalization and death.

Weaker immune system, more lung resistance

Secondly, any virus can weaken the host’s defence of the immune system. Researchers showed this previously with the influenza virus. But now with Covid-19 coronavirus the cytokine storm due to a weak immune system is a major factor in making the viral infection worse. A lack of vitamin D is another factor in promoting the cytokine storm.

Third, obesity decreases lung function and it is difficult to improve this. There is greater lung resistance in the airways and it is difficult to expand the lungs in obese patients. When the doctor transfers patients with obesity to the intensive care unit, it is more difficult to increase their oxygen saturation with artificial ventilation.

Unhealthy environment, so fat deposits mean higher Covid-19 risk

The researchers point out that we live in a very unhealthy environment. In 2016 there were 1.9 billion people worldwide who were overweight or obese. These figures are rapidly rising. Presently about 65% to 70% are overweight or obese in the UK or the US. Obesity causes high blood pressure, heart disease, strokes, type 2 diabetes and cancer. We are all surrounded by processed food with extra salt, sugar, wheat and other unhealthy ingredients. The high mortality and deaths rates of Covid-19 in overweight and obese people point to the problem that society has.

Reduce salt, sugar and saturated fats in food

The culprits are salt, sugar and saturated fats. Merchants and food producers must reduce them in processed food. In the UK new government regulations have already resulted in lower salt content in foods. As a result, there is less high blood pressure and cardiovascular disease is in decline. All nations need to reduce salt, sugar, and saturated fat. When the weight comes down, we all are less prone to catching dangerous viruses.

Fat Deposits Mean Higher Covid-19 Risk

Conclusion

The pandemic has taught us a new lesson, namely that overweight and obese people are at higher risk of contracting Covid-19 coronavirus. In a research paper of the British Medical Journal concrete figures showed that the Covid-19 risk is 44% higher in overweight people and that it is 97% higher in people with obesity. The OpenSAFELY study also showed that obese people with a BMI of 30-34.9 have a 1.27-fold increased risk of catching Covid-19. But morbidly obese people with a BMI of greater than 40 have a 2.27-fold risk of catching Covid-19. There is a clear linear dose-response curve between the amount of fat a person accumulates and the risk for Covid-19.

Cut out junk food and decrease your risk for Covid-19

Covid-19 is directly related to the amount of junk food we eat. As a result we can say that eating junk food increases the Covid-19 risk. The opposite is true also: sensible eating and cutting out junk food makes you lose some pounds, and your risk for Covid-19 decreases.

Jul

2020

Probiotics and a Phage Blend for Digestive Problems

By Ray Schilling | Abdominal Pain, antibiotics, diet, Gastrointestinal Disease, immune system

In general, probiotics and a phage blend for digestive problems can help patients with irritable bowel syndrome (IBS). It is important to realize that about ¾ of Americans suffer from digestive problems. They develop symptoms of gas, bloating, diarrhea and stomach pains. To put it another way, about 1 in 7 Americans suffer from the condition, called chronic irritable bowel syndrome. That is to say, he underlying problem is an imbalance of gut bacteria where the bad ones outnumber the good ones. There are a number or reasons why bowel flora gets disrupted. We eat more processed foods, less fiber, and beef products from industry farms contain antibiotic residues. In feedlots for beef cattle antibiotics are fed to the animals as growth promoters. The residues in the meat kill the good bacteria in our guts and the bad ones proliferate. This causes digestive problems, but also weakens our immune system.

How probiotics work

Probiotics can restore our gut flora to a large extent. But some of the probiotic action gets lost in the stomach from the acidic milieu. A recent publication from a panel of gastroenterologists has not supported the wide use of probiotics. They came to the conclusion that probiotics have not shown enough benefit to a number of clinical conditions. The researchers mentioned Crohn’s disease, C. difficile infection, ulcerative colitis and irritable bowel syndrome (IBS) in particular of not responding to probiotics. But this may be because of inactivation of some of the power of the probiotics by stomach acid. In addition, by not using phages to potentiate the probiotic action probiotics may fail to permanently to improve the gut flora. I have previously discussed the importance of probiotics for the gut flora.

History and use of bacteriophages

Bacteriophages are now often just called phages. Dr. Frederick Twort, an Englishman detected phages in 1915 during World War I. Essentially a phage consists of either DNA or RNA and a protein envelope around this. Phages are very specific for certain bacterial strains. They attach to the bacteria and inject their own DNA or RNA into the bacteria. This stops the bacteria from multiplying, but makes the bacteria produce many more identical phages. Phages are useful to control the growth of problem bugs including antibiotic-resistant bacteria. However, the regulatory agencies were slow to approve phages despite a good safety record. Life Extension Magazine recently published a review article about this subject.

Phages helping to protect probiotic bacteria

Phages naturally play a role in keeping the gut flora stable. In this lengthy review, published in January 2020 phage actions are reviewed. It also mentions the connection between the gut flora and the immune system. The Life Extension Magazine article mentioned above describes experiments that show the action of phages. E. coli is the main bacterium in the large intestine. It is also the bacterium that can cause pneumonia, diarrhea and urinary tract infections.

Experiments with bacteria and phages in Petri dishes

According to the Life Extension Magazine article researchers did experiments with Bifidobacterium longum, one of the desirable gut bacteria. This was placed on a Petri dish along with E. coli bacteria. In a second Petri dish Bifidobacterium longum, E. coli and a phage mix were placed. After 5 hours there was hardly any growth of Bifidobacterium longum in the first petri dish, as it was crowded out by E. coli. The result in the second Petri dish was interesting: the Bifidobacterium longum colonies were 7000-times higher in number than in the other Petri dish without the phage mixture. The phages had selectively attacked the E. coli bacteria, which made room for the Bifidobacterium longum bacteria to multiply.

Animal experiments with bacteria and phages

The Life Extension Magazine review mentions animal experiments with phages next. One group of mice received B. longum and the disease-causing E. coli in their food. The other group had the same bacteria plus a mix of phages directed against E. coli. For the phage group the results within 24 hours were as follows.

The E. coli count in the small intestine was 10-fold lower, in the large intestine 100-fold lower and in the fecal matter 100-fold lower.
The phage group also had a 100-fold increase of the B. longum count in the small intestine. The large intestine also had a 100-fold increase of the B. longum count. And there was a 40-fold increase of B. longum in the fecal matter.

Control mice without the phage mix developed constipation and intestinal segments showed redness, swelling and leaks. In contrast, the phage mix group of mice showed no side effects and had improved digestive function.

Human studies using probiotics and a phage blend for digestive problems

Safety tests of phage therapy were next in 2005 involving 15 volunteers. There were no side effects using two different phage concentrations to diminish E. coli. Researchers had done other safety experiments in Russia and in Poland in the past. Patients with ulcerative colitis responded with improved symptoms and improved endoscopic findings to treatment with two probiotics. They received fermented milk products (Cultura) containing live lactobacilli (La-5) and bifidobacteria (Bb-12) for 4 weeks. There were 51 patients with ulcerative colitis and 10 patients with familial adenomatous polyposis. Abdominal cramps, Involuntary defecation, leakage and the need for napkins were significantly reduced in both groups. An endoscopic score of inflammation showed a significant decreased when the baseline exam was compared to the exam after the 4-week intervention.

Literature review about phages

Here is a thorough review in a publication dated 2011, which describes research from Poland and other countries describing the action of bacteriophages, now simply called phages. It lists many human experiments and shows that phages are safe to use in humans.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) presents with a pathological intestinal function, which can be quite disabling. Another name for it is “spastic colon”, because many patients complain of significant bowel spasms. Some health providers still use this alternative term. This syndrome is more common among women and there is a theory that female hormones may have something to do with the pathophysiology of irritable bowel syndrome. Testosterone on the other hand may have a calming effect on the gastrointestinal tract.

Symptoms and treatment of IBS

Generally speaking, irritable bowel syndrome occurs first in the teens or early twenties, but then frequently tends to become chronic. The patient chiefly complains of abdominal bloating and distension. Bowel movements lead to a marked relief of pain. There is often mucous in the stools. After a bowel movement there is often a feeling that the rectum did not empty entirely, even though it did. Food intake or stress can bring on these symptoms and they always occur during the waking period. At nights most patients have no pain.

Among other measures taking probiotics alone or mixed with phages can normalize the bowel flora. In older men IBS symptoms may indicate a reduction in testosterone production. If the blood contains a low testosterone level, the physician may want to replace the missing testosterone with injections or bioidentical testosterone creams. This can improve IBS in older males.

A safe delivery system for probiotics and a phage blend for digestive problems

Life Extension has developed a dual capsule that brings the inner content safely through the stomach and protects the mix of probiotics and phages from stomach acid. The capsule only opens in the small intestine where it releases its content of probiotics and phages into the gut. This allows the good bacteria like B. longum to multiply and suppresses E. coli, which would otherwise interfere with the beneficial bacteria.

Probiotics and a Phage Blend for Digestive Problems

Conclusion

About ¾ of Americans suffer from digestive problems. Many have a disbalance of the gut flora. But it is not easy to replace poor gut flora with a healthy one. Recent research showed that a combination of 7 probiotic strains with a mix of 4 E. coli fighting phages can give tremendous relief from bloating, diarrhea and abdominal cramps to patients with irritable bowel syndrome (IBS). Life Extension has developed a special dual capsule that “sneaks” the capsule through the stomach. It will only open in the small intestine. This way the content of the inner capsule with the mix of probiotics/phages stays safe from the stomach acid. At the end many more beneficial bowel-bacteria are growing in the small and large intestine. This normalizes the symptoms of the patient and leads to better digestion of food. Probiotics and phages are the new players in the gut microbiome.

Jun

2020

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

By Ray Schilling | antibiotics, Infectious Disease, Mortality

A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The discovery of teixobactin took place in 2015. It is a peptide with 11 amino acid units. Teixobactin is derived from a gram-negative bacterium, Eleftheria terrae. It is the first of a new class of antibiotics that can kill superbugs. Two examples, for instance are methicillin-resistant Staphylococcus aureus and resistant Mycobacterium tuberculosis. Researchers have been battling with difficult solubility of teixobactin and problems synthesizing this peptide in the laboratory. Teixobactin binds to the membranes of the bacteria it fights. This is a new mechanism for this new class of antibiotics, different from conventional antibiotics.

Mechanisms of fighting bacteria resistant to conventional antibiotics

But it is exactly this quality that is necessary to fight the antibiotic-resistant bacteria. The researchers showed that teixobactin binds weakly to a component of the bacterial cell wall, called “Lipid II”. But they found a second mechanism, namely blocking precursors of cell membrane synthesis in the bacteria they fight. Because of these unique mechanisms it is possible for them to fight a multitude of bacteria resistant to conventional antibiotics. Teixobactin has a unique molecular structure, which makes it difficult for resistant bacteria to develop resistance to it.

Antibiotic resistance

Resistance to antibiotics is a worldwide problem. There are several factors that worked together to make antibiotic resistance such a big issue. For instance, in the past many doctors prescribed antibiotics for any viral cold, even knowing that antibiotics only work against bacteria. Aside from this, the agricultural practice of using antibiotics as a growth stimulator is also an important factor for antibiotic resistance to develop. It is the bacteria that become resistant, not the human body. Several clinical entities involving resistant bacteria exist that show the magnitude of the problem.

Flesh-eating disease

Necrotizing fasciitis (or flesh-eating disease) can develop when you swim in contaminated waters and the bacterium, Vibrio vulnificus enters through skin sores or wounds. The CDC warns that you should stay out of salt water or brackish water, if you have a skin wound. The flesh-eating bacteria, Vibrio vulnificus can become very aggressive, once it has entered the body. Right now, 1 out of 5 people who get infected will die and many people require ICU treatment. Others need limb amputations. All of this can happen within only 1 or 2 days of becoming ill. The hope is that with the development of teixobactin as an injectable medication or as an oral pill there will no longer be deaths, amputations and scarring due to this bacterium, as the antibiotic will very quickly eradicate Vibrio vulnificus. I have previously written about what hospitals can do to fight superbugs.

The most common antibiotic-resistant bacteria

Here is a brief review of the most common antibiotic-resistant bacteria.

Mycobacterium tuberculosis

Since the 1950’s and 1960’s tuberculosis was treatable with a combination of two antibiotics over a period of six months to two years. But in the last 10 years more and more resistant strains of tuberculosis have developed. This is called multi-drug-resistant TB. In 2013 statistics showed that 3.7% of newly diagnosed tuberculosis cases were multi-drug-resistant TB. Many of these cases can be traced back to prisons and homeless shelters.

Methicillin-resistant Staphylococcus aureus (MRSA)

MRSA has become a common resistant bacterium that can present with difficult to treat boils in the skin, but also as a fulminant infection as necrotizing fasciitis (or “flesh-eating disease”). About 1/3 of the cases of flesh-eating disease are caused by MRSA.

Clostridium difficile (C. difficile)

This gut bacterium is naturally resistant to many antibiotics. The rest of the gut bacteria usually suppress the growth of C. difficile. But many patients can get overgrowth of C. difficile in their gut following treatment with antibiotics. Recolonization with probiotics can help to reintroduce a balanced bowel flora. In the US about 500,000 individuals come down every year with diarrhea due to C. difficile. This leads to approximately 15,000 deaths yearly.

Vancomycin-resistant Enterococci (VRE)

Physicians find enterococci in the gut and the female genital tract of patients. They can become resistant when the patient is treated with vancomycin for another infection. The VRE can then become a problem of its own with difficult to treat infections in the genital tract of females, the gut or in wounds from surgery. It has become a problem in immunocompromised patients.

The gonorrhea causing bacteria

In the last 70 to 80 years Neisseria gonorrhoea, the cause of gonorrhea, has been treated with only one antibiotic, but gradually the bacterium developed antibiotic-resistance. Lately, with more and more resistant strains of Neisseria gonorrhoea, the CDC has recommended to treat gonorrhea with two overlapping antibiotics.

Carbapenem-resistant Enterobacteriaceae (CRE)

There are two problem bugs among this category of enterobacteria, Klebsiella species and Escherichia coli (E. coli). These bacteria reside in hospitals where they can accumulate and are present in patients with immune system compromise. Medical devices like catheters and ventilators transmit these bacteria. Once a patient is sick with CRE, there is a danger of blood poisoning (septicemia), which has a high death rate.

How do regular antibiotics kill bacteria and how can they become resistant?

Normally, when antibiotics are not resistant, they interfere with the cell membrane production of the bacteria. Specifically, conventional antibiotics prevent bacteria from synthesizing a molecule, called peptidoglycan. Without peptidoglycan bacteria are not stable enough to survive in humans. But there are other mechanisms as explained in this link how antibiotics manage to kill bacteria.

Now I like to address the question how bacteria can become resistant to conventional antibiotics. This happens with overuse of antibiotics, i.e. prescribing antibiotics when a person suffers from a viral illness where antibiotics do not work. Other overuse comes from agriculture where cattle in feed lots get antibiotics as growth promoters. The FDA is strongly criticizing this practice, because residuals of antibiotics in beef can alter the bowel flora in man. The antibiotics kill all the sensitive bacteria. But the resistant bacteria, that have undergone mutations and adapted to the antibiotics, will survive.

Why teixobactin and analogues can avoid resistance

Since the detection of teixobactin many analogues have been synthesized. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The teixobactin analogues need more fine tuning, but they will be a breakthrough in the treatment of resistant bacteria. As this peptide attacks two targets on bacteria, it is not easy for bacteria to develop resistance against these new antibiotics.

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

Conclusion

Resistant bacteria have become a serious health concern in the last decade. Physicians overprescribing antibiotics and farmers feeding antibiotics to cattle in feedlots as growth promoters were the driving forces. In 2015 came the breakthrough and discovery of teixobactin. This is a peptide with 11 amino acid units. Teixobactin is a derivative of a gram-negative bacterium, Eleftheria terrae. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. In the meantime, researchers have been able to improve solubility by developing teixobactin analogues. More research is necessary. But all of the researchers who work in this field claim that this will very soon be extremely useful for patients with super bugs. This super-antibiotic will be a weapon fighting super bugs. Before the release of this medication clinical trials will be the next step.

Jun

2020

Chronic Inflammation Can Cause Many Diseases

By Ray Schilling | Alzheimer’s disease, Asthma, Cardiovascular disease, Diabetes, fish oil, heart attack, Inflammation, kidney disease, Obesity, omega-3 fatty acids, osteoarthritis, Pain, polyunsaturated oil, Vitamins and supplements

We knew since the mid 1990’s that chronic inflammation can cause many diseases. Among these are cancer, hardening of the arteries (atherosclerosis), arthritis, dementia (Alzheimer’s disease), frailty and other degenerative disorders. LifeExtension reviewed this topic in 2019.

Older people often accumulate chronic inflammation, which associates with the aging process. Persistent pain is one of the symptoms that chronic inflammation can cause.

Doctors use tests like the C-reactive protein, hemoglobin A1C, homocysteine and the erythrocyte sedimentation rate to measure chronic inflammation.

When the doctor diagnoses chronic inflammation, it is important to find ways to inhibit it and finally resolve it. Curcumin, ginger and non-steroidal anti-inflammatories are examples of measures that help inhibit inflammation. But it is only lately that scientists have found specialized pro-resolving mediators (SPM) that help to resolve chronic inflammation. They are polyunsaturated fatty acids, which health food stores offer as supplements.

Specialized pro-resolving mediators (SPM)

Researchers isolated several pro-resolving mediators that are metabolites of omega-3 fatty acids. This link discusses an experiment where researchers obtained synovial fluid from arthritis patients who took omega-3 fatty acids. They compared this to synovial fluid from volunteers who also took omega-3 fatty acid supplements. Within 4 weeks there was a big difference for the arthritis patients with higher levels of E- and D-series SPMs in synovial fluid and plasma. Dr. Silverman reviewed the action of SPMs here. He points out that they can be taken as supplements and that they are safe, because they do not have any side effects. Conditions such as asthma, irritable bowel syndrome and various musculoskeletal conditions with chronic inflammation respond very well to SPM supplements. Omega-3 fatty acid supplements (EPA) metabolize into the E-series resolvins. On the other hand, Krill oil with Docosahexaenoic acid (DHA) metabolizes into protectins, maresins and the D-series resolvins.

Three vital tasks of pro-resolving mediators

SPMs fulfill three vital tasks, called remove, restore and renew. First, they activate macrophages, which remove dead cells and cellular debris as a result of chronic inflammation. Second, they restore the healthy balance of inflammatory compounds and anti-inflammatory substances. Third, SPMs help renew tissues that were damaged by chronic inflammation.

Some examples where SPM’s were helpful resolving inflammation in health conditions

Alzheimer’s disease patients had reduced SPMs in cerebrospinal fluid of living patients and in the hippocampus of corpses who had Alzheimer’s disease.
A research group showed that defective SPM resolution can be responsible for missing resolution of atheromatous plaques in arteries. This leads to more and more hardening of arteries until a heart attack or stroke occurs.
With obesity or metabolic syndrome insulin resistance develops. Researchers found that certain SPM’s are missing in obesity, which causes chronic inflammation. However, they also found that precursors of SPMs such as 17-hydroxydocosahexaenoic acid (17-HDHA) can serve as a novel treatment agent to treat obesity-related complications.

Newer studies about SPMs

62 patients with knee osteoarthritis had the precursor of resolvins, 17-HDHA tested in the blood. Compared to controls with no arthritis the 17-HDHA level in the arthritis patients was low. When levels of 17-HDHA were high, there was no pain in osteoarthritis patients.
Chronic periodontitis is a chronic inflammatory condition in the mouth. In a rabbit model this condition was cured with resolvin E1 derived from omega-3 fatty acids.
Delayed wound healing is typical for type 2 diabetes. In a mouse model with diabetic mice researchers inflicted skin wounds on mice. Subsequently they showed that with resolvins mice wounds healed much faster than in control mice.
Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system in humans. Potentially they will be healed with the help of resolvins or their precursors, which includes the omega-3 fatty acids EPA and DHA.

Chronic Inflammation Can Cause Many Diseases

Conclusion

New compounds have been detected that derive from the omega-3 fatty acids EPA and DHA. They have the name specialized pro-resolving mediators (SPM). Included are the resolvins D1 and D2, the resolvins E1, E2 and E3 as well as the precursors 18-hydroxyeicosapentaenoic acid (18-HEPE) and 17-hydroxydocosahexaenoic acid (17-HDHA). The function of these compounds is to stimulate macrophages to clean up areas of chronic inflammation and remove cell debris and injured cells that cannot survive. While anti-inflammatories like ginger and curcumin only tone down the inflammation, SPMs help to resolve chronic inflammation. Various chronic clinical conditions were identified as being due to chronic inflammation. Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system. We may soon see alternative approaches treating these conditions with specialized pro-resolving mediators.

Jun

2020

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

By Ray Schilling | Cardiovascular disease, cholesterol, Diabetes, food, heart attack, Heart Disease, High Blood Pressure, Mortality, Nutrition, olive oil, omega-3 fatty acids, Processed food, Stroke

A recent publication came to the conclusion that a Mediterranean diet reduces heart attacks and strokes in diabetes. This Canadian and Spanish study compared prospective cohort studies and randomized trials (RCT). 41 reports (3 RCTs and 38 cohorts) formed the basis for this analysis.

Details of the study

Metaanalysis showed that a Mediterranean diet reduced the cardiovascular disease incidence by 38%. It also reduced myocardial infarctions (heart attacks) by 35%. Next the authors compared the highest to the lowest adherents to the Mediterranean diet (Med diet). The highest Med diet adherents showed the following reductions:

Cardiovascular disease mortality: 21%

Coronary heart disease incidence: 27%

Coronary heart disease mortality: 17%

Stroke incidence: 20%

Stroke mortality: 13%

The conclusion was that the Mediterranean diet is beneficial to prevent heart disease and strokes in people with diabetes.

Other studies

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. Again, the question came up, what the effect of a Mediterranean diet was on cardiovascular disease incidence and mortality. The authors reviewed 30 RCTs (49 papers) with12,461 randomized participants and seven ongoing trials. In one study the observation time was 46 months. A Mediterranean diet reduced the cardiovascular disease mortality by 65%!

Another study from Spain published in 2019 examined 7356 older adults (average 67 years) and followed them for 6.8 years. The investigators kept track of the physical activity and put everybody except the controls on a Mediterranean diet. The group on the lightest leisure-time physical activity consuming a Mediterranean diet had the lowest mortality. The all-cause mortality of this group was 73% lower than the control group.

What is so healthy about the Mediterranean diet?

Despite a wide variation between all the 15 countries bordering the Mediterranean Sea, there are common characteristics: an abundance of vegetables and fruit, along with nuts and legumes. Cereal products are largely whole grain. Olive oil is the principal fat source, and people eat fish, seafoods and poultry in moderation. They consume red meat rarely. Cheese and yogurt can be part of the diet, depending on the region.

The first clinical evidence supporting the health benefits of the Mediterranean diet came from the Lyon Heart Study. The researchers placed patients who had a heart attack either on the diet designed by the American Heart Association or a Mediterranean style diet. After a follow-up of 27 months, the group eating the Mediterranean diet had a reduction of heart attacks by 73% and a decreased mortality by 70% compared to the other group.

More detail on the ingredients of the Mediterranean diet

An analysis of the various foods of the Mediterranean diet shows the reasons for the health benefits clearly. The fats that people on a Mediterranean diet eat are heart-healthy monounsaturated fats like olive oil or fats that contain omega-3 fatty acids. They come from fish (tuna, salmon, trout, sardines) or from plant sources (walnuts, other tree nuts and flax seed).

As there is an emphasis on natural foods, the diet is extremely low in trans fatty acids (hydrogenated fats), which increase the risk for cardiovascular disease. As people consume more than 300g of vegetables per capita daily, the contents of antioxidants and other beneficial plant chemicals is much higher in comparison to Western diets. There are many individual components of the Mediterranean diet that contribute to the reduction of disease. This is particularly true for heart disease. It also is apparent, that it is not one single food or nutrient that is responsible for the health benefits. What matters are the interactive effects of all the nutrients that lead to the health benefits.

No processed food means healthier living

The practical application does not mean deprivation and starvation, but a move away from processed fats (margarine), baked goods (donuts, muffins, pastries), and high saturated fat snacks and trans fats (chips, crackers, cookies, pies). Food choices move towards those of fresh fruits and vegetables, nuts, fish, and olive oil. Portions or servings have to be adequate to maintain a healthy weight.

Mediterranean food is not the heaping plate of pasta with an afterthought of vegetables. It also is not the super-size fast food pizza with pepperoni and cheese. Mediterranean food incorporates fresh food rather than the fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Low amounts of alcohol, especially red wine can make a meal enjoyable, which means one drink per day for women, and two drinks per day for men. And after dinner go for a walk!

Olive oil is one of the reasons why the Mediterranean diet is so healthy

In the past it was thought that the monounsaturated fatty acids in olive oil would be the reason why it is protective of the heart. However, newer studies have shown that it is the polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protect you from hardening of the arteries.

In a 2012 study from Spain it was found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

How polyphenols in olive oil work for you

Only two tablespoons of extra virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. When there is more polyphenol in olive oil (such as in extra virgin olive oil), the body produces more HDL, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil will increase the size of the HDL particles (these larger particles are called HDL2), which are more efficient in extracting oxidized LDL from arterial plaques. A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles, which cleans out plaques from arteries more efficiently than the regular, cheaper olive oil.

Endothelial function

The endothelium is the lining of the arteries. Normal endothelial functioning involves widening of the arteries and maintaining its flexibility. The body achieves this through production of a signal molecule, called nitric oxide; the endothelial cells that line our arteries from inside produce it. Exercise increases the production of nitric oxide as well (Ref.1).

In a group of patients with poor endothelial function 2 tablespoons of olive oil (polyphenol rich) per day given over 4 months (the time of the study) showed a significant improvement of endothelial function.

The authors suggested that an enzyme in the endothelial cells, called nitric oxide synthase is being stimulated by components of polyphenol-rich olive oil. This leads to protracted release of nitric oxide, which in turn keeps blood vessels flexible and wide open. Other investigators found that olive oil can influence even a hereditary gene variant of endothelial nitric oxide synthase found in people with a history of premature heart attacks. This high-risk group of people should take extra virgin olive oil regularly to prevent premature heart attacks and strokes.

Endothelial dysfunction occurs when the arteries no longer can deliver adequate amounts of blood to vital organs like the heart or the brain. Endothelial dysfunction is also present in patients with type 2 diabetes, obesity, high blood pressure and metabolic syndrome. Introducing extra virgin olive oil in the diet of these patients will help restore their endothelial function.

Lowering blood pressure

In a study on 23 hypertensive patients it was shown as far back as in 2000 that extra virgin olive oil over 6 months allowed physicians to reduce high blood pressure medications by 48%. When the study was crossed over, the reverse was the case for the control group on sunflower oil. The polyphenols of olive oil released nitric oxide, which is known to lower blood pressure. This is an important finding. High blood pressure is a risk factor for the development of hardening of the coronary arteries. This leads to heart attacks, congestive heart failure, but also stroke. Regular intake of 2 tablespoons of extra virgin olive oil often will reverse high blood pressure and restore normal endothelial function.

Preventing heart attacks and strokes

In April of 2013 The New England Journal of Medicine published a Spanish diet study that showed that a participants on a Mediterranean diet with olive oil or nuts had 30% less heart attacks over 5 years than people on a low fat control diet. Other studies have also shown that olive oil and omega-3 fatty acids play a big role in preventing heart attacks and strokes. We also know that regular exercise reduces the risk further; so does keeping your body mass index below 25.0. Extra virgin olive oil is part of the protection from heart attacks and strokes. The study did not show any protection against cancer.

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

Conclusion

A Mediterranean diet reduced heart attacks and strokes in diabetic patients, but also in patients without diabetes. Here I attempted to show what the ingredients of a Mediterranean diet are that lead to such astounding positive effects. There is an emphasis on vegetables and fresh ingredients of food. In addition, olive oil and a lack of processed food are also important. With these wholesome ingredients the lining of the arteries works best. The body reduces cholesterol and lowers blood pressure. The end result is that there are less heart attacks and strokes, and people live longer.

Note: Part of this was previously published here and also here.

Jun

2020

Adequate Vitamin D Level Strengthens the Immune System

By Ray Schilling | immune system, Infectious Disease, Inflammation, kidney disease, Lung Disease, Mortality, Prevention, Vitamins and supplements

The Covid-19 coronavirus crisis is teaching us that an adequate vitamin D level strengthens the immune system.

When we age, our resistance to infections weakens, but this may be because our immune system needs more vitamin D3. I have reviewed the super powers of vitamin D3 before in 2014. In the past the thought was that the human body would need only 400 IU of vitamin D3 every day to cure rickets. And these were the daily vitamin D3 recommendations from medical authorities for several decades. Gradually it became known that for cancer prevention, infection prevention, cardiovascular illness prevention and for diabetes prevention much higher doses of vitamin D3 were necessary. As pointed out in the previous link, almost 50% of the world population is deficient in vitamin D. This is due to a lack of exposure to sunlight and due to inadequate supplementation with vitamin D3.

History of vitamin D

Dr. Adolf Windaus received the Nobel prize for chemistry in 1928. It was to acknowledge “… his studies on the constitution of the sterols and their connection with vitamins”. His work involved the metabolism of vitamin D and the precursors of vitamin D.

Rickets

As the above link shows, rachitic children were treated since the mid 1800’s with cod liver oil and since the early 1900’s also with ultraviolet light. But we know now that 400 IU of vitamin D3 per day is just enough to cure rachitic children, but it is not enough to strengthen the immune system to fight influenza viruses or the Covid-19 coronavirus. I will discuss further below what vitamin D blood levels are important to achieve a healthy state of the immune system.

Adequate vitamin D level strengthens the immune system

The immune system is very complicated and consists of many cell types that interact with each other and the rest of the body. It is important to recognize that the innate immune system immediately inactivates intruding viruses. But the vitamin D blood concentration has to be high enough. The acquired immunity consists of antibodies that are produced by B cells. The antibodies were produced during prior infections that you have survived and you are now immune to. However, other antibodies that circulate in your blood may have originated from vaccines you received in the past (whooping cough, measles, tetanus, diphtheria etc.). With the Covid-19 coronavirus it is the innate immunity that plays the biggest role until a vaccine will be found in the future.

Vitamin D is a hormone

This 2013 paper explains that vitamin D is a hormone that stimulates its own vitamin D receptor. This is a nuclear receptor that has close relations to the cell DNA and can stimulate more than 900 polypeptides. They are messenger molecules that are involved in a variety of physiological functions. One of the key functions is the immune system. This link explains that T cells that have vitamin D receptors can develop into cytotoxic T cells (also known as “killer T cells”). They are important in fighting cancer, but also parasites.

The key is that the hormone vitamin D can release more than 100 polypeptides that have the power to fight virus attacks including the Covid-19 coronavirus.

Three mechanisms how vitamin D works against the virus

The researchers outlined 3 mechanisms of how vitamin D works:

Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate.
“Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the blood stream within 1 to 2 days.
“…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” It is people who get the viral pneumonia that are at a high risk of death. By bringing the blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Two polypeptides, cathelicidin and defensins

Again, I like to emphasize that it is not vitamin D that has a direct effect on the virus. It is two polypeptides, cathelicidin and defensins, which are powerful antiviral polypeptides, that are released by vitamin D.

They can kill viruses that have invaded the blood stream and can eliminate the cytokine storm. This all happens very fast, within only 1 to 2 days. But you have to have an adequate vitamin blood level for this to occur (about 50-80 ng/mL).

Sources of vitamin D

First of all, vitamin D is readily absorbed from food. But there are not many foods that contain enough vitamin D for the immune system. The ones that contain vitamin D are as follows:

“Fatty fish, like tuna, mackerel, and salmon.
Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
Beef liver.
Cheese
Egg yolks. “

Sun induced amount of vitamin D

Secondly, vitamin D can be synthesized in the skin from exposure to sunlight. But for this to happen all the necessary enzymes need to be present. This link explains that many older people above the age of 65 have low vitamin D blood levels because of a lack of sun exposure and a lack of cutaneous synthesis because of enzyme issues.

Vitamin D supplements

The most reliable source of vitamin D are vitamin D3 supplements. When people supplement with the same dose of vitamin D3 there will be people who get higher vitamin D blood levels than others, as absorption in the gut is different for different people. The ones who have relatively low vitamin D blood levels are often called “slow vitamin D absorbers”. But when the vitamin D3 dosage is increased even those people will reach the recommended high normal range (50-80 ng/mL).

Vitamin D blood level

The vitamin D blood test has the scientific name “25-hydroxy vitamin D level”. This is now the recognized gold standard for determining who is deficient or has normal levels with respect to vitamin D. The following 2013 publication has studied the vitamin D level of 1,470 healthy Swiss men and women, 60 years or older. Vitamin D levels were classified as severely deficient when the level was below 10 ng/mL. The vitamin D level was deficient between 10 and 20 ng/mL. The level was insufficient when between 21 and 29 ng/mL. A level above 30 ng/mL is normal.

8 % of the subjects were severely insufficient and 66% had insufficient vitamin D levels. Only 26.1% of the subjects had normal levels. Over 50% of healthy older Swiss (above the age of 70) had insufficient vitamin D levels.

Which vitamin D level is safe and which is not?

A peer-reviewed publication of the effects of vitamin D in health and disease contains 269 references.

What vitamin D level is optimal? This question was reviewed in this paper.

Below 15 ng/mL the immune system is paralyzed
With a level above 30 ng/mL the immune system is working
A level of 50-80 ng/mL has the immune system working optimally
Above 150 ng/mL toxic vitamin D levels start
With 300 ng/mL severe toxicity begins

Vitamin D toxicity

It is only with high levels of vitamin D (more than 150 ng/mL) that you have to worry about high calcium levels in the blood or kidney stones (toxic levels). But the key is to not exceed 80 ng/mL regarding the vitamin D blood level. This gives you a lot of flexibility before you reach toxic levels (above 150 ng/mL). For those who want more information, here is a thorough, peer reviewed publication about vitamin D toxicity with 59 references.

Vitamin D supplement compliance

The question is why not more people take adequate vitamin D3 supplements. We know that vitamin D can prevent so many chronic diseases including serious viral infections. The answer is complex, but it includes a fear of the population of vitamin toxicity (kidney stone and high calcium levels). However, as pointed out before, this occurs only above a vitamin D level of 150 ng/mL. With proper vitamin D blood level monitoring you never reach toxic levels of vitamin D.

Denial

Denial likely is another major factor. People feel that if they have a balanced diet, they would be protected from vitamin D insufficiency. As pointed out before this is a grave error to think as our food does not contain sufficient vitamin D to strengthen our immune system.

False security with low doses of vitamin D

Finally, there are people who think that low doses of vitamin D, like 1000 IU of vitamin D daily, would be enough. But it is not enough. This is why testing vitamin D blood levels is so important. It is a reality check. The blood level must be in the high normal range (50-80 ng/mL). At this level the immune system functions optimally.

Compliance issues

In this context there was an interesting study done by LifeExtension, a company that publishes monthly health magazines. In this study the company examined the vitamin D blood levels of LifeExtension members. They are the ones who should be knowledgeable in how important it is to have good, preventative vitamin D blood levels. The study showed that 38% of the vitamin D test results were less than 30 ng/mL. In addition, 69% of the vitamin D tests were less than 40 ng/mL. Finally, 85% of the vitamin D test results were less than 50 ng/mL. What this means is that LifeExtension members were non-compliant when it came to taking regular adequate vitamin D3 doses. This resulted in levels that were too low for the majority to protect them from the Covid-19 coronavirus.

Covid-19 coronavirus infections and vitamin D blood level

There is a tight relationship between vitamin D blood levels and the strength of the immune system. Essentially, coronavirus mortality measures who is vitamin D deficient. Without enough vitamin D on board the virus penetrates into the blood stream and penetrates the lining of the respiratory tract. Next the cytokine storm develops, which leads to viral pneumonia. Higher doses of vitamin D3 will mitigate the course of Covid-19 coronavirus.

Adequate Vitamin D Level Strengthens the Immune System

Conclusion

The Covid-19 coronavirus pandemic has taught us how important an intact immune system is to survive the virus when you get it. We do know for some time how closely related a good vitamin D level is with the functioning of the immune system. I have reviewed here what a desirable vitamin D level is and how we can achieve this with oral vitamin D3 supplements. The goal is to achieve a vitamin D level in the upper range of normal (50-80 ng/mL). With a level like this the virus cannot penetrate the mucous membranes of the respiratory tract and even if it did, it cannot produce a cytokine storm in the blood that would lead to the deadly viral pneumonia or to blood clots. When the virus invades the bloodstream, vitamin D releases powerful antiviral polypeptides that can kill viruses within 1 to 2 days.

Literature

Here are some peer-reviewed publications on vitamin D:

https://www.mdpi.com/2072-6643/12/4/988/htm157 references (April 2, 2020 publication)
The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality
Startling Findings About Vitamin D

May

2020

New Multi Cancer Blood Screening Test

By Ray Schilling | breast cancer, Cancer, cervical cancer, leukemia, lung cancer, prostate cancer

A recent publication describes how a new multi cancer blood screening test can diagnose various cancers early. Many years back the same research group at the Johns Hopkins Medical School did lung cancer screening studies. The researchers then were analyzing saliva samples between 1974 and 1982. They identified 15 patients who later developed adenocarcinoma of the lung. The researchers were able to diagnose the lung cancer 1 year prior to what ordinary screening tests could do. This ensured an early diagnosis and early treatment with a better long-term prognosis.

Liquid biopsy promises early cancer detection

The new publication from the Johns Hopkins University in Baltimore, Maryland, is based on the following fact: Cancer cells consist of mutated cells. They shed DNA with mutations typical for this cancer into the bloodstream. By taking blood samples and analyzing the circulating mutated DNA researchers can first establish that the DNA belongs to a certain cancer mutation. But at the same time, they can locate the cancer, if they find mutated DNA. The pathologist can say that the patient has a cancer in a breast, the colon, lungs or ovaries, wherever it is located.

Oncoblot test was a precursor to the multi cancer blood screening test

Around 2014 a cancer screening test came out of the human genome project. It was called the Oncoblot test. It screened for 25 of the most common cancers. And it was screening for ENOX2 proteins from cancer cells. Apparently, this is a fetal protein normally expressed only during fetal life, bit in adults only expressed when a cell turns cancerous. It was a 1000 USD test in the US that health plans did not cover. But it screened for more than 25 different common cancers 6 to 8 years before they become clinically manifest: Suddenly around 2017 the Oncoblot test was no longer available. I could not find out the reason for this. Was the test producing too many false positives or false negatives? This would have made this cancer screening test unreliable. Apparently researchers of the Oncoblot test company are attempting to refine the test further.

My own case of prostate cancer

Strangely enough in 2016 I had an Oncoblot test done and it accurately diagnosed that I had prostate cancer. My cancer specialist from Ft. Lauderdale used Doppler ultrasound to visualize it and performed a 3-dimensional prostate biopsy to verify the histology. Subsequently he removed it with ablation cryotherapy, because a study of his involving 70 prostate cancer patients and spanning over 10 years had shown the best survival data. My 3-monthly PSA values since have been negative for recurrent prostate cancer.

New multi cancer blood screening test from Johns Hopkins Medical School

A review in Science magazine explains the details of the new multi cancer blood screening test. It is called CancerSEEK and is based on 16 common genetic markers that show changes in cancer cells. In addition, the researchers also test for cancer-related proteins, which change when cancer cells are present. The test also indicates the location of the early cancer. CancerSEEK can detect about 60% of liver cancers and 100% of ovarian cancer. The researchers tested 812 healthy controls. Only 7 (1%) tested positive for cancer. CancerSEEK also tested 1005 patients who had early cancer.

More details of the CancerSEEK test

The test detected between 33% and 98% of cases, which depended on the tumor type. The sensitivity was 69% or higher for stomach, pancreatic, and esophageal cancers; ovarian and liver cancer had a sensitivity of 98%. In 80% of the cases physicians could narrow the positive cancer test to two possible sites. The researchers think that the cost of one CancerSEEK test will be less than 500.00 USD. There is another study described where 9,911 participants were enrolled. 25 cancers were found. The diagnosis involved 2 lymphomas, 2 colorectal cancers, one appendix cancer, 2 uterine cancers, one thyroid cancer, one kidney cancer, 9 lung cancers, one breast cancer and 6 ovarian cancers. This study will continue to go on for another 5 years.

Possible problems with the new multi cancer blood screening test

Researchers dubbed the cancer screening test as “liquid biopsies” with the purpose to detect hidden cancers. The smaller the cancer is, the less the cancer cells excrete DNA and cancer proteins into the bloodstream. This means that in some of the early cancer cases the sensitivity of the test could be very small. Because many cancers will be detected much earlier there could be definite cures, if the cancer is in an early stage. On the other hand, Dr. Nickolas Papadopoulos from the Johns Hopkins University in Baltimore, Maryland, said: “The issue is not overdiagnosis, but overtreatment.” Some of the small tumors may never turn into larger tumors and it is justified to observe for a period of time.

A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. A private philanthropic group, The Marcus Foundation, is funding this project.

New Multi Cancer Blood Screening Test

Conclusion

A new multi cancer blood screening test, the CancerSEEK test, is in development. It is based on a combination of various cancer markers. Researchers measure cancer DNA mutations and also cancer proteins. They also determine the tissue location of the cancer. Researchers did much work already in terms of sensitivity and specificity of the test. Physicians integrate the test further with conventional medical tests to confirm the location of the cancer. With breast cancer mammograms are the additional tests, with colorectal cancer colonoscopies. A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. In future the CancerSEEK test will become a routine screening test for cancer. The cost for one CancerSEEK test will be less than 500.00 USD. The hope is that cancer cures will improve due to earlier detection.

May

2020

Unusual Presentations of the Covid-19 Coronavirus

By Ray Schilling | Uncategorized

Unusual presentations of the Covid-19 coronavirus were unknown when it first emerged in Wuhan, China at the end of 2019. Initially the virus presented with a high fever, cough, tiredness, sore throat and aches and pains. Subsequently cases of diarrhea, conjunctivitis, headaches and loss of smell were often accompanying the illness. Patients with a weak immune system in old age or from chronic diseases are particularly vulnerable. They can come down with viral pneumonia, which often results in intubating the patient. 50% of these cases may recover, the other 50% die.

Descriptions of unusual presentations of the Covid-19 coronavirus

In the last few months doctors have seen unusual presentations of the Covid-19 coronavirus. There were cases that seemed to be fine in the first 10 days. But then sudden severe illness struck. In one case a 38-old man was diagnosed with Covid-19 coronavirus in an urgent care clinic. He was told to go home and isolate. He felt not too bad, but had a bit of a cough. The following day he woke up with his legs feeling cold and numb. His leg muscles were so weak, he could not walk. An ambulance took him to the Westchester Medical Center in New York.

Blood clot secondary to Codid-19 coronavirus

Tests showed that he had a large blood clot in his aorta right at the bifurcation of the iliac arteries. When no blood goes through the iliac arteries, no blood can reach the femoral arteries. This explained his leg symptoms. Emergency surgery removed the blood clot and saved this man’s legs and life.

Pediatric multisystem inflammatory syndrome

This syndrome can affect children less than 5 years of age, although in the beginning it was assumed that children would be less likely to have Covid-19 coronavirus infections. Pediatric multisystem inflammatory syndrome is the second phase of a coronavirus infection. Symptoms include abdominal pain, gastrointestinal symptoms and inflammation of the heart. Symptoms are persistent fever, inflammation and poor function in one or more organs. Some children present with shock. These children need admission and treatment in a pediatric ICU ward right away. Some doctors think that the cytokine storm initiated by the Covid-19 coronavirus is responsible for this syndrome. It may be an overreaction of the immune system that can be the cause.

Delirium in patient testing positive for Covid-19 coronavirus

A patient in Saudi Arabia who has been traveling abroad presented with confusion from a delirium. He had a spiking fever and mild respiratory symptoms. A swab test for SARS-CoV-2 was positive. He recovered very quickly and spontaneously and had no residual problems.

Unusual presentations of the Covid-19 coronavirus in elderly patients

In a study from French Switzerland coronavirus patients who were older than 70 years of age were analyzed. Half of the patients who died were over 83 years old. Symptoms can be as vague as “altered general condition”, unusual fatigue or delirium. Even a fracture can be an indication that a hidden coronavirus infection caused dizziness, loss of balance and a fall.

Gastrointestinal symptoms common in adults

In adults symptoms of fatigue, diarrhea, nausea and vomiting are common for Covid-19 coronavirus. This is in contrast to the usual presentation of upper respiratory symptoms followed by a fever and coughing.

Unusual presentations of the Covid-19 coronavirus in pregnant women

A publication from Wuhan, China reported about pregnant women shortly before and after their deliveries.

Their gestational age was between 38th weeks to 41st weeks. Prior to their delivery they had no fever or symptoms of coronavirus. Following the delivery many had a mild fever of 37.5℃-38.5℃. Kidney and liver functions were normal. Two women had mild elevation of heart enzymes. The newborn babies were all healthy. Women before the delivery tend to not have any fever. After the delivery low-grade postpartum fever or mild respiratory symptoms were the only symptoms present in those with positive tests for Covdi-19 coronavirus.

Unusual Presentations of the Covid-19 Coronavirus

Conclusion

There are unusual presentations of the Covid-19 coronavirus. Older people may present with an “altered general condition”, unusual fatigue or delirium. In very young children the pediatric multisystem inflammatory syndrome may present as abdominal pain, gastrointestinal symptoms and inflammation of the heart. On the other hand, in more severe cases acute shock may be present. In late pregnancy shortly before delivery the pregnant women had hardly any symptom and no fever. But post-delivery women with positive Covid-19 test presented with a mild fever and cold also show mild respiratory symptoms. In middle aged adults sudden blood clots stemming from inflammation of the lining of blood vessels can shut off the blood supply to multiple organs. This causes a dangerous condition of multiple organ failure. The liver, heart and kidneys are often affected.

This is still a new virus, and researchers do not know enough. Much more research is necessary to clarify the differences of presentation in patients with Covid-19 coronavirus.

May

2020

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

By Ray Schilling | addiction, alcohol, breast cancer, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, exercise, Fitness, food, heart attack, Inflammation, lifestyle, lung cancer, Mortality, Nutrition, Obesity, Prevention, Stroke

A Jan. 8, 2020 study stated that cutting out bad lifestyle habits increases life expectancy. It was a publication in the British Medical Journal by the Harvard T.H. Chan School of Public Health. The senior author of the study was Frank Hu, chair of the Department of Nutrition at Harvard Chan School. The researchers looked at data collected from a large group of males and females that had been accumulated for 34 years. They found that a 50-year-old male or female who did not change their lifestyle habits had another 25.5 years to live for males and another 29 years to live for females.

Five bad lifestyles and life expectancy

The 5 bad lifestyle habits were smoking, a body mass index above 25.0, excessive alcohol intake, less than 30 minutes of exercise per day and an unhealthy diet.

When people cut out all of those risky lifestyles, 50-year-old men and women had a life expectancy of 37.6 years for men and 43.1 years for women. This was an addition of 12 years of healthy life for men compared to controls who did not change their lifestyles. With regard to women there was an addition of 14 years of life compared to controls.

Diseases that kill prematurely

The research team wanted to know what diseases caused the most reduction in life expectancy when people did not change their bad lifestyle habits. Men and women who cut out all negative lifestyle habits were 82% less likely to die from cardiovascular disease. They also were 65% less likely to die from cancer. Bad lifestyles caused the two major diseases, cardiovascular disease (heart attack and strokes) and cancer, which increased overall mortality. The overall study time was about 30 years. The third major disease that can cost lives is diabetes. In addition, the research team identified chronic diseases as being another potential cause of people dying prematurely.

Additional life expectancy

When life expectancies were broken down according to diseases, the following was noticed.

For men:

When cancer free When free of heart issues Without diabetes

6 more years 9 more years 10 more years

For women:

When cancer free When free of heart issues Without diabetes

8 more years 10 more years 12 more years

Dr. Frank Hu, who chairs the department of nutrition at Harvard T.H. Chan School of Public Health said: ”We found that following a healthy lifestyle can substantially extend the years a person lives disease-free”. Those who do not shed their bad lifestyle habits will come down with one or more of the mentioned diseases and die prematurely. Others who cut out all their bad lifestyle choices live substantially longer.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack.

It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking.

Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, cancer of the colon and rectum are also caused by consuming too much alcohol in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into the system and adds to the chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Conclusion

Bad lifestyle habits are what causes us to get illnesses and die prematurely. Functional medicine and anti-aging medicine are at the frontier of modern medicine. These specialties are teaching us how to stay well and age gracefully. For decades conventional medicine has treated only symptoms, but not the causes of diseases. But this has not changed the mortality rates of heart attacks and cancer. Smoking, a body mass index above 25.0, excessive alcohol intake, exercising less than 30 minutes of exercise per day and an unhealthy diet are causes that make us sick. These bad lifestyle factors cause chronic inflammation in our system. They are the real cause of heart attacks, strokes, cancer and diabetes, the major killer diseases that prevent healthy aging.

Facing bad lifestyle habits

Bad lifestyle habits cause chronic inflammation. T he C-reactive protein blood test can measure the degree of inflammation that is present. A fasting insulin level can detect whether a person is in danger of developing diabetes and improved lifestyle habits can prevent this from happening. Men can add 12 years and women 14 years of healthy life by eliminating bad lifestyle habits. By eliminating chronic inflammation our new life expectancy, which is 79 to 80 years, now can reach 92 to 94 years. It is up to you how healthy you stay and whether or not you age gracefully.