Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, September 18, 2017

Agreeing? Disagreeing! Antidepressants

"It's possible for a normal person to have increased risk of stroke or upper GI [gastrointestinal] bleeding events that could be harmful or deadly [by inadvertently interfering with platelet function]."
Paul Andrews, evolutionary biologist, associate professor, McMaster University, Hamilton

"A single study like this shouldn't frighten anybody. You've heard about the replication crisis in medicine and psychology?" 
"More people are taking [antidepressants] for a lifetime. So is this safe?"
"Up to now we have said we haven't seen any problems."
Dr. Joel Paris, past chair of psychiatry, McGill University, Montreal
Controversial new research suggests antidepressants dispensed by the millions in Canada increase the risk of dying early.  Aaron Lynett/National Post file photo
"[Antidepressants] are a life-saver for many, reducing the risk of suicide in depressed patients."
Royal College of Psychiatrists, U.K.
And yet another voice, that of Dr. David Baldwin, chair of the psychopharmacology committee of the Royal College of Psychiatrists in Britain speaks of those suffering from depression representing a group known to be at elevated risk of of a wide network of health problems (little wonder they're depressed) "all of which carry a risk of increased mortality", more or less putting things into another perspective, looking at the wider picture.

But then, no research is quite complete if it doesn't examine a problem from all perspectives; taking into account the add-ons, the variables that can impact the veracity of conclusions rather than focusing on a narrow range of issues, ignoring the bigger picture, and arriving at a conclusion that may fit a preconception. On the other hand, there are times that findings do zero in on inescapable conclusions based on verifiable facts. And then a balance must be achieved in risk assessment.

New research is often controversial, with proponents of results they have derived from studies they deem to have reliability being countered by others in the profession protesting the incompleteness of the conclusion. In the instance of a new research result concluding that the use of antidepressants used by millions of people in North America may be the cause of an increase in the risk of early death, many of those prominent in the field of psychiatry, scorn the paper's conclusions as alarmist.

The lead author of the study is sticking to his conclusion, that those pills that psychiatrist feel are "life-savers" for people suffering from extreme depression, are also responsible for a greater number of deaths than they manage to save. Their effect on blood platelets, he points out, whose use is to stop bleeding by forming clots a case in point. The brain chemical serotonin pairs with platelets to enable them to function the way they are meant to, yet the most-prescribed antidepressants on the market have the effect of blocking the absorption of serotonin.

They do this, it is speculated, since such drugs act on the blood as blood thinners thus elevating the risk of abnormal bleeding and hemorrhagic stroke. Molecules  -- called monoamines -- with broad effects beyond the brain, the researchers wrote in the journal Psychotherapy and Psychosomatics, are targeted by all of the prescribed antidepressants, and Dr. Andrews, the lead author of the study,  emphasizes this.

For people who do have heart disease the drugs appear to be less threatening given that they would emulate the function say, of Aspirin, to thin the blood and keep it flowing through narrowed arteries clogged through cholesterol buildup in atherosclerosis. Over 40 million prescriptions were filled in 2014, according to market research, affirming that Canadians present among the top antidepressant users in the world, along with the United States and Britain.
The use of antidepressants is dramatically increasing, with 64.7million prescriptions given out in England last year ¿ double the number of a decade ago (file image)
The use of antidepressants is dramatically increasing, with 64.7million prescriptions given out in England last year – double the number of a decade ago (file image)

Evidence appears to be growing that the drugs have about as much beneficial effect as placebos in the treatment of mild depression, which has led to psychiatrists being blamed for prescribing antidepressants too frequently and inappropriately. Yet family doctors are among the most frequent prescribers of antidepressants and for many more conditions than depression; insomnia, hot flashes and chronic pain among them.

The researchers had initiated their study by conducting a meta analysis in reviewing 16 studies which taken together involved over 378,000 patients and this led them to the finding that antidepressant users had a 33 percent higher opportunity of earlier death than others not using the drugs. A 14 percent higher risk of triggering a 'new' cardiovascular event like stroke or heart attack, also attached to the use of antidepressants.

Serotonin acts as neurotransmitter in the brain, while most of the body serotonin is synthesized in the gut and spills into the bloodstream, is then taken up by cells, tissues and organs throughout the body. At the same time, serotonin is vital for mitochondria, whose function is similar to miniature power plants, supplying energy to every body cell.

Side-effects of selective serotonin reuptake inhibitors are known among other effects to cause abnormally slow heartbeats and fainting. Earlier this year, the pills were linked in another study to a two=fold increase in the possibility of developing dementia. As for the condition of depression itself, it is known for its association with increased death risk, inclusive of suicide.

There are no simple solutions to human health gone awry, and every time we take a drug out of prescribed condition necessity, that interaction will always result in some kind of consequences, mostly in good outcomes, but occasionally not.

In 2011, Canada reported the third-highest level of antidepressant use among 23 countries.   CTV News

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Sunday, September 17, 2017

To Vitaminize Oneself -- or Not

"We take multiple different ones [supplemental vitamins], in combination with whatever prescription drugs we might also be taking."
"We've bought into the idea that these products are simultaneously miraculous and entirely safe."
"Wrapped in with all of that is the desire for longevity . . . to just feel good."
"It gets tricky to determine which ones [vitamins] have good science behind them and which don't."
Catherine Price, journalist, writer, Philadelphia

"What's the best available evidence? Is there good evidence that taking these things helps or improves outcomes?"
"There is very good evidence. People have studied this over and over and over again. And in otherwise healthy people, [vitamin supplementation] appears to do virtually nothing."
"It's not a definitive thing that they definitely increase mortality [people using antioxidant supplements]. But they shouldn't even have a hint of increasing mortality, because the whole point of taking them is to live healthier and longer."
"I don't have any skin in this game. I wish they worked. Who wouldn't?"
"It's a two-edged sword. They might think, 'I guess I don't need to eat properly anymore, because I'm taking these vitamins'."
"The best way to get your nutrients is through foods. If there's one [supplement] that has at least some evidence for benefit -- and likely no harm, unless used in mega-doses -- you could go ahead and take some calcium and vitamin D. But choose the least expensive you can find. And don't get too neurotic about it."
James McCormack, professor, faculty of pharmaceutical sciences, University of British Columbia
Woman looking at shelves of dietary supplement bottles
"B12 is another one that, as we get older, we may not be able to get sufficient food sources of."
"I don't think there's any evidence that an older person needs more vitamins [unless a specific health problem requiring supplemental nutrients exists]."
"I think people don't understand that they just take the supplements to be sure they are getting enough."
Stephanie Atkinson, professor, department of pediatrics, McMaster University

"There are the classic tea-and-toasters, where people [elderly retired on fixed incomes] are just having essentially tea and white bread with not much on it."
"Those are the people at really high risk for nutritional insufficiency."
"It's the purified capsules that really haven't shown to be beneficial [as opposed to an adequate, balanced diet]. Probably because there are multiple nutrients present in food, and recapitulating exactly which ones might be the best is kind of a false hope."
Dr. Mark Tarnopolsky, expert, neuromuscular diseases, McMaster University, Hamilton

A recent University of Alberta research team's goal studying whether there was evidence to support the belief that vitamin D substantially improves health outcomes, its devoted use reducing falls, fractures, rheumatoid arthritis, cancer and risk of early death led them to the conclusion that calcium-absorption vitamin D does have some benefit in the prevention of fractures and falls, but marginally. Of a study group of 45 to 57 people using vitamin D and calcium daily over a decade, one only would benefit from fracture avoidance. Additionally a small reduction in mortality risk was found in people aged 70 and older.      
Most people do not need to take vitamin supplements,  but in some situations, taking the pills may provide health benefits.  Image: Thinkstock

In searching for reliable scientific evidence to support the use of vitamin D supplements in the prevention of cancer, respiratory infections or rheumatoid arthritis or for the maintenance of mental well-being "no other effects are proven", the researchers stated. What they did discover was that on the evidence mega-doses of vitamin D could presage unexpected outcomes, inclusive of a potential increased risk of early death; now that's mind-fixing.

According to Statistics Canada, about 16 million Canadians, representing almost 50 percent of the entire population, made use of at least one nutritional supplement -- while in the U.S., dietary supplements are known to represent a $36-billion industry, amply demonstrating the generalized trust in the power of vitamins and dietary supplements for enhanced health and longevity. It isn't just vitamin D, of course, but the belief in marketing claims that antioxidants or omega 3s are hugely beneficial, burden our lives as well in the thought that they are disease-preventives and guard against premature death.

In genuine instances of vitamin deficiencies, the most common of which is scurvy or rickets, vitamin supplementation has proven to be hugely effective; in fact there are thirteen vitamins that the human body does require, to live healthily, that become confused in people's minds with the add-ons that are in fact, redundant if people consume a wide range of whole foods in moderation. Health Canada informs us that a balanced diet is capable of providing all the nutrients required to sustain good health for most people.

And it is people age 50 and up who most benefit from taking additional vitamin D. A 'moderate' daily dose of under 800 IU of vitamin D daily in combination with about 500 mg of calcium results in a reduction in fractures, osteoporosis, so that Health Canada cites a maximum daily dosage of vitamin D age 50 and up to be 4,000 IU as long as the users speak to their family doctor before embarking on regular supplemental use. The older we get the less able we are to synthesize vitamin D from exposure to the sun. And in northern climates like Canada's, winter exposure to sun diminishes our vitamin D intake.

B12 on the other hand is necessary to ensure normal nerve function and healthy red blood cells. Pernicious anemia can result from low levels of B12, a blood disorder causing fatigue and mental imbalance in thought and concentration. Again, it is older people whose absorption of B12 from foods becomes impaired, and even more so in the presence of regular antacid use. The propensity is of people geared feel that if the use of a vitamin is recommended, then perhaps increasing the dosage would be even more beneficial.

Yet the body can be overtaxed when people indulge in the belief that more is better, when it results in issues such as hypercalcemia; abnormal calcium levels in the blood as a result of taking excessive amounts of vitamin D. Too much vitamin A intake has been linked to bone loss, on the other hand, along with an increase in hip fractures. Dr. McCormack emphasizes that no absolute and consistent evidence can be relied upon that vitamin supplements will benefit healthy people.

Studies published in the journal Annals of Internal Medicine in 2013 found:
  • taking a daily multivitamin for 12 years failed to slow cognitive decline in male physicians age 65 and older;
  • high doses of multivitamins and minerals did not associate with reduced risk of a second heart attack, stroke or hospitalization for angina in people age 50 and older with previous myocardial infarction;
  • a review involving over 400,000 community groups randomly assigned to multivitamin supplements or single or paired vitamins discovered no clear evidence of a beneficial effect on cardiovascular disease, cancer or death from any cause.
On the other hand, an Iowa Women's Health Study found that multivitamin use was associated with a 2.4 percent increased absolute risk in mortality when 39,000 older women were studied. The Cochrane collaboration produced a 2012 report on antioxidants covering 78 randomized trials in which 300,000 people were studied to find no evidence exists in support of the use of antioxidant supplements to prolong life. Those using antioxidant supplements, in fact, were found to be marginally likelier [1.03 times as likely] to die early as opposed to those not using these supplements for it seems that beta-carotene and possibly vitamin E and A appear to increase mortality while vitamin C or selenium do not.


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Saturday, September 16, 2017

Favouritism, Cronyism, Nepotism, Racketeering

"None of the budgets noted indicate a cost of $500,000. We are unaware of how between March 22, 2016 and April 29, 2016, the budget grew from $260,000 to $500,000."
"We understand the police have been notified of the alleged theft and are investigating."
"No other individuals, council members or otherwise, were copied on the email [arranging the funds] to the bank."
"No other council members approved he bank draft."
"We recommend a formal legal opinion be obtained with regards to whether a conflict of interest existed between Chief Hillier and the contact with Moccasin Media and its proprietor David Hillier."
"We are unable to confirm the amounts paid ..." We are unable to determine whether any cash may have been misappropriated."
"[Band] members sought financial information ... We understand no information was initially shared with the members."
Matson Discoll & Damico Ltd. audit of Caldwell First Nation powwow
Caldwell First Nation
Members of the Caldwell First Nation in Leamington, Ont. are shocked by a forensic audit that shows there were "minimal controls" over more than $240,000 in prize money for a powwow last year. (Caldwell First Nation website)

The suggestion that funds may have been stolen from a small band council arranging a celebratory powwow for its 368-member group in southern Ontario certainly looks, on the evidence of the audit, that it has great merit. Chief Louise Hillier, it seems, was in a conflict of interest given that she chose to award an untendered contact to the value of $290,000 to make a video of the powwow.

On the strength of the audit's findings Chief Hillier has been temporarily suspended as has the entire council itself after a motion from one of the councillors. Unusually large cash prizes represented another puzzling decision to reward contests in singing, dancing and drumming, to a total of $280,000 unsupported by receipts.

All to celebrate the conclusion of the band's land claim in 2010, when the Province of Ontario settled with the band for the historical claim when, 200 years earlier, settlers took their traditional lands at Point Pelee. The band has no designated geographic reserve, but with its settlement funds it has plans for the development of an urban reserve to be located in Leamington, Ontario.

Last summer's powwow was the celebration of a "repatriation ceremony", named Rejuvenation of the Spirit. The 129-page audit appears to have taken all the airy puffery out of that rejuvenated spirit; of the million-plus settlement, fully half was scattered to the winds, and almost half of that ended up in the flush bank account of the chief's son for his Moccasin Media company.

There was a complete lack of financial control in the council, no drawing up of an official budget, merely a draft resolution expressing the band's intention of launching the celebration; a follow-up resolution had no financial value connected to it; nothing specific whatever, though an audio recording of the council meeting had councillors discussing a budget of $260,000.

A bank investigation revealed that 99 $50 bills were missing; whoof! poof! gone! There was a convention however, stating a councillor "cannot sign his/her own cheque and cannot sign a cheque for immediate family ...", but still the chief's son's video company was awarded a contract just shy of $200,000 when the band had been discussing contracts not to exceed $20,000.

Local media reported up to 6,000 people attending the powwow, with ticket sales at $5 each entrance at the gate, and when the gate revenues were totted up it seems that only 1,123 entrants may have paid the fee -- or the fees just kind of disappeared. Souvenir revenues came to a whopping $2,596, accounting for memorabilia for the powwow that the band had spent $17,197 on acquiring.

Attendees loved the cash prizes, with young competitors, six to 12 years of age awarded $400 in first place, $150 for coming in fifth. The awards were doubled for the older girls and boys, and the adult competitors received $1,600 for winning first and $800 for finishing fifth. If there were any losers, they were the forgettable concepts of straight-shooting and honesty.

The former federal Conservative government had instituted a regulation whereby band councils were expected to post all revenues and expenditures for public viewing, rather than do as they wished with the tax-funded monies annually received to fund reserve operations. One of the first things the new Liberal government did was to waive that requirement.

The reserves that are well-run by honourable councils who care deeply about the welfare of their members, saw no need to waive an assurance they complied with; those administered by First Nations elites who saw nothing untoward in cheating their people doubtless celebrated wildly.

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Friday, September 15, 2017

Human Nutrition: The Settled Science

"A decrease in fat intake automatically led to an increase in carbohydrate consumption and our findings may explain why certain populations such as South Asians, who do not consume much fat but consume a lot of carbohydrates, have higher mortality rates."
Mahshid Dehgha, Population Health Research Institute, McMaster University

"Our study found the lowest risk of death in those who consumed three to four servings or the equivalent to 375 to 500 grams of fruits, vegetables and legumes per day, with little additional benefit for intake beyond that range. Additionally, fruit intake was more strongly associated with benefit than vegetables."
"The PURE study includes populations from geographic regions which have not been studied before, and the diversity of populations adds considerable strength that these foods reduce disease risk."
"Raw vegetable intake was more strongly associated with a lower risk of death compared to cooked vegetable intake, but raw vegetables are rarely eaten in South Asia, Africa and Southeast Asia."  "Dietary guidelines do not differentiate between the benefits of raw versus cooked vegetables -- our results indicate that recommendations should emphasize raw vegetable intake over cooked."
Victoria Miller, McMaster doctoral student
Diet Study Suggests It's Carbs, Not Fats, That Are Bad for You
HealthDay News
This major study out of McMaster University, comparing various diets around the world represented a major nutritional-longevity study where lead author Mahshid Dehgha maintained that people reserving at least 30 percent of food intake in fats, saturated or unsaturated, had succeeded in lowering their mortality risk. The results of the study have been heralded as a breakthrough in understanding the effects of the composition of the human diet, pro and con mortality, yet on the other hand, there are those in the scientific community involved in human nutrition that remain skeptical.

Medical journals are rife with the results of a multitude of food/health studies. Medical studies can fall into two categories; the randomized controlled clinical trials recognized as the gold standard of medical research and the observational type of studies. The first type is severely limited when dealing directly with human subjects since people who take part in these studies cannot be subjected to the same type of treatment as would be apportioned to laboratory-test animals.

In other words, the study cannot be crafted to ensure that one-half of the study participants are given a diet that might be inimical to their health, while the other half are apportioned a healthy diet known to lead to good outcomes. Most nutrition studies as a result represent observational types, relying on food diaries where the participants make note of their food intake, also called "food frequency questionnaires". Since this type of study relies on truthfulness and careful listing of all foods consumed, they are seen to be less useful to a reliable outcome.

CTV News Channel: ‘Big piece of evidence
In one recent study published in the International Journal of Obesity, the authors concluded that the data they relied upon obtained through self-reported food studies proved to be of such poor quality they realized they were incompatible with scientific research. The researchers involved in the McMaster study concluded that a correlation between a higher-fat diet and fewer deaths existed, as they interpreted the results.

But then there is the issue of other factors, like family history, exercise, income levels, lifestyle, etcetera to be considered. Apart from which studies tend to contradict one another, some rallying against conventional wisdom; as an illustration that diets high in fat and low in carbohydrates tend to help people lose weight, while other studies claim the reverse to reflect reality. Yet researchers at the University of Pennsylvania in 2003 concluded that whether someone was on high-fat, low-carbohydrate, or a high-carbohydrate and low-fat diet was immaterial.

A follow-up study replicated the original study's results, taken seven years on. With the added observation that irrespective of which diet was used, once the diets ended so did the weight loss; weight soon returned. The human body metabolizes foods differently from individual to individual. Up to the present, cheese, milk, butter, eggs and beef have been identified in the past few decades as representing the intake of harmful foods. And then other research proceeds to reverse those results.

The public is sternly informed that excess weight leads to pressure on internal organs, and to diabetes which in turn deleteriously affects the heart, eyesight, the likelihood of stroke, kidney disease and other related ailments such as neurological problems. Yet newer studies conclude that carrying around some extra weight as we age may in fact help us get over illnesses better and live longer lives.
One thing, however, is indisputable; it is moderation in all things, including dietary intake, that exemplifies the best of all possible diets.

Butter and cheese may not be so bad
Moderate amounts of saturated fat, found in butter and cheese, may actually help protect against heart disease and stroke. (Madlen/

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Thursday, September 14, 2017

Commitment and Tragedy

"The two people with the SUV were taken to hospital and the driver of the van was also taken to hospital where he was treated, released and has been taken into police custody."
RCMP Cpl. Julie Rogers-Marsh, New Brunswick

"I think traffic was his passion. He came to work every day and did a 100 percent job."
"He was always friendly, always a happy, go-lucky guy and he's going to be sadly missed."
Cpl. Darren Galley, Codiac detachment, New Brunswick

"As I got closer I noticed there were cars in places where they shouldn't have been on the side of the road. I noticed a lot of flashing lights and a police car that looked severely damaged."
"They [RCMP] put their lives at risk a lot. They have a tough and difficult job and don't receive a lot of credit for what they do."
John Morris, Photographer, passing motorist, Trans-Canada Highway
Const. Francis Deschenes, book of condolences
Members of the public are being encouraged to sign books of condolences set up at the RCMP detachment in Amherst and at the headquarters in Halifax. (Tori Weldon/CBC)
"It is extremely challenging to describe what it feels like when we lose one of our own. In the RCMP, we are a family and every employee in Nova Scotia and across the country is impacted by the loss of Francis … Frank as he was better known."
"[His actions on Tuesday] speaks to the core of what policing should be — involved in your community, looking out for people, taking the time to do those small things that would go a long way."
"They (Const. Deschenes' family] are dealing with unimaginable tragedy, and I ask that they be given the privacy and respect they deserve as they grieve the loss of their husband, son, brother and friend."
Assistant RCMP Commissioner Brian Brennan
In 2008, Nova Scotia Mountie Francis Deschenes came to the help of a 26-year-old woman near Truro, Nova Scotia. Her vehicle had come to a stop on railroad tracks even while a Canadian National freight train was oncoming at high speed. With the quick thinking this man was noted for, he pushed the stalled car off the tracks using his own cruiser to accomplish the feat with seconds to spare, saving the situation from becoming a tragedy.

A trail derailment could have resulted had the oncoming train collided with the car, and most certainly its inhabitant, the young woman, would have died in the collision. This event earned him recognition as a heroic figure, able to think swiftly of a solution to an emergent calamity. In 2013, by then having been with the RCMP for a decade of distinguished service, he became a recipient of the Queen's Diamond Jubilee medal, meant to recognize and honour "significant contributions and achievements by Canadians."

Since then he married, as recently as the past summer. He was in uniform, in a police vehicle when he stopped to assist motorists more recently, two days ago in south-eastern New Brunswick. The officer had stopped on the Trans-Canada Highway to offer help when he saw two people in a SUV trying to change a tire. His specialty with the national police force was as a traffic reconstructionist trained to investigate collisions and determine their causes; a member of the Special Tactical Operations/Tact Troop. Irrespective of the presence of his parked police vehicle, lights flashing as a warning, a driver of a van heedlessly crashed into the cruiser and the SUV, killing Const. Deschenes immediately.

Const.Deschenes, 35, formerly a member of the RCMP's musical ride program, was stationed in Amherst, Nova Scotia, involved in efforts to inform the public that legislation existed in Nova Scotia and New Brunswick requiring drivers to slow down and move over whenever they see emergency vehicles stopped along the highway. It is a supreme irony that this dedicated police officer, who took an especial role with respect to traffic safety would have lost his life while helping members of the public, by the very vehicular homicide he was attempting to alert drivers to.

Amherst flag lowered Sept. 13, 2017
Flags outside the Amherst RCMP detachment were at half-mast on Wednesday. (Tori Weldon/CBC)

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Wednesday, September 13, 2017

The World Within In Us

"We don't have a good grasp of what these seasonally varying microbes even do."
"We have to think of ourselves as these composite organisms, with microbial and human parts."
"An abrupt change in diet will lead to an abrupt change in the gut microbiome, on the order of a day or two."
"We're in some weird, perturbed state where many of the microbes we co-evolved with are not equipped to flourish."
Justin Sonnenburg, microbiologist, Stanford University, California
Hadza man eating honeycomb and larvae from a beehive.
Matthieu Paley/National Geographic

If we are what we eat is true, what we eat significantly affects our elimination patterns of what we intake. Which, at one time in human evolution consisted in the whole of whatever a hunter-gatherer society could bring to the table, as it were. That was a function reflective of the seasons primarily. Whereas at the present time in any advanced society where food has been regularized in the sense that it only resembles now what it was like in its original, natural whole-food state for the most part.

Even fruits and vegetables which can be untouched from the ground to the table, have undergone vast changes from their original state as what is now quaintly termed 'heritage' types have given way to cultivars bred carefully for their taste, shape, abundance, and ability to withstand shipment across continents have also changed. Not quite to the extent that whole foods undergoing processing and supplemental additions have, transforming them entirely into another sub-food category.

All of these things affect the gut biome that we acquire as a reflection of what it is we eat. Scientists interested in such matters since they impact on human health and longevity, have studied an ethnic minority living in Tanzania, comprised of only 1,300 people. What makes this small group unique is that they continue to live as their ancestors did, sustaining themselves with hunting, scavenging for berries, honey and a handful of wild foods.

This was how all human groups once fed themselves. As a result of their isolation and their way of life, they have attracted the attention of researchers who study intestinal microbiome, the life of our intestines, through the bacteria inhabiting them and ultimately fashioning how we excrete waste. Researchers detected an annual rhythm in the gut of this group where some bacterial species absent themselves for parts of the year, and then make their entrance once again, as the Hazda people regularly alter their diets in synchronicity with the seasons.

Thousands of species of bacteria inhabit the intestines of every human being; an estimated 30 trillion bacteria teeming in our guts, every one of us. The idea was in this study to compare the microbiome of hunter-gathers in as close to the original state of early human development with those of people living in various 'advanced' societies, enabling scientists to understand the manner in which diets influence the composition of gut bacteria.

Stool samples were collected from the Hadza four times over the course of a year, a trial that began in 2013 when a visiting research fellow at King's College London, initiated work with Tanzania's National Institute for Medical Research. An analysis was taken of some of the samples. The study, published in the journal Science, laid out the manner in which Dr. Sonnenburg and his colleagues detected sharp fluctuations in the composition of the Hadza gut bacteria. Recognizing some species to be more evident in one season, not another while some absented themselves altogether.

In the course of a year, the Hadza gather fruits from baobab trees, while in the dry season tubers are eaten along with plenty of meat since dry seasons favour hunting. Foraging for berries and harvest honey from beehives takes place primarily in the wet season when hunting is less gainful. The Hadza microbiome was compared with those of people living in 17 other societies, inclusive of American urbanites and Amazon rain forest Yanomamo villagers, another isolated group.

The goal was to try to understand how it might be possible that gut microbes linked to industrialization affect the health of people in those societies. The Hadza microbiome representing those living in traditional societies, least akin to those living in industrialized societies, far from the natural world and its rhythms where the availability of certain foodstuffs is dictated by the seasons. Whereas in materially developed countries food tends to be shipped far and wide.

Dr. Sonnenburg speculates that consuming the same foods year-round led to the loss of food seasonality and the disappearance of ancestral bacterial species. Which in turn have given impetus to a new set of gut microbes over those that fed on plant fibers.

Hadza women cook tubers they've foraged throughout the day. Compared to the men, who spend their day hunting game, the women have more gut bacteria for breaking down fibrous veggies.
Image: Alyssa Crittenden

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Tuesday, September 12, 2017

Bacterial Safeguards

"[The study] is an absolute game-changer."
"There's nothing we have like this in our armamentarium to prevent infections in newborns. Also, there's how cheap it is, its ease of use -- it's oral -- and its independence of pharmaceutical companies and their patent issues."
Dr. Tobias R. Kollmann, pediatric immunologist, University of British Columbia
Matt Twombly for NPR
Matt Twombly for NPR

The journal Nature published the results of a large clinical trial in rural India recently, whose findings have hugely impressed the medical world of child medicine. A condition caused by chronic malnutrition and diarrhea -- lethal sepsis -- was found to be responsive to a new probiotic treatment pioneered by Dr. Pinaki Panigrahi, a pediatrician at the University of Nebraska Medical Center's Child Health Research Institute.

Sepsis, a life-threatening bloodstream infection, is the cause of death of 600,000 newborn babies every year. The clinical trial took place in rural India, feeding babies a special strain of Lactobacillus bacteria. In the controlled study, after one week of treatment the babies receiving the probiotic responded so amazingly well -- 40 percent less likely to develop sepsis -- that it was considered to be immoral to continue the study with the children who were chosen to receive a placebo, not sharing in the obvious advantages of the treatment.

A treatment that proved so immediately to be so exceedingly successful that the babies given the probiotic -- costing a mere $1 -- were found to have fewer bouts of pneumonia, of diarrhea, fewer ear infections, as well as infections of the umbilical cord stump. The takeaway from this swiftly-rewarding protocol was that probiotics individually chosen, could also be useful in helping to prevent stunting, a condition afflicting 160 million of the globe's children.

Caused by chronic malnutrition and diarrhea, stunting confoundedly persists even in conditions that see children fed sufficient food, leaving experts to believe that it is a lack of needed bacteria to absorb nutrients that is responsible. The purpose of probiotic supplements is to have the gut colonized with beneficial bacteria with a view to preventing harmful strains from gaining the upper hand. But Dr. Panigrahi cautions that probiotics are required to be precisely matched to the illness for which they are prescribed.

Selecting an incorrect bacteria for an ill baby could be the cause of that child's death.

Dr. Panigrahi's research team tested 280 different strains of bacteria over a decade, searching for one that would attach to the gut, not enter the bloodstream, and be capable of outgrowing harmful bacteria. The samples examined from Indian yogurts of health food shops proved to be useless. But sample No. ATCC-202195 of Lactobacillus plantarum was derived from a healthy 11-month-old child in Maryland, and it provided the answer the researchers were looking for.

Funded by the National Institutes of Health in America, Dr. Panigrahi's successful work will enable him to extend testing to premature and sickly infants in greatest danger of contracting sepsis. As well, in some parts of the world, stunting leaves about half of the children living there of lesser proportions than they should attain to, leaving them as well to suffer from lifelong learning difficulties.

A woman holds her baby in Mumbai     Danish Siddiqui / Reuters

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