Tag Archive for: immune system

How Can Vaccinations Reduce Alzheimer’s Disease?

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In reading possible explanations for the potential benefits of flu vaccinations for reducing the risk of Alzheimer’s disease (AD), it always comes back to reducing inflammation. Further, it isn’t just the flu vaccine that seems to have that effect. Pneumonia, DTAP booster, shingles, and others have also been studied with similar results: vaccinations seem to reduce the risk of AD. The question is still why? I’ll give you two possibilities.

Vaccines Stimulate the Immune System

Whenever you get a vaccination, the immune system is stimulated. It may be that the activated system addresses weaknesses in the immune system that should be protecting the nervous system. Some researchers speculate it may reduce the formation of amyloid bodies (sticky proteins that harm the brain) and prevent the progression of dementia.

One thing to remember is the population being studied. It might be that, in spite of lifestyle habits, inflammation increases as we age, specifically in the brain. Some people may have genetics that can help. However, it may not just be the nervous system in the brain that’s at risk from increased inflammation. There is an increase in cardiac arrythmias of all types, decreases in muscle function, and many other effects that we attribute to simple aging. It may not be as simple as working hard on a healthy lifestyle, and it may exceed our attempts at living healthier.

Viral Infections Cause Inflammation

“I never get sick!” I’ve heard that a time or two. My question is “How do you know?” Maybe you’re sick, but your immune system has fought off all the symptoms you expect. The assumption is that every virus you get exposed to will leave you with some form of physical manifestation: a cough or runny nose during a cold, vomiting or diarrhea with a food-borne pathogen, or a fever from the flu.

But how do you know that you’re not in a state of inflammation, wreaking havoc on your nervous system, your heart, or another organ? You think your immune system isn’t working even though you don’t “feel” it? It can be. If we’re not flat on our backs, we don’t think we are undergoing immune system challenges. That’s simply not reality, and the problem is that the challenges get worse as we get older.

The Bottom Line

I think this research causes a dilemma for some people: vaccinate or not? As we get older, our immune system doesn’t work as well. Let’s be honest: lots of things don’t work as well, but we’re still kicking, darn it! What we could ignore in our youth now demands our attention. Yes, we need a healthy lifestyle that includes a better diet, a little exercise, and some immune-boosting supplements such as vitamin D and C.

The challenge is the anti-science climate we now live in, and nothing is more controversial than talking about vaccinations. Opinions may be based on flawed science—or in some cases, no science, just opinion—and access to social media where people can say anything they want to say. For me, the science is pointing to benefits from vaccinations if you’re older than 65. Just spread them out over a few weeks or months to give your immune system a chance to adapt.

Whatever you decide to do, it’s your body. It’s your choice.

What are you prepared to do today?

        Dr. Chet

References:
1. J Alz Dis. 88 (2022). 1061–1074. DOI 10.3233/JAD-220361
2. Vaccine. 2021. https://doi.org/10.1016/j.vaccine.2021.08.046

Reducing Calories Improves Immunity

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The two-year results from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) clinical trial—the first controlled study of calorie restriction in healthy humans—were released last week. The purpose of the study was to determine the benefits and hazards of calorie restriction. Animal studies have demonstrated that reducing calories up to 40% allows the animals to live longer, but at a cost: their immune systems become compromised and as a result they have more infections. On top of that, you can restrict that many calories from animals because you feed them, but it’s unrealistic in free-living humans.

After meticulously assessing each person’s basal caloric need, they asked half of the 200 subjects to restrict their calories by 14% and sustain it; if they required 2,100 calories per day, that’s a reduction of about 300 calories a day. That’s just two tablespoons of oil per day; skip the mayo on a burger and get a small order of fries instead of a medium, and that’s it. There are hundreds of little changes like that a person could make to reduce calories by 300 a day.

Under-eating just that little bit and maintaining it triggered an interesting effect: it stimulated the immune response to operate even better than before. I’ll talk about why (and a confirmation of what I’ve always said) on Saturday.

What are you prepared to do today?

        Dr. Chet

P.S. The Super Bowl Webinar is over, but you can still watch the replay. Just click if you want to learn more about Reclaiming Your Power!

Reference: SCIENCE. Feb 2022. 375(6581):671-677

The Bottom Line on Fasting

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In the past four Memos, I’ve focused on explaining fasting. The questions I left you with on Saturday were: “Is it worth it to fast? Is it effective? Is there science to support it?” The answer to all three is yes. I think it can be summed up in one quote from the reference.

“In response to starvation, mammalian cells enter either a non-dividing or a low-dividing state and invest energy resources in cellular protection against various insults.”

While the statement is complicated, it means that metabolism is decreased. That allows the body to shift energy sources from glucose to fat metabolites such as ketones. The body focuses on reducing the production of proteins that can be destructive, such as inflammatory hormones, thereby protecting cells. It also helps improve the immune system so it functions better. The stress of reducing food intake in a controlled fashion helps cells function better.

The research review is available for free; it goes into more detail but demonstrates that fasting is beneficial when used properly. The bulk of the research is on the two- to-five-day fast with fewer than 1,000 calories on the fast day; I’ll use a two-day version before my knee replacement next week to help my body prepare. Just be sure to check with your physician before you fast if you have any metabolic issues such as diabetes or if you take medications, both of which can be impacted by restricting food.

Wednesday is the final scheduled Insider call of 2021. This may be the time to join to help you achieve your health goals in 2022. Hope to see you (or hear you) at 9 p.m. Eastern Time.

What are you prepared to do today?

        Dr. Chet

Reference:Trends Endocrinol Metab. 2018 April; 29(4): 271–280.

The Fasting Dilemma

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I hope you all had a wonderful Thanksgiving. Because we’ve entered the “weight-gain portal” time of the year, let’s talk about the fasting craze that some people are doing and the rest are thinking about trying. As I see it, the problem is the lack of clarity in terminology and subsequently the execution of a fasting program. Terms such as “5:2” and “16:8” are thrown around. What exactly is a fast? What can it do for a person? What’s the best way to do a fast?

The problem begins with defining the term “fast”; there’s no consistent way the term is used, and that includes in the methodology of research studies. Fasting can mean avoiding all food and in some cases drink. That definition can describe fasts done for religious purposes as well as the fasts talked about for weight loss and controlling metabolism.

Another definition of fasting is severely reducing calories; if you lower your intake from 2,000 to 1,400 calories to lose weight, that’s a fast. If you’re drastically reducing calories for two to four days to help reset your immune system, that’s also a fast. But if you’re not consuming any calories, whether for a specific number of hours per day or a whole day, that’s more accurately called “abstinence from food.” Is that a big deal? Yes, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet

Fasting: Another Piece of the Puzzle

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Fasting is gaining popularity. Actually, periods of complete abstinence from food within a 24-hour cycle is what really seems to be gaining in popularity, but this study doesn’t address intermittent fasting. It examines fasting for a specific period of time before a dietary change—in this case, to the DASH diet. We don’t know if the results would be the same if someone were switching to a ketogenic diet or a paleolithic diet. These are the major results of the study we began examining on Tuesday.

The Results

  • The five-day fast prior to beginning the DASH diet appeared to have positive effects on blood pressure. There was an average drop of eight points in systolic BP and a reduction in the use of medication to lower blood pressure.
  • Subjects adhering to the DASH diet lost weight as well. However, it was not the reduction in weight loss that caused the drop in systolic blood pressure based on their analysis.
  • The immunome, a portion of the total proteome I talked about a few weeks ago, improved. While the exact mechanism is not known, the positive changes in immune proteins appeared to have a positive effect on lowering blood pressure.
  • Researchers also discovered genetic differences between those who responded to the fast and the subsequent DASH diet by lowering their blood pressure and those who did not. The key seems to be in the bacteria that produce short-chain fatty acids. Fasting was identified as a way to increase the bacteria producing those SCFAs.

What Does It Mean?

What are we to conclude? With only 71 total subjects, there’s not a lot of data to generalize to entire populations, but here’s what I think is important.

First, fasting does have a role to play in the health of our microbiome; it also has role to play in our immune function. It’s not completely clear why these changes can occur, but research shows that they do. It may be that eliminating food for a period of time helps the naturally occurring bacteria to function better.

Second, it doesn’t seem to have anything to do with intermittent fasting. It very well may be that complete abstinence from food could get you similar benefits if you were to withhold food for 18 or 20 hours a day and only eat in a very small block of time. But until fasting for a specific amount of days is compared with hourly intermittent fasting, we just don’t have the best answers yet.

The Bottom Line

Fasting, however you define it, appears to have some beneficial effects. If you find a way that fits into your lifestyle, there doesn’t seem to be any reason that you shouldn’t do it unless you have a metabolic disorder and must eat. For example, if you have problems with your blood sugar or take meds that must be accompanied by food, fasting may not be for you.

Here’s my plan: now and then, I’m going to try a reduction to 500 to 800 hundred calories per day for one to three days. That seems to be supported by the most science. It also appears to benefit immune function the most.

Anticipating questions from those doing a ketogenic or paleolithic diet, is the diet after the fast important? Maybe if you select the right foods, such as going vegan during those fasting days, you may get the positive changes in your microbiome. What would happen if you then went on a ketogenic or paleo diet after that? We just don’t know whether the changes would last. This study provided a few pieces of the puzzle, but there’s much we still need to know.

What are you prepared to do today?

        Dr. Chet

Reference: Nat Comm (2021)12:1970. https://doi.org/10.1038/s41467-021-22097-0

How Periodontal Disease Makes COVID-19 Worse

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

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

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

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

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

The Bottom Line

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

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

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

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

What are you prepared to do today?

        Dr. Chet

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

Using Melatonin to Treat COVID-19

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Today’s research paper is a type of study that uses large datasets to examine the relationship between successful treatments for people with COVID-19 and related viral infections. Let’s take a look.

Network-Based Drug Repurposing

To say that this is complicated is a tremendous understatement, but let’s give it a go. Researchers identified specific targets for the many different strains of COVID and SARS viruses, including all of the research on the receptor targets in the body for every COVID-related virus, such as the ACE2 receptor. Then they examined each drug that has been used to treat people with the virus to see how effective it was, along with drugs that had specific receptor targets when used for other reasons. Researchers weren’t looking for a cure; they wanted to determine whether specific symptoms in various parts of the body improved such as the lungs, the heart, fatigue, etc.

They started with dozens of receptors and over 2,000 FDA-approved medications, and after running the initial analysis, they reduced the number of drugs to 135. They ultimately came up with three pairs of medications that could be effective in treating COVID-19: sirolimus plus dactinomycin, mercaptopurine plus melatonin, and toremifene plus emodin. I would wager that five of those are medications you’ve never heard of, but you’re probably acquainted with melatonin. That’s what caught my attention, so let’s take a look at why melatonin would be included in a potential treatment for COVID-19.

Melatonin as an Antiviral

In their explanation, researchers said melatonin has been reported to have a potential for treating antiviral infection because of its anti-inflammatory and antioxidant effects. As suggested, melatonin can indirectly impact the ACE2 receptor, which is a key target of the COVID-19 virus. Mercaptopurine blocks specific papain-like proteases such as the ACE2 receptor; the hope is that the combination will block the ACE2 and other target receptors from the virus and reduce the inflammatory response.

The Bottom Line

The researchers say there’s a long way to go before this combination can be used to treat COVID-19—pre-clinical and clinical trials for sure to test whether this combination actually works to treat the virus.

When it comes to melatonin, it makes sense to add it to our immune-boosting regimen. Its mechanism of action is different from the zinc, vitamin D, and vitamin C we may already be taking. The question is how much? I don’t have a specific answer because there’s still so much research to review. But I’m going to begin with 6 mg. That’s not too much and even if it doesn’t work for immune boosting, the potential benefits for memory, etc., make it worth taking; take it at night, of course, because of its ability to help you sleep. When I’ve reviewed more research, I may be able to give you a more definitive answer. In the meantime, there’s no apparent downside to taking melatonin. If you feel you need the additional immune boosting—and who doesn’t—give it a try.

What are you prepared to do today?

        Dr. Chet

Reference: Nature. https://doi.org/10.1038/s41421-020-0153-3

The Skin Microbiome: Skincare and Cosmetics

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While the state of the current pandemic has restricted the ability to socialize to any great degree, it may turn out to be beneficial for the skin microbiome. Be honest. If you don’t have to go to work or out into the public, do you still maintain the same personal grooming practices? Do you put on all your makeup? Based on what people say in virtual meetings, the answer is no. Why is that beneficial for the skin microbiome?

The final potential insult to our skin microbiome is from products we willingly use. Most people apply some form of skincare and/or cosmetic products every day, plus deodorant or anti-perspirant, haircare products, moisturizers, and a plethora of make-up products. Here’s the key point: most of these products contain anti-microbials to maintain the safety of the product before use. That means when applied to the skin, they could also impact the microbiome of the skin.

After reading a review article on the state of research on the entire gamut of skincare products, several researchers outlined the type of research that should be done. While encouraging, that means that not much has been done. I couldn’t find any research that directly examined the impact of skin and cosmetic products on the skin microbiome. We just don’t know.

Strategies for Healthy Skin

There are several things we can do to indirectly help our skin.

  • Drink one-half your body weight in ounces of liquid every day.
  • Take 1 to 4 grams of omega-3 fatty acids every day. There are many reasons to take your omegas, but one is to help reduce the production of inflammatory hormones.
  • Take a probiotic with several types of bacteria with a prebiotic every day. They contribute to a healthy immune system and internal microbiome.
  • There are several supplements that may also contribute to the health of the skin including biotin, vitamin C, and collagen. They may not affect the skin’s microbiome, but starting with a healthier surface may be beneficial.
  • Regular exercise increases blood flow to all areas of the body, including the skin. That can deliver nutrients and help remove waste products.

The Bottom Line

Our skin microbiome is part of our first line of defense against microbial invaders. At this point, there’s not enough research to know whether the skincare routines we’ve become accustomed to are beneficial, harmful, or at least neutral. Is that worth stopping all skincare and cosmetic products? Should we stop taking showers? I don’t think we need to do any of those, but if we start paying more attention to the products we use and make better choices in selecting them, that may give us an edge while science catches up with this amazing part of our immune system.

What are you prepared to do today?

        Dr. Chet

Reference: Int J Cosmet Sci. 2020 Apr;42(2):116-126. doi: 10.1111/ics.12594.

The Skin Microbiome: pH

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The water we shower and bathe in may impact our skin microbiome, but we don’t generally just rinse off with water. We use soaps and shampoos as well. How could they impact the microbiome of the skin? Let’s take a look.

Normal healthy skin has a pH range of 5.4 to 5.9. At that pH, the body maintains a normal microbiome. Researchers examined the pH of shampoos and soaps in about 100 different products. Most soaps were highly alkaline with a pH that averaged between 9 and 10. Shampoos fared much better with most in the 6 to 7 pH range.

Will the exposure to these products damage the skin microbiome? If it does, will it be temporary? After all, the exposure will be limited depending on the length of the shower or bath. We don’t have all the answers on that. The closest I’ve seen to sequential testing was a multi-country study that found that the skin pH was still elevated six hours after washing with soap. The rise was less than a single point; still, the actual impact on the microbiome wasn’t evaluated. There’s still much we don’t know.

We’re still not done with the skin microbiome so we’ll finish this up on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. Int Microbiol. 2019 Mar;22(1):1-6. doi: 10.1007/s10123-018-00049-x.
2. Indian J Dermatol. 2014 Sep-Oct; 59(5): 442–444. doi: 10.4103/0019-5154.139861.
3. International J of cosmetic science. 2006 DOI: 10.1111/j.1467-2494.2006.00344

The Skin Microbiome: Birth and Water

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I began last week’s focus on the skin microbiome based on reading an interview with a scientist who hasn’t taken a shower in over five years (Clean by James Hamblin). We’ve established the basics about skin and the microbes that are supposed to reside in the skin microbiome. This week we’ll cover how the skin microbiome is affected by our environment. What are we doing to our skin that may be impacting our health?

It actually can begin at birth. If we are delivered via the birth canal, we are immersed in vaginal microbes that seed our skin with microbes. In the 1970s, C-sections began to rise from 5% to the current rate of 30%. That means close to one-third of newborns don’t get the initial exposure to skin microbes. Does that result in an increase in skin conditions such as dermatitis? Maybe, but there’s no confirming research to date.

Depending on your water supply, the water may be treated with chlorine and fluoride. While they can kill bacteria to make the water safer, those chemicals may also damage the microbes that live on our skin, hence Hamblin’s avoidance of showers. That impacts the skin microbiome and consequently, our immune system.

What else can impact our skin? I’ll cover more on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: Int Microbiol. 2019 Mar;22(1):1-6. doi: 10.1007/s10123-018-00049-x.