Omega-3 fatty acids (especially DHA) may protect against ulcerative colitis

Omega-3 fatty acids (for example, the EPA and the DHA in your fish oil supplements) have an anti-inflammatory effect, of interest to researchers in a recent study of inflammatory bowel disease, specifically ulcerative colitis. This large study, which focused on people from 45 to 74 years old, found that those with the highest consumption of DHA (410 mg to 2,000 mg per day) had a 77% reduction in the risk of developing ulcerative colitis over an average period of four years than those consuming the lowest amount (up to 110 mg per day). On the basis of their research, the study authors suggest that higher intake of omega-3 fatty acids, especially DHA, could have a protective effect against development of ulcerative colitis.

For more information on DHA, EPA and other fatty acid supplements, see the NYBC category:
Fatty acid supplements
Note that NYBC stocks a variety of these supplements, both from fish oil (Nordic Naturals and Jarrow), and from vegetarian (algae) sources.

Reference:
John, S et al. Dietary n-3 polyunsaturated fatty acids and the aetiology of ulcerative colitis: a UK prospective cohort study. Eur J Gastroenterol Hepatol. 2010 May; 22(5):602-6

Glutamine for the Gut

We’re reprinting information on the use of Glutamine for Inflammatory Bowel Disease (ulcerative colitis and Crohn’s disease) and for HIV/AIDS. These excerpts are from the University of Maryland Medical Center’s Complementary Medicine web resource, which provides an extensive and generally up-to-date database on nutritional supplements and their applications.

NYBC stocks two forms of Glutamine. And, by the way, we’ve just noticed that our bulk Glutamine powder (1 kilogram) is about HALF THE PRICE of a “discounted” Glutamine powder offered by a chain of vitamin/supplement stores! (GNC…sssshhh)

Read these entries for dosage recommendations:

Glutamine as a bulk powder (1 kilogram)

and

Glutamine capsules 500mg/100.

Glutamine is the most abundant amino acid (building block of protein) in the bloodstream. It is considered a “conditionally essential amino acid” because it can be manufactured in the body, but under extreme physical stress the demand for glutamine exceeds the body’s ability to synthesize it.

Inflammatory Bowel Disease (IBD)
Glutamine helps to protect the lining of the gastrointestinal tract known as the mucosa. Because of this, some experts speculate that glutamine deficiency may play a role in the development of IBD, namely ulcerative colitis and Crohn’s disease. These conditions are characterized by damage to the mucosal lining of the small and/or large intestines, which leads to inflammation, infection, and ulcerations (holes). In fact, some preliminary research suggests that glutamine may be a valuable supplement during treatment of IBD because it promotes healing of the cells in the intestines and improves diarrhea associated with IBD.

HIV/AIDS
Individuals with advanced stages of human immunodeficiency virus (HIV) often experience severe weight loss (particularly loss of muscle mass). Some studies of individuals with HIV have demonstrated that glutamine supplementation, along with other important nutrients including vitamins C and E, beta-carotene, selenium, and N-acetylcysteine, may reduce the severe weight loss associated with this condition.

Florastor/ Saccharomyces boulardii

Here’s the NYBC summary of recent research on Saccharomyces boulardii, which is available under the tradename Florastor:

Saccharomyces boulardii, sometimes abbreviated Sac. boulardii or S. boulardii, is a very well-researched probiotic, with several hundred peer-reviewed studies to its credit, many from the past two decades. It’s now the first choice among probiotics for antibiotic-associated diarrhea, C. difficile colitis, and “traveler’s diarrhea.” It can also help with irritable bowel syndrome, ulcerative colitis and Crohn’s disease. Here are some recent research highlights:

-Harvard Medical School researchers have identified specific pathways by which Saccharomyces boulardii decreases intestinal inflammatory responses; their 2006 report helps explain the broad range of protective effects that this probiotic exerts in a variety of gastrointestinal disorders. (Sougioultzis S, et al. Saccharomyces boulardii produces a soluble anti-inflammatory factor that inhibits NF-kappaB-mediated IL-8 gene expression. Biochem Biophys Res Commun. 2006 Apr 28;343(1):69-76.)

-A 2006 meta-analysis (combined analysis of multiple individual studies) found that Saccharomyces boulardii was the only probiotic studied that was effective against Clostridium difficile disease, a common form of antibiotic-associated diarrhea. (McFarland L V. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006 Apr;101(4):812-22.)

-A 2008 study found that Crohn’s patients receiving Saccharomyces boulardii treatment showed significant improvements in intestinal function compared with those given a placebo. (Garcia Vilela E, et al. Influence of Saccharomyces boulardii on the intestinal permeability of patients with Crohn’s disease in remission. Scand J Gastroenterol. 2008;43(7):842-8.)

-An investigation published in 2009 found that, of a variety of probiotics, Saccharomyces boulardii was uniquely able to stimulate production of secretory IgA, the main immunoglobin found in mucus, saliva, and secretions from the intestine and the lining of the lungs, and a main component of the body’s protective mechanism against pathogens. Thus Saccharomyces boulardii may now be credited with an ability to enhance immune function in general. (Flaviano S. et al. Comparative study of Bifidobacterium animalis, Escherichia coli, Lactobacillus casei and Saccharomyces boulardii probiotic properties. Archives of Microbiology, Volume 191, Number 8 / August, 2009.)

See the NYBC entry for more details, including recommended dosages:

http://nybcsecure.org/product_info.php?products_id=217

Jarro-Dophilus EPS

Jarrow Formulas advertises this product as the number one selling probiotic supplement on the US market, and, at least in this case, we tend to think that’s a sign that it is a worthwhile supplement, helpful for people dealing with malabsorption or various gastrointestinal disturbances that prevent adequate digestion.

Here’s the product review from the NYBC website:

Jarro-Dophilus EPS (Jarrow) Each bottle, 60 capsules. Each capsule contains 4.4 billion probiotic organisms, including various species of Lactobacillus, Bifidus, Pediooccus acidilactici and Lactococcus diacetylactis. These capsules are enterically-coated to preserve them without refrigeration, which makes this an ideal product for use while travelling. However, if at home, refrigerate anyway, just to preserve them as well. Blister packed. Suggested use is 1-2 capsules per day, if possible, without food. Dairy-free and vegetarian formulation. Also contains potato starch, magensium stearate and ascorbic acid.

Note: A 2006 consumerlab.com report evaluated several brands of acidophilus-containing products. This Jarrow product passed all of their tests!

Further information on this and other probiotic supplements can be found on the NYBC website:

http://nybcsecure.org/index.php?cPath=27

Probiotics, yogurt and gut health in people with HIV

The online information resource for people with HIV, The Body, recently published an article on probiotics, yogurt and gastrointesinal health in people with HIV: A “Cultured” Response to HIV:
Probiotics in Yogurt Could Hold Keys to Optimal Gut Health in HIVers
. Here’s an excerpt:

HIV researchers have known since the early days of the pandemic that HIV can wreak havoc on the gut, which is home to an abundance of CD4 cells. This apparently occurs quite soon after someone is infected with HIV. “It’s almost like the gut is a magnet for the virus early on,” says Bill Critchfield of the University of California at Davis. “[It] becomes compromised in weeks.”

The gut also harbors roughly 100 trillion microorganisms that help with immunity and digestion. HIV infection can upset the balance of healthy bacteria in the gut, allowing “bad” bacteria and fungi to flourish there. Several recent studies have suggested that probiotics — the “friendly bacteria” that turn milk into yogurt and also provide health benefits when eaten — can help restore that balance by repopulating the gut with healthy bacteria or by tuckering out the bad bacteria by competing with them for nutrients.

As Nature Medicine reports, microbiologist Gregor Reid of Lawson Health Research Institute in Ontario, Canada, has been studying the health benefits of probiotics for over 25 years. He’s created his own probiotic, called Lactobacillus rhamnosus GR-1, which he has put into a yogurt that is being used in research involving people with HIV. Reid and others around the world have conducted small studies that show probiotics have a positive effect on CD4 counts, though larger studies are certainly needed to confirm those findings.

The article in the journal Nature Medicine is found at
http://www.lhrionhealth.ca/crdcp/pdf/Nature%20Medicine%20feature.pdf. It looks especially at a pilot study in Tanzania on yogurt, gut health and HIV.

NYBC, like its predecessor supplements buyers’ club DAAIR, has long been interested in probiotics for gut health in people with HIV. See the NYBC entries at Probiotics for detailed recommendations for use.

NYBC’s Quick Guide to Gastrointestinal Health

A number of NYBC members and visitors to our website and blog have asked us to reprint the NYBC “Quick Guide to Gastrointestinal Health,” which first appeared in the Winter 2009 issue of our free newsletter THE SUPPLEMENT:

NYBC’s Quick Guide to Gastrointestinal Health

Gastrointestinal or gut health is basic to overall health, whether you’re talking about how well you feel on a daily basis (nausea, cramps, diarrhea, etc. being among our least favorite experiences), or the importance of properly absorbing food that you eat and thereby supplying your body with the nutrients it needs to stay healthy over the long term.

Gastrointestinal health can also be a complicated issue, since gut disturbances may stem from many different causes, whether it’s a bug picked up from poor food handling practices, a side effect of medications, or one of the symptoms of an underlying disease or infection (such as HIV) that requires treatment in itself. Identifying the root cause or causes of gastrointestinal problems can be a major challenge, and of course we urge you to work with your healthcare provider to sort that question out, especially if your condition lingers, becomes acute, or has an impact on your ability to go about your daily life.

Below we present various tips, tricks, news and research notes, all designed to help you maintain good gastrointestinal health, or find help when things are not going so well in your digestive tract.

Probiotics. These are “friendly” microorganisms that can re-balance the ecology of your gut. Probiotics are well-known for their benefit to digestive health, and especially for their ability to resolve some types of diarrhea. Here are the major types stocked by NYBC: bifidus (as Bifidus Balance/Jarrow); lactobacillus/bifidus (as Jarrodophilus/Jarrow—needs refrigeration); lactobacillus/bifidus (as Jarrodophilus EPS–needs no refrigeration); and Saccharomyces boulardii (as Florastor from Biocodex—needs no refrigeration).
Some NYBC members find that using Jarrodophilus every other day keeps diarrhea away. (And it’s actually cheaper than getting the probiotics from yogurt—though admittedly not quite so tasty or nutritious.) Another approach: try the green foods supplement Pro Greens (Nutricology), which has a rich variety of nutrients, but also includes a substantial lactobacillus/bifidus component. The BioCodex product Florastor, meanwhile, is most often used for antibiotic-associated diarrhea or to avoid “traveler’s diarrhea” (when started in advance of the trip).

Research note, as reported last year by John James in the online AIDS Treatment News Daily Alerts. The note deals with C. difficile, a diarrhea-producing infection that’s on the rise, and is often a lingering byproduct of antibiotic treatment: “A recent meta-analysis of 31 studies compiled and published in the American Journal of Gastroenterology concluded that S. boulardii is the only probiotic that is effective in fighting recurrent C. diff-associated disease. […] ‘Because Florastor (S. boulardii) is a yeast and not a bacteria, it is not killed by the strong antibiotics that are being used to kill the C. diff bacteria, so it survives in the digestive tract,’ says [researcher] Dr. Raymond. ‘When the ‘baby’ C. diff emerge from their spores, they are greeted by a well-colonized gut, rather than an empty playground.’”

Glutamine and other supplements to prevent diarrhea and maintain body weight. In the era of antiretroviral therapy, weight loss has become less of a problem for people with HIV. Yet maintaining muscle mass over time remains a big concern, and one key to that is controlling diarrhea, which deprives the body of needed protein and other essential nutrients.

One frequently used remedy for diarrhea is the amino acid glutamine. It has been studied for leaky gut syndrome, which results when intestinal tissues are damaged, and also has a long history of application to maldigestion in people with HIV. Anecdotally, people with protease-inhibitor diarrhea find relief using 30-40 grams per day. Start with about 15 grams per day and increase the dose until the diarrhea is controlled. A daily maintenance dose is about five grams a day. Note that glutamine is best taken in three daily doses.

Research note: A well-designed study published in the journal Nutrition found that a glutamine-antioxidant regimen was effective at helping HIV+ people with weight loss to regain body weight. The regimen included glutamine (40 g per day), along with vitamin C (800 mg), vitamin E (500 IU), beta-carotene (27,000 IU), selenium (280 mcg), and N-acetylcysteine (2,400 mg). People who took the supplements showed significant weight gain in 12 weeks, while participants taking a placebo did not.

Other supplements have also been used to counteract malabsorption and diarrhea associated with HIV and/or HIV medications:

Calcium: two Canadian studies from 2004 and 2005 re-affirm the thinking that calcium carbonate can be useful in controlling protease inhibitor-related diarrhea. Calcium supplements have long been used for this purpose by buyers’ club members; see the recommendations under “Digestive Maintenance” on the NYBC website for details.

Soluble fiber such as apple pectin, oat bran, and flax seed. For some people, soluble fiber can help food stay in the digestive tract for longer periods of time, increasing the amount of nutrients that are absorbed, and lessening bowel frequency.

Traditional botanicals/remedies for gastrointestinal health. NYBC stocks two formulas produced by the well-regarded California-based developers of herbals, Health Concerns and Pacific BioLogic. Both formulas are derived from traditional schools of herbal medicine (Chinese or Tibetan), but are also informed by modern clinical practice. Here are the indications for use supplied by the manufacturers:

Quiet Digestion (Health Concerns). Used to reduce gastric distress including pain, cramping, nausea, vomiting, diarrhea, regurgitation, poor appetite; addresses viral or bacterial gastroenteritis as well as motion sickness, hangover and jet lag effects.

GI Tract: Gastro Regulator (formerly Digest Ease) from Pacific BioLogic. Derived from a Tibetan medicine formula, it is designed to help the function of the gastrointestinal tract, helping to optimize the course of digestion and colonic function, particularly problems arising from bad dietary habits. There may be a brief period of diarrhea or constipation at the beginning of using this product.

Recently an NYBC member called our attention to Mastic Gum, a resin traditionally used in the Eastern Mediterranean as a remedy for heartburn, and generally to protect the stomach and duodenum. Now there’s intriguing new research supporting use of mastic for gastrointestinal health and perhaps additional purposes as well:

1. A study published in 2007 found evidence that mastic could help prevent or manage prostate cancer. This prostate-protective effect may be achieved via an inhibition of nF-KB–interestingly, that’s a cellular protein that HIV also hijacks to help produce more of itself.

2. Another recent study looked at use of 2.22 grams of mastic/day among patients with Crohn’s disease (a chronic, debilitating bowel disorder). Not only did this dosage help in this small pilot study, but two markers of inflammation were significantly reduced: interleukin-6 and C-reactive protein. Again, it’s of interest that both markers are also often elevated in HIV disease.

TheBody.com booklet: “The HIVer’s Guide to Coping with Diarrhea & Other Gut Side Effects.” NYBC recommends this thorough and easy-to-read booklet, which has been reviewed by HIV specialist physicians, and also includes case studies of people with HIV who have worked through some typical gastrointestinal problems. It can be read online, or ordered from thebody.com at http://www.thebody.com/content/art13137.html.
Here’s a capsule summary of the 29-page booklet:

Gastrointestinal or gut problems–diarrhea, nausea, indigestion, gas, loss of appetite–are very common for people with HIV, with consequences ranging from temporary to very serious. This booklet takes you through the common causes: HIV meds, other meds or supplements, the effects of HIV itself, your diet, psychological triggers, or other health problems (such as parasites). It then sorts through some of the most used remedies, including over-the-counter drugs, supplements, prescription meds, or changing your diet or your HIV drug regimen.

For further information, please also see individual product entries in the “Digestive Maintenance” section of the NYBC catalog. In addition to the items mentioned above in our “Quick Guide,” you’ll also find here our recommendations in the category of digestive enzymes:

DIGESTIVE MAINTENANCE

Glutamine and other supplements for gastrointestinal health (and to maintain lean muscle mass): Looking at Westerly Market’s online information about managing HIV/AIDS

Before there was Whole Foods, a friend likes to remind us, there was the Westerly Natural Market on Manhattan’s West Side. One of the nice things about Westerly, we’ve just been informed by the same person, is that they offer a very user-friendly website for those interested in getting more information about supplements, herbs, and how these substances or other “complementary and alternative” therapies are used for various conditions.

So, we took a look at the Westerly website’s Reference Library entry on HIV and AIDS, and found a concise account with several good points. One of these, we thought, was the discussion about maintaining muscle mass and preventing diarrhea, which over time deprives the body of needed protein. Here’s an excerpt:

Using certain supplements may help in maintaining body weight. A well-designed study compared the use of a daily supplement regimen that included enormous amounts of the amino acid glutamine (40 g per day), along with vitamin C (800 mg), vitamin E (500 IU), beta-carotene (27,000 IU), selenium (280 mcg), and N-acetyl cysteine (2,400 mg) to placebo. People who took the supplements gained significantly more weight after 12 weeks than those who took the placebo.

Glutamine is a key supplement here, and has long been recommended by NYBC and its predecessor DAAIR for gastrointestinal support. See the NYBC entry

Glutamine Powder

or

Glutamine Capsules

Note that N-acetyl cysteine, Vitamin C and Vitamin E, beta carotene (as Carotenall), and selenium are also available through NYBC’s purchasing co-op–follow the links to see specific recommendations in each category.