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The Healthy Gut Plan

If you want to lose stubborn, bulgy fat, eliminate food allergies, constipation, leaky gut, cellulite, brain fog, eczema (and other skin conditions) and PMS Forever then The Healthy Gut Plan is the perfect program for you! Created by Laura Thompson, a top Nutritional Therapist with 25 years of experience working as a weight loss specialist. You'll get to discover the second brain secret to a healthy body which happens to be your gut. However, a leaky gut can lead to inflammation and a source of the majority of illnesses. All the same, you'll learn how to restore your leaky gut through the 4-step process of Remove, Replace, Repair, Rebalance and maintain. On downloading the program, you'll get a simple to follow Healthy Gut Plan. The dos and don'ts of effortless fat loss that took Laura Thompson almost 25 years to learn, distill and compile. A complete 21 day and six-week meal plan along with super gut ingredients to almost double your results. A simple, safe, supplement program for turning your gut and body into a fat-burning machine. Also included are some healthy gut delicious recipes. Continue reading...

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Gastrointestinal Conditions

Oral Aloe vera Is a popular treatment for a variety of gastrointestinal disorders. It has been shown to improve different parameters of gastrointestinal function in normal subjects, such as colonic bacterial activity, gastrointestinal pH, stool specific gravity and gastrointestinal motility (Bland 1986). Due to its anthraquinone content, it is used as a stimulant laxative.

Lactose Digestion and Gastrointestinal Function

Lactose is hydrolyzed at the intestinal jejunal brush border by the enzyme lactase into its absorbable monosaccharides glucose and galactose. Lactase activity is robust during infancy and, as is the case in humans and most mammals, declines after weaning. Accordingly, the general pattern of lactase non-persistence is a continuous decline in genetically programmed populations. A shifting pattern of lactose digestion and gastrointestinal function is a result of lactase nonpersistence. The pattern can be described and monitored during three distinct clinical phases. Initially, many reports treated the population studied as a single unit and paid incomplete attention to age-specific considerations. Distinctions between secondary lactose malabsorption due to short-term intestinal injury and primary lactose malabsorption that has a genetic basis were not always made. This introduced additional confounding variables. Differences in an individual's capacity to hydrolyze and tolerate a lactose...

Bacterial overgrowth

The small intestine normally supports a large number of bacterial flora. These are normally kept in check by intestinal peristalsis, the acidity of chyme leaving the stomach, and the secretion of immunoglobulins into the intestinal lumen by mucosal cells. If one or more of these factors is reduced, bacterial overgrowth may result in malabsorption. Diagnosis is by aspiration of the contents of the jejunum, which will reveal increased numbers of both aerobic and anaerobic organisms. If bacterial overgrowth is present, enzymes in the bacteria can inactivate bile acids, leading to fat malabsorption. The gut flora may catabolise ingested proteins, metabolise sugars and bind vitamin B12. Bacterial overgrowth is treated with antibiotics.

Gaining Acceptance of Microbial Endocrinology

Further, the bidirectional nature of bacterial neuroendocrine interactions contained within the theory of microbial endocrinology also suggests that bacteria can influence mammalian function. More recent work utilizing metabolomics to compare the blood metabolic profile of conventional-reared and germ-free mice revealed that the gut microbiome contributed to the concentration of neuroactive components in the circulation (Wikoff et al. 2009). That the presence of a micro-bial community within the gut, and inherent interactions between the host and gut microflora, is crucial to an animal's neurological health was demonstrated in 2004 when Nobuyuki Sudo and colleagues at Kyushu University in Japan examined the role of microbial colonization on the hypothalamic-pituitary-adrenal response to stress in gnotobiotic, germ-free, and conventionally-reared mice (Sudo et al. 2004). Not only did the development of host neural systems that control the physiological response to stress depend on...

Whither Microbial Endocrinology

Microbial endocrinology in many ways represents an interdisciplinary discipline that seeks to understand the role of microbes in health and disease that is driven fundamentally by an evolutionary approach (see Chap. 2 for a discussion of the ubiquitous distribution of neuroactive compounds throughout nature). Although much has been made of the use of the term interdisciplinary (and the many variants such as multidisciplinary), the take home message may be that in approaching a study of neuroactive compounds in microbiology, microbial endocrinology represents an opportunity for true interaction of microbiologists with individuals from disciplines not readily associated with the study of microbial processes, such as physiologists, endocrinologists, and behaviorists, to name a few. The accumulated evidence which suggests the ability of the gut microbiota to play a role not only in host neural development and function, but in overall behavior as well, has recently been addressed in an...

Enteroendocrine Cells

Mucosal enteroendocrine cells constitute the largest mass of endocrine cells in the body. They are distributed diffusely along the length of the intestine where they are poised to sample luminal contents and come into contact with mucosa-associated bacteria. Compared to animals with normal gut microbiota, germ-free animals manifest differences in the numbers and hormonal contents of enteroendocrine cells

A look at nonspecific host defenses 821 Physical barriers

Initial access of foodborne pathogens into the body is barred by physical barriers established by enterocytes, by the mucous layer coating the intestinal mucosal surface, and by the continual motion of the gastrointestinal tract provided by peristalsis. While these physical barriers provide a highly effective defense against foodborne pathogens, microbial mechanisms of evasion have evolved. Enterocytes or intestinal epithelial cells (IEC) form a cohesive barrier preventing ready access of pathogens and many other agents to the internal tissues beyond. These multifunctional cells are active in nutrient transport, exchange of water and electrolytes, hormone production, and also form a protective barrier at the gastrointestinal mucosal interface. In addition to all these roles, IEC are now acknowledged as interactive participants in the mucosal immune response, mediating crosstalk between bacteria in the gut and cells of the gut-associated lymphoid tissue (reviewed in Lu and Walker, 2001...

Documenting a Diagnosis of Food Allergy

Another common problem is the misinterpretation of a sequence of events. For example, a child with an ear infection is given an antibiotic, and 3 days later gets diarrhea, so the parents come to believe the child is allergic to the antibiotic. In fact the cause of the diarrhea is far more likely to be either an underlying viral infection, or a disturbance of the gut flora. Another example is the report of a child who is believed to be allergic to sesame seeds because of reactions occurring after eating buns coated with sesame seeds many such children are in fact not allergic to sesame seeds but are reacting to the egg glaze that has been used as an adhesive for the seed coating. Another common example is the child with asthma who coughs and wheezes after drinking a diluted orange squash drink, with the result that it is believed that the child is reacting to the yellow-orange coloring agent tartrazine. If fact such reactions are more likely to be due to sulfite preservatives in the...

Summary of Research and Conclusions

When ingested, the active flaxseed lignan SECO (se-coisolariciresinol) and a variety of other plant lignans are acted on by gut bacteria to produce the mammalian lignans enterodiol and enterolactone, which then circulate in the plasma. Enterolactone appears to be more potent than enterodiol against cancer cells and it has been the subject of at least seven in-vitro studies.66, 72-77 As a whole, these studies found that enterolactone inhibited proliferation of several cancer cells lines at concentrations of 10 to 50 jM.

Irritable Bowel Syndrome

People suffering from IBS sometimes experience symptoms of abdominal cramping and either diarrhoea or constipation or a combination of both. Although the aetiology of IBS is still unknown, there is growing suspicion that there is a persistent, mild inflammatory state with changes in mucosal function or structure and an associated imbalance of intestinal flora (Camilleri 2006). This imbalance can lead to inefficient metabolism of nutrients and the formation of gas and short-chain fatty acids, both of which induce propulsive contractions and accelerate colonic transit or enhance fluid and sodium absorption in the colon. As such, clinical trials have been conducted to clarify the role of probiotics in this condition, so far producing promising results. In a 4-week, double-blind placebo-controlled trial, 60 people with IBS were treated with L. plantarum or placebo. The patients recorded their own gastrointestinal function, starting 2 weeks before the study and continuing throughout the...

Assessment of the Stressed Mucosa

Small intestinal health is pivotal to whole body health and the bioavailability of drugs but it is difficult to assess it in animals and humans. Current invasive techniques such as endoscopy and biopsy are painful, invasive, expensive and not necessarily representative of gastrointestinal function. The recent advance of wireless capsule endoscopy may change our ability to visualize the bowel but again not its functionality.

Starch Use In Bakery Applications

Interaction of starch of gluten-free flours with gums influences the food matrix Interaction with microbial metabolites and microorganisms during fluid fermentation processes in bakery and retention of a wide spectrum of ligand molecules (i.e., butanol and n-pentanol) Interaction with microorganisms Interaction with gut microbiota a fraction of starch (RS) escapes digestion and plays an important role in human health Starch interactions with gut microbiota

Pharmacological Management of Undernutrition

Gynecomastia and hypoglycemia were noted furthermore, the increase in muscle bulk failed to produce a parallel increase in muscle strength. Inadequate data regarding the safety and efficacy of growth hormone administration precludes routine clinical use. Similarly, the role of insulin-like growth factor (IGF-I) in the management of undernutrition is questionable. Although the data suggest that exo-genously administered IGF-I may enhance nitrogen retention, gluconeogenesis, and maintenance of normal gastrointestinal function, evidence-based outcome studies are lacking.

Hivaids Complications

A second complication is that of weight loss and wasting. According to Derek Macallan, in Wasting HIV Infection and AIDS, wasting may be either acute (associated with a secondary disease) or chronic (associated with gastrointestinal disease), and is the result of a variety of processes, including drug use, medications, concurrent disease, and HIV itself. HIV infection causes abnormal protein and fat metabolism. During episodes of acute wasting the patient may require a prescription for steroids, to help support tissue maintenance and tissue development, in combination with optimal protein and calories in the diet. Contributing to weight loss and wasting is malabsorption (the failure of nutritional substances to be absorbed in the intestines). Malabsorption occurs in advanced cases of HIV infection when gastrointestinal disease is present. Diseases that can cause malabsorption in HIV AIDS patients include Kaposi's sarcoma, non-Hodgkin's lymphoma, cytomegalovirus, Mycobacterium avium...

What supplements should I take

Vitamin C, taken in generous doses (such as 3g or more over the day), is the primary nutrient to help prevent cancer and, indeed, to promote good health. High levels of vitamin C may cause slight diarrhoea - if this occurs, reduce the amount slightly, then gradually increase back to the original amount, or even more if your gut will tolerate this vital anti-cancer substance. Do not suddenly cease this supplementation, however to do so may result in deficiency symptoms as the body has got used to high amounts in circulation.

Dual energy Xray absortiometry DEXA A

Use of certain drugs (clofibrate, estrogens, and bile acid sequestrants), and presence of gastrointestinal disease. Gallstones sometimes develop during dieting for weight reduction. There is an increased risk for gallstones and acute gallbladder disease during severe caloric restriction. Glucose tolerance The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach blood sugar should return to normal in 2 to 2M hours after ingestion.

Substance P NKi receptor antagonists

Substance Headache

Abstract Stress responses involve changes in hormone secretion, respiration, cardiovascular, and gastrointestinal function, and behavior in order to prepare an organism to respond to perceived or actual danger. They are orchestrated by neural circuits including the amygdala, brainstem, and hypothalamus. Substance P is a peptide neurotransmitter that is expressed within these neural pathways and can activate various physiological systems in a manner consistent with an integrated stress response. Preliminary clinical trials using highly selective substance P (NK) receptor) antagonists (SPAs) have shown promising findings in patients with stress-related disorders (major depression, irritable bowel syndrome and social phobia). These observations suggest that substance P in the brain is involved in the pathophysiology of stress-related disorders and that SPAs may provide a novel approach to pharmacotherapy. Gastrointestinal function Acute, traumatic stressors can cause marked perturbations...

Oral Cavity and Alimentary Tract

Intestinal motility is reduced with aging as a result of functional changes in the visceral nerves. With decreased transit the residence time of the chyme on the absorptive surfaces is longer, compensating for any senescence in the mucosal uptake itself. The reduction in motility produces the most noticeable and notorious of the manifestations of intestinal health in older persons, namely reduced frequency of defecations.

Drugs Used to Treat Infectious Diseases

Ampicillin (Trades names Amcill, Omnipen, Polycillin, Principen) A penicillin-type semisynthetic antibiotic used to treat conditions caused by a broad spectrum of gram-negative and gram-positive organisms in the urinary, respiratory, biliary, and intestinal tracts. Some of these conditions include cystitis, bronchitis, gonorrhea, typhoid fever, and ear and eye infections. It is inactivated by penicillinase, and therefore cannot be used against organisms that produce this enzyme. ciprofloxacin (Trade name Cipro) An antimicrobial used to treat lower respiratory and urinary tract infection, infections of skin, bone and joints, and gastrointestinal disease. It is administered by mouth or IV. neomycin (Trade names Mycifradin, Myciguent, Neobiotic) An aminoglycoside antibiotic used to treat infections of the intestine, eyes, and (topically) of the skin caused by a wide range of bacteria. It is usually applied in creams or drops with other antibiotics, but it can also be given by mouth....

Epidural anaesthesia analgesia

And its contents tend to occupy a greater proportion of space. Hence, a given volume of drugs affects a greater number of segments the more cranially it is introduced. The epidural space contains nerve roots, fat, spinal arteries and lymphatics, as well as a valveless venous system that communicates directly with both the intracranial sinuses via the basovertebral veins and the general circulation via the azygos vein. Dorsal and ventral spinal nerve roots covered by dura mater pass across the epidural space and drugs within this space can act on any nerve that traverses it - whether it be motor, sensory or autonomic. Epidural analgesics may prevent the release of neurotransmitters from afferent pain fibres, block receptors to neurotransmitters released by primary afferent pain fibres or interrupt the transmission of pain-related information in the dorsal horn of the spinal cord. Drugs introduced into the epidural space also have the potential to pass into the brain and the general...

Solanaceae Nightshade family

One benefit of lycium that is generally accepted is to promote a healthy gut flora, while lowering bad LDL and VLDL cholesterol levels in the bloodstream. The berries serve to stabilize the capillaries, veins, and arteries throughout the body. They work on thread and varicose veins, and fragile capillaries that bleed under the skin. They also help to reduce narrowing of the arteries (atherosclerosis), thereby benefiting cold hands and feet.

Absorption Transport and Storage Status Measurement

The contribution of the gut flora to the available pantothenate for humans is unknown, but there is some evidence that bacterial synthesis of the vitamin may be important in animals, especially ruminants, since severe deficiency can only be achieved by using antibiotics or antagonists. Clinical conditions such as ulcers or colitis can adversely affect pantothenate status and excretion rates, and dietary fiber may affect its absorption.

Acquired immunity to foodborne pathogens

T cell priming in the presence of IL-4 and absence of IL-12 results in development of a TH2 T cell response in which T cells are induced to secrete IL-4, IL-5 and IL-13 (Mosmann, 1986 Murphy and Reiner, 2002 Finkelman et al., 2004). Such a reaction is essential for host resistance to intestinal nematode parasites such as Trichinella spiralis through induction of local mast cell mastocytosis, eosinophilia and IgE responses that lead to worm expulsion in the mouse model (Finkelman et al., 2004). In addition, direct effects of IL-4 and IL-13 on non-bone marrow-derived cells in the intestine give rise to increased mucus production and increased smooth muscle contractility that also contribute to elimination of the parasite (Finkelman et al., 2004). Interestingly, the ability of intestinal helminth infection to induce a robust TH2 response has suggested that such infections may actually protect against TH1-mediated colitis (including Crohn's disease) by skewing the cytokine profile away...

Health Effects of Carbohydrates

High intakes of NSP, in the range of 4-32 gday-1, have been shown to contribute to the prevention and treatment of constipation. Population studies have linked the prevalence of hemorrhoids, diverticular disease, and appendicitis to NSP intakes, although there are several dietary and lifestyle confounding factors that could directly affect these relationships. High-carbohydrate diets may be related to bacterial growth in the gut and subsequent reduction of acute infective gastrointestinal disease risk.

Nonplant Myrosinases

Apart from the GSL-producing plant genera, myrosinase enzymes have also been characterized in insects, fungi, and bacteria (37). Endogenous myrosinase have been identified in the cabbage aphid Brevicoryne brassicae and the mustard aphid Liaphis erysimi. However, from a human nutritional perspective nonplant myrosinases present in bacteria are of greater importance. Microbial myrosinases have been isolated from Aspergillus niger, Aspergillus sydowi, and, more significantly, the gut bacteria Enterobacter cloacae (38,39). Indeed, the bacterial metabolism of sinigrin to its ITC and as yet other unidentified metabolites has been demonstrated by human microflora in vitro (40). Metabolism of sinigrin to its respective ITC in gnotobiotic rats inoculated with the human faecal bacteria Bacteriodes thetaiotaomicron has also been described. However, as yet no attempts have been made to characterize the bacterial myrosinase enzyme involved (41). The GSL myrosinase system is pivotal in the...

Population Groups at Risk of Vitamin K Deficiency

Because of the minimal extent of transfer of vitamin K across the placenta, the fetus and newborn infant have much lower circulating vitamin K than adults (typically 30-fold lower). In addition, human milk has a lower concentration of the vitamin than that of most other mammalian species. Although low vitamin K levels have not been found to affect the developing fetus in a functionally deleterious way, it is clear that the newborn, and especially the solely breast-fed infant, is at higher risk of functional deficiency than older infants and adults. In a minority of cases, this can lead to life-threatening or long-term damage associated with intracranial bleeding. Hemorrhagic disease of the newborn (HDN) is classified as early (first 24 h of life), classic (days 1-7), or late (2-12 weeks). Of these, the third category is most likely to involve dangerous intracranial bleeding. Risk factors for HDN include intestinal fat malabsorption and hepatic disease. In Western countries, since the...

Enteropathy Caused by Food Hypersensitivity

Mechanisms inducing oral tolerance are in general not complete at birth but develop postnatally, mainly in response or intimate relation to the gut flora and to activation of specific Toll-like receptors on regulatory T cells 1, 18 . The key role of the luminal bacteria is highlighted by the impaired tolerance in germfree mice 1 , by the different intestinal flora in populations that will develop atopy, by the immune-modulatory properties of specific probiotics and by the promising results of interventional studies. Allergic infants showed, even before the appearance of symptoms, a significantly higher prevalence of clostridia, coliforms and Stapkylococcus aureus versus lactobacilli and Bifidobacterium (bifidum). Manipulation of the gut flora as early as in the first days or months of life may influence through microenvironment modification and competition subsequent colonization and expression of regulatory cytokines. Specific probiotics including LGG may induce anti-inflammatory...

Modulating host nonspecific defenses to foodborne pathogens

Prebiotics are defined as 'non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and or activity of one or a limited number of indigenous bacteria' (Gibson and Roberfroid, 1995). Pre-biotics act by selectively stimulating growth of certain intestinal microbes with potential health-promoting effects, and they are used with the aim of controlling the gut microflora in a beneficial manner (reviewed in Roy, 2004). Prebiotics in the form of nondigestible oligosaccharides, which are resistant to digestion in the upper gastrointestinal tract but are broken down and fermented in the large intestine, are used to promote the growth of Bifidobacteria and Lactobacilli. This increases the production of short-chain fatty acids, which can then provide energy for the host and alter fecal pH (reviewed in Farnworth, 2001). An additional mechanism through which prebiotics may act to reduce host susceptibility to infection is to act as 'decoys' for...

Route of Nutrition in Malabsorption

Several factors need to be considered when recommending whether oral, enteral, or parenteral nutrition should be used to provide nutrition to the patient with malabsorption, including etiology of malabsorption, severity of gastrointestinal disease, and underlying nutritional and medical condition. Oral nutrition using modified diets as noted previously is the most customary and desirable by physician and patient alike. In cases of mild lactose malabsorption, modification of a regular, healthy diet to avoid foods high in lactose should be sufficient. In cases in which widespread gastrointestinal disease is leading to severe malabsorption, enteral or 'tube' feeding is helpful for two main reasons (i) Use of proprietary formulas specially designed for malabsorption is often indicated, and these formulas may be unpalatable, and (ii) enteral feedings, especially slow continuous 'drip' feedings, make efficient use of nutrient transport kinetics, thereby maximizing residual gastrointestinal...

Necrotizing enterocolitis

Necrotizing enterocolitis (NEC) This gastrointestinal disease primarily affects premature infants, infecting, inflaming, and eventually destroying part of the infant's bowel. Although it affects only one infant in 2,000 to 4,000 births, (up to 5 percent of neonatal intensive care unit admissions), it is the most common and serious gastrointestinal disorder among hospitalized preterm infants. Necrotizing enterocolitis (NEC) typically begins within the first two weeks of life, because premature infants have immature bowels that are sensitive to changes in blood flow and prone to infection. They may have difficulty with blood and oxygen circulation and digestion, which increases their chances of developing NEC. However, the exact cause of NEC is unknown. Experts suspect that the intestinal tissues of premature infants are weakened by too little oxygen or blood flow, and when milk feedings are begun, the added stress of moving food through the intestine allows bacteria to damage the...

Metabolic Effects Of Lupine Kernel Fiber

Important metabolic effects of DF for reducing the risk of CVD, diabetes, and cancer were originally suggested by Burkitt (1969) in his DF-hypothesis. A number of reviewers have examined studies concerning the relationship between DF consumption and the incidence of CVD and gastrointestinal disease, and most of them have found protective effects for one or both classes of disease. LKFiber is a novel food ingredient containing both soluble and insoluble fiber fractions. The objective oftwo human intervention studies was to examine the broader physiological effects of LKFiber (L. angustifolius Boregine) on different stool and digestive parameters in humans. The administration of the tested LKFiber at a dose of 25 g DF day over 2 weeks (study 1, pure LKFiber) or 4 weeks (study 2, LKFiber-enriched food) was well tolerated by the subjects. The LKFiber interventions resulted in a significantly higher daily fecal mass and daily fecal dry matter. Consequently, the frequency of defecations was...

Functional Interactions

Alterations in the GI microflora Alterations in the GI microflora may affect the availability of nutrients produced by the normal gut flora, such as vitamin B12'. Since many drugs are susceptible to bacterial metabolism, changes in the gut flora may also affect drug bioavailability. In certain cases, drug cleavage by intestinal microorganisms is an expected and necessary step for adequate drug action. For example, the anti-inflammatory agent 5-aminosalicylic acid is given as its precursor sulfasalazine, which is converted into the active compound by colonic bacteria. An altered colonic flora will affect the production of the active compound. Drugs can also affect nutrient absorption by directly inhibiting protein synthesis in the enterocyte. Since most transport systems require active protein synthesis and turnover, such inhibition results in a decreased rate of nutrient absorption. Furthermore, certain drugs undergo initial metabolism in the enterocyte, before reaching the...

Microbial Polymerization Activity

The production of glucan and levan from sucrose by Lactobacillus reuteri and the production of a levan-type fructan by L. sanfranciscensis have been described by van Geel-Shutten et al. (1998). As suggested by Di Cagno et al. (2006), the synthesis of the previously mentioned EPS by sourdough LAB could be considered as a useful tool to replace the commercial additives used for improving the texture of baked goods. The fructan from L. sanfranciscensis has been found to positively affect dough rheology and bread texture. Moreover, glucan, fructans, and gluco- and fructooligosaccharides have potential gut health-promoting properties (Poutanen et al, 2009). Fructose oligosaccharides and inulin are increasingly used as prebiotic additives in baked goods. They are not digested by pancreatic enzymes and thus are available for metabolism by intestinal microorganisms, mainly Bifidobacteria (Tieking et al, 2003). In general, EPS are reported to be able to replace hydrocolloids currently used for...

Food and Nutrient Intakes of College Students

Which is important for intestinal health. In terms of vitamins, a low vitamin C status has been associated with college students' low intake of fruits and vegetables (with levels of vitamin C being even lower among smokers). In terms of minerals, calcium, iron, and zinc intake are low, while sodium intake is generally higher than recommended.

Using calcium in functional food products

Generally, functional foods are neither dietetic products nor food supplements, but processed foods with distinctive added-value features such as health and well-being. In order to be able to differentiate themselves from the established products, food companies use specific health claims, among which the link between calcium and bone health is one of the most widely used and accepted claims worldwide. According to Leatherhead Food International (2005), the functional foods market in the five major European markets, the United States, Japan and Australia had a combined turnover of US 9.9 billion in 2003. Leatherhead uses a strict definition, measuring only products that make genuine functional health claims. By country, this can be broken down as follows Japan, 45.3 United States, 26.9 France, 7.2 UK, 7.1 Spain, 5.5 Germany, 4.9 Italy, 1.9 Australia, 1.2 . Total sales are expected to increase by 16 per annum over the next 5 years to reach US 21 billion by 2008, with Japan accounting...

Background And Relevant Pharmacokinetics

The generally accepted definition of a probiotic is 'a live microbial food supplement which beneficially affects the host animal by improving its intestinal microbial balance'. This definition is, however, rather limited as some probiotics are transient and do not take up residence in the intestinal tract. A better definition may be ' a microbial dietary supplement that beneficially affect the host physiology by modulating mucosal and systemic immunity, as well as improving nutritional and microbial balance of the intestinal tract' (Salminen et al 1998). The gastrointestinal tract is sterile at birth. Normal gut flora develops gradually over time and is influenced by factors such as composition of the maternal gut microflora, diet, degree of hygiene, use of antibiotics or other medication, the environment and possibly genetic aspects. Once established, a person's individual gut flora remains surprisingly constant throughout life. This is likely to be due to the fact that the gut...

Toward a Mechanism of Stressor Induced Alterations in Microflora

It is tempting to speculate on the mechanisms through which the intestinal microflora could have been altered by stressful pregnancy conditions. For example, it is known that cortisol can affect many aspects of infant development, and many of the effects of prenatal stress on the immune system can be mimicked by administration of ACTH or the synthetic glucocorticoid, dexamethasone (Coe et al. 1996). And, others have found that giving corticosterone to pregnant rats significantly reduced the concentrations of total and Gram-negative aerobes and facultative anaerobes (Schiffrin et al. 1993). The mechanisms through which glucocorticoids might affect the microflora are not known, but fetal development of the gi tract is thought to be influenced by glucocorticoids. For example, maturation of the intestines occurs concomitantly with the prepartum surge in cortisol in pre-cocial species, such as pigs, sheep, and humans (Trahair and Sangild 1997). Moreover, very high levels of glucocorticoids...

Vertical integration of agricultural production

Bacteria can become resistant to the antibiotics used in feed. The US Food and Drug Administration (FDA) concluded in October 2000 that two antibiotics used in poultry had spawned drug resistance (Consumer Reports, 2005b). Soil and waterborne bacteria seem to be acquiring tetracycline resistance genes from bacteria originating in pigs' guts (Ananthaswamy, 2001). Prophylactic feeding of antibiotics to animals can lead to the emergence of resistant strains of gut bacteria, such as Salmonella and hence enhance pathogenic risks.

Absorption Transport and Storage

Studies with these model systems have shown that the transport of riboflavin at low (e.g., micromolar) concentrations is temperature- and energy-dependent (it is inhibited by inhibitors of ATP production from energy substrates), it becomes saturated as the concentration of riboflavin increases, and it is sodium ion dependent. These characteristics are shared with many other types of small molecules that are actively transported across the gut wall. More specifically for riboflavin, the active transport mechanism involves phosphorylation (to riboflavin phosphate, also known as flavin mononucleotide, or FMN) followed by dephosphorylation, both occurring within the intestinal cells (Figure 1). This latter process is not shared by several other B vitamins, but it is one of a number of common strategies which the gut may use to entrap essential nutrients, and then relocate them, in a controlled manner and direction. A similar strategy is employed at other sites in the body, to ensure...

Naproxen

Naproxen's primary drawback is that it may slightly increase the risk of heart attack and stroke, especially if taken long-term. The risk for gastrointestinal disease is also increased, including such problems as heartburn, ulcers, and gastritis. Other side effects that may occur with naproxen include diarrhea or constipation, mouth sores, headache, dizziness, ringing in the ears, and light-headedness. As with ibuprofen, some people are more susceptible to side effects than others.

Crohns Disease

Crohn's disease may affect any part of the gut (most commonly the ileum and colon) with patchy mucosal ulceration and transmural inflammation due to excess (Th1 and macrophages) immune activation, increased free radicals and overexpression of matrix metalloproteinases. Crohn's disease results from a complex interaction among immune, genetic and environmental factors producing a dysregulated immune response to the gut flora. Tolerance to autologous flora appears to be lost and thus the luminal 'content' represents a persistent driving factor of the cell-mediated inflammatory process further stimulated by a possible defective response to (selected ) pathogens. The concept that the enteric flora is of profound importance in the development of Crohn's disease is supported by the absence of disease in germ-free conditions, by the recognition that a specific disease-associated gene such as Nod-2 encodes an intracellular molecule important in the inflammatory response to bacterial...

Psychological Stress

Several recent reviews 10, 11 have discussed the role of psychological stress in the pathophysiology of gastrointestinal disease. The stress response is complex and involves a number of regions in the brain and brain stem together with somatic and visceral afferents and the endocrine system (fig. 1). condition may predispose to an increased intestinal permeability and potentially contribute to altered motility in different regions of the gastrointestinal tract. Surrogate markers including fecal calprotectin (a neutrophil-specific protein) and intestinal permeability have been suggested as discriminators of organic versus nonorganic disease 14 . Carbohydrate malabsorption, particularly fructose and lactose, are also prominent in IBS and may contribute to symptoms 15 .

Phytoestrogens

After ingestion, the glycones daidzin and genistin are hydrolyzed by gut bacterial glucosidases and by mammalian intestinal lactase phlorizin hydrolase to release the aglycones genistein and daidzein. These may be absorbed or further metabolized. Although most studies suggest that the bioavailabilities of genistein and daidzein are similar, some indicate greater bioavailability for genistein. Daidzein can be metabolized by the gut microflora to form the isoflavan equol (oestrogenic and more potent anti-oxidant than daidzein) or O-desmethylangolensin (O-DMA nonoestrogenic), whereas genistein is metabolized to the nonoestrogenic p-ethyl phenol. In studies, only approximately 35 of subjects are able to convert daidzein to equol. Interindividual variation in the ability to metabolize daidzein to equol could thus influence the potential health protective effects of soya isoflavones. Equol is produced in greater amounts by subjects who consume diets that are low in fat and high in...

Concluding Remarks

I will briefly summarize the part on allergy and gastrointestinal disease before we go on with the last three talks on nutrition in the preterm baby. The first part of the meeting focused on allergy and Dr. Wahn gave us an introductory lecture showing the complex interaction between the genetic background and the environmental determinants leading to allergic manifestations and to the allergic phenotype, and several times he certainly stressed the importance of cats. Dr. Fuchs talked about the clinical aspect of chronic enteropathy and he showed that there are many causes of chronic enteropathy, but they differ between the developed and the developing world. Chronic enteropathy in developing countries is still a major cause of death in children, more than 1 million per year, and there is a direct interaction between intestinal mucosal injury, malnutrition and impaired immunity. Recovery is dependent on the proper nutritional management and the rehabilitation of that nutrition. Dr....

Polyps

Juvenile Polyp And Inflammatory Polyp

Intestinal polyps are intraluminal protuberant tumors characterized by their gross morphological appearance, location(s), number, size, and presence (pedunculated) or absence (sessile) of a stalk. Additional salient features include specific histological features used to discriminate between types and to aid in predicting malignant potential. Extraintestinal manifestations are also associated with specific poly-posis syndromes. Syndromes associated with juvenile polyps are summarized in Table 4. Other intestinal polyposis syndromes are outlined in Table 5. Increased intestinal mucus Diagnosis Presence of adherent organisms on small intestinal rectal biopsy Treatment Travel to endemic areas a risk factor Large intestinal commensal organism Transmission Person-to-person contact Contaminated food water (cysts) Figure 2 Endoscopic view of colonic polyps in a patient with juvenile polyposis col. (Reproduced with permission from Kleinman RE, Gilger MA, Braverman RM, Finegold MS, Hawkins EP,...

The Bran Layer

The bran layer is the outer thick-walled structure of the grain. It is rich in B vitamins and phytonutrients such as flavonoids and indoles plus a small amount of protein. It also contains antioxidant compounds including phytoestrogens such as lignans and isofla-vones. These hormonally active compounds, similar to estrogen, may influence sex hormone metabolism and may impact on hormone-related disease. The bran also contains factors that may decrease bioa-vailability of nutrients such as phytic acid, tannins, and enzyme inhibitors. It is also where the bulk of insoluble fiber is found. The insoluble fiber contained within the bran layer has long been recognized to play an important role in intestinal health, by optimizing bowel transit time and increasing fecal weight. But some of the health benefits associated with a high-fiber diet may come from other

Niacin

Quinolinate Phosphoribosyl Transferase

Nicotinamide nucleotides present in the intestinal lumen are hydrolyzed to nicotinamide. A number of intestinal bacteria have high nicotinamide deami-dase activity, and a significant proportion of dietary nicotinamide may be deamidated in the intestinal lumen. Both nicotinic acid and nicotinamide are absorbed from the small intestine by a sodium-dependent saturable process. Pellagra was a major problem of public health in the early part of the twentieth century and continued to be a problem until the 1980s in some parts of the world. It is now rare, although there were reports of outbreaks among refugees in Africa (Malfait et al., 1993), and occasional cases are reported in alcoholics in developed countries and among people being treated with isoniazid (Section 8.5.6) and some other drugs, and people with chronic gastrointestinal disease.

Cyp3a4

Oral estrogens undergo phase II hepatic metabolism to form glucuronide and sulfate conjugates that are excreted in bile. GI flora hydrolyze these conjugates, allowing for reabsorption of estrogens and maintenance of their pharmacologic effect. Consequently, breakthrough bleeding and pregnancies have been reported with use of oral contraceptives and antibiotics 14 . The estimated likelihood of this interaction is rare (approximately 1 ), and the recommendation to counsel patients about the potential for oral contraceptive failure remains controversial 14 . Alteration in gut flora that synthesize vitamin K is also thought to be one of the mechanisms by which b-lactams interact with warfarin. Warfarin exerts its anticoagulant effect by inhibiting the synthesis of vitamin K-dependent clotting factors and has a high potential for drug and food interactions 15 . Reducing endogenous vitamin K production can augment the effect of warfarin. In addition, semisynthetic cephalosporins such as...

Enteral Formulas

Isotonic formulas with fiber These formulas contain soluble and insoluble fibers that are most often soy based. Physiologically, fiber-based solutions delay intestinal transit time and may reduce the incidence of diarrhea compared with nonfiber solutions. Fibers stimulate pancreatic lipase activity and are degraded by gut bacteria into short-chain fatty acids, an important fuel for colonocytes. There are no contraindications for using fiber-containing formulas in critically ill patients.

Digestive Processes

The gut bacteria carry out a number of biochemical functions, including deconjugation and dehydroylation of bile acids, the conversion of bilirubin to urobilinogen, the metabolism of cholesterol to coprostanol, production of vitamins K, B1, B2, B6, B12 and generation of short-chain fatty acids. Probiotics are involved in balancing colonic microbiota and aid in the treatment of diarrhoea associated with travel and antibiotic therapy, and control of rotavirus and Clostridium difficile-induced colitis.

Clostridia

Clostridium perfringens and C. botulinum are potentially pathogenic microorganisms that are often contaminants in fresh meat. They are strictly anaerobic bacteria that may be present in the normal gut flora of animals and humans. They are spore-forming bacteria enabling them to survive in unfavourable environments, which present a challenge in food preservation.

Other Conditions

Glutamine is a popular supplement in naturopathic practice and sometimes used for conditions that may be associated with compromised intestinal permeability such as food allergies, leaky gut syndrome and malabsorption syndromes, including diarrhoea. It may also be used for conditions such as dermatitis and general fatigue based on the theory that compromised intestinal permeability provides the opportunity for undigested food particles (especially proteins) to enter the systemic circulation and gives rise to an unwanted immune response that manifests as a skin reaction or lethargy.

Probiotic Effects

Living microorganisms have long been used as supplements to restore gut health at times of dysfunction. It is clear that different strains from a given microbial group may possess different properties. It is thus important to establish which specific microbial strain may have a beneficial effect on the host even closely related strains can have significantly different or even counteracting effects. Their properties and characteristics should thus be well defined studies using closely related strains cannot be extrapolated to support each other. been shown that changes in intestinal microflora composition precede the development of some allergic diseases, indicating a potential area for probiotic application. LGG given prenatally to mothers and during the first months to infants with a high risk of atopic disease has reduced the prevalence of atopic eczema to about half in the infants receiving the strain. Furthermore, extensively

Medical History

One specific focus of medical history in a nutritional assessment context is the exploration of gastrointestinal function. Conditions such as chronic diarrhea, gastroesophageal reflux, and colonic disorders may be associated with reduced nutrient absorption or food avoidance that result in impaired nutritional status. Past history of gastrointestinal problems and or surgery may also point to current alterations in nutrient digestion or absorption. Other important components of the medical history are history of weight loss or gain, past and present use of medications, use of special foods or formulas, changes in taste or smell, and food allergies and intolerances.

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