Image by Adrian from Pixabay

July 3, 2023 

Literature Review:

1) Is loneliness tied to an increase in death risk? A new study in Nature says yes to a degree of the pooled effect size of 1.32 for all cause mortality. (Wang et. al. 2023) In effect, that is a very large effect of the variable loneliness on death risk. Why would this be? Many reasons come to mind. The greatest of which is the control that our mind wields on our immune system.

If we think in negative and in sad terms over a period of time, the immune system will shift into a pro inflammatory state and weakened pathogen killing which has massive downstream effects on physiology.

2) In an impressive inoculation study in the UK, researchers gave the ancestral strain of SARS2 to test subjects and then followed them for 2 weeks in quarantine. They noted some interesting findings1) symptom severity did NOT correlate with viral spread; 2) of the 34 test subjects, only 2 individuals accounted for 86% of all airborne spread noting the superspreader reality is real; 3) most of the spread occurs via the nasal passageway and not the mouth; 4) there was almost no viral transmission occurring before a patient was symptomatic. (Zhou et. al. 2023)

This study was done with the much less transmissible alpha variant ancestral strain. The new Omicron variants are much more infectious by 10-17x and less morbid to humans. The key here is that it is only a small part of the infected that drive most disease. Finding the reasons as to why they spread it so well is a worthy goal.

3) There is always a heated debate regarding the benefits of a multi mineral multi vitamin MM/MVsupplement in medicine. In a new small study from the Linus Pauling Institute we see the following: 35 men (>67 years) were given an MM/MV supplement to assess changes in blood micronutrient biomarkers from baseline to the six month mark. They assessed micronutrient levels and basal O2 consumption in immune monocytes as an indicator of cellular metabolism. The supplement improved blood levels of vitamins A, B6, D and E. The placebo group showed declines in blood vitamin concentrations. Supplementation did not significantly affect blood mineral levels of calcium, copper, iron, magnesium, and zinc. Supplementation did prevent the decline in immune cell monocyte O2 consumption rate. (Michels et. al. 2023)

This is a very small study but it does layer in some possibilities of enhanced cellular activity and metabolism. I believe that a diverse diet is key but adding a quality cofactor delivery supplement has logic in a world that doesn't espouse healthy eating nor adequacy of micronutrients. For teens, I love Garden of Life's prenatal and MV for men.

4) When the mitochondria in a cell burn calories for fuel and ATP generation they release oxidant byproducts that are chemically unstable leading to cellular damage if unchecked. In the journal PNAS, we see this reality play out in the brain's hippocampus and memory centers. From the study: "Dietary flavanols are food constituents found in certain fruits and vegetables that have been linked to cognitive aging." In this study of 3562 adults randomly assigned to 500 mg of cocoa flavanols versus placebo over 3 years, we note that flavanol intake positively correlated with hippocampal dependent memory function. The higher the flavanol level, the better the response. (Brickman et. al. 2023) This is straightforward data. We have a mechanism as to how falvanols help us. Flavanols will increase the production of nitric oxide synthase which leads to decreased inflammation and vascular dilation all of which improves cerebral perfusion and neuronal activity. They also act by increasing the production of BDNF which increases neuron production and survival over time. These effects are very useful if they occur in the hippocampus. (Socci et. al. 2017)

Food sources include: Cocoa, onions, scallions, kale, broccoli, apples, berries, camellia sinensis teas.

5) Breastfeeding for 1 year or longer is a cognitive benefit to the child. The study entitled: Association between breastfeeding duration and educational achievement in England: results from the Millennium Cohort Study was published in the British Medical Journal this year. The study: "Approximately 5000 children were included. Longer breastfeeding was associated with better educational outcomes. For example, after full adjustment for socioeconomic markers and maternal cognitive ability, in comparison with children who were never breastfed, those who were breastfed for longer were more likely to have a high pass in their English and Mathematics GCSEs, and less likely to fail the English GCSE (but not the Mathematics GCSE). Additionally, compared with those never breastfed, those breastfed for at least 4 months had, on average, a 2–3 point higher attainment 8 score."(Pereyra-Elias et. al. 2023) I can think of a million physiological reasons for the why this outcome has occurred, but ultimately it is the natural path that leads to the best outcomes regardless of the why. Just breastfeed should be a new slogan.

6) A new publication in cell further discusses research that I am a proponent of, microbial transfer at birth. In the Journal Cell Host and Microbe: "The microbiomes of cesarean-born infants differ from vaginally delivered infants and are associated with increased disease risks. Vaginal microbiota transfer (VMT) to newborns may reverse C-section-related microbiome disturbances. Here, we evaluated the effect of VMT by exposing newborns to maternal vaginal fluids and assessing neurodevelopment, as well as the fecal microbiota and metabolome. Sixty-eight cesarean-delivered infants were randomly assigned a VMT or saline gauze intervention immediately after delivery in a triple-blind manner. Adverse events were not significantly different between the two groups. Infant neurodevelopment, as measured by the Ages and Stages Questionnaire (ASQ-3) score at 6 months, was significantly higher with VMT than saline. VMT significantly accelerated gut microbiota maturation and regulated levels of certain fecal metabolites and metabolic functions, including carbohydrate, energy, and amino acid metabolisms, within 42 days after birth. Overall, VMT is likely safe and may partially normalize neurodevelopment and the fecal microbiome in cesarean-delivered infants." (Zhou et. al. 2023)

This is such an important study. A naturally occurring event should not need to be studied in order to be a part of our therapy for healthy c sectioned mother child dyads, but alas it is still not recommended. This study furthers the expected knowledge that cesaerian sections are taking away a natural microbial maternal to child transfer event. I am of the belief that vaginal microbial transfers should be the standard of care now.

7) In the Journal Nature Microbiology, Dr. Johansen and colleagues looked at the viruses in the gut of centenarians to understand the viromes effect on living long and fruitful lives. This is a fascinating new area of research. The virome or the collection of viruses that reside within our intestines are turning out to have bacterial modulating and suppressing effects. From the paper: "Distinct gut microbiome ecology may be implicated in the prevention of aging-related diseases as it influences systemic immune function and resistance to infections. Yet, the viral component of the microbiome throughout different stages in life remains unexplored. Here we present a characterization of the centenarian gut virome using previously published metagenomes from 195 individuals from Japan and Sardinia. Compared with gut viromes of younger adults (>18 yr) and older individuals (>60 yr), centenarians had a more diverse virome including previously undescribed viral genera, such as viruses associated with Clostridia. A population shift towards higher lytic activity was also observed. Finally, we investigated phage-encoded auxiliary functions that influence bacterial physiology, which revealed an enrichment of genes supporting key steps in sulfate metabolic pathways. Phage and bacterial members of the centenarian microbiome displayed an increased potential for converting methionine to homocysteine, sulfate to sulfide and taurine to sulfide. A greater metabolic output of microbial hydrogen sulfide in centenarians may in turn support mucosal integrity and resistance to pathobionts." (Johansen et. al. 2023)

So fascinating! These viruses have the machinery to influence the lysis and killing of certain bacteria to maintain a homeostatic environment all the while also influencing metabolism of these microbes.

8) The brain of humans is supposed to receive signals of satiety from the gut via hormones and neuroactive peptides in order to turn off the hunger and foraging behaviors that are making many Americans obese. In a new study in the Journal Nature Metabolism, we see a single blinded crossover study looking at these responses. From the study: "We show that intragastric glucose and lipid infusions induce orosensory-independent and preference-independent, nutrient-specific cerebral neuronal activity and striatal dopamine release in lean participants. In contrast, participants with obesity have severely impaired brain responses to post-ingestive nutrients. Importantly, the impaired neuronal responses are not restored after diet-induced weight loss. Impaired neuronal responses to nutritional signals may contribute to overeating and obesity, and ongoing resistance to post-ingestive nutrient signals after significant weight loss may in part explain the high rate of weight regain after successful weight loss." (van Galen et. al. 2023 )

This is yet another study in the reality that once a person adds the fat tissue to the body, the microbiome and the downstream lipid signals are all fighting against weight loss. This is a very large problem.

Dr. M

Wang Nature

Canas Gonzalez Front Psych

Graham Engeland Brain Behavior Immunity

Osimo Brain Behavior Immunity

Zhou Lancet Microbe

Michels Nutrients

Brickman PNAS

Socci Front Nutrition

Pereyra Elias BMJ

Zhou Cell Host Microbe

Johansen Nature Microb

van Galen Nature Metabolism