November 26, 2022

New review investigates vitamin D supplementation in patients with IBS

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to a study published last month in Nutrients, researchers investigated the effects of vitamin D supplementation to see if it causes any improvements in the symptoms of IBS.

This systematic review and meta-analysis included all studies published until April 4, 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcome including primary Irritable Bowel Severity Scoring System (IBS-SSS) and secondary IBS quality of life (IBS-QoL) as well as serum vitamin D 25-OH was performed in six databases. The research team included 6 studies consisting of a total of 616 patients.

As a result, the pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS. However, the pooled analysis favored vitamin D over placebo regarding increasing the serum level of vitamin D 15-OH and improving the IBS-QoL.

Vitamin D can impact the gastrointestinal tract by its immunomodulatory properties. In the pathogenesis of IBS, immunological and inflammatory roles are important as research has suggested that the activation of inflammatory mediators have a crucial role in the development of IBS development. For example, the upregulated mast cells, T-cells, and other pro-inflammatory cytokines are a few known key factors.

In addition, the increased inflammation upregulates the neural activity in the intestine leading to visceral hypersensitivity as well as abdominal pain. On the other hand, decreased inflammation can improve the sensory nervous system in the gut, causing normalization of gut functionality and reduced IBS symptoms. This can be explained by the presence of vitamin D receptors in the nervous system as they play a role in the synthesis, maintenance, and upregulation of neurotransmitters levels.

The gastrointestinal tract is the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains such as Saccharomyces cerevisiae CNCM I-3856 that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Abuelazm M, Muhammad S, et al. The Effect of Vitamin D Supplementation on the Severity of Symptoms and the Quality of Life in Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 14(13), 2618.

 

New study demonstrates the correlations between vitamin D levels and peripheral arterial stiffness in chronic kidney disease

Over 10% of the adult population suffer from chronic kidney disease (CKD). The two leading underlying causes of end-stage kidney disease are due to type II diabetes and hypertension.

According to a new study published yesterday in Nutrients, researchers investigated the relationship between serum vitamin D 25-OH levels and brachial-ankle pulse wave velocity (baPWV) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Vitamin D deficiency and baPWV are both independently associated with higher incidence of mortality and cardiovascular disease or cardiovascular events.

Vitamin D has an established role in mineral homeostasis and musculoskeletal function. Vitamin D is also known to exert extra-skeletal effects including modulation of endothelial function, immune function, inflammatory responses, and cell cycle regulation.

In addition, a vitamin D deficiency has been associated with albuminuria and impaired renal function in the general population as well as all-cause mortality and kidney failure requiring long-term dialysis in pre-diabetic and type II diabetes patients.

This study consisted of 180 patients with chronic kidney disease stage three to five from a renal outpatient department between January and December 2016. Assessments included serum vitamin D 25-OH levels and BaPWV. Either left or right baPWV > 18.0 m/s was considered indicative of peripheral arterial stiffness (PAS).

In this study, 73 patients (41%) were shown to have PAS. Compared to those without PAS, patients with PAS were older and had higher incidence of diabetes mellitus, higher blood pressure, higher parathyroid hormone levels, higher C-reactive protein levels, and lower levels of vitamin D levels. As a result, lower vitamin D levels and increased age were associated with PAS in patients with CKD.

Other nutrients to consider include fiber, resistant starch, fish oil, phosphatidylcholine, and n-acetyl-cysteine or glutathione.Fish oil supplementation has been shown to decrease protein in the urine as well as protect kidney function and slow the rate of kidney dysfunction. Doses up to 10 grams per day have been used.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Lee Chun-Jen, Hsieh Yi-Jen, et al. Correlation between Serum 25-Hydroxyvitamin D Level and Peripheral Arterial Stiffness in Chronic Kidney Disease Stage 3–5 Patients. 11 June 2022, Nutrients, 14(12), 2429.

New study demonstrates vitamin B6 status influences essential fatty acid status

B vitamins and omega-3 fatty acids are essential nutrients involved in numerous metabolic processes that play a significant role in cognitive health.

Previous research suggests a potential impact of aging and the relationship of vitamin B6

on polyunsaturated fatty acid (PUFA) metabolism. Limited information is known about the interrelationships between vitamin B6 and PUFAs in the elderly population.

According to a study published earlier this month in Nutrients, researchers investigated the associations of vitamin B6 intake and plasma pyridoxal 5-phosphate (PLP) levels along with plasma PUFA concentrations and ratios in older adults. In addition, they further investigated the relationship of adequate vitamin B6 status with high plasma PUFA compared to a deficient vitamin B6 status.

This cross-sectional study consisted of 461 participants at the age of 60 years and older from NHANES 2003–2004. Nutrient intakes were assessed using two 24-h recalls and supplement questionnaires. Vitamin B6 and PUFA concentrations were assessed. As a result, a higher vitamin B6 level in older adults was associated with a higher level of EPA, DHA, EPA + DHA, EPA/AA, and (EPA + DHA)/AA. Also, adequate vitamin B6 status was associated with high EPA and EPA/AA status. These findings demonstrate that sufficient vitamin B6 status positively effects PUFA metabolism in older adults.

I previously shared the importance b-vitamin and its relationship to omega-3 status in cognitive health. There was an interesting study published January 6, 2016 in the Journal of Alzheimer’s Disease. Prior studies have already established that B vitamins can slow cognitive decline in the elderly. This was most effective in those who had above average homocysteine levels, which is a common biomarker related to B vitamin status that may be toxic to the brain.  The research team found that there was a link between Omega-3 levels, homocysteine, and brain atrophy rates. There has been links between homocysteine and omega-3 fatty acids. As a result, B vitamins are essential for the synthesis of phospholipids.  In this study researchers investigated whether omega-3 fatty acid status had an effect on the treatment of B vitamins in mild cognitive impairment (MCI).

Two hundred and sixty-six participants with MCI over 70 year of age were randomized to B vitamins (folic acid, vitamins B6 and B12) or placebo for 2 years. Researchers performed baseline cognitive test performance, clinical dementia rating (CDR) scale, and plasma concentrations of homocysteine, DHA, and EPA fatty acids. The final results for verbal delayed recall, global cognition, and CDR were better in the B vitamin-treated group according to increasing baseline concentrations of omega-3 fatty acids. In contrast, the scores in the placebo group were similar across these concentrations. Among those with good omega-3 status, 33% of those on B vitamin treatment had global CDR scores >0 compared with 59% among those on placebo. Among all 3 outcome measures, higher concentrations of DHA alone significantly improved the cognitive effects of B vitamins, whereas EPA appeared to be less effective.

This study demonstrated that B vitamins had no effect on cognitive decline in MCI when omega-3 levels are low. However, when omega-3 levels are in an upper normal range, B vitamins slow cognitive decline and brain atrophy. These findings suggest that a combination of fish oil supplements and B vitamins may help to improve cognition and reduce age-related memory decline.

In conclusion, there are important synergistic interrelationships between omega-3 and b-vitamins. These studies demonstrate the importance of a comprehensive approach nutritionally and not a monotherapy approach.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Kim Hyojung, Enrione Evelyn B, et al. Associations of Vitamin B6 Intake and Plasma Pyridoxal 5′-Phosphate with Plasma Polyunsaturated Fatty Acids in US Older Adults: Findings from NHANES 2003-2004. Nutrients. 2022 Jun2;14(11):2336.

Abderrahim Oulhaja, Fredrik Jerneren, Helga Refsum, A. David Smith, Celeste A. de Jager. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. Journal of Alzheimer’s Disease, vol. 50, no. 2, pp. 547-557, 2016.  

New review investigates the effects of omega-3 supplementation on skeletal muscle in older adults

Aging is associated with chronic low-grade inflammation, sarcopenia and functional decline. The loss of muscle mass between the ages of 40 and 80 is approximately between 30% and 60% and is associated with disability, illness, and death. Age-related musculoskeletal decline is a significant risk for falls in the elderly.

Exercise and nutritional supplementation are currently recommended as preventative against the loss of muscle and muscle strength, however, most of the nutritional studies have focused on protein supplementation. Since sarcopenia is associated with increased inflammation and impaired glucose homeostasis, omega-3-fatty have also been investigated.

According to a new review published today in Nutrients, researchers investigated the effects of omega-3 fatty acids on alone and combined with resistance exercise on skeletal muscle in the elderly.

This systemic review and meta-analysis included 15 randomized controlled trials and one randomized, non-controlled trial consisting of 2,438 participants (1,660 females, 778 males). Dosing ranged from as little as 230 mg of EPA/DHA up to 5 grams of fish oil and one study used 14 grams of flaxseed oil. The study durations ranged from 6 weeks to 36 months.

As a result, this review demonstrated that omega-3 supplementation does not impact lean tissue mass but does improve lower body strength as wells as lower body functional performance. Supplementation was effective when taken alone, but less when taken in conjunction with resistance training. No impacts were observed for walking speed.

There finding are significant as lower body strength is preferentially affected by aging and sarcopenic individuals suffer from reduced functional performance. Tests such as the timed-up-and-go and sit-to-stand test were improved with omega-3 supplementation and are important predictors of functional ability in older adults.

Omega-3 fatty acids are incorporated into the cell membranes and improve the ability to recruit motor units enhancing the neuronal activation of muscle.

These findings demonstrate a role of the effects of omega-3 fatty acids on muscle mass. Other nutrients to consider patients with sarcopenia include vitamin D, magnesium, vitamin C, collagen, BCAAs, tocotrienols, and probiotics.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Cornish S, Cordingley D, et al. Effects of Omega-3 Supplementation Alone and Combined with Resistance Exercise on Skeletal Muscle in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2022, 14(11), 2222.

 

New review demonstrates the benefits of blueberry supplementation in patients with metabolic syndrome

Metabolic syndrome and insulin resistance are a significant health care problem in the United States. Type 2 diabetes affects more than 300 million people.

Insulin resistance is preventable and reversible through lifestyle changes, proper nutrition, supplements, exercise and stress management. Weight loss and exercise are the best treatments for restoring the body’s ability to respond to insulin.

According to a new review published two weeks ago in Food and Function, researchers investigated the effect of blueberry supplementation on different biomarkers in patients with metabolic syndrome. Blueberries are rich in flavonoids, which contain powerful antioxidant and anti-inflammatory properties.

This review consisted of 25 studies between published between 2007 and 2021. These studies ranged from 3 weeks to 24 weeks in length with a dosage of 13 grams to 300 grams as well as two using extracts. The results of review demonstrated a significant improvement in blood pressure, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol, and insulin levels. Anthocyanins found in blueberries have a role in regulating key enzymes involved in cholesterol metabolism. All but three studies concluded that blueberry consumption positively impacted insulin resistance.

In addition, anthocyanins found in blueberries have a role in regulating key enzymes involved in cholesterol metabolism. Blueberry supplementation also showed a significant effect on body weight reduction but not waist circumference or body mass index (BMI).

A diet rich in blueberries decreases the production of free radicals due to their antioxidant capacity. This review demonstrates that blueberry supplementation should be considered in patients with metabolic syndrome.

Inositol is another nutrient that should also be considered for patients with diabetes.

Inositol acts as second messenger which regulates several hormones such as thyroid stimulating hormone and insulin.

Studies have shown that an inositol deficiency is common in patients with insulin resistance. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of insulin resistance. As a result, the nutritional requirements of these patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these individuals.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Azari H, Morovati A, et al. Beneficial effects of blueberry supplementation on the components of metabolic syndrome: a systematic review and meta-analysis. Food Funct. 2022 Apr 21. doi: 10.1039/d1fo03715c

New review investigates the role of resveratrol in MCI and AD

Alzheimer’s disease and related disorders (ADRD) are a group of conditions that cause mild cognitive impairment (MCI) or dementia. These conditions affect one’s ability to function socially, personally, and professionally. It’s important to recognize that Alzheimer’s disease begins long before symptoms start just like many other conditions. There is evidence that simple prevention strategies can reduce the risk of ADRD by as much as 50%.

The prevalence of dementia for those over 65 years of age is 14% in men and 32% in women. By the age of 80, sixty three percent of those with dementia are women.

Resveratrol is a polyphenol with powerful antioxidant and anti-inflammatory properties.  It has been widely publicized for its cardiovascular, anti-carcinogenic, and anti-aging benefits.  However, researchers believe it also has positive effects on the hippocampus, an area of the brain that is critical to functions such as memory, learning and mood.

According to a recent review published last month in the Journal of Medicinal Food, researchers investigated the role of resveratrol in mild cognitive impairment (MCI) and Alzheimer’s disease (AD).

This review consisted of five RCTs studies including three studies in patients with AD and two studies conducted in patients with MCI. These studies included 201 patients: 151 patients with AD and 52 patients with MCI. The patients’ ages ranged between 49 and 80 years of age and dosing on resveratrol was as low as 5 mg up to 1 gram twice daily.  

This review demonstrated that resveratrol supplementation can be an adjuvant to a patients’ therapeutic approach. Resveratrol has both anti-inflammatory and antioxidant effects and is effective in reducing biomarkers and disease scores and as a result, improves overall cognitive performance and improves brain metabolism. This is suggestive of a protective effect of resveratrol against early metabolic decline.

Other brain supportive nutrients to consider are GPC, CDP-choline, gingko biloba, and phosphatidylserine, and fish oil. GPC and CDP-choline are water soluble forms of choline that can cross the blood brain barrier and support brain health. These help make more acetylcholine, neurotransmitters, as well as phosphatidylcholine in the cell membranes. In addition, phosphatidylserine is an essential nutrient for brain function and is not found in the diet. Research has demonstrated that phosphatidylserine improves depressive symptoms, memory, and behavior.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Buglio DS, Marton LT, et al. The Role of Resveratrol in Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review. J Med Food. 2022 Mar 28. doi: 10.1089/jmf.2021.0084.

 

 

 

New study investigates the effect of zinc supplementation on blood glucose levels in type II diabetes

Insulin resistance is preventable and reversible through lifestyle changes, proper nutrition, supplements, exercise and stress management. Weight loss and exercise are the best treatments for restoring the body’s ability to respond to insulin.

Metabolic syndrome and insulin resistance are a significant health care problem in the United States. Type 2 diabetes affects more than 300 million people. Up to 15% of patients cannot take metformin because of kidney damage risks.

There are many different cofactors that can improve dysglycemia such as zinc, alpha lipoic acid, chromium, and vanadium.

According to a study published last month, researchers investigated the effect of zinc supplementation on blood glucose levels in different age groups of type II diabetes.

This randomized placebo-control trial included 144 diabetic patients. All the participants were randomly divided into Group 1 (zinc 20 mg/day) and Group 2 (control group with placebo). Each group was further divided into two age categories: category 1 (30-50 years of age) and category 2 (51-70 Years of age). Data collection included demographic data, anthropometric measurements, and a 24-h dietary recall. Laboratory assessment consisted of fasting glucose levels, HbA1C, and serum zinc levels taken at baseline and at the end of the study 60 days later. 

As a result, final fasting glucose levels were significantly lowered in the zinc supplementation group compared to placebo, however, the results were significant in the older age group (51-70 years). A similar trend was also found in the HbA1c, serum zinc levels and the BMI of the participants. These results demonstrate a better response to zinc supplementation among aged patients as compared to younger group, suggesting possible higher zinc demands with advanced age.

Inositol is another nutrient that should also be considered for patients with diabetes.

Inositol acts as second messenger which regulates several hormones such as thyroid stimulating hormone and insulin.

Studies have shown that an inositol deficiency is common in patients with insulin resistance. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of insulin resistance. As a result, the nutritional requirements of these patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these individuals.

Since diabetes is an increased risk factor for cognitive decline, other nutrients such as phosphatidylserine, GPC, and acetyl-l-carnitine are important. Phosphatidylserine is an essential brain nutrient that has been shown to improve the brain’s energy consumption of glucose.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Aslam M, Bashir S, et al. Effect of zinc supplementation on blood glucose level in different age groups of diabetes type 2. Nutr Health. 2022 Mar 29; 2601060221088382.

New study demonstrates success of IgG food antibody elimination diet patients with IBS

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects. A low-FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) diet is not a new treatment.

According to a study published in the Journal of Clinical Medicine, researchers compared the effectiveness of three different dietary approaches in patients with mixed irritable bowel syndrome. These dietary interventions included a low FODMAP diet, an IgG based elimination diet, or nutrition advice from a gastroenterologist.

This study included 73 female patients diagnosed with mixed irritable bowel syndrome (IBS-M). As a result, there were significant differences in the reduction of IBS symptoms found between the different approaches over an 8-week period. IBS symptoms as well as comorbid symptoms significantly improved or disappeared completely in the IgG food antibody elimination diet. These symptoms included generalized abdominal pain, abdominal pain after a meal, and abdominal pain during defecation. The low FODMAP diet did show some improvement of the IBS symptoms such as reduced mucus in the stool decreased bloating. There were no significant improvements seen by the nutritional advise by the gastroenterologist.

This study demonstrates that various dietary interventions in the treatment of IBS-M patients do not equally affect the course and outcomes of disease management and that everyone patient is unique; therefore, each dietary approach should be personalized as well.

As a result, rotation diets based on IgG food antibody elimination show significantly better results compared to other diets tested. In addition, only the IgG antibody elimination diet demonstrated significant improvements in all the monitored IBS-M symptoms as well as extra-intestinal symptoms.

It is important to note that none of the diets were shown 100% effective. By following an IgG antibody elimination diet some FODMAPs are automatically removed depending on which foods must be avoided. One possible strategy could be to start with the elimination-rotation diet and combining it with a low-FODMAP diet.

Diet is the most effective means to returning balance within the gastrointestinal system. Some patients may need a combination of botanicals, enzymes, and probiotics to optimize the gastrointestinal environment. Certain diagnostic tests may also be beneficial, including stool testing as well as food antibody testing.

The gastrointestinal tract is considered to be the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains such as Saccharomyces cerevisiae CNCM I-3856 that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Ostrowka L, Wasiluk D, et al. Igg Food Antibody Guided Elimination-Rotation Diet Was More Effective than FODMAP Diet and Control Diet in the Treatment of Women with Mixed IBS-Results from an Open Label Study. J Clin Med. 2021 Sep 23;10(19):4317.

New review demonstrates the effects of probiotic supplementation on the immune system in the elderly

As the body ages, the immune system changes and goes through a remodeling process. There is a reduction in immune cell functions which can lead to an increasing risk of infection, viral reactivation, and increased risk of autoimmune disease and cancer.

According to a review published last week in the European Journal of Clinical Nutrition, researchers investigated the effects of probiotic supplementation on natural killer cell function in healthy elderly individuals.

This review included six randomized control trials consisting of 364 healthy individuals over 65 years of age. Five of the studies used Lactobacillus alone or in combination with Bifidobacterum and one study used only Bacillus coagulans. The dosing ranged between 1 billion and 4 billion colony-forming units over a duration of 3 to 12 weeks. As a result, probiotic supplementation significantly increased natural killer (NK) activity in healthy elderly individuals. Natural killer cells are an essential part of the innate immune system and regulating the immune response. NK cells are involved in eliminating viruses and play a role in cancers and autoimmune disorders. This is the first review to only address randomized control trials and markers of NK cell function.

Accumulating research also demonstrates the association of the gut microbiome to health status and aging. There is evidence that age-related changes in the gut microbiome may be related to elevated inflammatory makers and numerous geriatric conditions such as sarcopenia, frailty, and cognitive decline. Probiotics have the potential to rebalance gut microbiota and modulate gut immune response inhibiting the NF-κB pathway as well as control microbial populations, alter cytokine expression, increase secretory IgA, increase natural killer cell activity, and reduce the risk of infections.

Previous research has demonstrated how the gastrointestinal tract changes with aging and how this impacts overall health. As one ages, the gut has an increase in interleukin 6 (IL-6) which causes the immune system to release IL-6 and trigger inflammation.

Increased levels of IL-6 directly lead to increased intestinal permeability with no physical differences seen in its structure. Researchers also demonstrated that there was an association with a decreased immune response to microbes with aging, which may contribute to an increased susceptibility to infection.

These results demonstrate that probiotics can significantly increase immune function and reduce inflammation in middle-age and older adults. Other nutrients to consider for aging, inflammation, and the immune system include tocotrienols, geranylgeraniol, resveratrol, quercetin, and specialized pro-resolving mediators.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Gui Q, Wang A, et al. Effects of probiotic supplementation on natural killer cell function in healthy elderly individuals: a meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2020 Jun 8: 1-8.

New review investigates exercise, diet, and supplementation on the immune system and aging

As the body ages, the immune system changes and goes through a remodeling process. There is a reduction in immune cell functions which can lead to an increasing risk of infection, viral reactivation, and increased risk of autoimmune disease and cancer. These changes are affected by exercise, muscle mass, and nutritional status.

In addition, chronic low grade inflammation has been shown to contribute to almost all chronic disease and has been correlated with aging. After 40 years of age the body’s cells are typically less able to produce antioxidants and soak up free radicals making them more susceptible to damage and death.

According to a review published last month in Nutrients, researchers investigated the effects of exercise, diet, and supplementation on the immune system and aging.

Numerous studies have demonstrated the benefits of exercise on aging and the immune system. Exercise has been shown to increase natural killer cell function. In addition, cross-sectional studies in older adults in highly trained individuals, runners, and cyclists have showed improved function of the adaptive immune system including improved T-cell proliferation, reduced inflammation, and decreased thymus output.

Dietary intake of polyunsaturated fatty acids are also essential for overall health as well as impacting immune function. Studies on omega-3 fatty acid supplementation had dosing ranges of 2 to 3.3 grams per day over a duration of 3 to 6-month period. Supplementation with omega-3 fatty acids significantly reduce kynuerinine levels. Kynuernate is a metabolite of tryptophan, which is elevated in chronic low grade inflammation.

Accumulating research also demonstrates the association of the gut microbiome to health status and aging. There is evidence that age-related changes in the gut microbiome may be related to elevated inflammatory makers and other geriatric conditions such as sarcopenia, frailty, cognitive decline secondary to reduced short chain fatty acid production. Also, the immune system has a tendency to decline with age which makes one more susceptible to infections as well as increasing the risk of chronic disease. Probiotics have the potential to rebalance gut microbiota and modulate gut immune response inhibiting the NF-κB pathway. Probiotics control microbial populations, alter cytokine expression, increase secretory IgA, increase natural killer cell activity, and reduce the risk of infections.

Previous research has demonstrated how the gastrointestinal tract changes with aging and how this impacts overall health. As one ages, the gut has an increase in interleukin 6 (IL-6) which causes the immune system to release IL-6 and trigger inflammation.

Increased levels of IL-6 directly lead to increased intestinal permeability with no physical differences seen in its structure. They also showed there was an association with a decreased immune response to microbes with aging, which may contribute to an increased susceptibility to infection.

Probiotics help encourage microbial diversity, especially if the probiotic supplement is of mixed species. In ecological terms, it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome.

These results suggest that nutritional supplements including both omega-3 fatty acids and probiotics can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. Other nutrients to consider for aging and inflammation and the immune system include tocotrienols, geranylgeraniol, resveratrol, quercetin, and specialized pro-resolving mediators.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Weyh C, Kruger K, et al. Physical Activity and Diet Shape the Immune System during Aging. Nutrients 2020, 12(3), 622.