Gut Instincts

References

They say following your gut is important in living a balanced, healthy life. This is especially true in the realm of gastrointestinal wellness. There are many natural aids to answer the call of distress from within. From maintaining friendly flora to fighting H. pylori, the right therapy can help keep the gut going strong.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), between 60 million and 70 million Americans are afflicted by digestive disease. The cumulative effect includes 50 million physician visits and 10 million hospitalizations annually, with a direct and indirect cost on the economy of more than $107 billion.

Increasing numbers of consumers are managing or treating digestive health conditions, according to the Natural Marketing Institute (NMI). Information from its 2004 Health & Wellness Trends Database showed in 2004, more than 15 percent of households were managing constipation, 14 percent irritable bowel and 4.5 percent stomach ulcer. Consumers do seem willing to enhance their digestive health with natural products. NMI found 31 percent of households had used antioxidants, almost 20 percent had used fiber, and more than 10 percent had used acidophilus in managing digestive health.

Functional foods, those providing health benefits from medically-beneficial ingredients in addition to basic nutrients, including probiotics, were a $25 billion industry in 2006 and projected to gross $39 billion by 2011, according to research from Packaged Facts (www.packagedfacts.com).

The path of digestion is an arduous journey through treacherous environments including stormy seas, acid rains, and dry, desert-like conditions. It can take several daysand nothing comes through unchanged. Sounds like a science fiction novel, but these harsh environments actually exist within the human body at various points in the digestive system.

Basically, the function of digestion is to convert the raw material of food into essential nutrients and byproducts which can then be metabolized by the body into energy. Digestion is broken down into two components, mechanical and chemical.

The mechanical process entails food being chewed and mixed with a powerful concoction of acids (saliva) in the mouth. Salivary enzymes begin the chemical digestion of food by converting starch molecules into less complex sugars. Throughout the process, food is moved along the digestive corridor (esophagus) by peristalsis (an involuntary muscle movement) to the stomach. In this environment where hydrochloric acid reigns, the food is churned with powerful enzymes that chemically denature protein and ionize essential minerals.

When the mixture, now known as chyme, is ready, it enters the small intestine. Over its average 21-foot length, the small intestine digests, absorbs and transports ingested macro and micronutrients. The journey comes to an end, literally, when the unabsorbed substances from the small intestine are transported to the large intestine. In this section of the gastrointestinal (GI) tract, also known as the colon, any remaining essential electrolytes and excess water in the waste material are reabsorbed into the system; the final waste product is then eliminated.

While most people realize the GI tract processes food, it is less well known that about 70 percent of the immune system is located there, including between 400 and 500 bacterial types supporting nutrient production and immune function.

Research in the world of natural GI therapiesincluding pre- and probiotics, digestive enzymes and othersis still a developing field; but, nature offers compounds to assist in the digestion process and ease the pain of distress from within.

Multi-Functional Fiber

Fiber

, a digestive aid and fundamental compound, is classified as soluble or insoluble. Although there is no official list of physiologic functions that a compound should possess to meet the definition of fiber, generally accepted actions include an effect on intestinal function and the improvement of blood lipid parameters.¹ Dietary fibers also typically have a reduced caloric value. Health benefits of consuming fiber include aiding in digestion and maintaining heart health. In fact, the American Heart Association Eating Plan suggests eating foods high in both types of fiber to promote cardiovascular wellness. The use of soluble dietary fibers (such as guar gum, locust bean gum and psyllium), resistant starch and other slowly digestible carbohydrates has been shown to alter food structure, texture and viscosity and, hence, the rates of starch degradation during digestion, according to a New Zealand review.² Furthermore, There is an association between the rate of carbohydrate degradation during digestion, and the regulation of postprandial blood sugar and insulin levels, wrote the reviewers.

In addition, while Spanish reviewers did not find sufficient evidence to recommend the systematic use of fiber formulas in total enteral nutrition (EN), they noted: In critically-ill and postsurgery patients, the use of formulas with fermentable fiber tends to reduce the incidence of diarrhea.³

For those looking to add whole food soluble fiber to the diet, the National Institutes of Health (NIH) identifies some food sources with higher quantities of soluble fiber as: psyllium (Plantago ovata Forsk) seeds, prunes, lima beans, kidney beans and Brussels sprouts. Important to elimination, psyllium seed contains the bioactive mucilage polysaccharide (refined psyllium seed husk), the psyllium component principally used as the soluble fiber source for laxatives, cereals and nutritional supplements, according to the Physicians Desk Reference (PDR). Psyllium is a soluble gel-forming fiber that has been shown to bind to the bile acids in the gut and prevent their normal reabsorption, similar to the bile acid sequestrant drugs.⁴

An added fiber bonus for diabetics, blood glucose control was demonstrated by FenuLife (Frutarom); compared to several popular food fibers, known for high viscosity properties, including psyllium husk, Fenulife was the most efficient in successfully binding glucose.⁵ Potato fiber and apple fiber performed significantly lower. Experiments conducted to determine the viscosities of both soluble and insoluble dietary fibers found rice bran, soy hulls and wood cellulose had the lowest viscosities, whereas guar gum, psyllium and xanthan gum had the highest viscosities, regardless of concentration.⁶ These viscous characteristics (as seen through small intestine simulation) indicate potential for these fibers to elicit blood glucose and lipid attenuation, researchers concluded. Another study comparing the efficacy and safety of psyllium seeds as compared with mesalamine in maintaining remission in ulcerative colitis (intestinal inflammation) concluded psyllium seeds might be as effective as the pharmaceutical treatment.⁷ Another soluble fiber, glucomannan from the konjac plant, demonstrated effectiveness as a natural laxative by increasing stool bulk and also improving colonic ecology in healthy adults.⁸ The placebo-controlled study out of Taiwan, supported by KGM, found konjac glucomannan significantly promoted the fecal concentrations of lactobacilli (P < 0.05) and total bacteria (P < 0.05), and promoted the daily output of bifidobacteria (P < 0.05), lactobacilli (P < 0.05), and total bacteria (P < 0.05) in eight healthy adults consuming KGM (1.5 g/meal, 4.5 g/ d) over 21 days. Glucomannan also promoted colonic fermentation as shown in the decreased fecal pH (P < 0.05) and increased fecal short-chain fatty acid concentrations (P < 0.05). Researchers concluded glucomannan in a low-fiber diet promoted defecation frequency in healthy adults, possibly by increasing the stool bulk, thus promoting the growth of lactic acid bacteria and colonic fermentation.

Pumping up supplemental fiber proved positive in adding stool bulk and providing the benefits of both soluble and insoluble fiber in two studies jointly reported in the Journal of Medicinal Food.⁹ In the study, 26 healthy young adults consumed up to 15 g/d of fiber as flax or psyllium supplement for two weeks once usual fecal weights were established. An increase in fecal weight was found with both fiber treatments. Supplemental fiber at intakes of 9.0 g/d (flax) and 10.4 g/d (psyllium) gave fecal bulking capacity of about 2.9 and 4.8 g of fecal weight/g of fiber, respectively. In study 2, the effect of flax bread versus control white bread on glycemic response was studied. Eleven fasting subjects completed four test periods (duplicate trials on each bread) under standardized glycemic testing conditions. Paired tests were used to analyze test compared with control peak blood glucose values and area under the curve (AUC). Peak blood glucose values and AUC were improved by ingestion of flax fiber in healthy subjects.

And consider a new type of insoluble fiber from the pea hull. In a six-week intervention study from Denmark, 1 g to 3 g/serving given to 17 institutionalized elderly was highly significant in improving bowel movements compared to wheat bran.¹⁰ The researchers concluded pea fiber may prove beneficial as a fiber supplement for diabetics.

The bulking effect of a proprietary fiber (as FIBREX, Danisco) has also been demonstrated in both animals and humans. One rat study comparing different fiber sources (guar, pectin, FIBREX, wheat bran), showed in terms of the effect per gram of dietary fiber, wheat bran had the greatest effect; but, since FIBREX contains 50- to 60-percent more dietary fiber per gram of product, the bulking effect exceeded that of the wheat bran.¹¹ And a German study demonstrated positive results in the bulking effect on five adults at the University of Edinburgh where 12 g fiber supplement (10 g were FIBREX) produced a fecal mass of increase of 3.3 g per gram of added fiber.¹²

Yet another insoluble fiber, fructooligosacharides (FOS), is a non-digestible form of carbohydrate that occurs naturally in a wide variety of plant foods, and acts as a prebiotic, supporting the growth of beneficial gut bacteria. When FOS reach the colon, they are used by bifidobacteria for growth. A healthy population of these good bacteria in the digestive tract enhances the digestion and absorption of nutrients,¹³ detoxification and elimination processes, and helps boost the immune system.¹⁴

Food for healthy bacteria, NutraFlora® (from GTC Nutrition) short-chain FOS (scFOS®), is a soluble fiber digested by the beneficial strains of gut bacteria.^15,16,17 This fermentation process produces short chain fatty acids (SCFA). SCFA promote protective effects on the gut and host, such as increased gut integrity enhanced immunity through pathogen inhibition, improved normal bowel function, and improved nutrient metabolism and absorption, without adverse effects, said Coni Francis, Ph.D., R.D., senior manager science, marketing and technical services, GTC Nutrition.

Similarly, inulin, a term applied to a heterogeneous blend of fructose polymers found widely distributed in nature,¹⁸ is considered a prebiotic because it is a nondigestible food ingredient that selectively stimulates growth and/or activity of a number of potentially health-stimulating intestinal bacteria.¹⁹ Inulin is well proven as a conjunction therapy to probiotics^20,21 due to it actions stimulating bifidobacteria growth in the intestine.²²

Larch Arabinogalactan (LAG), as FiberAid® from LONZA, a naturally occurring, soluble dietary fiber extracted from larch (L.occidentalis) tree offers a concentrated form of arabinogalactana digestive health boon. According to Joanne Slavin, Ph.D., R.D. lead researcher, and professor, Department of Food Science and Nutrition at the University of Minnesota, Rochester, LAG demonstrated broad physiological benefits including increased anaerobes in the gut and aided bowel habit. The results from Slavins research,²³ have shown LAG provides digestive health benefits with minimal gas and bloating commonly associated with other dietary fiber ingredients; and enhances a healthy colon by acting as a food source for the growth of friendly bacteria.

Maintaining Friendly Cultures

Recently, there has been increased awareness among consumers of the potential of probiotic and prebiotic therapies to restore balance to the GI tract and reduce intestinal inflammation.

Although the native culture in the colon is relatively stable throughout adulthood, agerelated changes in the GI tract, diet and immune system inevitably affect microflora culture composition. Probiotics are microbial supplements capable of re-colonizing the bowel with nonpathogenic strains of bacteria or yeast. Together with prebiotics, they may offer a new therapeutic option for the treatment of inflammatory bowel disease (IBD)^24,25 and improve bowel function by increasing stool frequency and stool weight. However, a greater understanding of the mechanisms behind their action on the gastrointestinal microbiota is required in order to determine which probiotic, prebiotic or combinations are the most beneficial.²⁶

Recent studies indicate shifts in the composition of the intestinal microbiota, which may lead to a greater susceptibility to disease. According to a review led by E.J. Woodmansey, at the Smith and Nephew Research Centre in Heslington, England, and published in Journal of Applied Microbiology, therapeutic strategies to counteract these changes have been suggested in the elderly.²⁷ These include dietary supplements containing prebiotics, probiotics and a combination of both of these, synbiotics. Limited feeding trials show promising results with these supplements, although further longer-term investigations are required to substantiate their use in elderly healthcare fields, wrote Woodmansey.

S.K. Dash, Ph.D., founder of UAS Laboratories, addressed various digestive conditions and various benefits of probiotics in A Consumers Guide to Probiotics: A number of factors are responsible for the lack of friendly cultures in our intestinal tract. Beneficial microflora are reduced by excessive use of antibiotics, chlorinated water, food preservatives, junk foods, and pollution in our environment.

But their right probiotic recipe for good gut health is very specific. As Dash wrote: A probiotic supplement can only be effective if it contains the right strain(s), in the right number (potency), in the right condition (viable) and in the right formulation.

The research shows the strength of probiotics lie in their ability to break down lactose and produce lactic acid to help acidify the GI tract; deconstructing protein to free up amino acids; and regulating the digestive motion of peristalsis, thus aiding bowel movements and improving nutrient absorption. The array of activities probiotics are involved in include preventing diarrhea²⁸ and constipation.²⁹ In the upper digestive tract, probiotics play a role in balancing Helicobacter pylori (H. pylori) bacteria levels to keep peptic ulcers at bay by minimizing or eradicating H. pylori bacteria in the stomach.³⁰ Researchers out of Dresden, Germany, even found in unclear cases of halitosis (bad breath), an increased formation of intestinal gases should also be considered.31 Xylo-oligosacharide (as XOS, from OptiPure), another prebiotic simple carbohydrate the body does not absorb, functions to balance intestinal flora. It demonstrated its effects in an unpublished Chinese study of 42 subjects with habitual constipation. Each were given 1.4 g/d servings of XOS. During treatment, antibiotics and other related bacterial controls, as well as other drugs affecting GI digestion and function, were halted. After two weeks of treatment, 92.9 percent of the patients experienced either complete remission or obvious improvement in their conditions, seeing an increased amount of bowel movements. Another unpublished Chinese study targeted 50 subjects with irritable bowel syndrome (IBS). Each were given 0.7 g/d for two weeks and showed a 90 percent improvement rate; in addition, changes in abdominal pain, distension and dyspepsia within the population were observed, with improvements of 50 percent, 81.1 percent and 57.2 percent, respectively.

Probiotics and prebiotics have the potential to significantly impact progression and treatment of the third most common form of cancer, colorectal cancer, and may have a valuable role in cancer prevention, according to Australian researchers.³²

Prebiotics may also support healthy digestive function by preventing intestinal attachment of enteropathogens by acting as receptor homologues, resulting in the suppression of harmful microorganisms, the stimulation of probiotic growth, or both.³³

Lyophilized probiotic cultures (as LAFTI® L. acidophilus, from DSM Nutritional Products) in capsule form given orally twice daily for three weeks (5 x 109 CFU/day) with a meal had greater beneficial effect than placebo.³⁴ There was a trend of reduced score for the level of diarrhea, constipation, flatulence or bloating during treatment with LAFTI. The difference in average score between treatments with LAFTI L. and placebo was statistically significant, indicating it reduces several of these disturbances.

As a finished product, probiotic tablets (as Immunobiotics®, BioScientifics) using the probiotic blend LiveBac® (Nutraceutix Inc.), were shown in an unpublished clinical study to support immunity by enhancing phagocytosis by monocytes and neutrophils in a healthy adult human population. Tim Gamble, vice president sales and marketing, Nutraceutix Inc., commented on the results presented at the North American Research Conference on Complementary and Integrative Medicine in Edmonton, Alberta (2006): This is a strong indicator that properly delivered probiotics are able to positively impact our overall health by supporting a key component of the immune system.

Probiotics also aid in controlling IBDs such as ulcerative colitis,³⁵ and its cousin, another IBD, irritable bowel syndrome (IBS).³⁶ Richard M. Fedorak, M.D., of the University of Alberta, Canada, explained at a symposium during Digestive Week 2000: In IBD, bacteria adhere to the lining of the colon like icing on a cake. Probiotics are able to negotiate through this layer and prevent bacteria from adhering to or crossing the epithelium. The pathogenic role of certain microorganism of intestinal flora has been demonstrated in experimental colitis in animals and strongly suspected in IBDs in humans, especially in Crohns disease (inflammation of the small intestine) and pouchitis.^37,38

In his book, Dash outlines IBS, a common functional disorder of the intestines, noting it is estimated to affect 5 million Americans. Of critical importance is restoration of friendly bacteria to the gut and appropriate lifestyle and dietary changes.

Scientists at the Mayo Clinic College of Medicine using a probiotic named VSL#3 in patients with diagnosed IBS, reported this probiotic reduced levels of flatulence and slows colonic transit; symptoms such as bloating and bowel function were not improved.³⁹

A blend of certain Lactobacillus and Bifidobacterium species, as found in the finished product blend, IBS Prob, (FutureCeuticals), has been shown in clinical trials to improve abdominal bloating in patients with IBS.^40,41 Though the mechanism of action behind probiotics on IBS is still vague, some of these mechanisms may include the formation of SCFA inducing propulsive contractions⁴² and enhancement of fluid and sodium absorption in the colon.⁴³

Promising data exist for the primary prevention of the inflammatory bowel condition pouchitis. In a review out of Cologne, Germany, probiotics were established in the maintenance therapy of ulcerative colitis and chronic recurrent or refractory pouchitis.⁴⁴

Other ailments probiotics have proven their worth for include diarrhea and constipation. One study using Lactobacilli and S. boulardii significantly reduced stool frequency, duration of the illness and vomiting as compared to placebo.⁴⁵ Another benefit of probiotics is preventing overgrowth of yeast (Candida albicans) in the digestive tract, a condition often caused by use of antibiotics. In a pilot clinical study from Wakunaga, manufacturers of the Kyo-Dophilus® line of probiotics, 89 percent of 36 patients infected with Candida had lower symptom scores after taking Lactobacillus acidophilus and Bifidobacterium bifidum (from Wakunaga). In addition, of those supplemented, 72 percent had a greater than 25-percent improvement in symptom scores, 33 percent had a more than 50-percent improvement in scores, and two patients became completely symptom free after one month without undergoing any changes in diet or other treatments.

L. acidophilus DDS-1 is a particularly valuable strain as its acid, bile and alkaline stability allow it to survive the harsh environment in the stomach and proliferate in the intestines. In one study, done by Nebraska Cultures, L. acidophilus DDS-1 was able to bind to intestinal cell lines, with a capability to displace the harmful bacterium E. coli; the researchers noted the strains antimicrobial activity might help to alleviate diarrhea and other intestinal infections.

Enzyme Mediators

Enzymes are fundamental in digestion. According to Troy Aupperle, president and chief executive officer (CEO), Enzymology Research Center Inc.: Enzymes help 

Digestive enzymes are used to fight dyspepsia and aid digestion by breaking down food in the GI tract. Approximately 22 digestive enzymes exist within the human body, with specific functions to break down protein, carbohydrates, sugars and fats. Their function is to catalyze chemical reactions within the cells so that physiological processes can occur. According to Edward Howell, M.D., founder of National Enzyme Co. (NEC), the human body relies on food enzymes to help with digestion and cannot carry the entire load alone; intake of exogenous enzymes from foods or supplements allows the body to concentrate more of its energy on the activity of metabolic enzymes.⁴⁶

Protease enzymes not only digest protein from food, but also organisms that cause certain viruses and toxic bacteria. Proteases digest protein, amylases digest carbohydrate and lipases digest fat.

Most often derived from the pig and cow pancreas, digestive enzymes, known as pancreatins, are of particular benefit to patients with malabsorption syndrome due to pancreatic insufficiency.⁴⁷ Animal-sourced pepsin provides a proteolytic enzyme produced by the stomach.

Enzymes are also found in plant sources such as fruits. The job of the proteolytic enzymes found here is digesting protein in acid, alkaline or neutral media. Papaya contains the proteinases papain, caricain, chymopapain and glycine endopeptidase;⁴⁸pineapple, a traditional digestion aid used by South and Central Americans,⁴⁹ is a source of the enzyme bromelain. Papaya and pineapple enzymes are thought to be particularly effective in lowering intestinal inflammation, as they become active in higher temperatures associated with the inflammatory response.

But a majority of enzymes are produced through fermentation techniques. Proprietary blends of enzymes developed as alternatives to the animal based pancreatinas the Biocore line of products from the National Enzyme Companyisolated from fermentation of fungal sources. Biocore, a line of enzymes including lipases designed to target digestive problems associated with the high fat content of a fast food diet, enzymes designed to improve assimilation of carbohydrates, and products geared toward specific GI and digestive conditions such as lactose intolerance. According to a proprietary study from NEC and The Netherlands Organization for Applied Scientific Research (TNO), a blend of fungal proteases, carbohydrases and lipases improved digestibility and bioaccessibility of proteins and carbohydrates in the lumen of the small intestine in computer-controlled dynamic gastrointestinal models (TIM) of healthy and impaired human digestion. According to the company, the study demonstrates the value of enzyme supplementation in both healthy individuals and those with digestive problems.

For the wheat intolerant, Italian researchers found a probiotic preparation used as a starter for dough fermentation in starter has the capacity to hydrolyze proteins responsible for wheat allergy.⁵⁰ In the simulation test, the probiotic caused a marked degradation of wheat proteins, including some IgE-binding proteins (such as the putative transcription factor APFI and wheat alpha-amylase inhibitors). The IgE-binding profile of the bread made with probiotic was largely different from that of bakers yeast bread, said researchers. The IgE-binding proteins that persisted in the bread made with [probiotics] VSL#3 were completely degraded by pepsin and pancreatin, they concluded.

Botanical Breakthroughs

Another category of therapies demonstrating support for the GI tract encompasses botanical-sourced ingredients. One, a glycosylated form of quercetin (as quercitrin) may defend against injury by stabilizing GI mast cells, which are involved in many pathologic effects in the GI system, such as food hypersensitivity.⁵¹ A Spanish study showed concurrent administration of a fish oil-, oliveoil and quercitrin-rich diet to rats with induced colitis produced an intestinal anti-inflammatory effect, as evidenced by a significant improvement of all biochemical parameters of colonic inflammation assayed in comparison with control rats.⁵²

Another aid to the GI is found in the Aloe vera plantthought to lower intestinal inflammation by stabilizing mast cells. In vitro work conducted in Barts, England, found Aloe vera gel had a dosedependent inhibitory effect on ROS production, and also inhibited the production of some types of inflammatory cytokines.⁵³ In another study, on rats, Aloe vera treatment was shown to successfully reduce leukocyte adherence and TNF-alpha level, elevate IL-10 level and promote gastric ulcer healing.⁵⁴ And Russian researchers found aloe worked with coenzyme Q10 (CoQ10) to alleviate inflammation and oxidative stress parameters in a rat model of colitis.⁵⁵

In an open-label study in a small sample (n=10) of healthy subjects, Aloe vera juice (similar to ACTIValoe, Aloecorp) appeared to act as a GI tonic by stabilizing gastrointestinal pH, facilitating gastric motility, normalizing gut flora composition, reducing intestinal putrefaction, facilitating protein digestion, and preventing gastric and systemic inflammation.⁵⁶ Following baseline measurements, subjects ingested 6 oz. concentrated Aloe juice three times daily for one week, with no other changes in diet or lifestyle. Of six patients showing changes in gut flora composition, all had lower counts of pathogenic bacteria following the study; four of the six had indications of yeast overgrowth in their stools prior to initiation of the study, which was lowered following Aloe treatment.

Researchers assert favorable trends in an Aloe vera gel with results including modest anti-inflammatory activity, alleviating symptoms of ulcerative colitis, with improvement in SCCAI scores after four weeks, and small but statistically significant improvement in histological scores after four weeks.⁵⁷

Peppermint leaf and peppermint oil have a long history of use for digestive disorders. Recent evidence suggests that enteric-coated peppermint oil may be effective in relieving some of the symptoms of IBS according to a 2007 MEDLINE review conducted by New York researchers.⁵⁸ And in Italy, a four-week treatment with peppermint oil improved abdominal symptoms in patients with IBS.⁵⁹ Fifty-seven patients with IBS (according to the Rome II criteria), with normal lactose and lactulose breath tests and negative antibody screening for celiac disease, were treated with peppermint oil (two enteric-coated capsules twice/d or placebo) for four weeks in double blind fashion. The symptoms (abdominal bloating, abdominal pain or discomfort, diarrhea, constipation, feeling of incomplete evacuation, pain at defecation, passage of gas or mucus, and urgency at defecation) were assessed before therapy, after the first four weeks of therapy and four weeks after the end of therapy. By the fourth week of therapy, 75 percent of the patients consuming peppermint oil group showed at least 50-percent reduction of basal total IBS symptoms score. Researchers concluded the four-week treatment with peppermint oil improves abdominal symptoms in patients with irritable bowel syndrome.

Ginger (Zingiber officinale) is often advocated as beneficial for nausea and vomiting. In a systematic review of the evidence from randomized controlled trials, studies collectively favoured ginger over placebo, wrote English researchers.⁶⁰ Taiwanese researchers conducted a more recent systematic review and meta-analysis of trials using ginger for nausea and vomiting found that a fixed dose at least 1 g of ginger is more effective than placebo for the prevention of postoperative nausea and vomiting.⁶¹ Another Taiwanese study reported ginger may ameliorate nausea by preventing development of gastric dysrhythmias and elevation of plasma vasopressin.⁶²

Many other botanical compounds also appear to have anti-ulcer activity, including flavonoids, gum guar and licorice.⁶³ A review on botanical compounds and gastric health reported studies on garlic have found the plant to be effective against common pathogenic bacteria, including H. pylori.⁶⁴

From C to Zinc

Zinc, an essential element, has a fundamental role in cellular metabolism, with profound effects on the immune system and the intestinal mucosa. Supplementation has shown significant benefits in prevention and treatment of diarrhea and pneumonia, according to a review from All India Institute of Medical Sciences, New Delhi.⁶⁵ And the benefits of zinc in diarrhea treatment led researchers from the Centre for International Health at the University of Bergen, Norway, to conclude zinc should be included in standard case management of acute diarrhea in developing countries as a cost-effective means of enhancing standard management of the illness.⁶⁶ Zinc may also prove beneficial for Crohns patients, who are susceptible to low antioxidant defenses. Low serum zinc concentrations in Crohns sufferers are related to significantly reduced zinc absorption, even with supplementation.⁶⁷ Italian researchers found in a study of 12 patients with Crohns disease that supplementation with zinc sulfate (110 mg tid) resolved intestinal permeability alterations in patients in remission.⁶⁸

A prospective cross sectional study estimating levels of trace elements was done in a childrens hospital in London, involving 74 children (38 ulcerative colitis and 36 Crohns disease) suffering from IBD and 40 matched controls.⁶⁹ Serum zinc, copper and selenium were assayed at presentation. Assay results showed serum selenium was significantly lower in both forms of IBD as compared to the controls. Serum copper was significantly higher in Crohns sufferers than in the ones with ulcerative colitis and the controls. Children with Crohns had lower serum zinc than the controls and ulcerative colitis. Researchers concluded children with IBD have abnormalities in the area of trace elements, probably as a result of inadequate intake, reduced absorption and increased intestinal loss due to the impairment of absorption resulting from the inflammatory process. The decrease in free radical scavenging action of the zinc and selenium as a result of the deficiency could contribute to the continued inflammatory process of IBD, they said.

Additional research demonstrates vitamin C may help reduce inflammation in the GI tract. In vitro work found ascorbic acid reduced PGE-2 expression.⁷⁰ It may also help to inhibit gastric cell cancer growth, as in vitro work in gastric cell cancer lines with different H. pylori strains found higher levels of ascorbic acid could induce cell cycle arrest in the cancer cells.⁷¹

One in 10 Americans develops an ulcer at sometime in his lifetime, with common causes including long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) or bacterial infection, generally with H. pylori. Vitamin C has been one of the primary compounds investigated for its interaction with H. pylori. Data from 6,746 adults enrolled in the Third National Health and Nutrition Examination Study (NHANES III) was analyzed to determine the relationship between serum ascorbic acid and H. pylori expression.⁷² The researchers found higher serum levels of ascorbic acid were associated with a decreased incidence of H. pylori infection, leading them to conclude ascorbic acid may positively impact infection rate and the risk for peptic ulcer and gastric cancer.

Another study examining ascorbic acid levels and H. pylori infection involved 452 children, who underwent gastroduoendoscopy over a five-year period.⁷³ Those children with higher levels of vitamin C in the blood, plasma and gastric juice had a significantly lower risk of severe H. pylori infection and histologic changes in the stomach. Similarly, a five year intervention study in Japan involved 244 subjects receiving low-dose (50 mg/d) or high-dose (500 mg/d) of vitamin C to assess H. pylori infection and gastritis progression.74 Both vitamin C groups showed a significant protection against progression of gastric mucosal atrophy compared to placebo.

A chelate of zinc plus the amino acid L-carnosine (known as Polaprezinc, sold in the United States by Lonza as PepZin GI®) may also target H. pylori infection. Japanese researchers reported a 12-week intervention study on gerbils with H. pylori-induced gastritis found the zinc-carnosine chelate attenuated development of gastric mucosal injury.⁷⁵ Follow up animal work found the compound could inhibit gastric lesion formation and reduce mucosal oxidative inflammation.⁷⁶ In addition, in vitro work shows Polaprezinc enhanced healing of gastric lesions,⁷⁷ and protected the stomach from NSAIDinduced mucosal injury.⁷⁸

High fat, high stress, low fiber diets with inadequate nutrition can lead to a plethora of digestive ailments begging attention. Key in digestive harmony is keeping bacterial colonies in balancethe good the bad and the ugly. And when it is all said and done, maintaining balanced health from within is easier with the natural ingredients that aboundespecially as we age. From a gut perspective, the right ingredientsfrom fiber, to synbiotics to enzymes, can make for a balanced and distress-free GI. 

References

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16. Hidaka, H. et al. Proliferation of Bifidobacteria by Oligosaccharides and their Useful Effect on Human Health. Bifidobacteria Microflora, 1990, 10(1): 65 - 79.

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