Pesticides and Neurological Disorders

Pesticides and Neurological Disorders

Pesticide exposures are associated with numerous disorders. Some of those associations have been studied extensively but many are only suspected or somewhat likely. Research on the effects of different pesticides has obstacles such as metabolites being quickly eliminated or the long period of time between exposure to a chemical and the changes in tissues. Still, there is enough information to be able to guide decisions, such as whether to buy organic produce or what to use if you have insects in your house.

There are also a couple groups of people that are at high risk for some of the effects of pesticides. Infants, small children, and the elderly are particularly vulnerable. And considering the fact that pesticides are most often used on produce, people that try to eat the recommended number of fruit and vegetable servings each day are also susceptible to illnesses linked to pesticides. This will be the first of several articles on pesticide-associated diseases. It is a sad annotation that there are so many neurological disorders pesticides may cause that they warrant an entire article.

Infants and small children are so vulnerable because of their neurological development. Exposure to pesticides has been postulated to increase the chances of a child having an attention deficit disorder or developmental delay.

In “Dietary Intake and its contribution to longitudinal Organophosphorus Pesticide Exposure in Urban/Suburban Children,” by C. Lu, et al (Environmental Health Perspectives, vol. 116, #4, April, 2008) it is noted that levels of organophosphorus urine metabolites were higher in children during winter and spring. This is the time of year children are most likely to be fed fruits and vegetables imported from other countries. Since the Food Quality Protection Act of 1996, produce from the U.S. has had lower levels of such pesticides. Many countries don’t have these restrictions so their produce typically has more pesticide residues on them. The article also notes that children fed only organic produce usually don’t have pesticide metabolites in their urine, further underscoring that produce is the main source of pesticides.

There is also a suspected link between prenatal pesticide exposure and a group of neurological abnormalities called autism spectrum disorders. These disorders are more likely to develop if the mother was exposed to pesticides and had a folate deficiency while pregnant. This is from “Combined Prenatal Pesticide exposure and folic acid intake in relation to Autism Spectrum Disorders,” in Environmental Health Perspectives, 097007-1. Since 1 in 68 children is affected by one of these disorders, avoiding home and agriculture pesticides is certainly worth the extra effort.

The link between Parkinson’s disease is strong enough to also make changes. In “Association of Parkinson’s Disease and Its Subtypes with Agricultural Pesticide Exposures in Men:  A Case Control Study in France,” (by F. Maisan, et al, in Environmental Health Perspectives, vol. 123, #11, November, 2015) there is a 60% increase in Parkinson’s Disease risk associated with insecticide exposure. The subtype of the disease it may cause is tremor-dominant Parkinson’s, the most common type. Because there is a 3 to 7-year lag between the destruction of nerve cells and motor (movement) symptoms, it took a while to uncover this likely cause.

An individual’s risk of developing Alzheimer’s disease also increases with pesticide exposure. In “Alzheimer’s disease linked to DDT pesticide,” (in Nursing and Residential Care, April 2014, p. 189), those with an elevated level of DDE, a metabolite of DDT, had a quadruple risk of getting this disorder. This risk is even higher in individuals with one or more genes associated with Alzheimer’s disease. Of note, having a gene for a disease doesn’t automatically mean the person will get it, and the field of epigenetics covers the multitude of ways genetic effects can be modified. Conversely, not having a gene associated with a disease doesn’t mean you won’t get it.

In Dennis Relojo’s article “On the Road to Therapeutics:  Biological Mechanisms of Parkinson’s Disease and Alzheimer’s Disease,” (I-manager’s Journal on Nursing, vol. 5, #3, October, 2015) Alzheimer’s disease accounts for two-thirds of the cases of dementia and is the most common neurodegenerative disease. The second most common is Parkinson’s disease. Kind of makes organic produce, at least for produce from the “dirty dozen,” worth the extra money or effort, doesn’t it?

 

 

 

 

 

 

 

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Vitamin D Deficiency and Diabetes

Vitamin D Deficiency and Diabetes

While vitamin D deficiency has long been linked with bone disorders such as rickets, a large number of research studies have found evidence that it may increase a person’s risk for autoimmune disorders, particularly type 1 diabetes. More recent studies have found that a lack of vitamin D may also increase the risk of type 2 diabetes. Conversely, having consistently adequate levels seems to offer protection from colon cancer, as well as infections. This may seem like a pretty broad effect but studies have uncovered some facts that may explain that.

According to the article “Role of Vitamin D in Insulin Resistance,” by C. Sung, et al (Journal of Biomedicine and Biotechnology, volume 2012, article ID 634195) vitamin D has been found to be involved in tempering both the adaptive immune and inflammatory responses. It is also involved in managing cell proliferation and differentiation. That translates to helping the body attack foreign invaders but keeping it from attacking its own tissues. Autoimmune disorders are caused by the immune cells attacking the body’s tissues. Many immune cells have vitamin D receptor so it isn’t surprising that immune cells damaged by a vitamin D deficiency would be more likely to do that.

It is a little more complicated how vitamin D deficiency may promote the development of type 2 diabetes. What we do know is that there are receptors for vitamin D on pancreatic cells and the vitamin protects the insulin-producing beta cells in the pancreas from harmful immune cell attacks. It also improves beta cell functioning.

Insulin receptors are found on skeletal muscles, fat cells and in the liver. When insulin fits in these receptors, it causes the cells to allow glucose to enter so that the cells can make energy. But those receptors don’t work very well in those with type 2 diabetes. It is significant that vitamin D improves insulin receptor functioning, or, as it is often called, insulin sensitivity. If the vitamin protects insulin producing cells in the pancreas and enhances the functioning of the insulin receptors, it isn’t surprising that it lowers the risk of type 2 diabetes.

Since vitamin D is a fat-soluble vitamin, it is difficult for the body to get rid of excess vitamin D. The recommended intake for adults up to age 71 is 600 IU/day, and for those 71 and older its 800 IU/day. The upper limit is 4,000 IU/day. In The Clinical Advisor for August 2017, a study of vitamin D intake noted that people are taking more of it (“High-dose vitamin D supplements and adverse events”). 3% in the study exceeded that amount. It is too soon to say what the harmful effects are from too much vitamin D, but there doesn’t seem to be any benefit from exceeding that upper limit. This information isn’t intended to replace consultation with your health care provider and their recommendations.

Of Pathogens and Produce:  Let the salad-lover beware

Of Pathogens and Produce:  Let the salad-lover beware

Until recently, foodborne illnesses have usually been associated with contaminated meat and poultry. Improved surveillance of and practices by those industries, as well as public education about proper handling have helped lower the rates of those sources. But an increase in uncooked vegetables and contamination of these products has developed.

In the International Journal of Environmental Health Research article “Prevalence of multiple antibiotic-resistant Gram-negative bacteria on bagged, ready-to-eat baby spinach,” by S. Walia, et al (Vol. 23, No.2, for April, 2013, pages 108-118), infections caused by pathogens (microorganisms that cause disease) found on uncooked fresh produce are increasing. Perhaps even more concerning is that many of these germs carry the genes for multiple-drug resistance. Thus, if someone consumes these pathogens on their produce, they could get an infection and/or have these dangerous genes passed on to bacteria in their intestines. Antibiotics used in agriculture to increase yield are suspected to have caused the antibiotic-resistant organisms to survive and even thrive. There has been an increase in serious intestinal infections in the most vulnerable – children, the elderly, and those with a weakened immune system.

The study reported in this article noted that pathogens are found even in bagged, ready-to-eat baby spinach. Other studies found pathogens on other produce. High-risk produce includes green onions, spinach and other leafy greens, cilantro, tomatoes, peppers, and alfalfa sprouts.

The CDC’s “Burden of Foodborne Illness:  Findings” which were last updated 7/15/2016, states that 1 in 6 Americans develop a foodborne illness every year. Some half of infections are caused by pathogens not yet identified, and the other half are caused by 31 known microorganisms, but 8 account for the majority of cases of foodborne illness. Norovirus causes the most of these. Salmonella is also a common cause and the most likely to lead to hospitalization or death. (http://wwwnc.cdc.gov/eid/article/17/1/p1-1101 article).

In “Vital Signs:  Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food – Foodborne Diseases Active Surveillance Network, 10 U.S. Sites 1996-2010″ (Morbidity and Mortality Weekly Report for 6/10/2011, Vol. 60, #22) it is noted that most foodborne illnesses occur in people that aren’t included in reported disease outbreaks. Most foodborne illnesses entail mild to severe diarrhea. In the vulnerable such as the elderly, and even in the healthy, severe complications like kidney damage and meningitis can develop.

In Eat, Drink and Be Wary by Charles M. Duncan (Lanham, MD:  Rowman & Littlefield, 2015) it is stated that 20% of our fresh vegetables and 40% of our fruit and nuts are imported. This may be the greatest risk for foodborne infections, but this hasn’t been confirmed. Since fresh produce is the source of about half of foodborne illnesses a year, and since monitoring has decreased the past 5 years, a few precautions are worthwhile:  wash meticulously all fruits and vegetables, even those with a rind you won’t eat, wash 15 seconds and rinse 15 seconds before and after preparing any produce.

Super Star Spinach

Super Star Spinach

Spinach is not only listed as one of the super foods in Dr. Steven Pratt’s SuperFoods Rx (also by Kathy Matthews, NY, NY, 2004), he considers it so rich in so many important nutrients, it is almost in a class by itself. But before I start singing its praises, I have to add his important note that there are other similar foods that also have many of the same impressive substances.

Spinach Knock-offs

  • Kale
  • Collards
  • Swiss chard
  • Mustard and turnip greens
  • Bok choy
  • Romaine lettuce
  • Orange bell peppers (yes, that struck me as a pretty distant relative too)

 

On to the resume for these super stars (using spinach as the proto-type)

  • The carotenoids lutein, zeaxanthin (both associated with lower macular degeneration and cataract rates), and beta-carotene
  • The antioxidants glutathione (protects DNA), alpha lipoic acid (anti-aging nutrient), vitamin C, and vitamin E
  • Vitamin K (important for blood clotting and thus to be avoided if taking warfarin (Coumadin) a blood thinner)
  • Coenzyme Q10 (needed for cell energy production)
  • B vitamins thiamine, riboflavin, B6, and folate (cancer fighter)
  • Chlorophyll (a potential cancer fighter), Polyphenols, Betaine (may help lower arterial disease risk)
  • Plant-derived omega-3 fatty acids

 

Which is better, raw or cooked spinach? There are benefits to each. Cooked spinach makes the carotenoids more available and increases lutein, but decreases the vitamin C and folate. So, it is probably best to consume raw and cooked spinach each day. Also, adding olive oil, nuts or avocado to cooked spinach will increase the carotenoid absorption.

One more note about the “knock off” vegetables. Kale, as noted in Super Foods by Tonia Reinhard (Buffalo, NY:  Firefly Books, 2014) has more than twice the level of antioxidants compared with other leafy greens. Okay kale, you’ve got my vote, and a place of prominence in my garden.

Medications and conditions that can cause constipation

Medications and disorders that can cause Constipation

There are many causes of constipation, including some types of medications. Those that already have problems with constipation before starting medications might want to discuss a change in medications if they’ve started one that has that as a side effect.

Medications that can cause or worsen constipation:

Antidepressants including many of the tricyclic antidepressants like Elavil, some of the SSRIs like Prozac, some of the SNRIs

Antipsychotic agents

Calcium carbonate and calcium or aluminum-based antacids

Iron (some are worse than others in this respect)

Antihistamines that are sedating (diphenhydramine for example)

Urge incontinence medications

Calcium channel blockers (an antihypertensive and heart medication)

Disorders the diseases that can cause or worsen constipation:

Dehydration

Irritable bowel syndrome (IBS)

Hypothyroidism

Diverticulosis

Excess stimulant laxative use

Some cancers

Anorexia

Neuromuscular diseases like MS and Parkinson’s disease

Pregnancy

Hypercalcemia

References:  Alison Bardsley, Assessment and treatment options for patients with Constipation in British Journal of Nursing, 2017, Vol. 26, #6

Harvard Health letter, August, 2017, page 7. This is not meant to replace the care of your health care provider.

Adopting good habits and giving up bad ones

Help for making changes to lose weight

Knowing what causes weight gain and weight loss does not lead to permanent weight loss. That is the sad fact that leaves many hopeless about losing weight. In “Improving Cardiovascular health with Motivational Interviewing” (M. Van Nes and J. Sawatzky, Journal of the American Academy of Nurse Practitioners, 2010, 654-659), it is noted that the traditional method of giving advice to change behavior rarely leads to sustained behavior change. In fact, such advising may actually decrease the changes of behavior changes. This article taps into the wisdom of the Transtheoretical Model for Health Promotion (J. Prochasky and C. DiClemente), in which individuals that need to make behavior changes are classified on a continuum with one end being not even appreciating the need for change, then listening, all the way through wanting to change, doing it and then maintaining the change for good. The article authors note statistics that some two-thirds of people that need to make a behavioral change are in one of the first two stages and often stay there.

In Big Fat Crisis, by Deborah Cohen, M.D. MPH (Philadelphia, PA:  Nation Books, 2014), the barrage of processed foods available at grocery stores, fast food restaurants and numerous other places, overwhelms our self-control. The advertising that promotes these foods is meant to lure us, and avoiding those is also smart. Dr. Robert Lustig, author of Fat Chance (New York, NY:  Penguin Group, 2012) writes about changing one’s food environment to stop the hormonal abnormalities that drive overeating. He encourages a high fiber diet to increase fullness and satiety, eating breakfast and include protein if possible, avoiding processed foods and especially sugar, and exercising. But, as he wisely notes, don’t look to exercise to lose pounds but to improve your health (and that is hopefully what you are primarily after, right?).

So, this is the what is needed:  decide to make the change (I assume most of the readers of this blog article are at least approaching this point to even be reading this article). Next, plan what you’ll need to do to make the changes such as avoiding restaurant meals, cutting out soft drinks, eating lots of fiber, staying away from processed foods, going to the Farmer’s market for locally grown fruits and vegetables, etc. YOU CAN DO IT. Set a date for starting, and if you trip and fall off your diet/new lifestyle, start back on your healthy diet the next day. One mistake does not equal failure by any means.

If it is easier to make the changes more gradually, do so! And remember that increasing fiber too quickly can create some gastrointestinal problems so introduce it slowly. I recommend oatmeal with ground flax, bran, and berries. Also, vegetables throughout the day. Avoid juice because they have carbohydrates without the essential fiber. And please, please, dear reader, do what you can to decrease stress because this nasty response can lead to high cortisol levels. As Dr. Lustig notes, exercise, even 15 minutes a day of walking, can lower cortisol levels.

All of this is hard work but these changes including regular exercise can go very far in losing weight, keeping it off and avoiding many chronic diseases. And it is worth it, isn’t it? This is not meant to replace the care of your primary health care provider.

What to avoid if you want to lose weight and be healthier

What to avoid if you want to lose weight and be healthier

     Adding positive habits and good foods to one’s life takes work but is relatively easier than giving up practices and foods that have a hold on us. This is the real work of watching what goes in and building a foundation for good health. Following are some of the key things that need to be avoided if living longer and living a fuller, unimpeded life.

     Sugar

It isn’t needed and often leads to fat storage. It is also addictive, so the more of it you eat, the more you crave it. High fructose corn syrup is the worse of the worst, promoting fatty liver and potentially leading to liver failure. It also increases uric acid production and thus gout can develop or worsen.

Fruit juices

These are bad since they have sugar but no fiber. Many have as much sugar as soft drinks.

Artificial sweeteners

Although they don’t have any calories, they can cause hunger. Research studies have linked daily use to weight gain, as well as increased stroke and dementia risk.

Saturated fat

It’s found in beef, lamb, pork, chicken skin, and dairy products made from whole milk. They have a lot of calories, easily leading to weight gain. It also increases the bad type of cholesterol.

Trans fats

It deserves it title as the unhealthiest food. It increases bad cholesterol, decreases the good form of cholesterol, cause a heart attack, stroke, or Alzheimer’s disease. It is found in fried foods, fast foods like French fries, peanut butter, salad dressings, potato chips, crackers, cookies, doughnuts, pies and cake.

Processed meats

Meats like salami, as well as bacon, sausage, and hot dogs are high in saturated fat and thus a concentrated source of calories. They are also high in salt. Some have a lot of nitrate compounds. These chemicals are converted to carcinogens in the body.

Late night snacking

Will power often dwindles by the end of the day. Heading to bed with calories on board when they are least needed, can support weight loss. There is a lot to be said for fasting twelve hours each day. If you wake up in the middle of the night with stomach pain that is relieved with food, it could be the sign of an ulcer and warrants medical evaluation. Treating yourself with an over-the-counter acid reducer could result in inadequate treatment, especially for ulcers caused by a bacterial infection.