The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope (No Series) (33 page)

Keeping track of the vast array of food additives in use by the food manufacturing industry today and making sure that they don’t contain traces of harmful chemicals is a heady job. Food processing (for foods other than meat, poultry, and egg products) is regulated by the Food and Drug Administration, or FDA. FDA inspectors are responsible for visiting between sixty and eighty thousand facilities in any given year. The FDA devotes several hundred inspectors and laboratory personnel to this activity nationwide, and state and local governments also inspect food processing plants with varying frequencies and under varying standards, attempting to ensure that product ingredients are safe and free of chemical impurities.

But inspectors can’t be everywhere all the time. Food, drug, and supplement manufacturers sometimes make seemingly minute changes in the use or combination of chemicals that can result in dire consequences for consumers—some of which, in the past, have led to frightening overnight autoimmune cluster epidemics.

Such was the case, for example, in 1989 with an outbreak of eosinophilia-myalgia syndrome (EMS), an autoimmune cluster epidemic that caused severe fatigue, muscle pain, and weakness to the point that patients were rendered unable to function. EMS affected thousands of individuals around the world after a manufacturer made a minuscule change in the manufacturing of an amino acid food supplement, L-tryptophan. Unbeknownst to the manufacturer, the changes led to an increase in trace chemical impurities in the product and resulted in thousands of individuals who took the supplement falling ill with EMS. Similarly, in 1998, hundreds of Haitian children died from autoimmune pediatric renal failure, with others suffering permanent comas after ingesting a commonly used children’s acetaminophen cough syrup that had been defectively manufactured with trace amounts of diethylene glycol, a toxic substance.

Some researchers believe that such contamination of our food supply, or other consumer products, happens when large commercial networks operate without sufficiently tight oversight or when businesses are not knowledgeable about the consequences of making even minor alterations in manufacturing processes. One high-level researcher, who prefers to talk off the record, cautions that, without proper oversight and improved regulation, we may well see more such food-and additive-related clusters in the future, both in epidemic and sporadic form. The FDA itself has rather lax regulations for food products. And many of our food products are now imported from countries where regulations are even more lenient. This researcher plays out a frightening scenario that he hopes never to see. “Let’s say a manufacturer decides to change how they manufacture a food-coloring additive in a children’s cereal.” Bear in mind, he explains, that even a very minor change in manufacturing techniques and trace ingredients can cause molecular changes in something like a food additive to occur—creating a “neo-antigen,” or a new target for the immune system to potentially recognize as foreign. “That change might seem insignificant to the manufacturer,” he explains, “yet it might have a very severe impact, resulting in an autoimmune response in a subset of children who are genetically predisposed to autoimmunity.” Now let’s say that the fact that these children are getting sick from a causative agent in the cereal—the food coloring—goes unappreciated for some time. After all, it’s a cereal that these kids have been eating for years. “We could have thousands of kids who are exposed to the cereal falling ill or even dying before we remotely begin to figure out that this is another autoimmune cluster epidemic in motion.”

Several scientists are now working under the auspices of the World Health Organization to create an autoimmunity task force that, if given adequate dollars, would serve as a worldwide monitoring group to educate against manufacturing practices that are most likely to put populations at risk. Such a watchdog group would also act as a rapid response team, investigating outbreaks in time to prevent widespread problems.

If you decide to take supplements and vitamins, choose them with special care, and go over all of them with a qualified nutritionist or with your doctor if he/she is knowledgeable about cutting-edge studies on food-as-medicine. A good specialist recognizes that so-called natural remedies are drugs. After all, aspirin was originally derived from willow bark, and the anticancer chemotherapeutic agent Taxol was derived from the bark of the Pacific yew tree. Natural products can be very potent indeed, and some natural products are turning out to have a surprisingly profound effect in helping to quell an overenthusiastic autoimmune response. Supplements and vitamins that are currently being studied in autoimmune disease research include:

ANTIOXIDANTS.
In the normal process of metabolism, cells produce unstable oxygen molecules. These unstable molecules—known as free radicals—damage cells. Exposure to pollutants can increase free radicals, as can smoking and the use of cooking oils that become overheated. Antioxidants help to repair the damage done by free radicals.

Oxidative damage has been linked to the development of antibodies in lupus, and one recent study that followed the diet of twenty-five thousand individuals for nine years found that those who developed rheumatoid arthritis consumed 40 percent fewer antioxidants. Another study found low levels of antioxidants in patients with rheumatoid arthritis or lupus. Lab tests show that antioxidants help to decrease inflammation, which plays a role in many autoimmune diseases. Antioxidants are most easily available in the fruits and vegetables we eat. Blue-green algae (available at most health-food stores) contains omega fatty acids and the antioxidant phycocyanin and works similarly to a nonsteroidal anti-inflammatory drug like ibuprofen. Cranberries, blueberries, cherries, and blackberries are jam-packed with antioxidants called anthocyanins and polyphenols, which also have anti-inflammatory qualities. Leafy greens such as kale and spinach contain lutein, another superantioxidant. Cocoa carries flavonoids, particularly potent antioxidants that can zap free radicals and protect against inflammation. (The best way to consume cocoa is to add plain cocoa powder—preferably non-Dutched cocoa; Dutched cocoa is treated with an alkali during processing—into chili or other Southwestern recipes, thus avoiding the sugar in chocolate bars. If you eat chocolate, make sure it’s dark or extra dark chocolate with 60 to 80 percent cocoa solids and that it has low sugar content.) Small red beans, kidney beans, and black beans are also packed with antioxidants.

Antioxidants can also be found in supplement and vitamin form. One particular antioxidant currently under study, alpha lipoic acid, has been shown to help in the treatment of multiple sclerosis by balancing T-cell activity and has also been found to help lessen symptoms in those with diabetic neuropathy. Alpha lipoic acid has such a profound effect, says Mullin, because it penetrates into the central nervous system, offering protection from the kind of free-radical damage that is often seen in multiple sclerosis and other neurological autoimmune diseases.

Again, work carefully with your doctor and/or nutritionist. Just because a supplement or vitamin is rich in antioxidants doesn’t mean gobbling handfuls of it will be at all useful or prudent. Research on antioxidants and autoimmune disease is still new—as is research into antioxidants in general. For example, one highly controversial study suggested that people who consume high amounts of vitamin A may face an increased risk of certain illnesses. Vitamin E has also been the source of recent controversy. Figuring out what is salient and solid research is not easy—which is why it’s so important to work with a health-care professional who stays completely up to date on the latest data on food and supplements as medicine.

ESSENTIAL FATTY ACIDS.
There are two families of essential fatty acids, or EFAs: omega-3 and omega-6. High consumption of omega-6 can increase inflammation; in contrast, omega-3 fatty acids have strong anti-inflammatory properties. Omega-3 is most readily available through the consumption of fish and shellfish. Wild salmon, North Atlantic mackerel, sardines, flounder, sole, scallops, shrimp, pollack, red snapper, and tilapia are best because they all have a low mercury content. Avoid farmed salmon, which has a high PCB content, and high-mercury fish such as king mackerel, marlin, orange roughy, shark, swordfish, tilefish, and tuna. Essential fatty acids are also available in omega-3 rich eggs and flaxseed, as well as in supplement form. A growing number of studies show omega-3 to be beneficial in the prevention and management of Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. In one fascinating study, investigators at the Cleveland Clinic found that a nutritional supplement enriched with both fish oil and antioxidants reduced reliance on traditional therapies for people with ulcerative colitis, and that patients taking this oral supplement were less likely to need steroid therapy. Other research shows that higher dietary intake of omega-3 fatty acids is associated with a lowered risk of autoimmunity in children who are at genetic risk of type 1 diabetes.

VITAMIN D.
A striking body of data shows that having higher levels of vitamin D in the blood may lower the risk of developing multiple sclerosis significantly. Researchers from the Harvard School of Public Health examined more than 7 million U.S. military personnel who had serum samples stored in the Department of Defense Serum Repository and correlated each individual’s vitamin D levels. Those who had high levels of vitamin D were least likely to develop the disease later on in life. Likewise, a study of nearly thirty thousand women in their fifties and sixties found that the likelihood of having rheumatoid arthritis went down as dietary vitamin D intake increased.

Other studies show that vitamin D can be protective against not only multiple sclerosis but inflammatory bowel disease. According to Mullin, 75 percent of Crohn’s patients are deficient in vitamin D. There is growing evidence that vitamin D plays a central role in rebalancing T-cell activity, which is why it is proving to be such an important adjunct to the treatment of autoimmune diseases such as MS and Crohn’s disease. One provocative investigation looked at forty-two thousand people to determine why those born in the month of May have a 13 percent increased risk of developing multiple sclerosis (while being born in November carries a 19 percent
decreased
risk). The study concluded that the mother’s exposure to the sun—which directly affects a pregnant woman’s vitamin D levels and therefore that of her fetus—may influence the immune system even in the womb. Vitamin D occurs naturally in fish, but is most efficiently produced in the body by exposure to sunlight. Daily use of sunscreen and sunblock, however, can interfere with our absorption of vitamin D, says Mullin, making supplementation all the more critical. Juices fortified with vitamin D can also boost exposure, as can taking supplements.

CURCUMIN.
According to a recent study from the National Institutes of Health, turmeric, an ancient spice long used in traditional Asian medicine, may hold promise for the prevention of rheumatoid arthritis and osteoporosis. Scientists tested the extract of curcumin—found in this common spice—to see if it could help to stave off rheumatoid arthritis in lab animals. Turmeric, a key ingredient in curry, has been used for centuries by practitioners of Ayurvedic medicine to treat inflammatory disorders, and turmeric extract containing curcumin (not to be confused with cumin, a spice commonly associated with Moroccan cooking) is available in most health-food stores as a dietary supplement for the treatment and prevention of rheumatoid arthritis. NIH researchers found that curcumin completely inhibited the onset of rheumatoid arthritis in animals by working to keep inflammatory proteins from being released and preventing destruction in the joints. The daily dose of curcumin administered was roughly equivalent to 120 curry dinners—so future uses of curcumin in humans will revolve around supplementation rather than dietary intake. Meanwhile, clinical trials are currently planned to test turmeric supplements in suppressing rheumatoid arthritis in humans. Other investigations show that two grams of curcumin a day helps to control ulcerative colitis.

SEA ANEMONE EXTRACT.
In what sounds like something straight out of
Twenty Thousand Leagues Under the Sea,
researchers from the University of California, Irvine recently found that natural compounds derived from a Cuban sea anemone extract—referred to as SL5—block the autoimmune disease response in type 1 diabetes and rheumatoid arthritis. In one set of tests using blood samples from type 1 diabetes patients and joint fluid from people with rheumatoid arthritis, the researchers found that the extract suppressed cytokine overproduction at a level similar to that seen with pharmacological drugs—without affecting other critical cells that fight infection.

RUE SHRUB PLANT.
The same University of California, Irvine researchers working with sea anemone extract have likewise found that a compound from the rue shrub plant—known as PAP-1—delayed the onset and reduced the incidence of disease in diabetic rats and helped to improve the joint function of rats with rheumatoid arthritis. Research into both the rue plant, a small evergreen shrub also known as the herb of grace, and sea anemone extract began years ago when researchers at the University of California, Irvine came across a report that described the beneficial effect of a scorpion sting on a patient with multiple sclerosis. They began to ask themselves about other natural substances that might, in a more controlled manner, be able to influence T-cell and cytokine activity.

It remains to be seen if PAP-1 will work in people as well as it does in lab animals. Meanwhile, such discoveries speak to the importance of protecting our plant and animal biodiversity. Ironically, many of the same factors that are precipitating today’s autoimmunity epidemic—environmental degradation and chemical pollution both on land and at sea—are threatening to extinguish plant and animal species that may one day turn out to hold the very cures we seek for autoimmune disease.