The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope (No Series) (43 page)

$4 billion more than what they spend:
Americans spend roughly $5 billion a year at the movies and $12 billion a year on videos. See http://www.hollywoodmuseum.com/whoweare/whoweare_history.html (accessed May 24, 2007).

Even so, the vast majority:
Eisenberg DM et al. Trends in alternative medicine use in the United States, 1990–1997: Results of a follow-up national survey. JAMA 1998 Nov 11;280(18):1569–75.

a 2007 study of fifty-six second-year gastrointestinal fellows:
Scolapio JS et al. First Annual Fellows’ Nutrition Training Course: Outcome of nutrition support, obesity and basic and clinical nutrition training. Gastroenterology 2007 April;132(4):A519.

Patient studies show that higher intake:
Longnecker MP, Daniels JL. Environmental contaminants as etiologic factors for diabetes. Environ Health Perspect, 2001 Dec;109(Suppl 6):871–6.

There is also evidence it may trigger lupus:
Hess EV. Environmental chemicals and autoimmune disease: Cause and effect. Toxicology 2002 Dec 27;181–182:66.

Today, only 10 percent of all American adults:
See the USDA Healthy Eating Index: 1999–2000 at http://www.cnpp.usda.gov/publications/HEI/HEI99-00report.pdf (accessed May 24, 2007).

When you look at recent studies on what Americans do get in their diet:
Nielsen SJ, Popkin BM. Changes in beverage intake between 1977 and 2001. Am J Prev Med 2004 Oct;27(3):205–10.

75 percent of preschoolers in America:
Kranz S et al. Dietary fiber intake by American preschoolers is associated with more nutrient-dense diets. J Am Diet Assoc 2005 Feb;105(2):221–5.

fewer than 11 percent of Americans:
Casagrande SS et al. Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. Am J Prev Med 2007 Apr;32(4):257–63.

junk foods such as chips, snacks, desserts, and soft drinks:
http://www.berkeley.edu/news/media/releases/2004/06/01_usdiet.shtml (accessed May 24, 2007).

One reason is that farmers tend to select:
Davis DR et al. Changes in USDA food composition data for 43 garden crops, 1950 to 1999. J Am Coll Nutr 2004 Dec;23(6):669–82.

Acid rain has taken its toll:
Tang RH et al. Coupling diurnal cytosolic Ca2+ oscillations to the CAS-IP3 pathway in
Arabidopsis
. Science 2007 Mar 9;315(5817):1423–6.

Immigrants to America also fall under the spell:
Akresh IR. Many new immigrants to US change diet—and not for the better. University of Illinois at Urbana-Champlaign, study not yet published. See EurekAlert! press release, February 9, 2006, at eurekalert.org.

But what is especially striking:
Farrokhyar F et al. A critical review of epidemiological studies in inflammatory bowel disease. Scand J Gastroenterol 2001 Jan;36(1):2–15.

These villi are covered in cells:
Quigley EM, Quera R. Small intestinal bacterial overgrowth: Roles of antibiotics, prebiotics, and probiotics. Gastroenterology 2006 Feb;130(2 Suppl 1):S78–90.

In healthy individuals, as the villi are renewed:
Watson AJM et al. Epithelial barrier function in vivo is sustained despite gaps in epithelial layers. Gastroenterology 2005 Sept;129(3):902–12.

If food components or bacteria:
Glade M. Certification Board for Nutrition Specialists examination study guide, third edition. Clearwater, Fla.: American College of Nutrition, 2003;17–19.

The first step is to work with your physician:
According to Gerard Mullin, director of Integrative GI Nutrition Services at Johns Hopkins Medical Institutions, the best stool analysis to request your doctor to order is the Comprehensive Digestive Stool Analysis from Genova Diagnostics, available at http://www.gdx.net/home/assessments/findsystems/gastro.html (accessed May 25, 2007). The lactulose breath test is conducted in the gastroenterologist’s office.

Interestingly, laboratory studies show that when rats:
Sellon RK et al. Resident enteric bacteria are necessary for development of spontaneous colitis and immune system activation in interleukin-10-deficient mice. Infect Immun 1998 Nov;66(11):5224–31.

Mullin recommends beginning:
Ask your physician for suggestions on rice or whey protein powders from reliable companies.

In research on those with Crohn’s disease:
Giaffer MH et al. Long-term effects of elemental and exclusion diets for Crohn’s disease. Aliment Pharmacol Ther 1991 Apr;5(2):115–25. Suzuki H et al. An elemental diet controls inflammation in indomethacin-induced small bowel disease in rats: The role of low dietary fat and the elimination of dietary proteins. Dig Dis Sci 2005 Oct;50(10):1951–8.

In one study, 75 percent of patients with irritable bowel syndrome:
Atkinson W et al. Food elimination based on IgG antibodies in irritable bowel syndrome: A randomised controlled trial. Gut 2004 Oct;53(10):1459–64. O’Mahony L et al.
Lactobacillus
and
Bifidobacterium
in irritable bowel syndrome: Symptom responses and relationship to cytokine profiles. Gastroenterology 2005 Mar;128(3):541–51.

IgE allergic reactions are immediate:
For more information on IgE food allergy testing, see http://www.foodallergy.org (accessed May 27, 2007).

T-cell mediated food allergies:
Ferguson A et al. T-cell mediated immunity in food allergy. Ann Allergy 1983 Aug;51(2 Pt 2):246–8.

With IgG food sensitivities:
Shanahan F, Whorwell PJ. IgG-mediated food intolerance in irritable bowel syndrome: A real phenomenon or an epiphenomenon? Am J Gastroenterol 2005 Jul;100(7):1558–9. However, although the concept of IgG allergies is becoming increasingly accepted, not all doctors agree that IgG allergies exist.

In fact, in one new study at Children’s Hospital:
Astrakhan A et al. Local increase in thymic stromal lymphopoietin induces systemic alterations in B cell development. Nature Immunol 2007 May;8(5): 522–31. Epub 2007.

Studies confirm that for some patients:
Panush RS. Food induced (“allergic”) arthritis: Clinical and serologic studies. J Rheumatol 1990 Mar;17(3):291–4.

For this reason, Mullin recommends:
http://www.usbiotek.com/. US BioTek Laboratories offers “Serum IgG & IgE Antibody Panels for Foods, Indoor/Outdoor Inhalants, Spices & Herbs” as well as “Serum or Finger Stick IgG Antibody Panels for Foods, Spices & Herbs, Inhalants.”

What follows is a short list of foods:
For more information, especially on how special diets may help in arachnoiditis, see
Arachnoiditis: The Silent Epidemic,
by J. Antonio Aldrete, MD, MS, at www.arachnoidtitis.com/book.asp. In this book, Gerard Mullin and Loren Marks, DC, DACBN, a certified nutritionist in New York City who frequently works with patients with autoimmune disorders, cowrote a chapter in which they discuss some of the dietary guidelines and supplements that can help in fighting the disease.

consider eating a low-inflammatory diet:
In
Arachnoiditis: The Silent Epidemic,
nutritionist Loren Marks suggests consuming one of the following: smoked salmon on brown rice cakes; a two-to three-egg omelet from hens fed flaxseed, with sweet potatoes and rosemary and black beans on the side; hot brown rice cereal with cinnamon; unsweetened yogurt (if you are not allergic to or sensitive to milk) with flaxseed oil and a half cup of blueberries mixed in; or poached eggs with smoked salmon. Lunch or dinner might consist of a large mixed green salad with sardines and chopped yellow and green and red peppers; broiled red snapper with steamed broccoli and baked yams; four ounces of wild salmon with brown rice pasta and tomato sauce with extra oregano, thyme, and garlic with a side dish of grilled vegetables; or one chicken breast with rosemary, with a half cup of black-eyed peas, roasted onions or garlic, and a spinach salad.

In one recent study of seven hundred children:
Chatzi L et al. Protective effect of fruits, vegetables and the Meditterranean diet on asthma and allergies among children in Crete. Thorax, in press. Epub 2007 Apr 5.

In looking at infants born to Latinas:
Furlong CE et al. PON1 status of farmworker mothers and children as a predictor of organophosphate sensitivity. Pharmacogenet Genomics 2006 Mar;16(3): 183–90. Duramad, P et al. Early environmental exposures and intracellular Th1/Th2 cytokine profiles in 24-month-old children living in an agricultural area. Environ Health Perspect 2006 Dec;114(12):1916–22.

This is particularly frightening:
Young JG et al. Association between in utero organophosphate pesticide exposure and abnormal reflexes in neonates. Neurotoxicology 2005 Mar;26(2):199–209.

Combined exposure to mixtures of pesticides:
Duramad P et al. Early environmental exposures and tracellular Th1/Th2 cytokine profiles in 24-month-old children living in an agricultural area. Environ Health Perspect 2006 Dec;114(12):1916–22.

Most to the point:
Sobel ES et al. Acceleration of autoimmunity by organochlorine pesticides in (NZB x NZW)F1 mice. Environ Health Perspect 2005 Mar;113(3):323–8.

farmers who mix their own pesticides:
Rosenberg AM et al. Prevalence of antinuclear antibodies in a rural population. J Toxicol Environ Health A 1999 Jun 56(4):225–36. Cooper GS et al. Occupational risk factors for the development of systemic lupus erythematosus. J Rheumatol 2004 Oct;31(10):1928–33.

During the five days in which children ate an organic diet:
Lu C et al. Organic diets significantly lower children’s dietary exposure to organophosphorus pesticides. Environ Health Perspect 2006 Oct;114(10):A572; author reply A572–3.

According to new data from the Centers for Disease Control and Prevention:
Zhang J. When eating your vegetables makes you sick. Wall Street Journal, 2005 Nov 30;D1. FDA reviews response to food safety concerns. Sunday Capital, 2007 Mar 18;A3.

Unlike the meat, egg, milk, and processed-food industries:
FDA reviews response to food safety concerns. Sunday Capital, 2007 Mar 18;A3.

In May 1981, for instance, food product:
Posada de la Paz M et al. Toxic oil syndrome: the perspective after 20 years. Epidemiol Rev 2001;23(2):231–47.

FDA inspectors are responsible for visiting:
http://www.washingtonpost.com/wp-dyn/content/article/2007/04/22/AR2007042201551.html (accessed April 25, 2007). In this article (“FDA Was Aware of Dangers to Food”), Elizabeth Williamson quotes the FDA’s food safety chief, Robert E. Brackett: “‘We have 60,000 to 80,000 facilities that we’re responsible for in any given year.’ Brackett said. Explosive growth in the number of processors and the amount of imported foods means that manufacturers ‘have to build safety into their products rather than us chasing after them.’”

In 1989 with an outbreak of eosinophilia-myalgia:
Posada de la Paz M et al. Toxic oil syndrome.

in 1998, hundreds of Haitian children:
Epidemic of pediatric deaths from acute renal failure caused by diethylene glycol poisoning. JAMA 1998 Apr 15;279(15):1175–80.

The FDA itself has rather lax regulations:
Ibid.

Oxidative damage has been linked:
Kurien BT et al. Oxidatively modified autoantigens in autoimmune diseases. Free Radic Biol Med 2006 Aug 15;41(4):549–56. Epub 2006 May 23.

one recent study that followed the diet of twenty-five thousand individuals:
Pattison DJ et al. Dietary beta-cryptoxanthin and inflammatory polyarthritis: Results from a population-based prospective study. Am J Clin Nutr 2005 Aug;82(2):451–5.

Another study found low levels of antioxidants:
Vipartene D et al. [Pro-and antioxidant blood system in patients with rheumatoid arthritis and systemic lupus erythematosus.] Ter Arkh 2006;78(6): 10–4.

One particular antioxidant currently under study:
Yadav V et al. Lipoic acid in multiple sclerosis: A pilot study. Mult Scler 2005 Apr;11(2):159–65.

has also been found to help lessen symptoms:
Bregovskii VB et al. [Predictors of alpha-lipoic acid treatment efficacy in diabetic polyneuropathy of the lower limbs.] Ter Arkh 2005;77(10):15–19.

Alpha lipoic acid has such a profound effect:
Schreibelt G et al. Lipoic acid affects cellular migration into the central nervous system and stabilizes blood-brain barrier integrity. J Immunol 2006 Aug 15;177(4):2630–7.

A growing number of studies show omega-3:
Macdonald A. Omega-3 fatty acids as adjunctive therapy in Crohn’s disease. Gastroenterol Nurs 2006 Jul–Aug;29(4)295–301; quiz 302–3. Cleland LG et al. Reduction of cardiovascular risk factors with long-term fish oil treatment in early rheumatoid arthritis. J Rheumatol 2006 Oct;33(10):1973–9.