Autoimmunity Unlocked

5 Keys to Transform Microbiome, Immune, and Digestive Health and Reclaim Your Life. A 5R+ Holistic Guide for Rheumatoid Arthritis, Lupus, and Crohn’s (Encyclopedic Edition)

by Anar R Guliyev, M.D. www.autoimmunityunlocked.org

Appendix 2: References and Additional Reading

• Hope in the Face of the Incurable
• Immune System — The Good, the Bad, and the Ugly
  • The Ugly: An Ailing Immune System
    • Diseases Related to Immune System Disorders
    • Autoimmune Diseases — A Modern Epidemic
  • The Good: The Holistic Way to Restore the Immune System
    • DILL+: Locks and Vicious Cycles
• Key 1. Dysbiosis: Repopulate the Microbiome
  • The Last Discovered Organ That Reshapes Our Understanding of Health
    • Microbial Forces Within Us
    • A Busy, Adaptable Organ
  • Dimension 1: Microbiome Composition
    • Variety — Farmland vs Forest
  • Actively Repopulate
    • Building a Healthy Community
    • Probiotics
    • Feeding your Allies
    • Food Diversity
  • Dimension 2: Microbiome Distribution
    • SIBO, IBS, IBD, Ulcers: Many Faces of Microbiome Maldistribution
  • Healthy Digestion to Fix Microbiota Distribution
    • Don’t Rush the Reactor
    • Stomach Acid
    • Bile and Liver Health
    • Other Tactics for Fixing SIBO and Normalizing Microbiome Distribution
  • Fungi: Mold and Yeast
    • Addressing the SIFO Problem
  • Feeding Your Enemies
    • Sweet Does Not Equal Good
  • Other Risks to Your Microbiome Health
    • Inflammation
    • Antibiotics
    • Chlorine and Related Compounds in Water
    • Chemical Additives and Toxins in Our Food
• Key 2. Inflammation: Reduce
  • Intermittent Hormesis
  • Chronic Inflammation
    • Consequences of Chronic Inflammation
    • When You Change Your Own Genes
    • Immune Cells in the Intestine
  • Inflammation and Other DILL+ Factors
  • Inflammatory Foods
    • Fats and Oils
    • Proteins and Animal Products
  • Individual Food Reactions
    • Food sensitivity and allergies
    • Food Panel Tests
    • Elimination Diet and Autoimmune Protocol (AIP)
  • Spices and Herbs to Reduce Inflammation
    • Hot or Not
  • Supplements and Inflammation
    • Vitamin D
    • Zinc
  • Gum and Teeth Health
• Key 3. Leaky gut: Repair
  • Constant Repair
  • Unhealthy Intestinal Lining and Leaky Gut
  • Gut Lining and Other DILL+ Factors
  • Eliminate Obstacles
    • Obstacle #4: Harmful Food Ingredients
    • Obstacle #5: Medication
    • Obstacle #7: Insufficient Mastication
    • Obstacle #9: Chilled Food and Drinks
  • Active Repair
    • Nutrition For the Gut Epithelium
    • Other Nutrients
    • Water-Fasting
    • Elemental and Semi-Elemental Diets
• Key 4. Lazy gut: Reawaken
  • Gut Motility: Speedy or Sluggish
    • Bowel Transit Time
  • Gut Motility and Other DILL+ Factors
    • Effect on the Microbiome — River vs Swamps
    • Inflammation
  • Physical Activities for Optimal Bowel Transit
    • Strengthening the Core and Abdominal Muscles
  • Your Food and Gut Motility
    • The Fiber Paradox: Why Eat What You Can’t Digest
    • Prokinetic and Laxative Foods
  • Bile and Gut Motility
  • Careful With Laxatives
• Key 5. Factors Beyond Digestive Health: Recondition
  • The Hygiene Paradox: When Cleaning Backfires
    • Hygiene Hypothesis and “Old Friends” Effect
    • Skin Microbiome and T-Lymphocytes
    • More Time and Meals Outdoors
    • Non-Organic Agriculture
  • Environment and Climate: Where You Live Matters
    • Microclimate: Small Changes Without a Big Move
  • Hormones. Why Do Females Experience More Autoimmune Conditions?
    • Testosterone
    • Xenoestrogens
  • Physical Exercises
    • Timing
    • Exercises for Healthy Testosterone Levels
    • Improve Blood Circulation in Your Limbs: A Simple Exercise
    • Cardio Training
  • Sleep and Circadian Rhythms
    • Sleep’s Role in Combating Chronic Illness
    • Circadian Rhythms
    • Melatonin: Friend or Foe?
    • Snoring and Sleep Apnea: Hidden Threats to Brain Health
    • Your Digestive System Also Wants To Sleep
  • Hydrotherapy and Temperature Contrast
    • Contrast Showers: A Practice You Can Start Today
    • Sauna and Steam Room
  • Oral Health and Other Autoimmune Triggers
    • Chronic Inflammation in Your Body
    • Oral Microbiome, Gums, and Teeth

🔝

Hope in the Face of the Incurable

🔝

Immune System — The Good, the Bad, and the Ugly

🔝

The Ugly: An Ailing Immune System

Diseases Related to Immune System Disorders

The Immune System and Cancer — An Inconspicuous Link

• Ehrenfeld M. Autoimmune diseases and cancer. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 39. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459441/
• Isomäki, H. A., Hakulinen, T., & Joutsenlahti, U. (1978). Excess risk of lymphomas, leukemia and myeloma in patients with rheumatoid arthritis. Journal of chronic diseases, 31(11), 691–696. https://doi.org/10.1016/0021-9681(78)90071-1

Autoimmune Diseases — A Modern Epidemic

• Lerner, A. , Jeremias, P. , & Matthias, T. (2015). The World Incidence and Prevalence of Autoimmune Diseases is Increasing. International Journal of Celiac Disease, 3(4), 151-155. http://pubs.sciepub.com/ijcd/3/4/8/#

Immune Illness On the Rise

• Loh, W., & Tang, M. L. K. (2018). The Epidemiology of Food Allergy in the Global Context. International journal of environmental research and public health, 15(9), 2043. https://doi.org/10.3390/ijerph15092043
• IDF Diabetes Atlas, 7th edn, International Diabetes Federation, 2015.
• Burisch, J., Pedersen, N., Čuković-Čavka, S., Brinar, M., Kaimakliotis, I., Duricova, D., Shonová, O., Vind, I., Avnstrøm, S., Thorsgaard, N., Andersen, V., Krabbe, S., Dahlerup, J. F., Salupere, R., Nielsen, K. R., Olsen, J., Manninen, P., Collin, P., Tsianos, E. V., Katsanos, K. H., … EpiCom-group (2014). East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort. Gut, 63(4), 588–597. https://doi.org/10.1136/gutjnl-2013-304636
• Prescott, S. L., Pawankar, R., Allen, K. J., Campbell, D. E., Sinn, J. K.h, Fiocchi, A., Ebisawa, M., Sampson, H. A., Beyer, K., & Lee, B. W. (2013). A global survey of changing patterns of food allergy burden in children. The World Allergy Organization journal, 6(1), 21. https://doi.org/10.1186/1939-4551-6-21
• Platts-Mills T. A. (2015). The allergy epidemics: 1870-2010. The Journal of allergy and clinical immunology, 136(1), 3–13. https://doi.org/10.1016/j.jaci.2015.03.048
• Weiss S. T. (2002). Eat dirt–the hygiene hypothesis and allergic diseases. The New England journal of medicine, 347(12), 930–931. https://doi.org/10.1056/NEJMe020092
• Bach J. F. (2002). The effect of infections on susceptibility to autoimmune and allergic diseases. The New England journal of medicine, 347(12), 911–920. https://doi.org/10.1056/NEJMra020100
• Jackson KD, Howie LD, Akinbami LJ. Trends in allergic conditions among children: United States, 1997–2011. NCHS data brief, no 121. Hyattsville, MD: National Center for Health Statistics. 2013. https://www.cdc.gov/nchs/data/databriefs/db121.pdf
• Miller F. W. (2023). The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention. Current opinion in immunology, 80, 102266. https://doi.org/10.1016/j.coi.2022.102266

🔝

The Good: The Holistic Way to Restore the Immune System

DILL+: Locks and Vicious Cycles

• Guerreiro, C. S., Calado, Â., Sousa, J., & Fonseca, J. E. (2018). Diet, Microbiota, and Gut Permeability-The Unknown Triad in Rheumatoid Arthritis. Frontiers in medicine, 5, 349. https://doi.org/10.3389/fmed.2018.00349

🔝

Key 1. Dysbiosis: Repopulate the Microbiome

• Mills, S., Stanton, C., Lane, J. A., Smith, G. J., & Ross, R. P. (2019). Precision Nutrition and the Microbiome, Part I: Current State of the Science. Nutrients, 11(4), 923. https://doi.org/10.3390/nu11040923

🔝

The Last Discovered Organ That Reshapes Our Understanding of Health

• Marchesi, J. R., & Ravel, J. (2015). The vocabulary of microbiome research: a proposal. Microbiome, 3, 31. https://doi.org/10.1186/s40168-015-0094-5
• Appanna, V. D. (2023). Microbiomes and their functions: Why organisms need microbes. CRC Press.

Microbial Forces Within Us

• Kho, Z. Y., & Lal, S. K. (2018). The Human Gut Microbiome - A Potential Controller of Wellness and Disease. Frontiers in microbiology, 9, 1835. https://doi.org/10.3389/fmicb.2018.01835
• FAQ: Human Microbiome. Washington (DC): American Society for Microbiology; 2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562894/ doi: 10.1128/AAMCol.1-2013
• Dietert, R. (2017). The human superorganism: How the microbiome is revolutionizing the pursuit of a healthy life. New York: W.W. Norton & Company.
• O’Connor, J. P., & Sulzer, J. A. (2023). The invisible us: The human microbiome in health and disease. Science Repository, 1(1), 1-12. https://www.sciencerepository.org/the-invisible-us-the-human-microbiome-in-health-and-disease

A Busy, Adaptable Organ

• Pieter Van den Abbeele, Willy Verstraete, Sahar El Aidy, Annelies Geirnaert, Tom Van de Wiele (2013). Prebiotics, faecal transplants and microbial network units to stimulate biodiversity of the human gut microbiome. Science Repository https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/1751-7915.12049
• Morowitz, M. J., Carlisle, E. M., & Alverdy, J. C. (2011). Contributions of intestinal bacteria to nutrition and metabolism in the critically ill. The Surgical clinics of North America, 91(4), 771–viii. https://doi.org/10.1016/j.suc.2011.05.001
• Rowland, I., Gibson, G., Heinken, A., Scott, K., Swann, J., Thiele, I., & Tuohy, K. (2018). Gut microbiota functions: metabolism of nutrients and other food components. European journal of nutrition, 57(1), 1–24. https://doi.org/10.1007/s00394-017-1445-8
• Rembacken, B. J., Snelling, A. M., Hawkey, P. M., Chalmers, D. M., & Axon, A. T. (1999). Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet (London, England), 354(9179), 635–639. https://doi.org/10.1016/s0140-6736(98)06343-0
• Proal, A. D., Albert, P. J., & Marshall, T. G. (2013). The human microbiome and autoimmunity. Current opinion in rheumatology, 25(2), 234–240. https://doi.org/10.1097/BOR.0b013e32835cedbf
• Rembacken, B. J., Snelling, A. M., Hawkey, P. M., Chalmers, D. M., & Axon, A. T. (1999). Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet (London, England), 354(9179), 635–639. https://doi.org/10.1016/s0140-6736(98)06343-0
• De Luca, F., & Shoenfeld, Y. (2019). The microbiome in autoimmune diseases. Clinical and experimental immunology, 195(1), 74–85. https://doi.org/10.1111/cei.13158

🔝

Dimension 1: Microbiome Composition

Variety — Farmland vs Forest

• Schnorr, S., Candela, M., Rampelli, S. et al. Gut microbiome of the Hadza hunter-gatherers. Nat Commun 5, 3654 (2014). https://doi.org/10.1038/ncomms4654
• Conteville Liliane Costa, Oliveira-Ferreira Joseli, Vicente Ana Carolina Paulo (2019). Gut Microbiome Biomarkers and Functional Diversity Within an Amazonian Semi-Nomadic Hunter–Gatherer Group. Frontiers in Microbiology 2019-10. doi: 10.3389/fmicb.2019.01743 https://www.frontiersin.org/articles/10.3389/fmicb.2019.01743/full

🔝

Actively Repopulate

Building a Healthy Community

• Spiller R. (2008). Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary pharmacology & therapeutics, 28(4), 385–396. https://pubmed.ncbi.nlm.nih.gov/18532993/
• Sanders M. E. (2011). Impact of probiotics on colonizing microbiota of the gut. Journal of clinical gastroenterology, 45 Suppl, S115–S119. https://doi.org/10.1097/MCG.0b013e318227414a

Probiotics

• M. Andrea Azcarate-Peril, Roland R. Arnold, José M. Bruno-Bárcena. (2019). How Fermented Foods Feed a Healthy Gut Microbiota. A Nutrition Continuum. (ISBN: 978-3-030-28737-5). https://link.springer.com/book/10.1007/978-3-030-28737-5
• Marteau, P. R., de Vrese, M., Cellier, C. J., & Schrezenmeir, J. (2001). Protection from gastrointestinal diseases with the use of probiotics. The American journal of clinical nutrition, 73(2 Suppl), 430S–436S. https://doi.org/10.1093/ajcn/73.2.430s
• Massimo Campieri, Paolo Gionchetti (1999). Probiotics in inflammatory bowel disease: New insight to pathogenesis or a possible therapeutic alternative? Gastroenterology 1999;116:1246-1249 https://doi.org/10.1016/S0016-5085(99)70029-6
• Schultz, M., & Sartor, R. B. (2000). Probiotics and inflammatory bowel diseases. The American journal of gastroenterology, 95(1 Suppl), S19–S21. https://doi.org/10.1016/s0002-9270(99)00812-6
• Richards, J. L., Yap, Y. A., McLeod, K. H., Mackay, C. R., & Mariño, E. (2016). Dietary metabolites and the gut microbiota: an alternative approach to control inflammatory and autoimmune diseases. Clinical & translational immunology, 5(5), e82. https://doi.org/10.1038/cti.2016.29
• Narges Dargahi, Joshua Johnson, Osaana Donkor, Todor Vasiljevic, Vasso Apostolopoulos (2019). Immunomodulatory effects of probiotics: Can they be used to treat allergies and autoimmune diseases? Maturitas, Volume 119, 2019, Pages 25-38, ISSN 0378-5122, https://www.sciencedirect.com/science/article/pii/S0378512218305528
• Suez, J., Zmora, N., Zilberman-Schapira, G., Mor, U., Dori-Bachash, M., Bashiardes, S., Zur, M., Regev-Lehavi, D., Ben-Zeev Brik, R., Federici, S., Horn, M., Cohen, Y., Moor, A. E., Zeevi, D., Korem, T., Kotler, E., Harmelin, A., Itzkovitz, S., Maharshak, N., Shibolet, O., … Elinav, E. (2018). Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 174(6), 1406–1423.e16. https://doi.org/10.1016/j.cell.2018.08.047
• Wastyk, H. C., Perelman, D., Topf, M., Fragiadakis, G. K., Robinson, J. L., Sonnenburg, J. L., Gardner, C. D., & Sonnenburg, E. D. (2023). Randomized controlled trial demonstrates response to a probiotic intervention for metabolic syndrome that may correspond to diet. Gut microbes, 15(1), 2178794. https://doi.org/10.1080/19490976.2023.2178794
• Farnworth, E. R. (Ed.). (2008). Handbook of fermented functional foods. CRC Press.

Fermented Vegetables and Pickles

• Arasu, M.V., Al-Dhabi, N.A., Rejiniemon, T.S. et al. Identification and Characterization of Lactobacillus brevis P68 with Antifungal, Antioxidant and Probiotic Functional Properties. Indian J Microbiol 55, 19–28 (2015). https://doi.org/10.1007/s12088-014-0495-3
• Parvez, S., Malik, K., Ah Kang, S. and Kim, H.-Y. (2006), Probiotics and their fermented food products are beneficial for health. Journal of Applied Microbiology, 100: 1171-1185. https://doi.org/10.1111/j.1365-2672.2006.02963.x
• Sudhanshu S. Behera, Aly Farag El Sheikha, Riadh Hammami, Awanish Kumar (2020). Traditionally fermented pickles: How the microbial diversity associated with their nutritional and health benefits? Journal of Functional Foods, Volume 70, 2020, 103971, ISSN 1756-4646, https://www.sciencedirect.com/science/article/pii/S175646462030195X

Fermented Dairy

• Leeuwendaal, N. K., Stanton, C., O’Toole, P. W., & Beresford, T. P. (2022). Fermented Foods, Health and the Gut Microbiome. Nutrients, 14(7), 1527. https://doi.org/10.3390/nu14071527
• Shiby, V. K., & Mishra, H. N. (2013). Fermented milks and milk products as functional foods–a review. Critical reviews in food science and nutrition, 53(5), 482–496. https://doi.org/10.1080/10408398.2010.547398
• Nakazawa, Y., & Hosono, A. (1992). Functions of fermented milk: Challenges for the health sciences. Elsevier Science & Technology. https://www.cabdirect.org/cabdirect/abstract/19920455311
• Mani-López, E., Palou, E., & López-Malo, A. (2014). Probiotic viability and storage stability of yogurts and fermented milks prepared with several mixtures of lactic acid bacteria. Journal of dairy science, 97(5), 2578–2590. https://doi.org/10.3168/jds.2013-7551

Cheese

• Homayouni Aziz , Ansari Fereshteh , Azizi Aslan , Pourjafar Hadi *, Madadi Masuod (2020). Cheese as a Potential Food Carrier to Deliver Probiotic Microorganisms into the Human Gut: A Review, Current Nutrition & Food Science 2020; 16(1) . https://dx.doi.org/10.2174/1573401314666180817101526

Fecal Microbial Transplantation: Success or Temporary Fix?

• Stripling, J., & Rodriguez, M. (2018). Current Evidence in Delivery and Therapeutic Uses of Fecal Microbiota Transplantation in Human Diseases-Clostridium difficile Disease and Beyond. The American journal of the medical sciences, 356(5), 424–432. https://doi.org/10.1016/j.amjms.2018.08.010
• Han-Wen Kuo, Wang-Hsien Ding (2004). Trace determination of bisphenol A and phytoestrogens in infant formula powders by gas chromatography–mass spectrometry. Journal of Chromatography A, Volume 1027, Issues 1–2, 2004, Pages 67-74, ISSN 0021-9673. https://www.sciencedirect.com/science/article/abs/pii/S0021967303016261

Feeding your Allies

• Tuohy, K. M., Conterno, L., Gasperotti, M., & Viola, R. (2012). Up-regulating the human intestinal microbiome using whole plant foods, polyphenols, and/or fiber. Journal of agricultural and food chemistry, 60(36), 8776–8782. https://doi.org/10.1021/jf2053959

Prebiotics

• Holscher H. D. (2017). Dietary fiber and prebiotics and the gastrointestinal microbiota. Gut microbes, 8(2), 172–184. https://doi.org/10.1080/19490976.2017.1290756

Dead or Alive — Enzymes in Your Food

• Carmody, R. N., Bisanz, J. E., Bowen, B. P., Maurice, C. F., Lyalina, S., Louie, K. B., Treen, D., Chadaideh, K. S., Maini Rekdal, V., Bess, E. N., Spanogiannopoulos, P., Ang, Q. Y., Bauer, K. C., Balon, T. W., Pollard, K. S., Northen, T. R., & Turnbaugh, P. J. (2019). Cooking shapes the structure and function of the gut microbiome. Nature microbiology, 4(12), 2052–2063. https://doi.org/10.1038/s41564-019-0569-4

Frozen, Dried, Salted — Preserving Raw Produce

• Sarron, E., Gadonna-Widehem, P., & Aussenac, T. (2021). Ozone Treatments for Preserving Fresh Vegetables Quality: A Critical Review. Foods (Basel, Switzerland), 10(3), 605. https://doi.org/10.3390/foods10030605

Polyphenols: The Colorful Path to a Diverse Microbiome

• Kumar Singh, A., Cabral, C., Kumar, R., Ganguly, R., Kumar Rana, H., Gupta, A., Rosaria Lauro, M., Carbone, C., Reis, F., & Pandey, A. K. (2019). Beneficial Effects of Dietary Polyphenols on Gut Microbiota and Strategies to Improve Delivery Efficiency. Nutrients, 11(9), 2216. https://doi.org/10.3390/nu11092216
• Oliveira, A. L. B., Monteiro, V. V. S., Navegantes-Lima, K. C., Reis, J. F., Gomes, R. S., Rodrigues, D. V. S., Gaspar, S. L. F., & Monteiro, M. C. (2017). Resveratrol Role in Autoimmune Disease-A Mini-Review. Nutrients, 9(12), 1306. https://doi.org/10.3390/nu9121306
• Fernando Cardona, Cristina Andrés-Lacueva, Sara Tulipani, Francisco J. Tinahones, María Isabel Queipo-Ortuño (2013). Benefits of polyphenols on gut microbiota and implications in human health. The Journal of Nutritional Biochemistry, Volume 24, Issue 8, 2013, Pages 1415-1422, ISSN 0955-2863, https://doi.org/10.1016/j.jnutbio.2013.05.001
• Gunathilake, K. D. P. P., Ranaweera, K. K. D. S., & Rupasinghe, H. P. V. (2018). Effect of Different Cooking Methods on Polyphenols, Carotenoids and Antioxidant Activities of Selected Edible Leaves. Antioxidants (Basel, Switzerland), 7(9), 117. https://doi.org/10.3390/antiox7090117
• Manach, C., Scalbert, A., Morand, C., Rémésy, C., & Jiménez, L. (2004). Polyphenols: food sources and bioavailability. The American journal of clinical nutrition, 79(5), 727–747. https://doi.org/10.1093/ajcn/79.5.727

Vitamin K

• Ellis, J. L., Karl, J. P., Oliverio, A. M., Fu, X., Soares, J. W., Wolfe, B. E., Hernandez, C. J., Mason, J. B., & Booth, S. L. (2021). Dietary vitamin K is remodeled by gut microbiota and influences community composition. Gut microbes, 13(1), 1–16. https://doi.org/10.1080/19490976.2021.1887721
• Lai, Y., Masatoshi, H., Ma, Y., Guo, Y., & Zhang, B. (2022). Role of Vitamin K in Intestinal Health. Frontiers in immunology, 12, 791565. https://doi.org/10.3389/fimmu.2021.791565
• Mathers, J., Fernandez, F., Hill, M., McCarthy, P., Shearer, M., & Oxley, A. (1990). Dietary modification of potential vitamin K supply from enteric bacterial menaquinones in rats. British Journal of Nutrition, 63(3), 639-652. doi:10.1079/BJN19900150 https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dietary-modification-of-potential-vitamin-k-supply-from-enteric-bacterial-menaquinones-in-rats/AEB49A361AC03D5F80B952B34C4D6F94
• Zhang Y., Ma C., Zhao J., Xu H., Hou Q., Zhang H. Lactobacillus casei Zhang and vitamin K2 prevent intestinal tumorigenesis in mice via adiponectin-elevated different signaling pathways. Oncotarget. 2017; 8: 24719-24727. Retrieved from https://www.oncotarget.com/article/15791/text/
• van Ballegooijen, A. J., Pilz, S., Tomaschitz, A., Grübler, M. R., & Verheyen, N. (2017). The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review. International journal of endocrinology, 2017, 7454376. https://doi.org/10.1155/2017/7454376

The Myth of Healthy Toppings on Junk Food

• Kaczmarek, J. L., Liu, X., Charron, C. S., Novotny, J. A., Jeffery, E. H., Seifried, H. E., Ross, S. A., Miller, M. J., Swanson, K. S., & Holscher, H. D. (2019). Broccoli consumption affects the human gastrointestinal microbiota. The Journal of nutritional biochemistry, 63, 27–34. https://doi.org/10.1016/j.jnutbio.2018.09.015
• Shahinozzaman, M.; Raychaudhuri, S.; Fan, S.; Obanda, D.N. (2021). Kale Attenuates Inflammation and Modulates Gut Microbial Composition and Function in C57BL/6J Mice with Diet-Induced Obesity. Microorganisms 2021, 9, 238. https://doi.org/10.3390/microorganisms9020238
• Turner, Alexandria, Chijoff, Eileen, Veysey, Martin, Keely, Simon, Scarlett, Christopher J., Lucock, Mark, and Beckett, Emma L. (2019). Interactions between taste receptors and the gastrointestinal microbiome in inflammatory bowel disease. Journal of Nutrition and Intermediary Metabolism 18 100106 100106. https://doi.org/10.1016/j.jnim.2019.100106
• Guo, S., Geng, W., Chen, S., Wang, L., Rong, X., Wang, S., Wang, T., Xiong, L., Huang, J., Pang, X., & Lu, Y. (2021). Ginger Alleviates DSS-Induced Ulcerative Colitis Severity by Improving the Diversity and Function of Gut Microbiota. Frontiers in pharmacology, 12, 632569. https://doi.org/10.3389/fphar.2021.632569
• Anna Prizment, Timothy R. Church, Dorothy Hatsukami, Robert Madoff, Christopher Staley, Robert J. Straka, Allison Iwan, Jenn Stromberg, Ya-Feng Wen, Cheryl Stibbe, Marie Rahne; (2020). Abstract A26: Pilot trial to examine the effect of ginger on the gut microbiome: The Minnesota Cancer Clinical Trials Network. Cancer Epidemiol Biomarkers Prev 1 September 2020; 29 (9_Supplement): A26. https://doi.org/10.1158/1538-7755.MODPOP19-A26

Food Diversity

• Heiman, M. L., & Greenway, F. L. (2016). A healthy gastrointestinal microbiome is dependent on dietary diversity. Molecular metabolism, 5(5), 317–320. https://doi.org/10.1016/j.molmet.2016.02.005
• https://thefuturemarket.com/biodiversity
• FAO: What is Happening to Agrobiodiversity? https://www.fao.org/3/y5609e/y5609e02.htm#bm2

🔝

Dimension 2: Microbiome Distribution

• Dieterich, W., Schink, M., & Zopf, Y. (2018). Microbiota in the Gastrointestinal Tract. Medical sciences (Basel, Switzerland), 6(4), 116. https://doi.org/10.3390/medsci6040116
• Sekirov, I., Russell, S. L., Antunes, L. C., & Finlay, B. B. (2010). Gut microbiota in health and disease. Physiological reviews, 90(3), 859–904. https://doi.org/10.1152/physrev.00045.2009

SIBO, IBS, IBD, Ulcers: Many Faces of Microbiome Maldistribution

Small Intestinal Bacterial Overgrowth (SIBO)

• Sachdev, A. H., & Pimentel, M. (2013). Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Therapeutic advances in chronic disease, 4(5), 223–231. https://doi.org/10.1177/2040622313496126
• Roland, B. C., Ciarleglio, M. M., Clarke, J. O., Semler, J. R., Tomakin, E., Mullin, G. E., & Pasricha, P. J. (2015). Small Intestinal Transit Time Is Delayed in Small Intestinal Bacterial Overgrowth. Journal of clinical gastroenterology, 49(7), 571–576. https://doi.org/10.1097/MCG.0000000000000257

Below the Waterline: Subclinical SIBO

• Khoshini, R., Dai, S. C., Lezcano, S., & Pimentel, M. (2008). A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Digestive diseases and sciences, 53(6), 1443–1454. https://doi.org/10.1007/s10620-007-0065-1

Ulcers and Helicobacter pylori

• Bruno, G., Rocco, G., Zaccari, P., Porowska, B., Mascellino, M. T., & Severi, C. (2018). Helicobacter pylori Infection and Gastric Dysbiosis: Can Probiotics Administration Be Useful to Treat This Condition?. The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale, 2018, 6237239. https://doi.org/10.1155/2018/6237239
• Zhang, L., Zhao, M., & Fu, X. (2023). Gastric microbiota dysbiosis and Helicobacter pylori infection. Frontiers in microbiology, 14, 1153269. https://doi.org/10.3389/fmicb.2023.1153269

🔝

Healthy Digestion to Fix Microbiota Distribution

Don’t Rush the Reactor

Surgical Procedures to Avoid

• Dolan, R. D., Baker, J., Harer, K., Lee, A., Hasler, W., Saad, R., & Schulman, A. R. (2021). Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass. Obesity surgery, 31(2), 564–569. https://doi.org/10.1007/s11695-020-05032-y
• Sabate, J. M., Coupaye, M., Ledoux, S., Castel, B., Msika, S., Coffin, B., & Jouet, P. (2017). Consequences of Small Intestinal Bacterial Overgrowth in Obese Patients Before and After Bariatric Surgery. Obesity surgery, 27(3), 599–605. https://doi.org/10.1007/s11695-016-2343-5

Stomach Acid

Acid — The Protective Firewall

• Beasley, D. E., Koltz, A. M., Lambert, J. E., Fierer, N., & Dunn, R. R. (2015). The Evolution of Stomach Acidity and Its Relevance to the Human Microbiome. PloS one, 10(7), e0134116. https://doi.org/10.1371/journal.pone.0134116
• Martinsen, T. C., Fossmark, R., & Waldum, H. L. (2019). The Phylogeny and Biological Function of Gastric Juice-Microbiological Consequences of Removing Gastric Acid. International journal of molecular sciences, 20(23), 6031. https://doi.org/10.3390/ijms20236031

Antacids and “Heartburn” (Gastroesophageal Reflux)

• Theisen, J., Nehra, D., Citron, D., Johansson, J., Hagen, J. A., Crookes, P. F., DeMeester, S. R., Bremner, C. G., DeMeester, T. R., & Peters, J. H. (2000). Suppression of gastric acid secretion in patients with gastroesophageal reflux disease results in gastric bacterial overgrowth and deconjugation of bile acids. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract, 4(1), 50–54. https://doi.org/10.1016/s1091-255x(00)80032-3

Bile and Liver Health

• Sun, R., Xu, C., Feng, B., Gao, X., & Liu, Z. (2021). Critical roles of bile acids in regulating intestinal mucosal immune responses. Therapeutic advances in gastroenterology, 14, 17562848211018098. https://doi.org/10.1177/17562848211018098
• Vijayvargiya, P., Busciglio, I., Burton, D., Donato, L., Lueke, A., & Camilleri, M. (2018). Bile Acid Deficiency in a Subgroup of Patients With Irritable Bowel Syndrome With Constipation Based on Biomarkers in Serum and Fecal Samples. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 16(4), 522–527. https://doi.org/10.1016/j.cgh.2017.06.039

Bile Salt Malabsorption and the Microbiome

• Ridlon, J. M., Kang, D. J., Hylemon, P. B., & Bajaj, J. S. (2014). Bile acids and the gut microbiome. Current opinion in gastroenterology, 30(3), 332–338. https://doi.org/10.1097/MOG.0000000000000057
• Sagar, N. M., Duboc, H., Kay, G. L., Alam, M. T., Wicaksono, A. N., Covington, J. A., Quince, C., Kokkorou, M., Svolos, V., Palmieri, L. J., Gerasimidis, K., Walters, J. R. F., & Arasaradnam, R. P. (2020). The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids. Scientific reports, 10(1), 20436. https://doi.org/10.1038/s41598-020-77374-7
• Guzior, D. V., & Quinn, R. A. (2021). Review: microbial transformations of human bile acids. Microbiome, 9(1), 140. https://doi.org/10.1186/s40168-021-01101-1

Helping Your Liver

Reduce Toxic Load

• Bataller, R., Arab, J. P., & Shah, V. H. (2022). Alcohol-Associated Hepatitis. The New England journal of medicine, 387(26), 2436–2448. https://doi.org/10.1056/NEJMra2207599

Hepatoprotective Food

• Iahtisham-Ul-Haq, Butt, M. S., Randhawa, M. A., & Shahid, M. (2019). Hepatoprotective effects of red beetroot-based beverages against CCl4 -induced hepatic stress in Sprague Dawley rats. Journal of food biochemistry, 43(12), e13057. https://doi.org/10.1111/jfbc.13057
• Madrigal-Santillán, E., Madrigal-Bujaidar, E., Álvarez-González, I., Sumaya-Martínez, M. T., Gutiérrez-Salinas, J., Bautista, M., Morales-González, Á., García-Luna y González-Rubio, M., Aguilar-Faisal, J. L., & Morales-González, J. A. (2014). Review of natural products with hepatoprotective effects. World journal of gastroenterology, 20(40), 14787–14804. https://doi.org/10.3748/wjg.v20.i40.14787

Glutathione

• Fidelus, R. K., & Tsan, M. F. (1987). Glutathione and lymphocyte activation: a function of ageing and auto-immune disease. Immunology, 61(4), 503–508. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1453448/
• Perricone, C., De Carolis, C., & Perricone, R. (2009). Glutathione: a key player in autoimmunity. Autoimmunity reviews, 8(8), 697–701. https://doi.org/10.1016/j.autrev.2009.02.020
• Hassan, M. Q., Hadi, R. A., Al-Rawi, Z. S., Padron, V. A., & Stohs, S. J. (2001). The glutathione defense system in the pathogenesis of rheumatoid arthritis. Journal of applied toxicology : JAT, 21(1), 69–73. https://doi.org/10.1002/jat.736

Other Tactics for Fixing SIBO and Normalizing Microbiome Distribution

Power of Herbs, Spices, and Other Foods to Control Microbial Growth

• Dahl, S. M., Rolfe, V., Walton, G. E., & Gibson, G. R. (2023). Gut microbial modulation by culinary herbs and spices. Food chemistry, 409, 135286. https://doi.org/10.1016/j.foodchem.2022.135286

Spices to Avoid

• Xiang, Q., Tang, X., Cui, S., Zhang, Q., Liu, X., Zhao, J., Zhang, H., Mao, B., & Chen, W. (2022). Capsaicin, the Spicy Ingredient of Chili Peppers: Effects on Gastrointestinal Tract and Composition of Gut Microbiota at Various Dosages. Foods (Basel, Switzerland), 11(5), 686. https://doi.org/10.3390/foods11050686
• Kimball, E. S., Palmer, J. M., D’Andrea, M. R., Hornby, P. J., & Wade, P. R. (2005). Acute colitis induction by oil of mustard results in later development of an IBS-like accelerated upper GI transit in mice. American journal of physiology. Gastrointestinal and liver physiology, 288(6), G1266–G1273. https://doi.org/10.1152/ajpgi.00444.2004

Antimicrobial Herbs and Spices

• Olivier, Rachel. (2013). Select herbals proposed as beneficial in the eradication of small intestinal bacterial overgrowth. The Original Internist, March 2013 20(1):30-38.
• Delaquis, P. J., Stanich, K., Girard, B., & Mazza, G. (2002). Antimicrobial activity of individual and mixed fractions of dill, cilantro, coriander and eucalyptus essential oils. International journal of food microbiology, 74(1-2), 101–109. https://doi.org/10.1016/s0168-1605(01)00734-6
• Han, J., Lin, H., & Huang, W. (2011). Modulating gut microbiota as an anti-diabetic mechanism of berberine. Medical science monitor : international medical journal of experimental and clinical research, 17(7), RA164–RA167. https://doi.org/10.12659/msm.881842
• Joshi, P. V., Shirkhedkar, A. A., Prakash, K., & Maheshwari, V. L. (2011). Antidiarrheal activity, chemical and toxicity profile of Berberis aristata. Pharmaceutical biology, 49(1), 94–100. https://doi.org/10.3109/13880209.2010.500295
• Arcila-Lozano, C. C., Loarca-Piña, G., Lecona-Uribe, S., & González de Mejía, E. (2004). El orégano: propiedades, composición y actividad biológica de sus componentes [Oregano: properties, composition and biological activity]. Archivos latinoamericanos de nutricion, 54(1), 100–111. https://pubmed.ncbi.nlm.nih.gov/15332363/
• Saeed, S., & Tariq, P. (2009). Antibacterial activity of oregano (Origanum vulgare Linn.) against gram positive bacteria. Pakistan journal of pharmaceutical sciences, 22(4), 421–424. https://pubmed.ncbi.nlm.nih.gov/19783523/
• Zarringhalam, M., Zaringhalam, J., Shadnoush, M., Safaeyan, F., & Tekieh, E. (2013). Inhibitory Effect of Black and Red Pepper and Thyme Extracts and Essential Oils on Enterohemorrhagic Escherichia coli and DNase Activity of Staphylococcus aureus. Iranian journal of pharmaceutical research : IJPR, 12(3), 363–369. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813290/
• Esmaeili, D., Mobarez, A. M., & Tohidpour, A. (2012). Anti-helicobacter pylori activities of shoya powder and essential oils of thymus vulgaris and eucalyptus globulus. The open microbiology journal, 6, 65–69. https://doi.org/10.2174/1874285801206010065
• Sahib A. S. (2013). Treatment of irritable bowel syndrome using a selected herbal combination of Iraqi folk medicines. Journal of ethnopharmacology, 148(3), 1008–1012. https://doi.org/10.1016/j.jep.2013.05.034
• Ng, S. C., Lam, Y. T., Tsoi, K. K., Chan, F. K., Sung, J. J., & Wu, J. C. (2013). Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Alimentary pharmacology & therapeutics, 38(8), 854–863. https://doi.org/10.1111/apt.12464
• Triantafyllidi, A., Xanthos, T., Papalois, A., & Triantafillidis, J. K. (2015). Herbal and plant therapy in patients with inflammatory bowel disease. Annals of gastroenterology, 28(2), 210–220. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367210/
• Omer, B., Krebs, S., Omer, H., & Noor, T. O. (2007). Steroid-sparing effect of wormwood (Artemisia absinthium) in Crohn’s disease: a double-blind placebo-controlled study. Phytomedicine : international journal of phytotherapy and phytopharmacology, 14(2-3), 87–95. https://doi.org/10.1016/j.phymed.2007.01.001
• Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., Justino, E., Tomakin, E., & Mullin, G. E. (2014). Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global advances in health and medicine, 3(3), 16–24. https://doi.org/10.7453/gahmj.2014.019
• Anand, U., Jacobo-Herrera, N., Altemimi, A., & Lakhssassi, N. (2019). A Comprehensive Review on Medicinal Plants as Antimicrobial Therapeutics: Potential Avenues of Biocompatible Drug Discovery. Metabolites, 9(11), 258. https://doi.org/10.3390/metabo9110258

N-Acetylcysteine (NAC)

• Walker, A. W., & Lawley, T. D. (2013). Therapeutic modulation of intestinal dysbiosis. Pharmacological research, 69(1), 75–86. https://doi.org/10.1016/j.phrs.2012.09.008
• Dinicola, S., De Grazia, S., Carlomagno, G., & Pintucci, J. P. (2014). N-acetylcysteine as powerful molecule to destroy bacterial biofilms. A systematic review. European review for medical and pharmacological sciences, 18(19), 2942–2948. https://pubmed.ncbi.nlm.nih.gov/25339490/

🔝

Fungi: Mold and Yeast

Addressing the SIFO Problem

• Lange J. H. (2004). Endotoxin as a factor for joint pain and rheumatoid arthritis. Clinical rheumatology, 23(6), 566–567. https://doi.org/10.1007/s10067-004-0947-y
• Gray, M. R., Thrasher, J. D., Crago, R., Madison, R. A., Arnold, L., Campbell, A. W., & Vojdani, A. (2003). Mixed mold mycotoxicosis: immunological changes in humans following exposure in water-damaged buildings. Archives of environmental health, 58(7), 410–420. https://doi.org/10.1080/00039896.2003.11879142
• Jahreis, S., Kuhn, S., Madaj, A. M., Bauer, M., & Polte, T. (2017). Mold metabolites drive rheumatoid arthritis in mice via promotion of IFN-gamma- and IL-17-producing T cells. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association, 109(Pt 1), 405–413. https://doi.org/10.1016/j.fct.2017.09.027
• Lieberman, A., & Curtis, L. (2020). Mold Exposure and Mitochondrial Antibodies. Alternative therapies in health and medicine, 26(6), 44–47.

🔝

Feeding Your Enemies

Sweet Does Not Equal Good

Sugar

• Satokari R. (2020). High Intake of Sugar and the Balance between Pro- and Anti-Inflammatory Gut Bacteria. Nutrients, 12(5), 1348. https://doi.org/10.3390/nu12051348
• Weissmann, Gerald. (2006). Is Sugar the Missing Link in RA?. Internal Medicine News. 39. 11. 10.1016/S1097-8690(06)74010-0.

Natural Sweeteners

• Sheldon, M., Klyza, J., & Zimeri, A. M. (2019). Pesticide Contamination in Central Kentucky Urban Honey: A Pilot Study. Journal of Environmental Health, 82(1), 8–13. https://www.jstor.org/stable/26726953
• Bezirtzoglou E, Voidarou C, Stavropoulou E, et al. Emerging antibiotic resistance in honey as a hazard for human health. J Bacteriol Mycol Open Access. 2016;2(1):6-12. DOI: 10.15406/jbmoa.2016.02.00012
• A. Baggio , A. Gallina , C. Benetti & F. Mutinelli (2009) Residues of antibacterial drugs in honey from the Italian market, Food Additives & Contaminants: Part B, 2:1, 52-58, DOI: 10.1080/02652030902897721

Unnatural Sweeteners

• Ruiz-Ojeda, F. J., Plaza-Díaz, J., Sáez-Lara, M. J., & Gil, A. (2019). Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials. Advances in nutrition (Bethesda, Md.), 10(suppl_1), S31–S48. https://doi.org/10.1093/advances/nmy037
• Shil, A., & Chichger, H. (2021). Artificial Sweeteners Negatively Regulate Pathogenic Characteristics of Two Model Gut Bacteria, E. coli and E. faecalis. International journal of molecular sciences, 22(10), 5228. https://doi.org/10.3390/ijms22105228
• Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., Israeli, D., Zmora, N., Gilad, S., Weinberger, A., Kuperman, Y., Harmelin, A., Kolodkin-Gal, I., Shapiro, H., Halpern, Z., Segal, E., & Elinav, E. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181–186. https://doi.org/10.1038/nature13793
• Czarnecka, K., Pilarz, A., Rogut, A., Maj, P., Szymańska, J., Olejnik, Ł., & Szymański, P. (2021). Aspartame-True or False? Narrative Review of Safety Analysis of General Use in Products. Nutrients, 13(6), 1957. https://doi.org/10.3390/nu13061957
• Chi, L., Bian, X., Gao, B., Tu, P., Lai, Y., Ru, H., & Lu, K. (2018). Effects of the Artificial Sweetener Neotame on the Gut Microbiome and Fecal Metabolites in Mice. Molecules (Basel, Switzerland), 23(2), 367. https://doi.org/10.3390/molecules23020367

Conquering Sugar Cravings

Good Options for Sweet Cravings

• Pourmasoumi, M., Ghiasvand, R., Darvishi, L., Hadi, A., Bahreini, N., & Keshavarzpour, Z. (2019). Comparison and Assessment of Flixweed and Fig Effects on Irritable Bowel Syndrome with Predominant Constipation: A Single-Blind Randomized Clinical Trial. Explore (New York, N.Y.), 15(3), 198–205. https://doi.org/10.1016/j.explore.2018.09.003

Children’s Foods — Passing the Problem to the Next Generation

• Allergy Statistics and Facts https://www.webmd.com/allergies/allergy-statistics
• Zablotsky, B., Black, L. I., & Akinbami, L. J. (2023). Diagnosed Allergic Conditions in Children Aged 0-17 Years: United States, 2021. NCHS data brief, (459), 1–8. https://www.cdc.gov/nchs/data/databriefs/db459.pdf

🔝

Other Risks to Your Microbiome Health

Inflammation

• Al Bander, Z., Nitert, M. D., Mousa, A., & Naderpoor, N. (2020). The Gut Microbiota and Inflammation: An Overview. International journal of environmental research and public health, 17(20), 7618. https://doi.org/10.3390/ijerph17207618

Antibiotics

Antibiotics Residues in Food

• Franco, D. A., Webb, J., & Taylor, C. E. (1990). Antibiotic and Sulfonamide Residues in Meat: Implications for Human Health. Journal of food protection, 53(2), 178–185. https://doi.org/10.4315/0362-028X-53.2.178
• Ramatla, T., Ngoma, L., Adetunji, M., & Mwanza, M. (2017). Evaluation of Antibiotic Residues in Raw Meat Using Different Analytical Methods. Antibiotics (Basel, Switzerland), 6(4), 34. https://doi.org/10.3390/antibiotics6040034
• Price, L. B., Rogers, L., & Lo, K. (2022). Policy reforms for antibiotic use claims in livestock. Science (New York, N.Y.), 376(6589), 130–132. https://doi.org/10.1126/science.abj1823
• Treiber, F. M., & Beranek-Knauer, H. (2021). Antimicrobial Residues in Food from Animal Origin-A Review of the Literature Focusing on Products Collected in Stores and Markets Worldwide. Antibiotics (Basel, Switzerland), 10(5), 534. https://doi.org/10.3390/antibiotics10050534
• Van Boeckel, T. P., Brower, C., Gilbert, M., Grenfell, B. T., Levin, S. A., Robinson, T. P., Teillant, A., & Laxminarayan, R. (2015). Global trends in antimicrobial use in food animals. Proceedings of the National Academy of Sciences of the United States of America, 112(18), 5649–5654. https://doi.org/10.1073/pnas.1503141112

Antibiotics’ Effect on the Microbiota of Animal Products

• White, D. G., Zhao, S., Sudler, R., Ayers, S., Friedman, S., Chen, S., McDermott, P. F., McDermott, S., Wagner, D. D., & Meng, J. (2001). The isolation of antibiotic-resistant salmonella from retail ground meats. The New England journal of medicine, 345(16), 1147–1154. https://doi.org/10.1056/NEJMoa010315
• Manyi-Loh, C., Mamphweli, S., Meyer, E., & Okoh, A. (2018). Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications. Molecules (Basel, Switzerland), 23(4), 795. https://doi.org/10.3390/molecules23040795
• Butaye, P., Devriese, L. A., & Haesebrouck, F. (2003). Antimicrobial growth promoters used in animal feed: effects of less well known antibiotics on gram-positive bacteria. Clinical microbiology reviews, 16(2), 175–188. https://doi.org/10.1128/CMR.16.2.175-188.2003

Navigating Animal Products

• Van Boeckel, T. P., Brower, C., Gilbert, M., Grenfell, B. T., Levin, S. A., Robinson, T. P., Teillant, A., & Laxminarayan, R. (2015). Global trends in antimicrobial use in food animals. Proceedings of the National Academy of Sciences of the United States of America, 112(18), 5649–5654. https://doi.org/10.1073/pnas.1503141112
• Landers, T. F., Cohen, B., Wittum, T. E., & Larson, E. L. (2012). A review of antibiotic use in food animals: perspective, policy, and potential. Public health reports (Washington, D.C. : 1974), 127(1), 4–22. https://doi.org/10.1177/003335491212700103

Chlorine and Related Compounds in Water

• Xue, B., Dai, K., Zhang, X., Wang, S., Li, C., Zhao, C., Yang, X., Xi, Z., Qiu, Z., Shen, Z., & Wang, J. (2020). Low-concentration of dichloroacetonitrile (DCAN) in drinking water perturbs the health-associated gut microbiome and metabolic profile in rats. Chemosphere, 258, 127067. https://doi.org/10.1016/j.chemosphere.2020.127067
• Martino D. (2019). The Effects of Chlorinated Drinking Water on the Assembly of the Intestinal Microbiome. Challenges. 2019; 10(1):10. https://doi.org/10.3390/challe10010010

Reverse Osmosis and Remineralization

• Kozisek, Frantisek. (2004). Health Risk from Drinking Demineralized Water. Rolling Revision of the WHO Guidelines for Drinking Water Quality. National Institute of Public Health Czech Republic.

Why Water Quality Matters

• Guidelines for drinking-water quality: the fourth edition incorporating the first addendum. Geneva: World Health Organization; 2017. https://www.who.int/publications/i/item/9789241549950

Chemical Additives and Toxins in Our Food

Chemical Toxins in a Polluted World

Microplastics and Nanoplastics

• Mason, S. A., Welch, V. G., & Neratko, J. (2018). Synthetic Polymer Contamination in Bottled Water. Frontiers in chemistry, 6, 407. https://doi.org/10.3389/fchem.2018.00407
• Ge, Y., Yang, S., Zhang, T., Wan, X., Zhu, Y., Yang, F., Yin, L., Pu, Y., & Liang, G. (2023). The hepatotoxicity assessment of micro/nanoplastics: A preliminary study to apply the adverse outcome pathways. The Science of the total environment, 902, 165659. https://doi.org/10.1016/j.scitotenv.2023.165659

Fish Safety

• Savoca, M. S., McInturf, A. G., & Hazen, E. L. (2021). Plastic ingestion by marine fish is widespread and increasing. Global change biology, 27(10), 2188–2199. https://doi.org/10.1111/gcb.15533

Heavy Metals and Chelation Foods

• Potera C. (2007). U.S. rice serves up arsenic. Environmental health perspectives, 115(6), A296. https://doi.org/10.1289/ehp.115-a296
• F. Bamonti et al. Metal chelation therapy in rheumatoid arthritis: a case report. Successful management of rheumatoid arthritis by metal chelation therapy. Biometals 2011 Dec;24(6):1093–1098.
• T. Uchikawa et al. Chlorella suppresses methylmercury transfer to the fetus in pregnant mice. J Toxicol Sci 2011 Oct;36(5):675–680.
• David B. Smith, William F. Cannon, Laurel G. Woodruff, Federico Solano, and Karl J. Ellefsen. (2014) Geochemical and Mineralogical Maps for Soils of the Conterminous United States. U.S. Department of the Interior. U.S. Geological Survey. https://pubs.usgs.gov/of/2014/1082/pdf/ofr2014-1082.pdf
• Meharg, A. A., Williams, P. N., Adomako, E., Lawgali, Y. Y., Deacon, C., Villada, A., Cambell, R. C., Sun, G., Zhu, Y. G., Feldmann, J., Raab, A., Zhao, F. J., Islam, R., Hossain, S., & Yanai, J. (2009). Geographical variation in total and inorganic arsenic content of polished (white) rice. Environmental science & technology, 43(5), 1612–1617. https://doi.org/10.1021/es802612a
• Sears M. E. (2013). Chelation: harnessing and enhancing heavy metal detoxification–a review. TheScientificWorldJournal, 2013, 219840. https://doi.org/10.1155/2013/219840

Alcohol

• Zhang, X., Yasuda, K., Gilmore, R. A., Westmoreland, S. V., Platt, D. M., Miller, G. M., & Vallender, E. J. (2019). Alcohol-induced changes in the gut microbiome and metabolome of rhesus macaques. Psychopharmacology, 236(5), 1531–1544. https://doi.org/10.1007/s00213-019-05217-z
• Ames, N. J., Barb, J. J., Schuebel, K., Mudra, S., Meeks, B. K., Tuason, R. T. S., Brooks, A. T., Kazmi, N., Yang, S., Ratteree, K., Diazgranados, N., Krumlauf, M., Wallen, G. R., & Goldman, D. (2020). Longitudinal gut microbiome changes in alcohol use disorder are influenced by abstinence and drinking quantity. Gut microbes, 11(6), 1608–1631. https://doi.org/10.1080/19490976.2020.1758010
• Capurso, G., & Lahner, E. (2017). The interaction between smoking, alcohol and the gut microbiome. Best practice & research. Clinical gastroenterology, 31(5), 579–588. https://doi.org/10.1016/j.bpg.2017.10.006
• Gabbard, S. L., Lacy, B. E., Levine, G. M., & Crowell, M. D. (2014). The impact of alcohol consumption and cholecystectomy on small intestinal bacterial overgrowth. Digestive diseases and sciences, 59(3), 638–644. https://doi.org/10.1007/s10620-013-2960-y

Food Additives: Hacking the Food

Concealing Poverty

• Collins, J., Robinson, C., Danhof, H. et al. (2018). Dietary trehalose enhances virulence of epidemic Clostridium difficile. Nature 553, 291–294 (2018). https://doi.org/10.1038/nature25178
• Lebelo, K., Malebo, N., Mochane, M. J., & Masinde, M. (2021). Chemical Contamination Pathways and the Food Safety Implications along the Various Stages of Food Production: A Review. International journal of environmental research and public health, 18(11), 5795. https://doi.org/10.3390/ijerph18115795
• Naimi, S., Viennois, E., Gewirtz, A.T. et al. (2021). Direct impact of commonly used dietary emulsifiers on human gut microbiota. Microbiome 9, 66 (2021). https://doi.org/10.1186/s40168-020-00996-6
• Lerner, A., & Matthias, T. (2020). Processed Food Additive Microbial Transglutaminase and Its Cross-Linked Gliadin Complexes Are Potential Public Health Concerns in Celiac Disease. International journal of molecular sciences, 21(3), 1127. https://doi.org/10.3390/ijms21031127
• Baraldi, L. G., Martinez Steele, E., Canella, D. S., & Monteiro, C. A. (2018). Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ open, 8(3), e020574. https://doi.org/10.1136/bmjopen-2017-020574

🔝

Key 2. Inflammation: Reduce

🔝

Intermittent Hormesis

• Rattan S. I. (2008). Hormesis in aging. Ageing research reviews, 7(1), 63–78. https://doi.org/10.1016/j.arr.2007.03.002
• Calabrese E. J. (2008). Hormesis and medicine. British journal of clinical pharmacology, 66(5), 594–617. https://doi.org/10.1111/j.1365-2125.2008.03243.x

🔝

Chronic Inflammation

Consequences of Chronic Inflammation

• Abu-Shakra, M., & Shoenfeld, Y. (1991). Chronic infections and autoimmunity. Immunology series, 55, 285–313. https://pubmed.ncbi.nlm.nih.gov/1954289/
• Arango MT, Shoenfeld Y, Cervera R, et al. (2013). Infection and autoimmune diseases. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459437/

When You Change Your Own Genes

• Detanico, T., St Clair, J. B., Aviszus, K., Kirchenbaum, G., Guo, W., & Wysocki, L. J. (2013). Somatic mutagenesis in autoimmunity. Autoimmunity, 46(2), 102–114. https://doi.org/10.3109/08916934.2012.757597
• Dörner, T., Giesecke, C. & Lipsky, P.E. (2011). Mechanisms of B cell autoimmunity in SLE . Arthritis Res Ther 13, 243 (2011). https://doi.org/10.1186/ar3433
• Nobel Prize. (2023, August 23). The Nobel Prize in Physiology or Medicine 1987. NobelPrize.org. https://www.nobelprize.org/prizes/medicine/1987/summary/

Immune Cells in the Intestine

• Vighi, G., Marcucci, F., Sensi, L., Di Cara, G., & Frati, F. (2008). Allergy and the gastrointestinal system. Clinical and experimental immunology, 153 Suppl 1(Suppl 1), 3–6. https://doi.org/10.1111/j.1365-2249.2008.03713.x

🔝

Inflammation and Other DILL+ Factors

• Walker, A. W., & Lawley, T. D. (2013). Therapeutic modulation of intestinal dysbiosis. Pharmacological research, 69(1), 75–86. https://doi.org/10.1016/j.phrs.2012.09.008
• Shanahan F. (2000). Probiotics and inflammatory bowel disease: is there a scientific rationale?. Inflammatory bowel diseases, 6(2), 107–115. https://doi.org/10.1097/00054725-200005000-00007

🔝

Inflammatory Foods

• Vojdani, A., Gushgari, L. R., & Vojdani, E. (2020). Interaction between food antigens and the immune system: Association with autoimmune disorders. Autoimmunity reviews, 19(3), 102459. https://doi.org/10.1016/j.autrev.2020.102459

Fats and Oils

• Ergas, D., Eilat, E., Mendlovic, S., & Sthoeger, Z. M. (2002). n-3 fatty acids and the immune system in autoimmunity. The Israel Medical Association journal : IMAJ, 4(1), 34–38. https://pubmed.ncbi.nlm.nih.gov/11802309/
• Molendi-Coste, O., Legry, V., & Leclercq, I. A. (2011). Why and How Meet n-3 PUFA Dietary Recommendations?. Gastroenterology research and practice, 2011, 364040. https://doi.org/10.1155/2011/364040
• Yamashima, T., Ota, T., Mizukoshi, E., Nakamura, H., Yamamoto, Y., Kikuchi, M., Yamashita, T., & Kaneko, S. (2020). Intake of ω-6 Polyunsaturated Fatty Acid-Rich Vegetable Oils and Risk of Lifestyle Diseases. Advances in nutrition (Bethesda, Md.), 11(6), 1489–1509. https://doi.org/10.1093/advances/nmaa072
• Fernandes G. (1994). Dietary lipids and risk of autoimmune disease. Clinical immunology and immunopathology, 72(2), 193–197. https://doi.org/10.1006/clin.1994.1129
• Harbige L. S. (2003). Fatty acids, the immune response, and autoimmunity: a question of n-6 essentiality and the balance between n-6 and n-3. Lipids, 38(4), 323–341. https://doi.org/10.1007/s11745-003-1067-z
• Harbige L. S. (1998). Dietary n-6 and n-3 fatty acids in immunity and autoimmune disease. The Proceedings of the Nutrition Society, 57(4), 555–562. https://doi.org/10.1079/pns19980081
• Tortosa-Caparrós, E., Navas-Carrillo, D., Marín, F., & Orenes-Piñero, E. (2017). Anti-inflammatory effects of omega 3 and omega 6 polyunsaturated fatty acids in cardiovascular disease and metabolic syndrome. Critical reviews in food science and nutrition, 57(16), 3421–3429. https://doi.org/10.1080/10408398.2015.1126549
• Rodríguez-García, C., Sánchez-Quesada, C., Algarra, I., & Gaforio, J. J. (2020). The High-Fat Diet Based on Extra-Virgin Olive Oil Causes Dysbiosis Linked to Colorectal Cancer Prevention. Nutrients, 12(6), 1705. https://doi.org/10.3390/nu12061705
• Mboma, J., Leblanc, N., Angers, P., Rocher, A., Vigor, C., Oger, C., Reversat, G., Vercauteren, J., Galano, J. M., Durand, T., & Jacques, H. (2018). Effects of Cyclic Fatty Acid Monomers from Heated Vegetable Oil on Markers of Inflammation and Oxidative Stress in Male Wistar Rats. Journal of agricultural and food chemistry, 66(27), 7172–7180. https://doi.org/10.1021/acs.jafc.8b01836
• Lauretti, E., & Praticò, D. (2017). Effect of canola oil consumption on memory, synapse and neuropathology in the triple transgenic mouse model of Alzheimer’s disease. Scientific reports, 7(1), 17134. https://doi.org/10.1038/s41598-017-17373-3

Trans Fats and Hydrogenated Oils

• Okamura, T., Hashimoto, Y., Majima, S., Senmaru, T., Ushigome, E., Nakanishi, N., Asano, M., Yamazaki, M., Takakuwa, H., Hamaguchi, M., & Fukui, M. (2021). Trans Fatty Acid Intake Induces Intestinal Inflammation and Impaired Glucose Tolerance. Frontiers in immunology, 12, 669672. https://doi.org/10.3389/fimmu.2021.669672

Proteins and Animal Products

Characteristics of Various Protein-Rich Foods

• Lerner, A., & Matthias, T. (2020). Processed Food Additive Microbial Transglutaminase and Its Cross-Linked Gliadin Complexes Are Potential Public Health Concerns in Celiac Disease. International journal of molecular sciences, 21(3), 1127. https://doi.org/10.3390/ijms21031127

🔝

Individual Food Reactions

Food sensitivity and allergies

Food Panel Tests

• Bock S. A. (2010). AAAAI support of the EAACI Position Paper on IgG4. The Journal of allergy and clinical immunology, 125(6), 1410. https://doi.org/10.1016/j.jaci.2010.03.013
• Carr, S., Chan, E., Lavine, E., & Moote, W. (2012). CSACI Position statement on the testing of food-specific IgG. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 8(1), 12. https://doi.org/10.1186/1710-1492-8-12

Elimination Diet and Autoimmune Protocol (AIP)

• Konijeti, G. G., Kim, N., Lewis, J. D., Groven, S., Chandrasekaran, A., Grandhe, S., Diamant, C., Singh, E., Oliveira, G., Wang, X., Molparia, B., & Torkamani, A. (2017). Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Inflammatory bowel diseases, 23(11), 2054–2060. https://doi.org/10.1097/MIB.0000000000001221
• Chandrasekaran, A., Groven, S., Lewis, J. D., Levy, S. S., Diamant, C., Singh, E., & Konijeti, G. G. (2019). An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease. Crohn’s & colitis 360, 1(3), otz019. https://doi.org/10.1093/crocol/otz019
• Chandrasekaran, A., Molparia, B., Akhtar, E., Wang, X., Lewis, J. D., Chang, J. T., Oliveira, G., Torkamani, A., & Konijeti, G. G. (2019). The Autoimmune Protocol Diet Modifies Intestinal RNA Expression in Inflammatory Bowel Disease. Crohn’s & colitis 360, 1(3), otz016. https://doi.org/10.1093/crocol/otz016

🔝

Spices and Herbs to Reduce Inflammation

• Peter, K. V. (Ed.). (2012). Handbook of herbs and spices (Vol. 1). Woodhead Publishing Series in Food Science, Technology and Nutrition (2nd ed.). Cambridge, England: Woodhead Publishing.
• Jungbauer, A., & Medjakovic, S. (2012). Anti-inflammatory properties of culinary herbs and spices that ameliorate the effects of metabolic syndrome. Maturitas, 71(3), 227–239. https://doi.org/10.1016/j.maturitas.2011.12.009

Hot or Not

• Xiang, Q., Tang, X., Cui, S., Zhang, Q., Liu, X., Zhao, J., Zhang, H., Mao, B., & Chen, W. (2022). Capsaicin, the Spicy Ingredient of Chili Peppers: Effects on Gastrointestinal Tract and Composition of Gut Microbiota at Various Dosages. Foods (Basel, Switzerland), 11(5), 686. https://doi.org/10.3390/foods11050686
• Jensen-Jarolim, E., Gajdzik, L., Haberl, I., Kraft, D., Scheiner, O., & Graf, J. (1998). Hot spices influence permeability of human intestinal epithelial monolayers. The Journal of nutrition, 128(3), 577–581. https://doi.org/10.1093/jn/128.3.577

🔝

Supplements and Inflammation

Vitamin D

• Fletcher, J., Cooper, S. C., Ghosh, S., & Hewison, M. (2019). The Role of Vitamin D in Inflammatory Bowel Disease: Mechanism to Management. Nutrients, 11(5), 1019. https://doi.org/10.3390/nu11051019
• Cantorna, M. T., & Mahon, B. D. (2004). Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Experimental biology and medicine (Maywood, N.J.), 229(11), 1136–1142. https://doi.org/10.1177/153537020422901108
• Sean D Pitman, (2019). Beating Crohn’s: And Other Autoimmune Diseases.
• Yang, C. Y., Leung, P. S., Adamopoulos, I. E., & Gershwin, M. E. (2013). The implication of vitamin D and autoimmunity: a comprehensive review. Clinical reviews in allergy & immunology, 45(2), 217–226. https://doi.org/10.1007/s12016-013-8361-3
• van Ballegooijen, A. J., Pilz, S., Tomaschitz, A., Grübler, M. R., & Verheyen, N. (2017). The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review. International journal of endocrinology, 2017, 7454376. https://doi.org/10.1155/2017/7454376
• Kostoglou-Athanassiou, I., Athanassiou, P., Lyraki, A., Raftakis, I., & Antoniadis, C. (2012). Vitamin D and rheumatoid arthritis. Therapeutic advances in endocrinology and metabolism, 3(6), 181–187. https://doi.org/10.1177/2042018812471070

Zinc

• Sanna, A., Firinu, D., Zavattari, P., & Valera, P. (2018). Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis. Nutrients, 10(1), 68. https://doi.org/10.3390/nu10010068
• Haase, H., & Rink, L. (2014). Multiple impacts of zinc on immune function. Metallomics : integrated biometal science, 6(7), 1175–1180. https://doi.org/10.1039/c3mt00353a
• Kitabayashi, C., Fukada, T., Kanamoto, M., Ohashi, W., Hojyo, S., Atsumi, T., Ueda, N., Azuma, I., Hirota, H., Murakami, M., & Hirano, T. (2010). Zinc suppresses Th17 development via inhibition of STAT3 activation. International immunology, 22(5), 375–386. https://doi.org/10.1093/intimm/dxq017
• Rosenkranz, E., Metz, C. H., Maywald, M., Hilgers, R. D., Weßels, I., Senff, T., Haase, H., Jäger, M., Ott, M., Aspinall, R., Plümäkers, B., & Rink, L. (2016). Zinc supplementation induces regulatory T cells by inhibition of Sirt-1 deacetylase in mixed lymphocyte cultures. Molecular nutrition & food research, 60(3), 661–671. https://doi.org/10.1002/mnfr.201500524
• Hojyo, S., Miyai, T., Fujishiro, H., Kawamura, M., Yasuda, T., Hijikata, A., Bin, B. H., Irié, T., Tanaka, J., Atsumi, T., Murakami, M., Nakayama, M., Ohara, O., Himeno, S., Yoshida, H., Koseki, H., Ikawa, T., Mishima, K., & Fukada, T. (2014). Zinc transporter SLC39A10/ZIP10 controls humoral immunity by modulating B-cell receptor signal strength. Proceedings of the National Academy of Sciences of the United States of America, 111(32), 11786–11791. https://doi.org/10.1073/pnas.1323557111
• Prasad A. S. (2000). Effects of zinc deficiency on Th1 and Th2 cytokine shifts. The Journal of infectious diseases, 182 Suppl 1, S62–S68. https://doi.org/10.1086/315916
• Schubert, C., Guttek, K., Grüngreiff, K., Thielitz, A., Bühling, F., Reinhold, A., Brocke, S., & Reinhold, D. (2014). Oral zinc aspartate treats experimental autoimmune encephalomyelitis. Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine, 27(6), 1249–1262. https://doi.org/10.1007/s10534-014-9786-8

🔝

Gum and Teeth Health

• Ogrendik M. (2013). Rheumatoid arthritis is an autoimmune disease caused by periodontal pathogens. International journal of general medicine, 6, 383–386. https://doi.org/10.2147/IJGM.S45929
• Ogrendik M. (2009). Rheumatoid arthritis is linked to oral bacteria: etiological association. Modern rheumatology, 19(5), 453–456. https://doi.org/10.1007/s10165-009-0194-9
• Kaur, G., Mohindra, K., & Singla, S. (2017). Autoimmunity-Basics and link with periodontal disease. Autoimmunity reviews, 16(1), 64–71. https://doi.org/10.1016/j.autrev.2016.09.013
• Nesse, W., Dijkstra, P. U., Abbas, F., Spijkervet, F. K., Stijger, A., Tromp, J. A., van Dijk, J. L., & Vissink, A. (2010). Increased prevalence of cardiovascular and autoimmune diseases in periodontitis patients: a cross-sectional study. Journal of periodontology, 81(11), 1622–1628. https://doi.org/10.1902/jop.2010.100058

🔝

Key 3. Leaky gut: Repair

🔝

Constant Repair

• Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in immunology, 8, 598. https://doi.org/10.3389/fimmu.2017.00598
• Milo, R., & Phillips, R. (2015). Cell biology by the numbers. CRC Press.
• Park, J. H., Kotani, T., Konno, T., Setiawan, J., Kitamura, Y., Imada, S., Usui, Y., Hatano, N., Shinohara, M., Saito, Y., Murata, Y., & Matozaki, T. (2016). Promotion of Intestinal Epithelial Cell Turnover by Commensal Bacteria: Role of Short-Chain Fatty Acids. PloS one, 11(5), e0156334. https://doi.org/10.1371/journal.pone.0156334
• Williams, J. M., Duckworth, C. A., Burkitt, M. D., Watson, A. J., Campbell, B. J., & Pritchard, D. M. (2015). Epithelial cell shedding and barrier function: a matter of life and death at the small intestinal villus tip. Veterinary pathology, 52(3), 445–455. https://doi.org/10.1177/0300985814559404

🔝

Unhealthy Intestinal Lining and Leaky Gut

• Lerner, A., & Matthias, T. (2015). Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmunity reviews, 14(6), 479–489. https://doi.org/10.1016/j.autrev.2015.01.009

🔝

Gut Lining and Other DILL+ Factors

• Morris, G., Berk, M., Carvalho, A. F., Caso, J. R., Sanz, Y., & Maes, M. (2016). The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome. Current pharmaceutical design, 22(40), 6058–6075. https://doi.org/10.2174/1381612822666160914182822
• Salguero, M. V., Al-Obaide, M. A. I., Singh, R., Siepmann, T., & Vasylyeva, T. L. (2019). Dysbiosis of Gram-negative gut microbiota and the associated serum lipopolysaccharide exacerbates inflammation in type 2 diabetic patients with chronic kidney disease. Experimental and therapeutic medicine, 18(5), 3461–3469. https://doi.org/10.3892/etm.2019.7943
• Xi, Y., Yan, J., Li, M., Ying, S., & Shi, Z. (2019). Gut microbiota dysbiosis increases the risk of visceral gout in goslings through translocation of gut-derived lipopolysaccharide. Poultry science, 98(11), 5361–5373. https://doi.org/10.3382/ps/pez357
• Belančić A. (2020). Gut microbiome dysbiosis and endotoxemia - Additional pathophysiological explanation for increased COVID-19 severity in obesity. Obesity medicine, 20, 100302. https://doi.org/10.1016/j.obmed.2020.100302
• Pastor Rojo, O., López San Román, A., Albéniz Arbizu, E., de la Hera Martínez, A., Ripoll Sevillano, E., & Albillos Martínez, A. (2007). Serum lipopolysaccharide-binding protein in endotoxemic patients with inflammatory bowel disease. Inflammatory bowel diseases, 13(3), 269–277. https://doi.org/10.1002/ibd.20019
• Bischoff, S.C., Barbara, G., Buurman, W. et al. Intestinal permeability – a new target for disease prevention and therapy. BMC Gastroenterol 14, 189 (2014). https://doi.org/10.1186/s12876-014-0189-7

🔝

Eliminate Obstacles

Obstacle #4: Harmful Food Ingredients

Gluten

• Elkan, A. C., Sjöberg, B., Kolsrud, B., Ringertz, B., Hafström, I., & Frostegård, J. (2008). Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Arthritis research & therapy, 10(2), R34. https://doi.org/10.1186/ar2388
• Hafström, I., Ringertz, B., Spångberg, A., von Zweigbergk, L., Brannemark, S., Nylander, I., Rönnelid, J., Laasonen, L., & Klareskog, L. (2001). A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford, England), 40(10), 1175–1179. https://doi.org/10.1093/rheumatology/40.10.1175
• Sander, G. R., Cummins, A. G., Henshall, T., & Powell, B. C. (2005). Rapid disruption of intestinal barrier function by gliadin involves altered expression of apical junctional proteins. FEBS letters, 579(21), 4851–4855. https://doi.org/10.1016/j.febslet.2005.07.066
• Hollon, J., Puppa, E. L., Greenwald, B., Goldberg, E., Guerrerio, A., & Fasano, A. (2015). Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients, 7(3), 1565–1576. https://doi.org/10.3390/nu7031565
• Neyrinck, A. M., Van Hée, V. F., Piront, N., De Backer, F., Toussaint, O., Cani, P. D., & Delzenne, N. M. (2012). Wheat-derived arabinoxylan oligosaccharides with prebiotic effect increase satietogenic gut peptides and reduce metabolic endotoxemia in diet-induced obese mice. Nutrition & diabetes, 2(1), e28. https://doi.org/10.1038/nutd.2011.24
• Tojo, R., Suárez, A., Clemente, M. G., de los Reyes-Gavilán, C. G., Margolles, A., Gueimonde, M., & Ruas-Madiedo, P. (2014). Intestinal microbiota in health and disease: role of bifidobacteria in gut homeostasis. World journal of gastroenterology, 20(41), 15163–15176. https://doi.org/10.3748/wjg.v20.i41.15163

Saturated Fats and Excessive Omega-6 Oils

• Rohr, M. W., Narasimhulu, C. A., Rudeski-Rohr, T. A., & Parthasarathy, S. (2020). Negative Effects of a High-Fat Diet on Intestinal Permeability: A Review. Advances in nutrition (Bethesda, Md.), 11(1), 77–91. https://doi.org/10.1093/advances/nmz061
• Usami, M., Komurasaki, T., Hanada, A., Kinoshita, K., & Ohata, A. (2003). Effect of gamma-linolenic acid or docosahexaenoic acid on tight junction permeability in intestinal monolayer cells and their mechanism by protein kinase C activation and/or eicosanoid formation. Nutrition (Burbank, Los Angeles County, Calif.), 19(2), 150–156. https://doi.org/10.1016/s0899-9007(02)00927-9
• Usami, M., Muraki, K., Iwamoto, M., Ohata, A., Matsushita, E., & Miki, A. (2001). Effect of eicosapentaenoic acid (EPA) on tight junction permeability in intestinal monolayer cells. Clinical nutrition (Edinburgh, Scotland), 20(4), 351–359. https://doi.org/10.1054/clnu.2001.0430
• John, S., Luben, R., Shrestha, S. S., Welch, A., Khaw, K. T., & Hart, A. R. (2010). Dietary n-3 polyunsaturated fatty acids and the aetiology of ulcerative colitis: a UK prospective cohort study. European journal of gastroenterology & hepatology, 22(5), 602–606. https://doi.org/10.1097/MEG.0b013e3283352d05
• Willemsen, L. E., Koetsier, M. A., Balvers, M., Beermann, C., Stahl, B., & van Tol, E. A. (2008). Polyunsaturated fatty acids support epithelial barrier integrity and reduce IL-4 mediated permeability in vitro. European journal of nutrition, 47(4), 183–191. https://doi.org/10.1007/s00394-008-0712-0
• Uchiyama, K., Nakamura, M., Odahara, S., Koido, S., Katahira, K., Shiraishi, H., Ohkusa, T., Fujise, K., & Tajiri, H. (2010). N-3 polyunsaturated fatty acid diet therapy for patients with inflammatory bowel disease. Inflammatory bowel diseases, 16(10), 1696–1707. https://doi.org/10.1002/ibd.21251
• Scoville, E. A., Allaman, M. M., Adams, D. W., Motley, A. K., Peyton, S. C., Ferguson, S. L., Horst, S. N., Williams, C. S., Beaulieu, D. B., Schwartz, D. A., Wilson, K. T., & Coburn, L. A. (2019). Serum Polyunsaturated Fatty Acids Correlate with Serum Cytokines and Clinical Disease Activity in Crohn’s Disease. Scientific reports, 9(1), 2882. https://doi.org/10.1038/s41598-019-39232-z

Excessive Saponins and Lectins

• Johnson, I. T., Gee, J. M., Price, K., Curl, C., & Fenwick, G. R. (1986). Influence of saponins on gut permeability and active nutrient transport in vitro. The Journal of nutrition, 116(11), 2270–2277. https://doi.org/10.1093/jn/116.11.2270

Alcohol

• Bode, C., & Bode, J. C. (2003). Effect of alcohol consumption on the gut. Best practice & research. Clinical gastroenterology, 17(4), 575–592. https://doi.org/10.1016/s1521-6918(03)00034-9
• Draper, L. R., Gyure, L. A., Hall, J. G., & Robertson, D. (1983). Effect of alcohol on the integrity of the intestinal epithelium. Gut, 24(5), 399–404. https://doi.org/10.1136/gut.24.5.399
• Bishehsari, F., Magno, E., Swanson, G., Desai, V., Voigt, R. M., Forsyth, C. B., & Keshavarzian, A. (2015). Alcohol and gut-derived inflammation. Alcohol Research & Clinical Reviews, 38(2), 121-132. https://arcr.niaaa.nih.gov/volume/38/2/alcohol-and-gut-derived-inflammation
• Calleja-Conde, J., Echeverry-Alzate, V., Bühler, K. M., Durán-González, P., Morales-García, J. Á., Segovia-Rodríguez, L., Rodríguez de Fonseca, F., Giné, E., & López-Moreno, J. A. (2021). The Immune System through the Lens of Alcohol Intake and Gut Microbiota. International journal of molecular sciences, 22(14), 7485. https://doi.org/10.3390/ijms22147485
• Purohit, V., Bode, J. C., Bode, C., Brenner, D. A., Choudhry, M. A., Hamilton, F., Kang, Y. J., Keshavarzian, A., Rao, R., Sartor, R. B., Swanson, C., & Turner, J. R. (2008). Alcohol, intestinal bacterial growth, intestinal permeability to endotoxin, and medical consequences: summary of a symposium. Alcohol (Fayetteville, N.Y.), 42(5), 349–361. https://doi.org/10.1016/j.alcohol.2008.03.131

Obstacle #5: Medication

NSAIDs

• Montenegro, L., Losurdo, G., Licinio, R., Zamparella, M., Giorgio, F., Ierardi, E., Di Leo, A., & Principi, M. (2014). Non steroidal anti-inflammatory drug induced damage on lower gastro-intestinal tract: is there an involvement of microbiota?. Current drug safety, 9(3), 196–204. https://doi.org/10.2174/1574886309666140424143852
• Marlicz, W., Loniewski, I., Grimes, D. S., & Quigley, E. M. (2014). Nonsteroidal anti-inflammatory drugs, proton pump inhibitors, and gastrointestinal injury: contrasting interactions in the stomach and small intestine. Mayo Clinic proceedings, 89(12), 1699–1709. https://doi.org/10.1016/j.mayocp.2014.07.015
• Pavlidis, P., & Bjarnason, I. (2015). Aspirin Induced Adverse Effects on the Small and Large Intestine. Current pharmaceutical design, 21(35), 5089–5093. https://doi.org/10.2174/1381612821666150915110058
• Odenwald, M. A., & Turner, J. R. (2013). Intestinal permeability defects: is it time to treat?. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 11(9), 1075–1083. https://doi.org/10.1016/j.cgh.2013.07.001
• Weber, C. R., Raleigh, D. R., Su, L., Shen, L., Sullivan, E. A., Wang, Y., & Turner, J. R. (2010). Epithelial myosin light chain kinase activation induces mucosal interleukin-13 expression to alter tight junction ion selectivity. The Journal of biological chemistry, 285(16), 12037–12046. https://doi.org/10.1074/jbc.M109.064808
• Bjarnason, I., & Takeuchi, K. (2009). Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. Journal of gastroenterology, 44 Suppl 19, 23–29. https://doi.org/10.1007/s00535-008-2266-6
• Bjarnason, I., & Takeuchi, K. (2009). Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. Journal of gastroenterology, 44 Suppl 19, 23–29. https://doi.org/10.1007/s00535-008-2266-6
• Timpe Behnen E. Ask the Expert: Which NSAIDs are Most Selective for COX-1 and COX-2?. Pract Pain Manag. 2013;13(7).

Obstacle #7: Insufficient Mastication

• Rodrigues Neves, C., Buskermolen, J., Roffel, S., Waaijman, T., Thon, M., Veerman, E., & Gibbs, S. (2019). Human saliva stimulates skin and oral wound healing in vitro. Journal of tissue engineering and regenerative medicine, 13(6), 1079–1092. https://doi.org/10.1002/term.2865
• Keswani, S. G., Balaji, S., Le, L. D., Leung, A., Parvadia, J. K., Frischer, J., Yamano, S., Taichman, N., & Crombleholme, T. M. (2013). Role of salivary vascular endothelial growth factor (VEGF) in palatal mucosal wound healing. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 21(4), 554–562. https://doi.org/10.1111/wrr.12065

Obstacle #9: Chilled Food and Drinks

• Liu JQ, Hu TY, Diao KY, Yu D, Song YN, Mo LH, Yang G, Liu ZQ, Liu ZG, Yang PC. Cold stress promotes IL-33 expression in intestinal epithelial cells to facilitate food allergy development. Cytokine. 2020 Dec;136:155295. doi: 10.1016/j.cyto.2020.155295. Epub 2020 Sep 22. PMID: 32977238.

🔝

Active Repair

Nutrition For the Gut Epithelium

Butyrate and Other Short Chain Fatty Acids

• Schulthess, J., Pandey, S., Capitani, M., Rue-Albrecht, K. C., Arnold, I., Franchini, F., Chomka, A., Ilott, N. E., Johnston, D. G. W., Pires, E., McCullagh, J., Sansom, S. N., Arancibia-Cárcamo, C. V., Uhlig, H. H., & Powrie, F. (2019). The Short Chain Fatty Acid Butyrate Imprints an Antimicrobial Program in Macrophages. Immunity, 50(2), 432–445.e7. https://doi.org/10.1016/j.immuni.2018.12.018
• Chen, J., & Vitetta, L. (2020). Butyrate in Inflammatory Bowel Disease Therapy. Gastroenterology, 158(5), 1511. https://doi.org/10.1053/j.gastro.2019.08.064
• Richards, J. L., Yap, Y. A., McLeod, K. H., Mackay, C. R., & Mariño, E. (2016). Dietary metabolites and the gut microbiota: an alternative approach to control inflammatory and autoimmune diseases. Clinical & translational immunology, 5(5), e82. https://doi.org/10.1038/cti.2016.29
• Tan, J., McKenzie, C., Potamitis, M., Thorburn, A. N., Mackay, C. R., & Macia, L. (2014). The role of short-chain fatty acids in health and disease. Advances in immunology, 121, 91–119. https://doi.org/10.1016/B978-0-12-800100-4.00003-9

Resistant Starch

• Liljeberg Elmståhl H. (2002). Resistant starch content in a selection of starchy foods on the Swedish market. European journal of clinical nutrition, 56(6), 500–505. https://doi.org/10.1038/sj.ejcn.1601338
• Patterson, M. A., Maiya, M., & Stewart, M. L. (2020). Resistant Starch Content in Foods Commonly Consumed in the United States: A Narrative Review. Journal of the Academy of Nutrition and Dietetics, 120(2), 230–244. https://doi.org/10.1016/j.jand.2019.10.019
• Topping, D. L., & Clifton, P. M. (2001). Short-chain fatty acids and human colonic function: roles of resistant starch and nonstarch polysaccharides. Physiological reviews, 81(3), 1031–1064. https://doi.org/10.1152/physrev.2001.81.3.1031

Acetate and Lactate

• Duncan, S. H., Holtrop, G., Lobley, G. E., Calder, A. G., Stewart, C. S., & Flint, H. J. (2004). Contribution of acetate to butyrate formation by human faecal bacteria. The British journal of nutrition, 91(6), 915–923. https://doi.org/10.1079/BJN20041150
• Budak, N. H., Aykin, E., Seydim, A. C., Greene, A. K., & Guzel-Seydim, Z. B. (2014). Functional properties of vinegar. Journal of food science, 79(5), R757–R764. https://doi.org/10.1111/1750-3841.12434

Naturally Fermented Foods

• Shimizu, H., Masujima, Y., Ushiroda, C., Mizushima, R., Taira, S., Ohue-Kitano, R., & Kimura, I. (2019). Dietary short-chain fatty acid intake improves the hepatic metabolic condition via FFAR3. Scientific reports, 9(1), 16574. https://doi.org/10.1038/s41598-019-53242-x
• Montel, M. C., Buchin, S., Mallet, A., Delbes-Paus, C., Vuitton, D. A., Desmasures, N., & Berthier, F. (2014). Traditional cheeses: rich and diverse microbiota with associated benefits. International journal of food microbiology, 177, 136–154. https://doi.org/10.1016/j.ijfoodmicro.2014.02.019
• Madsen, K. L., Doyle, J. S., Jewell, L. D., Tavernini, M. M., & Fedorak, R. N. (1999). Lactobacillus species prevents colitis in interleukin 10 gene-deficient mice. Gastroenterology, 116(5), 1107–1114. https://doi.org/10.1016/s0016-5085(99)70013-2

Other Nutrients

Sulphur and Methylsulfonylmethane (MSM)

• University of Pennsylvania. (2015, August 11). Study details ‘rotten egg’ gas’ role in autoimmune disease. ScienceDaily. November 1, 2023 https://www.sciencedaily.com/releases/2015/08/150811171508.htm

Glutamine

• Rao, R., & Samak, G. (2012). Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. Journal of epithelial biology & pharmacology, 5(Suppl 1-M7), 47–54. https://doi.org/10.2174/1875044301205010047
• Shu, X. L., Yu, T. T., Kang, K., & Zhao, J. (2016). Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis. Experimental and therapeutic medicine, 12(6), 3499–3506. https://doi.org/10.3892/etm.2016.3799
• Zuhl, M. N., Lanphere, K. R., Kravitz, L., Mermier, C. M., Schneider, S., Dokladny, K., & Moseley, P. L. (2014). Effects of oral glutamine supplementation on exercise-induced gastrointestinal permeability and tight junction protein expression. Journal of applied physiology (Bethesda, Md. : 1985), 116(2), 183–191. https://doi.org/10.1152/japplphysiol.00646.2013
• Coëffier, M., Marion-Letellier, R., & Déchelotte, P. (2010). Potential for amino acids supplementation during inflammatory bowel diseases. Inflammatory bowel diseases, 16(3), 518–524. https://doi.org/10.1002/ibd.21017

Quercetin

• Suzuki, T., & Hara, H. (2009). Quercetin enhances intestinal barrier function through the assembly of zonula [corrected] occludens-2, occludin, and claudin-1 and the expression of claudin-4 in Caco-2 cells. The Journal of nutrition, 139(5), 965–974. https://doi.org/10.3945/jn.108.100867

Sea-buckthorn

• Shi, J., Wang, L., Lu, Y., Ji, Y., Wang, Y., Dong, K., Kong, X., & Sun, W. (2017). Protective effects of seabuckthorn pulp and seed oils against radiation-induced acute intestinal injury. Journal of radiation research, 58(1), 24–32. https://doi.org/10.1093/jrr/rrw069
• Ganju, L., Padwad, Y., Singh, R., Karan, D., Chanda, S., Chopra, M. K., Bhatnagar, P., Kashyap, R., & Sawhney, R. C. (2005). Anti-inflammatory activity of Seabuckthorn (Hippophae rhamnoides) leaves. International immunopharmacology, 5(12), 1675–1684. https://doi.org/10.1016/j.intimp.2005.03.017
• Erkkola, Risto & Yang, Baoru. (2003). Sea buckthorn oils: Towards healthy mucous membranes. Agro Food Industry Hi-Tech. 14. 53-57.
• Zielińska, A., & Nowak, I. (2017). Abundance of active ingredients in sea-buckthorn oil. Lipids in health and disease, 16(1), 95. https://doi.org/10.1186/s12944-017-0469-7

Flaxseed

• Xu, ZhenXia & Chen, Wenchao & Deng, Qianchun & Huang, Qingde & Wang, Xu & Yang, Chen & Huang, Fenghong. (2020). Flaxseed oligosaccharides alleviate DSS-induced colitis through modulation of gut microbiota and repair of intestinal barrier in mice. Food & Function. 11. 10.1039/D0FO01105C.

Traditional Bone Soup vs. Bone Broth

• Mar-Solís, L. M., Soto-Domínguez, A., Rodríguez-Tovar, L. E., Rodríguez-Rocha, H., García-García, A., Aguirre-Arzola, V. E., Zamora-Ávila, D. E., Garza-Arredondo, A. J., & Castillo-Velázquez, U. (2021). Analysis of the Anti-Inflammatory Capacity of Bone Broth in a Murine Model of Ulcerative Colitis. Medicina (Kaunas, Lithuania), 57(11), 1138. https://doi.org/10.3390/medicina57111138

Zinc

• Chai, F., Truong-Tran, A. Q., Evdokiou, A., Young, G. P., & Zalewski, P. D. (2000). Intracellular zinc depletion induces caspase activation and p21 Waf1/Cip1 cleavage in human epithelial cell lines. The Journal of infectious diseases, 182 Suppl 1, S85–S92. https://doi.org/10.1086/315914
• Virgili, F., Canali, R., Figus, E., Vignolini, F., Nobili, F., & Mengheri, E. (1999). Intestinal damage induced by zinc deficiency is associated with enhanced CuZn superoxide dismutase activity in rats: effect of dexamethasone or thyroxine treatment. Free radical biology & medicine, 26(9-10), 1194–1201. https://doi.org/10.1016/s0891-5849(98)00307-4
• Roy, S. K., Behrens, R. H., Haider, R., Akramuzzaman, S. M., Mahalanabis, D., Wahed, M. A., & Tomkins, A. M. (1992). Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome. Journal of pediatric gastroenterology and nutrition, 15(3), 289–296. https://doi.org/10.1097/00005176-199210000-00010
• Sachdev, H. P., Mittal, N. K., Mittal, S. K., & Yadav, H. S. (1988). A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. Journal of pediatric gastroenterology and nutrition, 7(6), 877–881. https://doi.org/10.1097/00005176-198811000-00015
• Hambidge K. M. (1992). Zinc and diarrhea. Acta paediatrica (Oslo, Norway : 1992). Supplement, 381, 82–86. https://doi.org/10.1111/j.1651-2227.1992.tb12377.x
• Arcasoy, A., Akar, N., Ors, U., Delilbasi, L., & Karayalcin, S. (1990). Ultrastructural changes in the mucosa of the small intestine in patients with geophagia (Prasad’s syndrome). Journal of pediatric gastroenterology and nutrition, 11(2), 279–282. https://doi.org/10.1097/00005176-199008000-00022

Vitamins

• Guerreiro, C. S., Calado, Â., Sousa, J., & Fonseca, J. E. (2018). Diet, Microbiota, and Gut Permeability-The Unknown Triad in Rheumatoid Arthritis. Frontiers in medicine, 5, 349. https://doi.org/10.3389/fmed.2018.00349
• Gordon, B. L., Galati, J. S., Yang, S., Longman, R. S., Lukin, D., Scherl, E. J., & Battat, R. (2022). Prevalence and factors associated with vitamin C deficiency in inflammatory bowel disease. World journal of gastroenterology, 28(33), 4834–4845. https://doi.org/10.3748/wjg.v28.i33.4834
• Cevikel, M. H., Tuncyurek, P., Ceylan, F., Meteoglu, I., Kozaci, D., & Boylu, S. (2008). Supplementation with high-dose ascorbic acid improves intestinal anastomotic healing. European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes, 40(1), 29–33. https://doi.org/10.1159/000108622
• Schoultz, I., McKay, C. M., Graepel, R., Phan, V. C., Wang, A., Söderholm, J., & McKay, D. M. (2012). Indomethacin-induced translocation of bacteria across enteric epithelia is reactive oxygen species-dependent and reduced by vitamin C. American journal of physiology. Gastrointestinal and liver physiology, 303(5), G536–G545. https://doi.org/10.1152/ajpgi.00125.2012
• Pham, V. T., Fehlbaum, S., Seifert, N., Richard, N., Bruins, M. J., Sybesma, W., Rehman, A., & Steinert, R. E. (2021). Effects of colon-targeted vitamins on the composition and metabolic activity of the human gut microbiome- a pilot study. Gut microbes, 13(1), 1–20. https://doi.org/10.1080/19490976.2021.1875774
• Xu, C., Sun, R., Qiao, X., Xu, C., Shang, X., Niu, W., & Chao, Y. (2014). Effect of vitamin e supplementation on intestinal barrier function in rats exposed to high altitude hypoxia environment. The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology, 18(4), 313–320. https://doi.org/10.4196/kjpp.2014.18.4.313
• Liu, F., Cottrell, J. J., Furness, J. B., Rivera, L. R., Kelly, F. W., Wijesiriwardana, U., Pustovit, R. V., Fothergill, L. J., Bravo, D. M., Celi, P., Leury, B. J., Gabler, N. K., & Dunshea, F. R. (2016). Selenium and vitamin E together improve intestinal epithelial barrier function and alleviate oxidative stress in heat-stressed pigs. Experimental physiology, 101(7), 801–810. https://doi.org/10.1113/EP085746
• Warden, R. A., Noltorp, R. S., Francis, J. L., Dunkley, P. R., & O’Loughlin, E. V. (1997). Vitamin A deficiency exacerbates methotrexate-induced jejunal injury in rats. The Journal of nutrition, 127(5), 770–776. https://doi.org/10.1093/jn/127.5.770
• Ulitsky, A., Ananthakrishnan, A. N., Naik, A., Skaros, S., Zadvornova, Y., Binion, D. G., & Issa, M. (2011). Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity and quality of life. JPEN. Journal of parenteral and enteral nutrition, 35(3), 308–316. https://doi.org/10.1177/0148607110381267
• Kong, J., Zhang, Z., Musch, M. W., Ning, G., Sun, J., Hart, J., Bissonnette, M., & Li, Y. C. (2008). Novel role of the vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier. American journal of physiology. Gastrointestinal and liver physiology, 294(1), G208–G216. https://doi.org/10.1152/ajpgi.00398.2007
• Liu, K. Y., Nakatsu, C. H., Jones-Hall, Y., Kozik, A., & Jiang, Q. (2021). Vitamin E alpha- and gamma-tocopherol mitigate colitis, protect intestinal barrier function and modulate the gut microbiota in mice. Free radical biology & medicine, 163, 180–189. https://doi.org/10.1016/j.freeradbiomed.2020.12.017

Water-Fasting

• Remely, M., Hippe, B., Geretschlaeger, I., Stegmayer, S., Hoefinger, I., & Haslberger, A. (2015). Increased gut microbiota diversity and abundance of Faecalibacterium prausnitzii and Akkermansia after fasting: a pilot study. Wiener klinische Wochenschrift, 127(9-10), 394–398. https://doi.org/10.1007/s00508-015-0755-1
• Özkul, C., Yalınay, M., & Karakan, T. (2019). Islamic fasting leads to an increased abundance of Akkermansia muciniphila and Bacteroides fragilis group: A preliminary study on intermittent fasting. The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 30(12), 1030–1035. https://doi.org/10.5152/tjg.2019.19185
• Cignarella, F., Cantoni, C., Ghezzi, L., Salter, A., Dorsett, Y., Chen, L., Phillips, D., Weinstock, G. M., Fontana, L., Cross, A. H., Zhou, Y., & Piccio, L. (2018). Intermittent Fasting Confers Protection in CNS Autoimmunity by Altering the Gut Microbiota. Cell metabolism, 27(6), 1222–1235.e6. https://doi.org/10.1016/j.cmet.2018.05.006
• Paoli, A., Tinsley, G., Bianco, A., & Moro, T. (2019). The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting. Nutrients, 11(4), 719. https://doi.org/10.3390/nu11040719
• Fuhrman, J., Sarter, B., & Calabro, D. J. (2002). Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Alternative therapies in health and medicine, 8(4), 112–111. <https://pubmed.ncbi.nlm.nih.gov/12126162/
• Hafström, I., Ringertz, B., Gyllenhammar, H., Palmblad, J., & Harms-Ringdahl, M. (1988). Effects of fasting on disease activity, neutrophil function, fatty acid composition, and leukotriene biosynthesis in patients with rheumatoid arthritis. Arthritis and rheumatism, 31(5), 585–592. https://doi.org/10.1002/art.1780310502
• Sundqvist, T., Lindström, F., Magnusson, K. E., Sköldstam, L., Stjernström, I., & Tagesson, C. (1982). Influence of fasting on intestinal permeability and disease activity in patients with rheumatoid arthritis. Scandinavian journal of rheumatology, 11(1), 33–38. https://doi.org/10.3109/03009748209098111

Elemental and Semi-Elemental Diets

• Andoh, A., Inoue, R., Kawada, Y., Morishima, S., Inatomi, O., Ohno, M., Bamba, S., Nishida, A., Kawahara, M., & Naito, Y. (2019). Elemental diet induces alterations of the gut microbial community in mice. Journal of clinical biochemistry and nutrition, 65(2), 118–124. https://doi.org/10.3164/jcbn.19-8
• Podas, T., Nightingale, J. M., Oldham, R., Roy, S., Sheehan, N. J., & Mayberry, J. F. (2007). Is rheumatoid arthritis a disease that starts in the intestine? A pilot study comparing an elemental diet with oral prednisolone. Postgraduate medical journal, 83(976), 128–131. https://doi.org/10.1136/pgmj.2006.050245
• Kanazawa, M., & Fukudo, S. (2006). Effects of fasting therapy on irritable bowel syndrome. International journal of behavioral medicine, 13(3), 214–220. https://doi.org/10.1207/s15327558ijbm1303_4
• Tavakkoli, H., Haghdani, S., Emami, M. H., Adilipour, H., Tavakkoli, M., & Tavakkoli, M. (2008). Ramadan fasting and inflammatory bowel disease. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 27(6), 239–241. https://pubmed.ncbi.nlm.nih.gov/19405258/
• Rajendran, N., & Kumar, D. (2010). Role of diet in the management of inflammatory bowel disease. World journal of gastroenterology, 16(12), 1442–1448. https://doi.org/10.3748/wjg.v16.i12.1442
• Heuschkel, R. B., Menache, C. C., Megerian, J. T., & Baird, A. E. (2000). Enteral nutrition and corticosteroids in the treatment of acute Crohn’s disease in children. Journal of pediatric gastroenterology and nutrition, 31(1), 8–15. https://doi.org/10.1097/00005176-200007000-00005
• Borrelli, O., Cordischi, L., Cirulli, M., Paganelli, M., Labalestra, V., Uccini, S., Russo, P. M., & Cucchiara, S. (2006). Polymeric diet alone versus corticosteroids in the treatment of active pediatric Crohn’s disease: a randomized controlled open-label trial. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 4(6), 744–753. https://doi.org/10.1016/j.cgh.2006.03.010
• Berni Canani, R., Terrin, G., Borrelli, O., Romano, M. T., Manguso, F., Coruzzo, A., D’Armiento, F., Romeo, E. F., & Cucchiara, S. (2006). Short- and long-term therapeutic efficacy of nutritional therapy and corticosteroids in paediatric Crohn’s disease. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 38(6), 381–387. https://doi.org/10.1016/j.dld.2005.10.005
• Pitman, S. D. (2019). Beating Crohn’s: And Other Autoimmune Diseases.

🔝

Key 4. Lazy gut: Reawaken

🔝

Gut Motility: Speedy or Sluggish

Bowel Transit Time

• Siegel, R. L., Fedewa, S. A., Anderson, W. F., Miller, K. D., Ma, J., Rosenberg, P. S., & Jemal, A. (2017). Colorectal Cancer Incidence Patterns in the United States, 1974-2013. Journal of the National Cancer Institute, 109(8), djw322. https://doi.org/10.1093/jnci/djw322
• Rebecca L. Siegel, Ahmedin Jemal, Elizabeth M. Ward; (2009). Increase in Incidence of Colorectal Cancer Among Young Men and Women in the United States. Cancer Epidemiol Biomarkers Prev 1 June 2009; 18 (6): 1695–1698. https://doi.org/10.1158/1055-9965.EPI-09-0186

🔝

Gut Motility and Other DILL+ Factors

Effect on the Microbiome — River vs Swamps

• Asnicar, F., Leeming, E. R., Dimidi, E., Mazidi, M., Franks, P. W., Al Khatib, H., Valdes, A. M., Davies, R., Bakker, E., Francis, L., Chan, A., Gibson, R., Hadjigeorgiou, G., Wolf, J., Spector, T. D., Segata, N., & Berry, S. E. (2021). Blue poo: impact of gut transit time on the gut microbiome using a novel marker. Gut, 70(9), 1665–1674. https://doi.org/10.1136/gutjnl-2020-323877
• Liu L. W. (2011). Chronic constipation: current treatment options. Canadian journal of gastroenterology = Journal canadien de gastroenterologie, 25 Suppl B(Suppl B), 22B–28B. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206558/
• Caenepeel, P., Janssens, J., Vantrappen, G. et al. Interdigestive myoelectric complex in germ-free rats. Digest Dis Sci 34, 1180–1184 (1989). https://doi.org/10.1007/BF01537265
• Zheng, Z., Tang, J., Hu, Y., & Zhang, W. (2022). Role of gut microbiota-derived signals in the regulation of gastrointestinal motility. Frontiers in medicine, 9, 961703. https://doi.org/10.3389/fmed.2022.961703
• Waclawiková, B., Codutti, A., Alim, K., & El Aidy, S. (2022). Gut microbiota-motility interregulation: insights from in vivo, ex vivo and in silico studies. Gut microbes, 14(1), 1997296. https://doi.org/10.1080/19490976.2021.1997296
• Quigley E. M. (2011). Microflora modulation of motility. Journal of neurogastroenterology and motility, 17(2), 140–147. https://doi.org/10.5056/jnm.2011.17.2.140
• Hyland, N. P., & Cryan, J. F. (2016). Microbe-host interactions: Influence of the gut microbiota on the enteric nervous system. Developmental biology, 417(2), 182–187. https://doi.org/10.1016/j.ydbio.2016.06.027

Inflammation

Damage to Interstitial Cells of Cajal (ICC)

• He, C. L., Soffer, E. E., Ferris, C. D., Walsh, R. M., Szurszewski, J. H., & Farrugia, G. (2001). Loss of interstitial cells of cajal and inhibitory innervation in insulin-dependent diabetes. Gastroenterology, 121(2), 427–434. https://doi.org/10.1053/gast.2001.26264
• Vieira Frez, F. C., Martins Colombo Perles, J. V., Robert Linden, D., Gibbons, S. J., Amilcar Martins, H., Almeida Brito Romualdo, D., de Souza, S. R., Daion Piovezana Bossolani, G., & Zanoni, J. N. (2017). Restoration of density of interstitial cells of Cajal in the jejunum of diabetic rats after quercetin supplementation. Revista espanola de enfermedades digestivas, 109(3), 190–195. https://doi.org/10.17235/reed.2016.4338/2016

🔝

Physical Activities for Optimal Bowel Transit

Strengthening the Core and Abdominal Muscles

• Song, B. K., Han, D., Brellenthin, A. G., & Kim, Y. S. (2021). Effects of core strengthening exercise on colon transit time in young adult women. Journal of exercise science and fitness, 19(3), 158–165. https://doi.org/10.1016/j.jesf.2021.02.001

🔝

Your Food and Gut Motility

The Fiber Paradox: Why Eat What You Can’t Digest

• O’Keefe S. J. (2019). The association between dietary fibre deficiency and high-income lifestyle-associated diseases: Burkitt’s hypothesis revisited. The lancet. Gastroenterology & hepatology, 4(12), 984–996. https://doi.org/10.1016/S2468-1253(19)30257-2
• Kjeldsen-Kragh, J., Haugen, M., Borchgrevink, C. F., & Førre, O. (1994). Vegetarian diet for patients with rheumatoid arthritis–status: two years after introduction of the diet. Clinical rheumatology, 13(3), 475–482. https://doi.org/10.1007/BF02242946
• Hafström, I., Ringertz, B., Spångberg, A., von Zweigbergk, L., Brannemark, S., Nylander, I., Rönnelid, J., Laasonen, L., & Klareskog, L. (2001). A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford, England), 40(10), 1175–1179. https://doi.org/10.1093/rheumatology/40.10.1175
• McDougall, J., Bruce, B., Spiller, G., Westerdahl, J., & McDougall, M. (2002). Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. Journal of alternative and complementary medicine (New York, N.Y.), 8(1), 71–75. https://doi.org/10.1089/107555302753507195
• Holscher H. D. (2017). Dietary fiber and prebiotics and the gastrointestinal microbiota. Gut microbes, 8(2), 172–184. https://doi.org/10.1080/19490976.2017.1290756

Prokinetic and Laxative Foods

• Alexandrovich, I., Rakovitskaya, O., Kolmo, E., Sidorova, T., & Shushunov, S. (2003). The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Alternative therapies in health and medicine, 9(4), 58–61. https://pubmed.ncbi.nlm.nih.gov/12868253/

🔝

Bile and Gut Motility

• Ticho, A. L., Malhotra, P., Dudeja, P. K., Gill, R. K., & Alrefai, W. A. (2019). Bile Acid Receptors and Gastrointestinal Functions. Liver research, 3(1), 31–39. https://doi.org/10.1016/j.livres.2019.01.001

🔝

Careful With Laxatives

• Liu L. W. (2011). Chronic constipation: current treatment options. Canadian journal of gastroenterology = Journal canadien de gastroenterologie, 25 Suppl B(Suppl B), 22B–28B.

🔝

Key 5. Factors Beyond Digestive Health: Recondition

🔝

The Hygiene Paradox: When Cleaning Backfires

Hygiene Hypothesis and “Old Friends” Effect

• Kondrashova, A., Seiskari, T., Ilonen, J., Knip, M., & Hyöty, H. (2013). The ‘Hygiene hypothesis’ and the sharp gradient in the incidence of autoimmune and allergic diseases between Russian Karelia and Finland. APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, 121(6), 478–493. https://doi.org/10.1111/apm.12023
• Haahtela, T., Laatikainen, T., Alenius, H., Auvinen, P., Fyhrquist, N., Hanski, I., von Hertzen, L., Jousilahti, P., Kosunen, T. U., Markelova, O., Mäkelä, M. J., Pantelejev, V., Uhanov, M., Zilber, E., & Vartiainen, E. (2015). Hunt for the origin of allergy - comparing the Finnish and Russian Karelia. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 45(5), 891–901. https://doi.org/10.1111/cea.12527
• Kondrashova, A., Reunanen, A., Romanov, A., Karvonen, A., Viskari, H., Vesikari, T., Ilonen, J., Knip, M., & Hyöty, H. (2005). A six-fold gradient in the incidence of type 1 diabetes at the eastern border of Finland. Annals of medicine, 37(1), 67–72. https://doi.org/10.1080/07853890410018952

Skin Microbiome and T-Lymphocytes

• Ostrov, B. E., & Amsterdam, D. (2017). Immunomodulatory interplay of the microbiome and therapy of rheumatic diseases. Immunological investigations, 46(8), 769–792. https://doi.org/10.1080/08820139.2017.1373828
• Clark R. A. (2010). Skin-resident T cells: the ups and downs of on site immunity. The Journal of investigative dermatology, 130(2), 362-370. https://doi.org/10.1038/jid.2009.247

More Time and Meals Outdoors

• Roslund, M. I., Puhakka, R., Grönroos, M., Nurminen, N., Oikarinen, S., Gazali, A. M., Cinek, O., Kramná, L., Siter, N., Vari, H. K., Soininen, L., Parajuli, A., Rajaniemi, J., Kinnunen, T., Laitinen, O. H., Hyöty, H., Sinkkonen, A., & ADELE research group (2020). Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Science advances, 6(42), eaba2578. https://doi.org/10.1126/sciadv.aba2578

Non-Organic Agriculture

• Meyer, A., Sandler, D. P., Beane Freeman, L. E., Hofmann, J. N., & Parks, C. G. (2017). Pesticide Exposure and Risk of Rheumatoid Arthritis among Licensed Male Pesticide Applicators in the Agricultural Health Study. Environmental health perspectives, 125(7), 077010. https://doi.org/10.1289/EHP1013
• Parks, C. G., Hoppin, J. A., De Roos, A. J., Costenbader, K. H., Alavanja, M. C., & Sandler, D. P. (2016). Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures. Environmental health perspectives, 124(11), 1728–1734. https://doi.org/10.1289/EHP129

🔝

Environment and Climate: Where You Live Matters

Microclimate: Small Changes Without a Big Move

• Khashoggi, Bandar & Murad, Abdulkader. (2020). Issues of Healthcare Planning and GIS: A Review. ISPRS International Journal of Geo-Information. 9. 352. 10.3390/ijgi9060352.

Sick House

• Luosujärvi, R. A., Husman, T. M., Seuri, M., Pietikäinen, M. A., Pollari, P., Pelkonen, J., Hujakka, H. T., Kaipiainen-Seppänen, O. A., & Aho, K. (2003). Joint symptoms and diseases associated with moisture damage in a health center. Clinical rheumatology, 22(6), 381–385. https://doi.org/10.1007/s10067-003-0753-y
• Pizzorno J. (2016). Is Mold Toxicity Really a Problem for Our Patients? Part I-Respiratory Conditions. Integrative medicine (Encinitas, Calif.), 15(2), 6–10.
• Tuuminen T. (2020). The Roles of Autoimmunity and Biotoxicosis in Sick Building Syndrome as a “Starting Point” for Irreversible Dampness and Mold Hypersensitivity Syndrome. Antibodies (Basel, Switzerland), 9(2), 26. https://doi.org/10.3390/antib9020026
• WHO Guidelines for Indoor Air Quality: Dampness and Mould. Geneva: World Health Organization; 2009. Available from: https://www.ncbi.nlm.nih.gov/books/NBK143941/

🔝

Hormones. Why Do Females Experience More Autoimmune Conditions?

• Moulton V. R. (2018). Sex Hormones in Acquired Immunity and Autoimmune Disease. Frontiers in immunology, 9, 2279. https://doi.org/10.3389/fimmu.2018.02279

Testosterone

• MInguez-Alarcón, L., Chavarro, J. E., Mendiola, J., Roca, M., Tanrikut, C., Vioque, J., Jørgensen, N., & Torres-Cantero, A. M. (2017). Fatty acid intake in relation to reproductive hormones and testicular volume among young healthy men. Asian journal of andrology, 19(2), 184–190. https://doi.org/10.4103/1008-682X.190323
• Lokeshwar, S. D., Patel, P., Fantus, R. J., Halpern, J., Chang, C., Kargi, A. Y., & Ramasamy, R. (2021). Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA. European urology focus, 7(4), 886–889. https://doi.org/10.1016/j.euf.2020.02.006 Patel, Premal; Fantus, Richard; Lokeshwar*, Soum; Halpern, Joshua; Chang, Cecilia; Kargi, Atil; Ramasamy, Ranjith (2020). MP78-01 TRENDS IN SERUM TESTOSTERONE LEVELS AMONG ADOLESCENT AND YOUNG ADULT MEN IN THE UNITED STATES, Journal of Urology: April 2020 - Volume 203 - Issue Supplement 4 https://doi.org/10.1097/JU.0000000000000964.01

Xenoestrogens

• Cecilia Chighizola and Pier Luigi Meroni. (2012). The role of environmental estrogens and autoimmunity. Autoimmun Rev 2012;11:A493–A501.
• Smith, D.B., Cannon, W.F., Woodruff, L.G., Solano, Federico, and Ellefsen, K.J., 2014, Geochemical and mineralogical maps for soils of the conterminous United States: U.S. Geological Survey Open-File Report 2014–1082, 386 p., http://dx.doi.org/10.3133/ofr20141082
• Kuhnle, G. G., Dell’Aquila, C., Aspinall, S. M., Runswick, S. A., Mulligan, A. A., & Bingham, S. A. (2008). Phytoestrogen content of foods of animal origin: dairy products, eggs, meat, fish, and seafood. Journal of agricultural and food chemistry, 56(21), 10099–10104. https://doi.org/10.1021/jf801344x
• Kuhnle, Gunter & Dell’Aquila, Caterina & Aspinall, Sue & Runswick, Shirley & Joosen, Annemiek & Mulligan, Angela & Bingham, Sheila. (2009). Phytoestrogen content of fruits and vegetables commonly consumed in the UK based on LC–MS and 13C-labelled standards. Food Chemistry. 116. 542-554. 10.1016/j.foodchem.2009.03.002.

🔝

Physical Exercises

• Bartlett, D. B., Willis, L. H., Slentz, C. A., Hoselton, A., Kelly, L., Huebner, J. L., Kraus, V. B., Moss, J., Muehlbauer, M. J., Spielmann, G., Kraus, W. E., Lord, J. M., & Huffman, K. M. (2018). Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study. Arthritis research & therapy, 20(1), 127. https://doi.org/10.1186/s13075-018-1624-x

Timing

• Costa, R. J. S., Snipe, R. M. J., Kitic, C. M., & Gibson, P. R. (2017). Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Alimentary pharmacology & therapeutics, 46(3), 246–265. https://doi.org/10.1111/apt.14157

Exercises for Healthy Testosterone Levels

• Nickmilder, M., & Bernard, A. (2011). Associations between testicular hormones at adolescence and attendance at chlorinated swimming pools during childhood. International journal of andrology, 34(5 Pt 2), e446–e458. https://doi.org/10.1111/j.1365-2605.2011.01174.x
• Tyndall, G.L., Kobe, R.W. & Houmard, J.A. Cortisol, testosterone, and insulin action during intense swimming training in humans. Europ. J. Appl. Physiol. 73, 61–65 (1996). https://doi.org/10.1007/BF00262810
• Cumming, D. C., Wall, S. R., Quinney, H. A., & Belcastro, A. N. (1987). Decrease in serum testosterone levels with maximal intensity swimming exercise in trained male and female swimmers. Endocrine research, 13(1), 31–41. https://doi.org/10.1080/07435808709023660

Improve Blood Circulation in Your Limbs: A Simple Exercise

• Venslauskas, M., Ostaševičius, V., & Marozas, V. (2013). Limb’s Vibrations Exercise Monitoring with MEMS Accelerometer to Identify Influence of Cardiovascular System. Vibroengineering. Vibroengineering Procedia. September 2013. Volume 1. ISSN 2345-0533 https://www.extrica.com/article/10759/pdf
• Nishi, K. (1977). Live longer the Nishi Health System Way: Prevent sickness, maintain health and treat ailments. Hawaii Nishi Kai, Inc.

Cardio Training

• Clarke, S. F., Murphy, E. F., O’Sullivan, O., Lucey, A. J., Humphreys, M., Hogan, A., Hayes, P., O’Reilly, M., Jeffery, I. B., Wood-Martin, R., Kerins, D. M., Quigley, E., Ross, R. P., O’Toole, P. W., Molloy, M. G., Falvey, E., Shanahan, F., & Cotter, P. D. (2014). Exercise and associated dietary extremes impact on gut microbial diversity. Gut, 63(12), 1913–1920. https://doi.org/10.1136/gutjnl-2013-306541
• Rao, R., & Samak, G. (2012). Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. Journal of epithelial biology & pharmacology, 5(Suppl 1-M7), 47–54. https://doi.org/10.2174/1875044301205010047

🔝

Sleep and Circadian Rhythms

Sleep’s Role in Combating Chronic Illness

• Poroyko, V. A., Carreras, A., Khalyfa, A., Khalyfa, A. A., Leone, V., Peris, E., Almendros, I., Gileles-Hillel, A., Qiao, Z., Hubert, N., Farré, R., Chang, E. B., & Gozal, D. (2016). Chronic Sleep Disruption Alters Gut Microbiota, Induces Systemic and Adipose Tissue Inflammation and Insulin Resistance in Mice. Scientific reports, 6, 35405. https://doi.org/10.1038/srep35405
• Wilson, R. G., Stevens, B. W., Guo, A. Y., Russell, C. N., Thornton, A., Cohen, M. A., Sturgeon, H. C., Giallourakis, C., Khalili, H., Nguyen, D. D., Yajnik, V., Sauk, J., & Ananthakrishnan, A. N. (2015). High C-Reactive Protein Is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease. Digestive diseases and sciences, 60(7), 2136–2143. https://doi.org/10.1007/s10620-015-3580-5
• Swanson, G. R., Burgess, H. J., & Keshavarzian, A. (2011). Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare?. Expert review of clinical immunology, 7(1), 29–36. https://doi.org/10.1586/eci.10.83

Circadian Rhythms

• Hsiao, Y. H., Chen, Y. T., Tseng, C. M., Wu, L. A., Lin, W. C., Su, V. Y., Perng, D. W., Chang, S. C., Chen, Y. M., Chen, T. J., Lee, Y. C., & Chou, K. T. (2015). Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea. Sleep, 38(4), 581–586. https://doi.org/10.5665/sleep.4574
• Kim, H. I., Jung, S. A., Choi, J. Y., Kim, S. E., Jung, H. K., Shim, K. N., & Yoo, K. (2013). Impact of shiftwork on irritable bowel syndrome and functional dyspepsia. Journal of Korean medical science, 28(3), 431–437. https://doi.org/10.3346/jkms.2013.28.3.431
• Nojkov, B., Rubenstein, J. H., Chey, W. D., & Hoogerwerf, W. A. (2010). The impact of rotating shift work on the prevalence of irritable bowel syndrome in nurses. The American journal of gastroenterology, 105(4), 842–847. https://doi.org/10.1038/ajg.2010.48
• Swanson, G. R., Burgess, H. J., & Keshavarzian, A. (2011). Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare?. Expert review of clinical immunology, 7(1), 29–36. https://doi.org/10.1586/eci.10.83
• Murakami, M., & Tognini, P. (2020). The Circadian Clock as an Essential Molecular Link Between Host Physiology and Microorganisms. Frontiers in cellular and infection microbiology, 9, 469. https://doi.org/10.3389/fcimb.2019.00469
• Martchenko, A., Martchenko, S. E., Biancolin, A. D., & Brubaker, P. L. (2020). Circadian Rhythms and the Gastrointestinal Tract: Relationship to Metabolism and Gut Hormones. Endocrinology, 161(12), bqaa167. https://doi.org/10.1210/endocr/bqaa167
• Voigt, R. M., Forsyth, C. B., Green, S. J., Engen, P. A., & Keshavarzian, A. (2016). Circadian Rhythm and the Gut Microbiome. International review of neurobiology, 131, 193–205. https://doi.org/10.1016/bs.irn.2016.07.002
• Frazier, K., & Chang, E. B. (2020). Intersection of the Gut Microbiome and Circadian Rhythms in Metabolism. Trends in endocrinology and metabolism: TEM, 31(1), 25–36. https://doi.org/10.1016/j.tem.2019.08.013
• Gombert, M., Carrasco-Luna, J., Pin-Arboledas, G., & Codoñer-Franch, P. (2019). The connection of circadian rhythm to inflammatory bowel disease. Translational research : the journal of laboratory and clinical medicine, 206, 107–118. https://doi.org/10.1016/j.trsl.2018.12.001
• Besedovsky, L., Lange, T., & Born, J. (2012). Sleep and immune function. Pflugers Archiv : European journal of physiology, 463(1), 121–137. https://doi.org/10.1007/s00424-011-1044-0
• Awuah, W. A., Huang, H., Kalmanovich, J., Mehta, A., Mikhailova, T., Ng, J. C., Abdul-Rahman, T., Adebusoye, F. T., Tan, J. K., Kamanousa, K., Ferreira, T., Roy, S., Kundu, M., Yarlagadda, R., Mukerjee, N., Alexiou, A., & Papadakis, M. (2023). Circadian rhythm in systemic autoimmune conditions: Potential of chrono-immunology in clinical practice: A narrative review. Medicine, 102(32), e34614. https://doi.org/10.1097/MD.0000000000034614
• AMHSI Research Team, Milken Research Team, Roitblat, Y., Burger, J., Vaiman, M., Nehuliaieva, L., Buchris, N., & Shterenshis, M. (2021). Owls and larks do not exist: COVID-19 quarantine sleep habits. Sleep medicine, 77, 177-183. https://doi.org/10.1016/j.sleep.2020.09.003
• Carvalho, F. G., Hidalgo, M. P., & Levandovski, R. (2014). Differences in circadian patterns between rural and urban populations: an epidemiological study in countryside. Chronobiology international, 31(3), 442-449. https://doi.org/10.3109/07420528.2013.846350

Melatonin: Friend or Foe?

• Watad, A., Azrielant, S., Bragazzi, N. L., Sharif, K., David, P., Katz, I., Aljadeff, G., Quaresma, M., Tanay, G., Adawi, M., Amital, H., & Shoenfeld, Y. (2017). Seasonality and autoimmune diseases: The contribution of the four seasons to the mosaic of autoimmunity. Journal of autoimmunity, 82, 13-30. https://doi.org/10.1016/j.jaut.2017.06.001
• Ghareghani, M., Zibara, K., & Rivest, S. (2023). Melatonin and vitamin D, two sides of the same coin, better to land on its edge to improve multiple sclerosis. Proceedings of the National Academy of Sciences of the United States of America, 120(14), e2219334120. https://doi.org/10.1073/pnas.2219334120
• Lin G-J, Huang S-H, Chen S-J, Wang C-H, Chang D-M, Sytwu H-K. Modulation by Melatonin of the Pathogenesis of Inflammatory Autoimmune Diseases. International Journal of Molecular Sciences. 2013; 14(6):11742-11766. https://doi.org/10.3390/ijms140611742
• Siah, K. T., Wong, R. K., & Ho, K. Y. (2014). Melatonin for the treatment of irritable bowel syndrome. World journal of gastroenterology, 20(10), 2492–2498. https://doi.org/10.3748/wjg.v20.i10.2492
• Swanson, G. R., Gorenz, A., Shaikh, M., Desai, V., Forsyth, C., Fogg, L., Burgess, H. J., & Keshavarzian, A. (2015). Decreased melatonin secretion is associated with increased intestinal permeability and marker of endotoxemia in alcoholics. American journal of physiology. Gastrointestinal and liver physiology, 308(12), G1004–G1011. https://doi.org/10.1152/ajpgi.00002.2015
• Chen, S. J., Huang, S. H., Chen, J. W., Wang, K. C., Yang, Y. R., Liu, P. F., Lin, G. J., & Sytwu, H. K. (2016). Melatonin enhances interleukin-10 expression and suppresses chemotaxis to inhibit inflammation in situ and reduce the severity of experimental autoimmune encephalomyelitis. International immunopharmacology, 31, 169–177. https://doi.org/10.1016/j.intimp.2015.12.020
• https://www.sciencedirect.com/science/article/abs/pii/S1359610119300449
• Zhao, C. N., Wang, P., Mao, Y. M., Dan, Y. L., Wu, Q., Li, X. M., Wang, D. G., Davis, C., Hu, W., & Pan, H. F. (2019). Potential role of melatonin in autoimmune diseases. Cytokine & growth factor reviews, 48, 1–10. https://doi.org/10.1016/j.cytogfr.2019.07.002

Snoring and Sleep Apnea: Hidden Threats to Brain Health

• Phillips, B. G., Wang, Y., Ambati, S., Ma, P., & Meagher, R. B. (2020). Airways therapy of obstructive sleep apnea dramatically improves aberrant levels of soluble cytokines involved in autoimmune disease. Clinical immunology (Orlando, Fla.), 221, 108601. https://doi.org/10.1016/j.clim.2020.108601
• Mirrakhimov A. E. (2013). Obstructive sleep apnea and autoimmune rheumatic disease: is there any link?. Inflammation & allergy drug targets, 12(5), 362-367. https://doi.org/10.2174/18715281113129990051
• Kang, J. H., & Lin, H. C. (2012). Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep medicine, 13(6), 583–588. https://doi.org/10.1016/j.sleep.2012.03.002

Oropharyngeal Exercises

• Rueda, J. R., Mugueta-Aguinaga, I., Vilaró, J., & Rueda-Etxebarria, M. (2020). Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea. The Cochrane database of systematic reviews, 11(11), CD013449. https://doi.org/10.1002/14651858.CD013449.pub2

Your Digestive System Also Wants To Sleep

• Martchenko, A., Martchenko, S. E., Biancolin, A. D., & Brubaker, P. L. (2020). Circadian Rhythms and the Gastrointestinal Tract: Relationship to Metabolism and Gut Hormones. Endocrinology, 161(12), bqaa167. https://doi.org/10.1210/endocr/bqaa167
• Vaughn, Brad & Rotolo, Sean & Roth, Heidi. (2014). Circadian rhythm and sleep influences on digestive physiology and disorders. ChronoPhysiology and Therapy. 2014. 67. 10.2147/CPT.S44806.
• Duboc, H., Coffin, B., & Siproudhis, L. (2020). Disruption of Circadian Rhythms and Gut Motility: An Overview of Underlying Mechanisms and Associated Pathologies. Journal of clinical gastroenterology, 54(5), 405–414. https://doi.org/10.1097/MCG.0000000000001333
• Vaughn B, Rotolo S, Roth H. (2014). Circadian rhythm and sleep influences on digestive physiology and disorders. ChronoPhysiology and Therapy. 2014;4:67-77

https://doi.org/10.2147/CPT.S44806

• Scheving L. A. (2000). Biological clocks and the digestive system. Gastroenterology, 119(2), 536–549. https://doi.org/10.1053/gast.2000.9305

🔝

Hydrotherapy and Temperature Contrast

Contrast Showers: A Practice You Can Start Today

• Buijze, G. A., Sierevelt, I. N., van der Heijden, B. C., Dijkgraaf, M. G., & Frings-Dresen, M. H. (2016). The Effect of Cold Showering on Health and Work: A Randomized Controlled Trial. PloS one, 11(9), e0161749. https://doi.org/10.1371/journal.pone.0161749

Sauna and Steam Room

• Crinnion W. J. (2011). Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant- induced and other chronic health problems. Alternative medicine review : a journal of clinical therapeutic, 16(3), 215–225.
• Oosterveld, F. G., Rasker, J. J., Floors, M., Landkroon, R., van Rennes, B., Zwijnenberg, J., van de Laar, M. A., & Koel, G. J. (2009). Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effects. Clinical rheumatology, 28(1), 29–34. https://doi.org/10.1007/s10067-008-0977-y
• Eversden, L., Maggs, F., Nightingale, P., & Jobanputra, P. (2007). A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC musculoskeletal disorders, 8, 23. https://doi.org/10.1186/1471-2474-8-23
• Mahlouji, M., Alizadeh Vaghasloo, M., Dadmehr, M., Rezaeizadeh, H., Nazem, E., & Tajadini, H. (2020). Sweating as a Preventive Care and Treatment Strategy in Traditional Persian Medicine. Galen medical journal, 9, e2003. https://doi.org/10.31661/gmj.v9i0.2003

🔝

Oral Health and Other Autoimmune Triggers

Chronic Inflammation in Your Body

• Rashid, T., & Ebringer, A. (2012). Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry. Autoimmune diseases, 2012, 539282. https://doi.org/10.1155/2012/539282
• Balandraud, N., Roudier, J., & Roudier, C. (2004). Epstein-Barr virus and rheumatoid arthritis. Autoimmunity reviews, 3(5), 362–367. https://doi.org/10.1016/j.autrev.2004.02.002
• Larsen, M., Sauce, D., Deback, C., Arnaud, L., Mathian, A., Miyara, M., Boutolleau, D., Parizot, C., Dorgham, K., Papagno, L., Appay, V., Amoura, Z., & Gorochov, G. (2011). Exhausted cytotoxic control of Epstein-Barr virus in human lupus. PLoS pathogens, 7(10), e1002328. https://doi.org/10.1371/journal.ppat.1002328
• Poole, B. D., Scofield, R. H., Harley, J. B., & James, J. A. (2006). Epstein-Barr virus and molecular mimicry in systemic lupus erythematosus. Autoimmunity, 39(1), 63–70. https://doi.org/10.1080/08916930500484849
• Pender M. P. (2012). CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis. Autoimmune diseases, 2012, 189096. https://doi.org/10.1155/2012/189096
• Toussirot, E., & Roudier, J. (2008). Epstein-Barr virus in autoimmune diseases. Best practice & research. Clinical rheumatology, 22(5), 883–896. https://doi.org/10.1016/j.berh.2008.09.007

Oral Microbiome, Gums, and Teeth

Chronic Gum Inflammation and Dental Pockets

• Mercado, F. B., Marshall, R. I., Klestov, A. C., & Bartold, P. M. (2001). Relationship between rheumatoid arthritis and periodontitis. Journal of periodontology, 72(6), 779-787. https://doi.org/10.1902/jop.2001.72.6.779
• Routsias, J. G., Goules, J. D., Goules, A., Charalampakis, G., & Pikazis, D. (2011). Autopathogenic correlation of periodontitis and rheumatoid arthritis. Rheumatology (Oxford, England), 50(7), 1189-1193. https://doi.org/10.1093/rheumatology/ker090

Oral Microbiome

• Loyola-Rodriguez, J. P., Martinez-Martinez, R. E., Abud-Mendoza, C., Patiño-Marin, N., & Seymour, G. J. (2010). Rheumatoid arthritis and the role of oral bacteria. Journal of oral microbiology, 2, 10.3402/jom.v2i0.5784. https://doi.org/10.3402/jom.v2i0.5784
• Olsen, I., & Yamazaki, K. (2019). Can oral bacteria affect the microbiome of the gut?. Journal of oral microbiology, 11(1), 1586422. https://doi.org/10.1080/20002297.2019.1586422