Fats

FATS - Average intake • 1999- Intake 38% of diet • 1996- 66 pounds of fats that have never been part of the human diet before. • 1970- 53 pounds of vegetable fats/year with reduction of fats from 40% to 34%. Obesity was constant 1960s-1980s at 14%, then it surged up 22%, • 1960- 43% of diet fat with butter replaced by oils, margarine and shortening- vegetable oils. • 1910- 25% of diet fats primarily lard, and some butter and fish oils. (80% saturated fats, 20% veggie fat) • Cholesterol is the same now as 1910 (500mg). 1979 480mg chol. 1940s chol intake was high-570mg.

• More fat and less fiber is associated by some to have increased cancer and atherosclerosis (ASD). This includes studies done in the 40s with eggs increasing hyper-cholesterolemia. – However, this occurred only with fried and freeze dried eggs (OXIDIZED fats). Mercola –No Grain Diet.

• Russel supports a 20% fat in diet. • Nat research council (NRC) – suggest 30% fat in diet. (This leads to increased sugar intake.) • The Zone suggests 30% in its diet. • Bernstein in his book Diabetes Solution says 60% fat in his diet. He shows convincing evidence that high sugar with high fat is the link to degenerative diseases. • Inuits eat 60-70% fats in their diet and don’t get ASD until they add processed foods and their BS rises. • It has been shown that 2 generations of eating only fish oil increases brain size by 2x. • What do you think?

• There is clear research that shows that ANIMAL FAT INTAKE DOES NOT CORRELATE WITH INCREASED CANCER AND HEART DISEASE! • (No Grain Diet p30-32, Mary Enig-Lipid research in the U. of Maryland’s Dept of Chemistry and Biochemistry found TRANS-FATS (oxidized) WERE THE CULPRIT IN CARDIOVASCULAR DISEASE.) • The fats Dr. Enig found most damaging in her review of 21 studies –150,000 people found vegetable fats were correlated with cancer and animal fat was not. • This was confirmed by the Mediterranean diet studies, with fats coming from lamb, fish, sausage and goat cheese. • Olive oil and nuts were ok too if not fried. Diabetics who cheated and ate more fat had a better HgA1C and less complications of diabetes.

DIFFERENT FATS: • -Simple lipids triacylglycerol (triglycerides- TGs) – most natural fats (98-99% natural fats) • Unsaturated fats have a bent configuration (more fluid fats) • Saturated fats are straighter and make TGs more rigid or solid. Compound lipids • Phospholipids – lecithin, cephalins and sphingomyelins • Glycolipids- compounds of fatty acid (FA plus CHO and N base  cerebrosides and gangliosides • Sulpholipids • Lipoproteins • Apolipoproteins • Lipopolysaccharides

-Derived Lipids -Sterols – cholesterol, ergosterol, steroid hormones, estrogen, cortisol, DHEA, VitD, Bile salts

-Misc lipids – fat soluble vit like VitA, carotenoids, VitE, VitK

NOMENCLATURE OF FATTY ACIDS (p37- Marz) • -Depends on number and placement of double bonds. • -Counting from the methyl group, count carbons to the first double bond. • -Carbons can vary from 4 to 20. • First # is the number of carbon atoms • Second # is the number of double bonds • Third is the number from the methyl group of the 1st double bond. • Short-chain fatty acids • Medium chain fatty acids • Long chain fatty acids

Saturation
• Saturated FAs – no double bonds, from dairy and meat. Do these cause Atherosclerosis (ASD)? • Unsaturated FAs – at least 1 double bond • Monosaturates – 1 double bond (olive oil and macadamia nut oil. • Polyunsaturated FAs – at least 2 double bonds, ? reduce CVD, unstable, susceptible to oxidative damage, • Form free radicals and peroxides, some increase cancer and CVD, (O6FAs) and some are protective (O3FAs/GLA).

Essential fatty acids (EFAs)
• Linoleic acid • Alpha Linolenic acid • Deficiencies – Dermatitis, stunted growth and hormone imbalance. Fatty acids also determine the ability of nerve receptor sites to function well. Trans fats act as antagonist to EFAs

Triglycerides
• One glycerol and 3 fatty acids. These fats can be saturated or unsaturated. (see Mars) • They can have oxidation, hydrogenation, saturation, saponification, and emulsification. • Light and heat are keys to their molecular status, causing oxidation and free radicial formation. Iron, copper and other metals can up-regulate the oxidation • If the liver is dysfunctional due to infections or exposure to chemicals, the liver can’t filter as well, thus there will be more free radicals like oxygen. – These radicals will be unbonded allowing them to bond to fatty acids double bonds – causing peroxidation of these fatty acids. • Without the appropriate FAs hormones won’t bind to their binding sites, and neurotransmitters don’t bind well either. • Cell to cell communication is not effective and many diseases occur.

Fats dictate the inflammatory tone
• Adipose tissue if present in large amounts will secrete inflammatory cytokines like – NF Kappa, TNFa, IL1, IL6. • Leptin resistance occurs with high cortisol and insulin. • If leptin resistance occurs, appetite will be enhanced and fatty acid breakdown is reduced, instead fatty acid addition to tissue occurs. Reduce leptin – exercise and cortisol, • Triglyceride elevation causes insulin receptor site closure inducing insulin resistance. • If insulin and sugar goes up due to insulin resistance, the liver begins lipogenesis via the enzyme HMGCoA reductase. • Statins (mevacor/lipitor).block this enzyme. • If cholesterol synthesis is stopped by statins, the body has reduced ability to make steroids and make neurological repairs. • If LDLs are elevated, triglycerides and adipose is increased they cause the inflammatory cytokine release. • If the inflammatory cytokines are elevated due to dysbiosis, infection or elevated cortisol, this will feed the fat build-up cycle and there will be increases in “metabolic syndrome”.

“Metabolic syndrome”.
• Increased BP • Increased LDLs • Insulin resistence and central obesity • Increased triglycerides • High blood sugar – Inflammatory sxs • Reduced thyroid fx, inc RT3 • Reduced Progest/Test • Increased cortisol • Anxiety and depression, low serotonin • Fatigue and malaise • Reduced TH1 immune function

Peroxidation of fats
• -Unsaturated fatty acids are vulnerable to oxygen binding to the double bond of the carbons. • - This is increased by light, heat, oxygen, and co-factors like iron and Cu++. • - More unsaturated (double) bonds, the more susceptibility to damage from free radicals. • - Peroxide formation will stimulate other peroxides to be formed, generating a chain reaction of peroxidation. (p39)

Hydrogenation:
• - Unsaturated fatty acids like corn oil are exposed to nickel plus hydrogen being bubble through it. • - This will saturate the double bonds, and stop rancidity. • - This makes the oils harder at lower temps. • - This is how vegetable oil is formed (Crisco and margarines). • - The double bonds can become trans rather than the naturally occurring cis. • - The trans fats are linked to cancers, neurological and cardiovascular disease. • They disrupt normal cell to cell communication. • We have no enzymes to break them down they get into cellular membranes and disrupt receptor sites bodily fxs.

- Unsaturated trans, hydrogenated fatty acids disrupt:
• Insulin, • inflammation, • neurotransmitters, • cortisol, • hormones

Saturated fats and heart disease
• Saturated fats – no increases in heart disease. – Meta analysis if 21 prospective cohort studies. 5-23 year follow-up, 347,747 people, 11,006 had cases of coronary heart disease or stroke. There was no significant association with saturated fats

Trans-fatty acids:
• -Commercial production of hydrogenated oils. • -Instead of natural cis- configuration, the transformation occurs with hydrogen and nickel exposure to the unsaturated fats. • -These fats increase cholesterol in general, especially LDLs, more than saturated fats. • When incorporated into the FAs of the body they disrupt membrane permeability and membrane receptor binding. • -Trans fats act as an antagonist to EFAs and interfere with normal prostaglandin production.

Saponification, Medium chain TGs Short chain TGs
• Saponification chemical process using alkali to cleave FAs off TGs – forms insoluble soaps with Na+ and K+ (p41) • Medium chain triglycerides -water soluble fats, absorbed directly into the blood not lymph. Good for patients with malabsorption problems. • Short chain triglycerides –short chain FAs that are absorbed into blood directly. They also protect from colon inflammation, damage and cancer. • Monoglycerides/diglycerides Breakdown products of TGs. Added to foods as thickeners, emulsifiers and stabilizers. (Ice cream/ chocolate/bread/ and candy) They tend to be more water soluble. • **Phospholipids** – contained in cell membranes, what we eat determines cell membrane excretion of prostaglandins, • -Leukotrienes, and thromboxanes. They dictate cell to cell communication. • -Phosphorus (hydrophilic) on the outside and fatty acids including cholesterol in the middle of the phospholipid bilayer. • Lecithin will normalize neurotransmitters in bipolar patients allowing withdrawl of lithium in some cases • Sphingomyelin, Liptontols and cephalins- in the nervous system, phospholipids that make membranes

• **Cholesterol**- Made in the liver from fats and lecithin, production stimulated by insulin & cortisol. • -It is used to make steroids and some neurotransmitters. (Epi, NE, Aldosterone, progest, E1,2,3, Test, DHEA…) • -We can also absorb it from our diet. • -7Dehydrocholesterol in skin is converted by the sun to cholecalciferol, which is then hydroxyklated by the liver and kidneys to active VitD. • -If elevated with more low density particles (LDLs), they may??? induce secretion of inflammatory cytokines, increasing PGE2 • -HDL cholesterol induces fat burning and noninflammatory cytokines. • Cholesterol • Does fat in the diet create higher cholesterol levels • Does cholesterol cause cardiovascular disease and plaquing in the arteries? • Facts: Diets of lard, butter and animal fat (high cholesterol food) – there were rare cardiovascular events until the 1930’s. • (Two written up in 1860). Dr. White, a heart specialist in 1921 never saw a heart attack (thrombosis), until 1931. • In 1920’s ready made cigarettes were invented and corn oil was starting to be used in food. • In 1940’s vegetable oil use was dramatically increased after WW2. 1950s – PUFAs primary fats

• In 1966 The prudent heart diet study was performed – polyunsaturates vs cholesterol. • In the study, cholesterol dropped from 225 to 200. • The low cholesterol group had 8 deaths – not mentioned in the study results. • The controls had NO DEATHS. Other studies showed low fat diets did not change heart attack rates. • People on polyunsaturated diets had increased cancer and thrombosis rates. • In 1953 Ansel Keys did the 6 country study (He omitted 22 counties research). • He showed a difference in animal fat intake an heart attack rates. • For instance Japan and Finland had a difference, but there were extreme flaws in his study – within • Finland there was a huge difference between Eastern and Western Finland meat intake and heart attacks that did not match his study. • He left the un-matching data out. ( Magnesium levels in the water made the biggest variations) The Cholesterol Myth,/ Prudent heart Diet – Wayne Martin..

• Crete had the lowest long-term rate of death • Cancer, heart disease, • 25% - 35%total energy 7-8% total calories • Rosetto, Pennsylvania – 100% Italian community – no heart attack deaths and no polyunsaturated oils. (Transactions of the American Clinical and Climatological Society 1973.) • Irish study, Masai study… no polyunsaturates- high cholesterol – no heart attacks. American Journal of Clinical Nutrition 1967. • 1978 Anderson wrote in New Scientist Feb 9, 1978 that the heart was receiving too much oxygen via oxidized fats due to the PUFAs in their diets. • Aspirin – no positive effect in preventing heart attacks– Lancet 1979, British Medical Journal 1974, JAMA 1980, $160million spent by USGov- no change in heart attacks, but severe GI side-effects. • 1988 British doctors trial with aspirin - no protective benefit. R. Peto British Medical Journal 1988, Vol296; 313-316. – No reduction in fatal heart attacks and survival was not increased. • 1980s Prudent heart diet and on ASA, 400,000 heart attacks and increased risk of thrombotic stroke (JAMA 1987)/ year, with almost none in 1900. • VitE – • Pycnogenols/ Flavonoids / Berberines/ Co Q10/Mg

Phytosterols
• Phytosterols fats found in plants. They stimulate the immune system (Moducare -sterolins) and are useful for reducing high or low cortisol with adrenal stress syndromes- very common in our culture today. I use them either in the form of juicing or pills in hepatitis, cancer, and chronic fatigue. • -Sterolins can reduce elevated serum cholesterol - LDLs- (CPSept2004/EurJClinNutr2004;58) • -Contain the precursors to VitD. • -Can convert CIN3 cervical cancer to normal cellsinducing differentiation? (Thorne Alt Med Rev2002)

LIPID DIGESTION
• Lingual lipase • Gastric lipase • Bile salts – form micelles (less with GB removal) • Pancreatic lipase breaks down free FAs into the brush border of the SI as mono and di-glycerides. • Across intestinal epithelial cells to reform chylomicrons • Entering the lacteals which go to the lymph system and enter the blood at the thoracic duct above the ht. • Small and medium chain FAs are absorbed directly into the blood and thus are taken directly to the liver and other tissues for beta-oxidation (break down for metabolism) • The brain, RBCs, skin and renal medulla don’t use fatty acids for fuel, they only use sugar. THE FAT STORY (Well Being Journal – May/June 2005) Ray Peat Ph.D • Dr Peat said in 1968 that PUFAs are the cause of cancer, arthritis, obesity, aging, thrombosis, immunodeficiencies. • Why? These fats contain long chains of fatty acids that are fragile and unstable. • As soon as they are exposed to heat, or air they oxidize and become rancid, even in the refrigerator. • When they enter the body they oxidize with the increased temp. and catalysts oxygen and iron. • If you stop eating them they stay in tissues until stress or fasting occurs (this includes at night). • They damage every part of the body especially the endocrine system. • The thyroid is especially sensitive to these fatty acids. • Sluggish thyroid function accompanies their intake. • In the history of cow fattening, there was experimentation by the farmers in the 40s to fatten cows with a drug that suppressed thyroid,= fat cows. • This drug was withdrawn because of it was extremely carcinogenic. • Then coconut oil was tried, – it improve thyroid function increase lean muscle mass – increased activity and hunger, – reducing fat

They tried a mixture of coconut oil and vegetable oils. The animals that had the most PUFAs weighed the most, on the least food. Then they tried soy and corn. This increased animal weight with less food. They bred animals that got the fattest and biggest on the least, and this is what defined current feeding practices. The hypothyroid connection with PUFA oils was found in the 1950s due to thyroid disrupting enzymes that were accompanying the fatty acids like soy and corn. – With the addition of dead animal parts a little late on. The American Soy Association (ASA) initiated a campaign in the 80’s to reduce coconut oil use and increase soy oil. • Many doctors testified that the PUFAs were biologically harmful, but the government and media sided with the soy and canola oil corporations fought. • The information clearly showed health of the pacific islanders having longer healthier lives with coconut oil being their primary fat. • But this was unheeded. • Fast food switched to PUFAs – canola and soy as their fatty acids for cooking with, avoiding saturated fats. • This increased, even doubling the fat content of foods. In ‘82 a restaurant food contained 2.4 gms of trans fats, whereas now the levels are at 19.2gm. • With 30-50% trans fats ingested in a meal with fried stuff, cookies, pastries, or crackers. • The safest PUFA is olive oil (8-10% polyunsaturated) • But its healthful effects are lost if it doesn’t have the residues from the polyphenols (the green stuff in the first pressing from the leaves and sticks included in the extra virgin labels). • (Bertoli’s doesn’t have this positive effect – too processed?) • Where did “EFA” come from? • In 1929 a rat study done by Burr and Burr. • It was hypothesized that the rats needed fatty acids. • Biochemistry knowledge was very limited. • At the end of WW2, the plant oil industry was displaced by petroleum. • It was then decided that these oils were healthy and heart protective in spite of animal studies showing the opposite. • The opinions were driven by corporate need for a market for their oils – flax and canola are examples of this. Kritchevsky showed in 1954 that cholesterol temporarily reduced cholesterol in rabbits. The theory caught fire with the oil industry, who supported it.

• The AHA (American heart assoc.) started its campaign, the Prudent heart diet, based on this hypothesis, and corn oil and margarine replaced lard and butter. • The studies that followed where the people overseeing the studies died of heart attacks and strokes, did not get recognized since they didn’t support the current hypothesis. • Dudley White MD, went public and said he never saw a heart attack until 1928, when corn oil started its cooking career. • The Mazola industry was very vocal in its support of the “knowledge” of corn oils health benefits. • In 1957, a study of the prudent heart diet showed it reduced cholesterol 30 points, but the increased death rate from clots and cancer were not included in the results. • The Journal of the AMA 1966 published this. • None of the meat eaters in the study died. • The head of the study died of a blood clot in 1961 of vascular thrombosis (called complications of diabetes). • Larger studies were abandoned when the chairman died of a heart attack.

• Mitochondrial studies showed – less mitochondrial degeneration, – Less transplant rejection, – less shock response, – less cancer, – less liver cirrhosis with etoh and – more immune stability with more animal fatty acid ingestion and no EFA ingestion.

• In the 1960s vegetable fats stopped immune transplant rejection – just like prednisone, also increasing cancer incidence. • Unsaturated fats were shown to block brain development, and • AGES damage was shown to be correlated to peroxidation of PUFA fats. • www.westonprice.org. www.efn.org/~raypeat(Enigs report) • The Healing Miracles of Coc Oil -Fife • Organic Coconut oil: 1-800-945-3801

Ketone bodies
• Liver makes acetyl CoA in excess when fats are burned exclusively. • Acetyl CoA is broken into 2 acetoacetic acids Acetoacetic acid is peripherally normally converted to acetyl CoA and used for beta oxidation. • When only fat is burned, they are converted partially into acetoacetic acid, which are then made into acetone and beta-hydroxybutyric acid. These are ketone bodies. • Skeletal muscle and heart can use ketones for energy.

The brain will after a few days, use ketones preferentially. The ketones can be detected in the urine and breath. Excessive ketones in the liver must be removed from the body. Ketones are acidic and use the body’s base neutralizing stores and the person will become acidic which is called ketoacidosis. The severe ketoacidosis causes calcium to be excreted, that can cause severe reactions including death.

• Insulin (Hormone/Insulin Sensitive Lipase- HSL/ISL) - inc. lipogenesis, inh. Lipolysis, by fat tissues. It up-regulates HMG CoA enzyme pathway inc. LDL Chol. It down-regulates HSL, blocking fat burning. It inc. inflammatory cytokines. • Thyroid hormone – inc. cellular metabolism (esp.T3), increases fat mobilization from fat cells. • If thyroid is low, LDLs, TGs and VLDLs will be very high with low HDLs. • Glucocorticoids – (ACTH and cortisol) inc. HSL and inc. rate of fat mobilization into cells. • Epinephrine, NE, (adrenal medulla hormones) inc. HSL, which increases rate of fat mobilization. If the person is not exercising, LDLs and TGs will rise. • Growth hormone - Stimulates IGF causing lipolysis and cellular repair.
 * Hormones and lipid metabolism**

Lipid Storage and transport
• White fat – Most fat is stored as white fat. Not metabolically active • Brown fat – Higher in babies and children, gets replaced with white fat as we age. Brown fat is very metabolically active and it burns fat. If we eat more carbs, it is thought we make less brown fat. • Chylomicrons – When the fats are brought across the cell membranes, they leave their chylomicron state, and then they coalesce in chylomicrons again in the lymph. • HDLs Cholesterol– are high density lipoproteins that take are cardioprotective. They reduce inflammation and transport fat to the liver where it is beta oxidized for energy. HDL3 is not considered cardioprotective.

• Brown fat and white fat • LDL –Low density lipoproteins, especially the very small particles are considered to be atherogenic. LDL has different sizes. The little ones cause heart disease. Niacin stops this. • LDLs transport fats to the periphery to be laid down for protection of blood vessel linings and storage. • Apolipoprotein A – Inversely correlated with heart disease. • Apolipoprotein B – positively associated with heart disease. Patients with elevated apo B levels have an increased risk of fatal acute myocardial infarction (Walldius G, et al. High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet 2001;358:2026-33). • Because apo(a)-a constituent of Lp(a)-has a similar structure to the clot-busting blood protein plasminogen, elevated Lp(a) levels may disrupt the normal removal of a clot that could block an artery. • Also because Lp(a) stimulates secretion of PAI-1 it leads to thrombogenesis  Clots • High Lp(a) in blood is a risk factor for cerebral vascular disease, coronary heart disease(CHD), (CVD), atherosclerosis and thrombosis, and stroke. • Lp-a concentrations may be affected by disease states, but are only slightly affected by diet, exercise, and other environmental factors. • Commonly prescribed lipid-reducing drugs have little or no effect on Lp(a) concentration. • Niacin (nicotinic acid) and aspirin are two relatively safe, easily available and inexpensive drugs known to significantly reduce the levels of Lp(a) in some individuals with high Lp(a); they should be used under the supervision of a qualified physician.

Fatty Acid functions:
• Energy provision • Protection –Padding • Body temp maintenance • Stomach emptying regulation • Palatability and satiety • Control of inflammation in the body

Trans Fats
• Trans fats increase LDLs • Increase triglycerides (TG) • Increase ApolipoproteinA • Increase platelet stickiness • Increase inflammation cytokines NFKappa B/TNFa • Increase heart disease at 7 gm intake, 50% • If left out of diet decrease heart disease 70% – Willett p82 • Reducing fats and increasing carbs: no change in CVD! – Willett p78/79 • Cancer and fats? EPA and DHA decreases. • ALA may increase or have no effect, one study was protective. (I go with using very little except in the form of small amounts of whole nuts – What we would find in nature.

PAIN AND INFLAMMMATION and integrative medicine
• Pain and inflammation are two of the greatest puzzles of medicine. • Pain is primarily what brings our patients in to visit us. • If we can help them get rid of their pain they think we’re good doctors. • Understanding the inflammatory pathways helps our efficiency in such an endeavor and integrating the different aspects of medicine also helps. • If any of the under-lying causes are not addressed when we are trying to resolve inflammation, we usually are not successful.

• The following is a chart of the underlying causes of the inflammatory pathways: 61 TH1 TH2 TH3 IL2, 1L12, TNFα, TNFβ, IFNγ IL4, 5, 10, 13 IL1b, IL6 ? Tolerance TGFβ, sIgA Bacteria, viruses, fungi & cancer (T cells) IgE,IgG1, some IgA (B cells) Increases with Bifidobacterium longum Increased Makes Ab and Fish oil L.Acidophilus inflammation /PGE2/CRP/TNfa Vit A Decreased with sugar, cortisol, and deficiency of VitA, B6, Zn, Fe INOS, Homocysteine Leukotrienes, cyclooxygenase CORTISOL Love and touch Relaxed/happy Decreased with Bifidobacterium Cortisol/stress Blood sugar/insulin Gut function/sIgA Blood lipids ALLERGIES Infection Detox pathways Thyroid/sex hormones Lifestyle Diet Neurotransmitters Inflammation Immunity clotting Fatigue/metabolism

• Cardiac illness is found among primarily the elderly. Its roots however are in youth. • Epidemiological it has shown in studies to be less in Italians in Italian communities (Risotto study). • What they have different than other groups is a very tight loving extended family. • We seem to need touch and knowing we’re special to someone. Also, anger is associated with heart disease. (TL Aug 2004 PNI) • -Rabbit study • -Monkey study • Obviously the way to treat cardiac disease is to prevent it or at least halt if not reverse its progression when it first begins. It can be a silent process and difficult to detect.

• Cardiac illness is found among primarily the elderly. Its roots however are in youth. • Epidemiological it has shown in studies to be less in Italians in Italian communities (Risotto study). • What they have different than other groups is a very tight loving extended family. • We seem to need touch and knowing we’re special to someone. Also, anger is associated with heart disease. (TL Aug 2004 PNI) • -Rabbit study • -Monkey study • Obviously the way to treat cardiac disease is to prevent it or at least halt if not reverse its progression when it first begins. It can be a silent process and difficult to detect.

INFLAMMATION AND NEUROTRANSMITTERS AND HORMONES
• The oil in our cell membrane and fat intake dictates our inflammatory response dramatically. • Toxic chemicals, high sugar levels and stress hormones increase NF Kappa BPGE2 pathway and vice versa. • PGE pathway (Prostaglandins):

Fatty acids and Inflammation
• The oil in our cell membrane and fats dictates our inflammatory response dramatically. • PGE pathway (Prostaglandins): • PGE1 PGE2 (meat fat) PGE3 • Vegetable oil (not O- 9) Arachadonic Acid Fish oil –O3FA • O-6-FA (B6, 3,Zn,C, E, Mg) Leukotrienes/COX EPA • GLA (EPO/human milk) Inflammation-pain DHA • ▲Plt aggreg,▼BP ▲WBC activity, edema ▼plt aggreg, • ▲ NF-Kappa-b Platelet aggregation Triglycerides • ▲mucin in st, ▲ NF-Kappa-b ▼inflammation • dilates smooth M. ▲Sm. M contraction ▼Permeability, ▲HDL • Corn oil & Canola is especially inflammatory – NF KappaB GLA  Arachidonic acid if sugar is high

PGE pathway (Prostaglandins):
PGE1 • Vegetable oil O-6-FA (B6, 3,Zn,C, E, Mg) NFKappa • ▲ Leukotrienes/COX 2 • Inflammation – pain • ▲WBC activity, edema • ▲ triglycerides &LDLs • ▲ Platelet aggregation • ▲Smooth M contraction • Reduced cAMP

• INFLAMMATORY MODE PGE2 GLA(EPO/human milk) • ▼BP • ▼plt aggreg, • ▲mucin in st • dilates smooth M. • ▼inflammation • ▼Permeability, • ▲HDL ▼triglycerides &LDLs • ANTIINFLAMMATORY • High sugar increased arachidonic acid formation

• Inflammation and O6FA: • DGLA is made from GLA and is an O6FA. It comes from borage/ evening primrose oil and it • -Decreases PGE2, • -Reduces platelet aggregation, • -Inhibits inflammatory leukotrienes • -Kills prostate cancer cells in vitro • -It’s useful in treating asthma, allergies, depression, PMS, breast cancer with tamoxifen, RA, endometriosis • NOTE: DGLA decreases production of O3FAs EPA and DHA. • Dose: 1500mg GLA

• **Interactions of PGE2 hormones and neurotransmitters:** • -PGE2 (Inflammatory pathway) inhibits activity of NK cells and TH1 and TH3. • -Cortisol up-regulates PGE2 and TH2 (increased antibodies) • -PGE2 up-regulates cortisol production, reducing thyroid, increasing insulin resistance, and decreasing serotonin production. (Damp heat, disrupting shen, injury kidneys creating stagnation, more dampness and liver qi constraint) • **CLA (Conjugated Linoleic Acid)** is an O6-FA that increases lean muscle mass and fat burning. It is found in non-grain fed red meat. • Other O6FAs (ALA –Alpha linoleic acid) are found in other vegetable oil. Too much O6FA has been shown to instigate cancer growth (John Boik- Cancer and Natural Medicine). • Some intake is efficacious. ALA does have strong anti-inflammatory effects. It has been shown to decrease PGE2 by means of urinary excretion 52- 85%. (Vioxx is 42% effective in PGE2 reduction)

• Vegetable O-3 FA comes from flax seeds, canola (9%ALA), soy oil, breast milk, walnuts, soybeans pine nuts, green veggies and beans. • No veg O-3-FA has been shown to increase DHA. • Large doses of fish oil have immune suppressive affects and thus are possibly problematic also. (Pizzarno Optimal Wellness) • Walter Crinnion ND, states that O3FAs can protect us neurologically from damage from fatsoluble toxins.
 * PGE3 and O-3-FA:**

• **DHA** is an O3FA found in wild fish, algae, free run chicken eggs. • Reduction of it reduces hippocampal brain development [stress center] (A.Vasquez-Nutritional Perspectives: Journal of the Council on Nutrition of the AmChiroAssoc –Vol.28-#1 Jan 05) • and development in general of infants, reducing infant IQ • as well as in adult brains.

DHA reduces: • Mental depression Schizophrenia, • Bi-polar (reducing Norepinephrine 30% when it f d t b l t d) • Autoimmune disorders : – Crohn’s, RA, and SLE. • degenerative neurological disorders its found to be elevated) di b • CVD • cancer, • learning disorders • diabetes, • otitis incidence. • arthritis,

• **EPA** is absent in vegan diets. • It functions to modulate cell membrane receptor sites where //hormones and neurotransmitters// are received. • It is anti-inflammatory and reduces eicosanoids such as: – LT-B4, PAFs, Cytokines- TNFa, IL1, and has extreme reductions in PGE2 and TX-B2 (Biomed Pharmacother Jy2002). – To increase bleeding time 4 grams/day are necessary. • It seems that to reduce inflammation a diet 1-2 gm/ day of O3FA is very effective.

Inflammation and Omega 6 Fatty Acids:
• **DGLA** is made from GLA and is an O6FA. It comes from borage/ evening primrose oil and • -decreases PGE2, • -Reduces platelet aggregation, • -inhibits inflammatory leukotrienes • -Kills prostate cancer cells in vitro • -It’s useful in treating asthma, allergies, depression, PMS, breast cancer with tamoxifen, RA, • NOTE: DGLA decreases production of O3FAs EPA and DHA. • Dose: 1500mg GLA

Other Omega 6 Fatty Acids (LA – linoleic acid) • CLA (Conjugated Linoleic Acid) is an O6-FA that increases lean muscle mass and fat burning. It is found in non-grain fed red meat. • Are found in other vegetable oil. • Too much O6FA has been shown to instigate cancer growth (John Boik- Cancer and Natural Medicine). Some intake is efficacious. • ALA does have strong anti-inflammatory effects. It has been shown to decrease PGE2 by means of urinary excretion 52-85%. • (Vioxx is 42% effective in PGE2 reduction) (A.Vasquez-Nutritional Perspectives: Journal of the Council on Nutrition of the AmChiroAssoc –Vol.28-#1 Jan 05)

Omega- 9-Fatty Acid: • Oleic oil contains with phenolics antioxidants and squalene. • It reduces NF KappaB • Extra-virgin cold press olive oil, avocado, mac oil • Without the phenolics olive oil failed to reduce CVD.

37 yo male MIGRAINE HEADACHE: • S: Duration since 12 years old. • <summer • 1 year ago went away (increased coffee) • Quit coffee HA every day since • Better 3-5 advil • Work: Painter and house finisher- Tiling, Latex paints • GI-Gas/Energy- poor • Tx 1: Acupuncture: K3, ST36, St 40, Liv3, Li4, Li11, Lu7, Bl60, GB20, CV6 • Explained hyper excitability of glutamate pathway in the brain caused by toxins, sugar, bad fats and allergens.

GABA and GLUT/NMDA • potential (Excitatory) inhibited- Glutamate Action glutathione/ Mg++ • Glutamate bound to its receptor (NMDA) increases Na+ and Ca++ ions entering the cells, increasing reactivity of neuron to incoming signals. • GABA Action potential (Inhibitory) enhanced serotonin and theanine valium, fish oils, taurine, BVit • What’s this got to do with nutrition?? Fish oil Mg/Glutathione/Milk thistle-blocks On Off Neuron GABA cell death Estrogen/testosterone -BVit Serotonin Toxins/inflammation PGE2Th2 Valium Bad fats/sugar/TNFa/IL1b Theanine Infection Th1/2 Taurine Epi/NE/cortisol Glutamate

St 36 stops the rise of BP with epinephrine injection (Clinical Scientific Basis ofAcupuncture, Hammerschlag, R./ Stux) • Ca++ ions influx into cells when there is damage to cells. PLA2 activated neutral proteolytic enzymes inducing damage to muscle cells. • In these cells, the mitochondria swell and break. • Respiratory function of the cells is lost due to Ca++ aggregation, inducing myodystrophy, ischemia, hypoxia of skeletal muscles leading functional failure and metabolic disorders. – Acupuncture changed intracellular Ca++, decreasing it significantly. – It assisted cellular recovery of transport function of Ca++ ion by membranes. –Normal membrane function was induced after three treatments. K+ levels increased intracellularly. – Acupuncture changed the membrane potential and induced normal cellular function of formerly damaged cells. (IJCA Vol12#3;2001,211)

• St36->B endorphins-> NK activity and Phagocytosis -> monocyte chemotaxis & “& SOD production (JTCM(1)55-63/1998) • Acupuncture, herbs, bodywork and life style change reduce the inflammatory cytokines. – St 36 reduces CRP and – GB20, SI3 and Bl60 reduce TNFa. – With lifestyle change, supplements and acupuncture IL1 and IL6 are reduced. (Cp/AJCM Vol32(1))

Tx for HAs • Gave: Magnesium aspartate 2-6mg – as needed – reduce glutamate stimulation and increase detoxification pathways and serotonin production. • O3FA- 1-2gm/d reduce glutamate over-excitation and TNFa • Antioxidant formula –reduce toxic load • Corydalis formula- Symptomatic for inflammation with migraines • Gave elimination diet (Stop eggs, shellfish, sugar, methylxanthines –Chocolate, coffee, gluten, bad fats, chemicals, red meat, dairy, corn, wine, ETOH, nuts, citrus) • Eat: olive oil, whole non-gluten grains –rice, quinoa, chicken, turkey, fish,… • Veggies, fruit –berries, apples, pears • Nuts, butter–(later), soft boiled eggs • Organic and fresh - OR Elisa test allergy test • HA better, no change with food elimination and reintroduction (increased gas sugar and dairy). • If starts to get one – rare- takes magnesium and corydalis and it goes away quickly. • Uses antioxidants and Multi vit when working with toxics
 * Results**

47YO woman with ANAL FISSURES, MIGRAINES, TMJ DYSFX AND MCS (multiple chemical sensitivities) considering jaw surgical repair…. • Acupuncture relieved pain, but it came back. • Txed with moxa on aconite ball for fissure- healed it, but it came back. • GI analysis negative – no yeast/ abnormal flora, or parasites, but -very inflamed –low sIgA • Nickel allergies- dental appliance had nickel in it – inflammatory cause? • Removed appliance improved condition 50%. • Positive for lyme disease -QRIBB test Treated with Samentoand enzymes –no more symptoms. • Could tolerate allergens, jaw moved into proper position, headaches gone, underlying fatigue gone, could tolerate exposure to former allergens, GI tract healed including fissures!

RRRRR
• Remove Poor food choices (Bld Sug.), infection Elimination diet. Reduce toxicity and allergens. Mediclear? • Replace what’s not been absorbed/ what’s been missing to allow this state of inflammation • Re-inoculate stimulates TH1 and TH3 • Rebuild O3Fa • Rest and Exercise reduced diabetes incidence 50%. • We need a balance of O9FAs, O3FAs (2 gm), and GLA (1gm); We also need CLA, and will use squalene, as well as other fats that are called EFAs.

Diabetes
Blood sugar – greater than 100ug/ml? 120ug/ml? 140ug/ml?

• Excess carbs  low blood sugar (BS), stimulating cortisol release, then eventually high BS (IRS closure) • Panic attacks, insomnia • Migraines, generalized pain (fibromyalgia) • Hostility • Decreased brain function • Depression and fatigue • Sleep disorder • Decreases TH1 immunity • Releases insulin insulin receptor site become resistant increased insulin and sugar make fat • Increased LDLs and triglycerides lowers HDLs and increases inflammatory cytokines IL6 clots • ALT increases with fats stuck in the liver • With High BS -Tissue gets glycosylated and it becomes dysfunctional – Arthritis – Neuropathy – Brain neuron degeneration – Slow healing – Poor circulation infections – Kidney dysfunction – Vision loss – Weight gain, obesity – Heart disease

NASH • Non- Alcoholic Steatic Hepatitis – Metabolic syndrome • Elevated Liver enzyme- ALT • AST increased with ETOH • Reduced with normalizing BS (Low simple sugar diet) + weight loss - slowly • Liver herbs- Milk thistle, tumeric, burdock, • Green tea, Betaine 20 gm/d, VitE, Pantethine – 600mg/d, Taurine – 2-6gm/d, Mg – 300mg/d, choline, carnitine, ... • Fiber, • Exercise • Relaxation • Acupuncture – things that reduce cholesterol but increase HDLs

Causes of Diabetes • Infections • - gut • - systemic • - teeth • Overeating/obesity • Nutrient deficiency • -chromium • -zinc • - magnesium • Sugar • Toxins • Genes • Hormone imbalance • - Iron overload • Vit D def. • Stress