Research Briefs for Practitioners – November 2022 - Dr. Michael Ruscio, DNM, DC

Does your gut need a reset?

Yes, I'm Ready

Do you want a second opinion?

Yes, I Need Help

Do you want to start feeling better?

Yes, Where Do I Start?
Future of Functional Medicine Review Clinical Newsletter

Research Briefs for Practitioners – November 2022

by the Ruscio Institute for Functional Medicine Clinical Team

Medically reviewed & fact checked by a
board-certified doctor
Medically reviewed & fact checked by a
board-certified doctor
Anchor link

Episode 76

Anchor link

Podcast Summary


Anchor link

Gastrointestinal Studies

Anchor link

Thyroid & Hormones Studies

Anchor link

Diet & Lifestyle Studies

Anchor link

Episode 75

Anchor link

Podcast Summary


Anchor link

Featured Study

Anchor link

Gastrointestinal Studies

Anchor link

Thyroid & Hormones Studies

Anchor link

Diet & Lifestyle Studies

Anchor link

Episode 74

Anchor link

Podcast Summary


Anchor link

Featured Study

  • Curcumin and Curcuma longa Extract in the Treatment of 10 Types of Autoimmune Diseases: A Systematic Review and Meta-Analysis of 31 Randomized Controlled Trials
    • 31 RCTs on 10 types of autoimmune diseases treated with curcumin
    • Curcumin supplementation led to improvements in multiple autoimmune diseases, including:
      • Ulcerative colitis (UC) (9 studies) 
        • Reduced disease activity (moderate effect size) 
        • Reduced inflammation markers (moderate effect size) 
      • Rheumatoid arthritis (RA) (5 studies)
        • Reduced disease activity (large effect size) 
        • Reduced inflammation markers (large effect size) 
      • Psoriasis (2 studies)
        • 1.6x greater chance of 50% reduction in symptoms
      • Lupus (2 studies) 
        • Reduced disease activity and inflammation markers 
      • Multiple sclerosis (2 studies)
        • Reduced disability and inflammatory markers 
      • Ankylosing spondylitis (1 study) 
        • Reduced inflammatory markers only
    • Curcumin had NO effect on: 
      • Oral lichen planus (6 studies) 
      • Crohn’s disease (2 studies) 
    • Commentary: The best researched applications of curcumin were for UC, RA and  lichen planus, with curcumin demonstrating the most benefit for UC and RA. Curcumin may be clinically useful for psoriasis, lupus and multiple sclerosis, however more studies are needed to draw better conclusions.

Anchor link

Gastrointestinal Studies

  • Probiotics for preventing acute upper respiratory tract infections
    • 23 RCTs, 6,950 participants, randomized to:
      • Control (placebo or no treatment) 
      • Probiotics (Lactobacillus) 
    • Probiotics led to:
      • 33% reduced number of people diagnosed with upper respiratory tract infection (URTI) 
      • Reduced duration of URTI (-1.2 days) 
      • 42% less antibiotics required for acute URTI 
    • Commentary: Probiotics may prevent URTI, lower the use of antibiotics and decrease the number of sick days.
  • Effect of a multistrain probiotic on leaky gut in patients with diarrhea-predominant irritable bowel syndrome (IBS-D): a pilot study
    • Open label study of 27 patients with IBS-D and leaky gut, treated with multi-strain probiotics (lacto/bifido blend) 
    • Leaky gut determined based on radionuclide tracers and serum zonulin 
    • After 1 month, probiotics led to:
      • 96% experienced satisfactory symptom relief 
      • Improved leaky gut in 82%
      • Normalization of leaky gut in 37%
      • Improved quality of life 
      • Improved abdominal pain and diarrhea
    • While leaky gut was improved based on radionuclide tracers, serum zonulin levels did NOT change 
    • Commentary: Probiotics led to improved IBS symptoms, quality of life and intestinal permeability as measured by radionuclide tracers. This study failed to show an improvement in serum zonulin, despite symptomatic improvement. This is a great example of why lab tests are only 25% of the data used to make clinical decisions.

Anchor link

Thyroid & Hormones Studies

  • Increased Incidence of Hashimoto Thyroiditis in Selenium Deficiency: A Prospective 6-Year Cohort Study
    • 1,254 individuals followed over 6 years, categorized by:
      • Low serum selenium (<80 ug/L) 
      • Adequate serum selenium (>80 ug/L) 
    • Compared to adequate selenium status, low selenium levels were associated with higher:
      • Prevalence of hashimoto’s thyroiditis (HT) (0.3% vs 0.1%) 
      • Prevalence of positive TPO-abs (10.2% vs 5.6%) 
      • Risk of developing HT (3.6x
    • Commentary: Low serum selenium was associated with an increased risk of developing HT.

Anchor link

Diet & Lifestyle Studies

  • Effects of regular sauna bathing in conjunction with exercise on cardiovascular function: a multi-arm, randomized controlled trial
    • 47 participants with ≥1 cardiovascular disease risk factor, randomized to:
      • Control group (no exercise) 
      • Exercise alone (Resistance training plus cardio, 3 times per week) 
      • Exercise followed by dry sauna (15 minutes) 
    • Compared to control or exercise alone, the addition of sauna led to:
      • Lower systolic blood pressure (-8 mmHg sauna vs 0 mmHg exercise alone)
      • Reduced fat mass (-4.2 vs -2.9 lb) 
      • Reduced total cholesterol (-12 vs +5 mg/dl) 
      • Improved VO2 max (+5.5 vs +2.6 mL/kg/min) 
    • Commentary: Compared to exercise alone, the addition of sauna therapy to exercise led to greater improvements in weight loss, cholesterol, systolic blood pressure and aerobic capacity. Note these benefits were attained with only 15 minutes per session.
  • Icosapent ethyl for reduction of persistent cardiovascular risk: a critical review of major medical society guidelines and statements
    • Aim of this review: Should icosapent ethyl (IPE) (highly purified EPA) be used for cardiovascular disease (CVD) prevention?
    • This review found IPE (4 g/day) reduced the risk of major CV events by 25% in high-risk patients with mildly to moderately elevated triglyceride levels despite statin-controlled cholesterol levels.
    • “Unfortunately, most drugs that lower triglyceride levels, such as niacin, fibrates, and mixed omega-3 fatty acids, have not reduced the risk of cardiovascular events in clinical trials”
    • Commentary: IPE has been shown to effectively lower triglyceride and reduce the
      risk of cardiovascular disease compared to other nutriceuticals such as fish oil.
Anchor link

Episode 73

Anchor link

Podcast Summary


Anchor link

Featured Studies

Both of these studies above provide data suggesting fecal microbiota transplant: 

1) Is a clinically useful therapy for treating ulcerative colitis
2) May be as effective as corticosteroids
3) Does have side effects, but the side effect profile is likely less severe compared to corticosteroids


Anchor link

Gastrointestinal Studies

  • Long Term Outcomes of the Six Food Elimination Diet and Food Reintroduction in a Large Cohort of Adults with Eosinophilic Esophagitis
    • Retrospective study, 213 patients with eosinophilic esophagitis (EoE)
    • All completed the 6 food elimination diet (Avoidance of milk, wheat, soy, eggs, tree nuts/peanuts, and fish/shellfish)
    • The elimination diet led to:
      • 58% response rate on endoscopy
      • 42% experiencing symptomatic improvement
    • After reintroduction, 69% of patients only had 1 food trigger, and the most common were:
      • Milk
      • Wheat
      • Soy
    • Commentary: This study found the 6 food elimination diet was helpful for patients with EoE, with most patients reporting only 1 food trigger after reintroduction.
  • Meta-analysis and systematic review of the association between adverse childhood events and irritable bowel syndrome
    • 15 studies, 272,686 participants
    • This study did NOT find a clear association between risk of developing IBS and childhood traumatic events
    • When assessed by gender, females with a traumatic childhood were at a 2.2x increased risk of developing IBS, whereas this association was NOT found in males
    • Commentary: The totality of the evidence is unclear whether or not IBS is associated with traumatic events in childhood. There may be a sex difference of how adversity in childhood contributes to IBS.
  • Human supplementation with Pediococcus acidilactici GR-1 decreases heavy metals levels through modifying the gut microbiota and metabolome
    • 152 participants with known heavy metal exposure (Cu and Ni), randomized to:
      • Placebo yogurt
      • Probiotic yogurt (Pediococcus acidilactici GR-1)
    • After 3 months, compared to placebo yogurt, the probiotic yogurt led to a greater reduction in blood levels of: 
      • Copper (-429 ug/L probiotic vs -200 ug/L)
      • Nickel (-2.5 ug/L vs -2 ug/L)
    • Commentary: This study highlights the ability of probiotics to act as heavy metal removers. The specific strain Pediococcus acidilactici GR-1 led to better removal of copper and nickel compared to conventional yogurt. Unfortunately, no other heavy metals were tested in this study.
  • Saccharomyces cerevisiae I-3856 in irritable bowel syndrome with predominant constipation
    • 456 participants with IBS-C, randomized to:
      • Placebo
      • Probiotic (Saccharomyces cerevisiae)
    • After 2 months, probiotic supplementation led to: 
      • Improved quality of life
      • Increased number of participants with improved abdominal pain (45% probiotic vs 34% placebo
      • NO difference in bowel movement frequency or consistency
    • Commentary: S. cerevisiae probiotic led to reduced abdominal pain and better quality of life, but NO improvement in constipation. Note the high placebo response for improvements in abdominal pain. 
Anchor link

Diet & Lifestyle Studies


Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

Leave a Reply

Your email address will not be published. Required fields are marked *