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We now know that a calorie deficit isn’t the end-all-be-all solution for losing weight. But why is this, and why do so many of us struggle to shed extra pounds? While poor diet is usually the number one culprit for stubborn excess body weight, a recent molecular finding sheds light on why weight loss may be so challenging. In a July 2019 study published in Cell, scientists uncovered a protein which resides on fat cell surfaces that plays an integral role in weight gain and loss. During times of stress, such as during dieting, excessive exercise, and overeating, the protein (RAGE, or receptor for advanced glycation end products) shuts down fat burning mechanisms. This protein could hold the answer for why it’s challenging to lose weight and even more challenging to keep weight off long term – especially when we’re trying our best by cutting calories and increasing our physical…

Urinary tract infections (UTIs), once easily curable, now affect millions and are much more challenging to treat, posing serious health risks. A July 13th New York Times article highlights the UTI treatment challenges, which spawn primarily from drug-resistant antibiotics. E. coli bacteria is the most common cause of UTIs, and it’s estimated that approximately one third of E. coli strains are resistant to Bactrim, the most common antibiotic treatment, and one fifth are resistant to the other 5 most common treatment drugs. Women, who during reproductive years are 50 times more likely to contract a UTI than men due to the anatomical proximity of the urethra to the rectum, are commonly going back for 2 and 3 rounds of antibiotic treatments, and are even being admitted into the hospital for intravenous antibiotics. UTIs that go untreated have the ability to travel into the kidneys and even the blood, which can…

Antibiotic therapy disrupts the gut microbiome and results in a pro-inflammatory response that negatively affects bone health. Previous studies have uncovered the direct relationship between a balanced microbiome and healthy bone development. A February 2019 study took this relationship further and investigated the use of a broad-spectrum antibiotic in mice to determine if there were any microbiome-mediated alterations in skeletal formation on a cellular level. After administering antibiotic therapy during the post-puberty phase (this phase is responsible for 40% of our bone accumulation), researchers found that the antibiotics led to significant disruptions in gut bacteria that altered the communication between immune cells and bone cells. These alterations led to substantial changes to trabecular bone – the bone type that experiences high rates of bone metabolism. The American Journal of Pathology  Takeaway: Antibiotics, especially broad-spectrum ones, significantly alter the gut microbiome, which may have negative and lasting effects on skeletal health. Researchers hope to conduct…

Weight control could be more genetic than previously thought.New studies confirm a genetic mutation that makes people feel full all the time, which may explain why some people are less interested in food and naturally thin. The first study included half a million participants between the ages of 40 and 69. Through DNA samples, medical records, and years of health tracking, scientists identified a genetic alteration in about 6% of the population that mutes appetite and protects against cardiovascular disease and diabetes. The single gene, MC4R, plays a key role in hunger and satiety (the feeling of fullness). During a meal, the gene is turned on to send signals of fullness, and then turns off. The mutation involved in this study occurs when the gene is turned on all the time, therefore the person always feels full. The gene can also play a role in obesity in those who have…

Rose was in a big hurry when she came to see me. Gallbladder surgery was looming on the horizon based on a test (HIDA scan) that showed a poorly functioning organ, and she needed answers fast. Her symptoms were pretty mild and non-specific: bloating, a feeling of fullness after eating, and vague abdominal discomfort, but as I read through her initial food journal, I tried to maintain a neutral expression. She had been having a cheese Danish with a latte for breakfast, a turkey and provolone sandwich for lunch, and steak, chicken, or cheese pasta for dinner, with ice cream for dessert. Occasionally she’d have an apple for a snack, but usually it was a chocolate bar, cookies, or frozen yogurt. I’ve seen lots of food journals in my time (and mine certainly isn’t always pristine), but Rose’s was Exhibit A for what not to eat if you have a…

Did you know since laparoscopic technique was introduced into popular practice in the 1990s, the number of cholecystectomies (surgery for gallbladder removal) in the US has almost doubled? Laparoscopic cholecystectomy minimized what was a large incision to a few tiny punctures, reduced infection rates, scar tissue, hospital stay, and surgery time, and sped up healing and recovery. But is it an incredible coincidence that just as the surgery got easier, so many more people developed gallbladder problems—or are there additional reasons to explain why people are losing their gallbladders in record numbers? Technological advances in medicine always generate excitement, and doctors don’t always follow guidelines designed to prevent unnecessary procedures. Plus, some doctors believe an ounce of prevention is worth a pound of cure and so have a low threshold for whipping out your gallbladder, even when the indication for surgery may be murky. If you aren’t asking lots of…

Oral antibiotics may raise the risk of kidney stones, and for children the risk is significantly higher. A recent study tracked antibiotic exposure 3 to 12 months before diagnosis in about 26,000 people with kidney stones. Results showed that oral exposure to any of the 5 classes of antibiotics significantly raised the risk of kidney stones. While the mechanism behind the association is unknown, researchers hypothesize that the effects of antibiotics on the gut and/or urinary microbiome is to blame. Journal of the American Society of Nephrology →Takeaway: This association reiterates the risk-benefit analysis that must take place when deciding to take an antibiotic. For a list of questions to ask your doctor when being prescribed an antibiotic, as well as what to do if you are taking an antibiotic, read The Microbiome Solution.

Relax! It may be just what the doctor ordered. While studies find that mind-body practices (yoga, meditation, etc.) that induce the relaxation response (RR) reduce blood pressure, the molecular pathways that lead to this association remain unknown. A recent study analyzed RR’s effects on gene pathways over an 8-week RR-based intervention in 58 patients diagnosed with hypertension. The intervention consisted of 20 minutes per day of diaphragmatic breathing, mantra repetition, and mindfulness meditation. Blood samples were taken for RNA analysis and results found that RR regulates 1771 genes in the following categories: immune regulatory pathways and metabolism, glucose metabolism, cardiovascular system development, and circadian rhythm. This is the first study to uncover the molecular mechanisms that support mind-body practices as an effective treatment for hypertension. The Journal of Alternative & Complimentary Medicine Society →Takeaway: While the science behind integrative treatment methods (nutrition, meditation, exercise, etc.) is oftentimes lacking, this study illustrates the profound…

Proton pump inhibitors (PPIs) increase the risk of pneumonia in older adults (60+ years). Researchers analyzed data from over 75,000 adults who used PPIs for 1 or more years. They then looked at the incidents of pneumonia in year 2 of treatment and compared these rates to a control group (age and sex-matched) not taking PPIs. The study found that for every 420 people treated with a proton pump inhibitor, there was 1 additional case of pneumonia. Journal of The American Geriatrics Society →Takeaway: The detrimental effects PPIs have on the gut microbiome could be to blame for the increased risk of pneumonia. Approximately 40% of older adults are prescribed PPIs, yet a 2013 studyfound that roughly 85% of them might not need them. In Dr. Chutkan’s practice, The Digestive Center for Wellness, she is finding that proton pump inhibitors may have an even more negative impact on the gut microbiome and overall health than…

A 20-year long study, including 6,235 participants with an average age of 34, uncovers the long-term impact of spray cleaners on lung function in women. The study found that women who regularly clean with cleaning sprays experience worsening of lung function over time when compared to women who don’t clean. To put the findings in more relatable terms, the lung function decline in women working as cleaners was equivalent to smoking roughly 20 packs of cigarettes per year. The decline in lung function is a result of damage to the airways from the day-to-day inhalation of tiny chemical particles over time. American Journal of Respiratory & Critical Care →Takeaway: Spray cleaners containing chemicals cause substantial long-term damage to the lungs. These cleaners, as the study’s lead scientist states, “…are usually unnecessary; microfiber cloths and water are more than enough for most purposes.” If you’re looking for a more substantive cleaner, use Dr. Chutkan’s…