Archive for September, 2009

Probiotics vs. Prebiotics: What’s the Deal?

by Leah Frankel, MS, RD

YogurtThere’s been a lot of buzz regarding prebiotics and probiotics lately.  You’ve heard rumors about yogurt and the “healthy” bacteria that yogurt contains but what’s the real deal?  Do they really work?  Do prebiotics and probiotics function differently in our body?  Do we need to be taking supplements daily?

What are probiotics and prebiotics?

There is a large debate regarding the definition of probiotics but the World Health Organization and Food and Agriculture Organization of the United Nations define probiotics as “living microorganism which, when administered in adequate amounts, confer health benefits to the host.” These microorganisms are usually bacteria and are sometimes referred to as “healthy”, “friendly”, “good” or “beneficial” bacteria. Probiotics are microorganisms similar to those that naturally exist in the gut.  The idea is that in order to stay healthy, we must maintain a delicate balance of microflora (i.e. a mix of different bacteria) in the gastrointerstinal tract.

Prebiotics are defined by several criteria: they are indigestible by the stomach and are not absorbed, they are fermented by the GI microflora (that mix of bacteria we just mentioned) and stimulate the growth and proliferation of beneficial bacteria in the gut. Prebiotics essentially help facilitate the effect of probiotics.


Where can we get probiotics and prebiotics in our diet?

Glass of MilkProbiotics (which include species of Lactobacillus, Bifidobacteria and Yeast) can be found in food as well as dietary supplements including yogurt, milk, miso, tempeh, and soy beverages. The largest group of probiotics are lactic acid bacteria (Lactobacillus acidophilus, found in yogurt, is the most well known).

Prebiotics can be derived from plants or synthesized. Sources include: soybeans, whole grains, onions, chicory root, bananas, garlic, leeks, artichokes and raw oats.

What are the proven health benefits of probiotics and prebiotics?

Studies have found multiple benefits associated with probitioics; typically probioitics are beneficial in a situation when the natural microflora in the gut may have been disturbed, as is commonly the case with antibiotic use. Probiotics have been found to:

  • Treat diarrhea

  • Treat IBS (Irritable Bowel Syndrome)

  • Prevent and treat a UTI (Urinary Tract Infection)

  • Reduce the recurrence of bladder cancer

  • Shorten the duration of intestinal infections

  • Prevent and manage eczema in children

  • Prevent and treat inflammation following colon surgery (called Pouchitis).

Prebiotics have been shown to have multiple benefits including:

  • Increased absorption of calcium and magnesium

  • Increased immune system effectiveness

  • Inhibition the growth the lesions in the gut, such as adenomas and carcinomas, therefore reducing risk factors associated with diseases in the rectum and colon.

Are there any side effects or risks associated with the use of probiotics and prebiotics?

While probiotics are generally found to be safe, few studies have been conducted on the elderly, young or immune compromised populations. In populations where probiotic use has been studied, side effects are typically mild (for example, increased gas or bloating).

GI SystemAs with probiotics, prebiotics can cause gas, bloating and increased frequency of bowel movements when consumed in large quantities (i.e. you may fart and poop more).

When prebiotics and probiotics are used together they are commonly referred to as “synbiotics”…essentially, when used together they work synergistically to provide a more beneficial probiotic effect than either would alone.

Daily consumption of foods containing these functional components is beneficial; however the effects of probiotics are dependent on the strain and species ingested and can only be assessed through clinical trials. While probiotics and prebiotics have been shown to have a variety of advantageous effects, additional supplementation is not vital since these bacteria already naturally exist in your gut and reproduce independently.

As with any supplement, always check with your doctor before beginning a new regimen. It’s important to note that dietary supplements (including vitamins and minerals) are not regulated by the FDA and therefore the product may not have the quality or purity that the label suggests. Choosing a well-known brand or looking for a USP label will ensure the product is safe.

22

09 2009

Urine: Nectar of the Gods?

GladiatorIt has been fabled since the days of Gladiators in Rome that drinking one’s own urine while training for battle  provided special nutritional value to the fighters in training. Fighters such as Lyoto Machida, who claims to swill his pee every morning, is one example.  These individuals profess that their urine is full of nutrients that their body could not absorb on the first pass. But is there any medical validity to this ancient practice?

Dr. Johnny Benjamin, sports columnist and renowned orthopedic surgeon shared the truth behind this myth with us, “Urine is 95 percent water, 2.5 percent urea, and a 2.5 percent mixture of minerals, salts, hormones, enzymes and non-toxic waste products.


“The practice of drinking urine is certainly not new or limited to a few modern practitioners of combat sports such as world champions Lyoto Machida in MMA and Juan Manuel Marquez in boxing. China, India, the Middle East and Rome all have ancient and modern writings that discuss the willful consumption of urine.

“I recently viewed an HBO 24/7 episode with Mr. Marquez sipping a steaming glass of his golden nectar in preparation for an upcoming fight with Floyd Mayweather Jr. I have the utmost respect for Marquez as a champion, but apparently the thought of a potential ass whipping will drive a man to consider a great many things.

“Although the potential benefits and healing capacities of drinking urine have been encouraged for centuries by many cultures, there is no credible medical literature or studies that support these beliefs.

Urine and Straw“Urine has been consumed to combat dehydration in extreme survival situations for its 95-percent water content. Also, water is reclaimed from urine, purified and filtered for consumption on the International Space Station.

“Drinking your own urine may reclaim a small bit of water, but if the body didn’t want the other five percent (waste products and the like) during the first time, why would it want it the second time around?  Wouldn’t it be easier (and probably considerably tastier) to just sip a tall refreshing glass of H20 and take a multivitamin?”

In addition, proteins are not present in a healthy individual’s urine.  Loss of proteins in urine is a sign of kidney problems and necessitates further medical investigation.  If you’re looking for extra protein in your diet, we recommend a hearty chicken breast or protein shake after your workout.

As Juan Manuel Marquez says in his HBO clip, he drinks his urine because “that’s where a lot of proteins and vitamins are, part of your vitamin intake, and why not drink them again instead of wasting them?”  That’s an interesting question, Dr. Marquez.  Our thoughts are that 1) it’s pretty disgusting, and 2) you can consume infinitely superior “proteins and vitamins” from any number of other non-urine-based sources.  Are we supposed to believe that hot urine contains super-nutrients that you can’t find at the GNC, and the body is flushing them out of your system?  No disrespect to our beloved light-heavyweight champion, but is it possible that the athletes who swear by urine-drinking just enjoy drinking pee?  Maybe it simply serves as means of intimidation to the opponent.  After all, we wouldn’t fight him.

16

09 2009

The Anatomy of a Hangover

by Joshua Goldman, MD, MBA

The Hangover

Anyone who drinks alcohol has woken up the morning after a big night out feeling like death (if you have no idea what we are referring to we recommend you see the recent hit The Hangover).  Yes, this is the hangover you masterfully crafted during your night out on the town.  We’re here to help you understand what causes you to feel so bad and recommend some tips to get you back to 100% as quickly as possible.

Apparently proving the underlying physiologic cause of a hangover is not at the top of the NIH’s To Do List.  As such, the verdict is still out as to the exact mechanism of a hangover but scientists believe it is a combination of four effects in your body:

1. Vasopressin Inhibition: Your Ticket to Dehydration
One of alcohol’s effects on the brain is to decrease the amount of vasopressin it produces.  Vasopressin, also known as anti-diuretic hormone (ADH), is produced in the pituitary gland and, when released into your bloodstream, prevents your body from excreting water in your urine.  When under the influence of alcohol, you body’s vasopressin level decreases and you lose more water in your urine (yes, this is why you pee so much when you’re drinking).  The effect is so strong that for every pint of beer you drink, you can lose up to 4 pints of water.  This is why you will undoubtedly be dehydrated the next morning. The vasopressin-induced hangover effects are from dehydration and include:

  • Dry Mouth – Your body’s signal that you are dehydrated


  • Headache – Less water in your body means less water in your brain.  As your brain shrinks from dehydration, it pulls on the membranes surrounding it causing pain.  Enter the headache.

  • Fatigue & Nausea – When water is lost in the urine, sodium, potassium, and magnesium go with it. Loss of these vital electrolytes can cause feelings of nausea and fatigue

2. Congeners of Alcohol: Inevitable Toxins
Congeners are alcohol derivatives that form as byproducts of the fermentation process utilized in alcohol production.  Congeners of alcohol are toxic and cause a number of damaging effects on the body leading to typical hangover symptoms.  These congerners are found in higher concentrations in darker alcohols such as red wine, whiskey, bourbon, and brandy.  One study found that when subjects drank and equivalent amount of bourbon and vodka, 33% of bourbon drinkers reported hangover symptoms while only 3% of vodka drinkers reported such symptoms.

3. Acetaldehyde: Toxins that Keep on Giving

The breakdown process of alcohol is quite complex.  What you need to know is that acetaldehyde, one of the products formed in a step in the process, wreaks havoc on your body.  Your body requires another chemical, glutathione, to breakdown acetaldehyde and clear it from your body.  The problem is that when you drink a LOT of alcohol, you run out of glutathione and are stuck with the toxic acetaldehyde in your system while your liver makes more glutathione.  Women have fewer of the necessary enzymes and less glutathione than men, making their hangovers longer and more painful.  The miserable effects of acetaldehyde include headache, nausea, and vomiting.

4. Glutamine Rebound: The Sleep Buster
Another one of alcohol’s effects on the brain is to suppress a chemical stimulant in your brain called glutamine.  When you stop consuming alcohol, your brain counters the suppressive effects of alcohol by secreting more glutamine that normal.  The increased level of glutamine stimulating your brain prevents you from sleeping as deeply as you normally would and leads to fatigue the next day.  If your glutamine rebound is especially strong, you may experience tremors, anxiety, and restlessness from glutamine’s stimulant effects.

Now you know why hangovers are so miserable, and knowing is half the battle.  Stay tuned for an upcoming article about hangover cures: myths, miracles, and proven remedies.

02

09 2009

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