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NUTRITION IN LYME and TICK INFECTIONS. Martin D. Fried, MD, FAAP, ABPNS Physician Nutrition Specialist 3200 Sunset Ave Suite 100 Ocean, NJ 07712 www.healthydays.info. Inflammed Stomach. Nodularity Gastritis. Leaky Gut from Infection.
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NUTRITION IN LYME andTICK INFECTIONS Martin D. Fried, MD, FAAP, ABPNS Physician Nutrition Specialist 3200 Sunset Ave Suite 100 Ocean, NJ 07712 www.healthydays.info
Inflammed Stomach Nodularity Gastritis
Leaky Gut from Infection • Gastritis with foreign protein leaking into the blood stream • Examples of immune activation psoriasis, IBD, Celiac Neovascular rashes
Inflammation causes permeable gutForeign proteins to immune systemCrohn’s, Colitis, Celiac
Immune/Autoimmune • Crohn’s, Celiac, Ulcerative Colitis • Lyme, Bartonella, Mycoplasma • Inflammatory mediators include: Tumor necrosis factor interleukins 2, 6, 10
Nutritional Goals • Minimize Nutritional Risk • Provide Nutrition • enhance absorption and tolerance • Maintain intestinal integrity • Favorably alter intestinal flora • Regulate immune system favorably • Address fatigue and obesity
Nutritional Goals • Minimize nutritional risk by providing: adequate calories, protein, carbohydrates healthy fats, vitamins and minerals
Provide Nutrition to Enhance Absorption and Tolerance • Whey verses Casein properties of milk • Whey empties faster (reference 1) • Casein delays gastric emptying • In cases of Neurologic conditions affecting gut motility, whey protein is preferred • Mixture of protein sizes of varying length helps absorption due to dual transport of Proteins (reference 2)
Lyme can cause IBD, Celiac • Genetic predisposition • Environmental trigger (infection) • albumin, protein absorption, folate • Calcium and fat Consider Zinc and Iron deficiencies (references 3-6)
Immune Activation Scalp Psoriasis to…….. Crohn’s Disease
Celiac vs Food Intolerance • Celiac is Autoimmune to wheat, rye, barley • Gluten, Genetics and Environment • Allergy is IgE mediated • Celiac is non IgE mediated
Maintain Intestinal Integrity • Iron, Zinc, Albumin • Fat soluble vitamins A,D,E,K (refer 4-7) • B12 malabsorption in ileum
Alter GI Flora Favorably • Minimize Clostridium difficile- colitis • Reduce Candida albicans – yeast overgrowth • Short chained Fructoligosaccharides (scFOS) • Promote growth of Bifidobacteria • Lactobacillus acidophillus
Clostridium difficile • C. difficile is normal bacterial flora • Antibiotics kill lactobacilli, bifidobacter • C. difficile overgrowth occurs • C. difficile elicits – Toxin A and Toxin B • Pseudomembranouscolits • Treat with Metronidazole and pre/probiotics
Candida Albicans • Normal Flora Yeast • Antibiotics kills Normal Flora • Yeast overgrowth occurs • Diet to produce lactobacillus, bifidobacteria • Short chained fructooligosaccharides (FOS)
Probiotics • > 90% killed by stomach acid • Lactobacillus • Bifidobacter
Prebiotics • Natural Carbohydrates not digested by : amylase, sucrase and maltase • scFOS • Sources include banana, garlic, onion, leeks, whole wheat, asparagus and tomato products
Keeps yeast and C difficile in check Lowers the pH in the colon Acidic environment is bifidogenic
Foods with sc FOS • Soluble Fiber in Fruits and Vegetables • Fermented in colon to short chain Fatty acids by normal colonic flora(refer 8,9) • banana onions • garlic asparagus • Barley wheat • Tomatoes leeks
Immune Supression ACNE progresses to….. THIRD DEGREE BURN
Down regulate Inflammation • Omega three oils are anti-inflammatory • Salmon, tuna, herring, walnuts, almonds • Omega six oils are inflammatory
Obesity • Inactivity, joint pains, malaise, fatigue • High caloric foods… leads to………….
Conclusions • Lyme, Bartonella, Mycoplasma cause inflammation and changes in the GI tract • Prevent yeast, c. difficile overgrowth with prebiotics and probiotics • Address specific nutritional deficiencies • Consider omega three foods to down regulate autoimmune activation
References • 1) J Pediatr 1992;120:569-572 • 2)Ann Rev Physiol 2004; 66:361-384 • 3) J PedGastroenterolNutr 1985;4:45-51 • 4) Am J Physiol 1995;268 • 5) Am J Physiol 1999;277 • 6) Ann Surg 1996; 223:316-333 • 7) J Nutr 2001; 131:2157-2163 • 8) Lancet 1993; 342:1266-1268 • 9) Am J Gastroenterol 1990;85:1307-1312