Is Frailty Inevitable As We Age? By E. Dylan Mayer and Emeran Mayer, MD When people reach their late 60s, many suddenly notice a slow decline in their physical strength, sense of balance, memory and cognitive function, and they realize that they can no longer do some of the things they were able to accomplish easily when they were young a adult. Such a progressive decrease in functions is called frailty, which is generally accompanied by a failure of multiple physiological systems and may include the development of chronic low-grade inflammation, loss of muscle (sarcopenia) and bone mass (osteoporosis), loss of cognitive function, and the increased risk of developing chronic diseases like type-2 diabetes, cardiovascular disease and degenerative brain diseases like Alzheimer’s and Parkinson’s disease. In contrast to physiological healthy aging, frailty is definitely not a necessary consequence of age, and it is preventable as several evidence-based remedies suggest. And we are not talking about remedies promoted by the multibillion dollar pharmaceutical industry which thrives off the consequences of frailty on our health. We are talking about two simple measures everybody can implement into their lives: The First Step Towards Healthy Aging Is Shifting Your Eating Habits The traditional Western diet, has been shown to be detrimental to our health, based on the numbers of people affected by chronic diseases of industrialization including obesity, metabolic syndrome,1 cardiovascular and liver diseases, depression, Alzheimer's, Parkinson’s and some forms of cancer in the US and other developed countries.2 The Western diet is characterized by low intake of fiber and high intakes of animal products, refined carbohydrates, sweets and sugary drinks, which have been shown to increase low-grade immune activation (metabolic endotoxemia).3 A recent publication in the prestigious journal Gut showed that a Mediterranean diet intervention altered the gut microbiome in older people across five European countries, and this was accompanied by reduced frailty and improved health status.4 The gut microbial taxa, which were enriched by adherence to the Mediterranean diet, were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17. The diet-modulated microbiome change included an increase in the relative prevalence of several beneficial microbial taxa including Faecalibacterium prausnitzii, Roseburia, Eubacterium, Bacteroides and Prevotella, and these microbial changes were associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and…

Challenging the Dietary Guidelines on Dairy By Juliette Frank and Emeran Mayer, MD Milk has always played an integral part in the Western diet and its high consumption has long been promoted on the concept that milk’s calcium and vitamin D content as necessary aids in development, bone health and prevention of fractures. The current recommended intake of dairy products in the United States for adults and children 9 years and older is three 8 oz (237 ml) servings per day while the average U.S. adult only consumes about 1.6 servings of dairy per day. However, as pointed out by a recent review article in the New England Journal of Medicine by two experts in the field of nutrition and health, Drs. Walter Willet and David Ludwig from Harvard University, there is no substantial evidence supporting health benefits from increased daily consumption, and concerns do exist about adverse health effects from a dairy heavy diet. One of the main focuses of milk’s benefit lies in its believed essential nutritional value for growth and development during early childhood. If breast milk is not available to a child, cow’s milk has long been recommended as a substitute for infant formula, even though neither formula nor cow’s milk contain any of the unique molecules contained in human breast milk, the so called human milk oligosaccharides (HMOs) which are essential for the early development of a healthy gut microbiome. As discussed by Dr. Sanjoy Gosh in a recent Mind Gut Conversation interview, another limitation of factory style milk production is related to the food that the cows are fed. Milk from grass fed cows has a significantly higher ratio of omega-3 to omega-6 fatty acids, which comes with a significant health benefit that large scale, industrial milk production does not have. In large scale dairy production in the U.S. cows have been bred to be pregnant for most of the time they are being milked, leading to higher levels of progestins, estrogen, and other growth hormones. These growth hormones increase the growth rate for children and lead to a higher attained height, which comes with both benefits and risks. An often ignored side product of this unique way of maximizing milk production are the huge numbers of baby cows slated for veal production, with all its ethical implications. Since milk increases height when consumed in adolescence and taller height is highly correlated with hip…

Nurturing Your Gut Microbial Health During the Lockdown By Juliette Frank and Emeran A. Mayer, MD During this unprecedented and stressful time, it is now more important than ever to keep yourself healthy and strengthen your immune system. With all the uncertainty regarding COVID-19, an action step we can all take towards building a more resilient immune system is to practice eating a nutritious diet in order to boost gut microbial health. The gut microbiome is made up of a vast ecosystem composed of trillions of microorganisms which work together to protect our gut and immune system, thereby increasing our resilience and resistance to disease. An unhealthy diet, chronic stress and frequent antibiotic intake weakens this ecosystem, compromising its ability to fight off potential threats such as pathogens and viruses. It is now well established, that foods that will promote a healthy gut microbiome and a tight intestinal barrier to prevent contact with the gut based immune system include a largely plant-based diet consisting of nutrients such as fiber, polyphenols, other inflammatory molecules and omega-3 fatty acids. These nutrients can be found in a diverse range of foods such as fruits, vegetables, nuts, seeds, healthy fats such as olive oil and avocado, and fermented foods such as yogurt, sauerkraut, and kimchi. The more varied the source of plants and fruits is, the better for microbial diversity. Refined carbohydrates, sugary drinks, ultra processed foods, and artificially flavored beverages should be avoided. While we all take precautions and anxiously await for this virus to unfold, we can all take steps towards strengthening our immune systems by choosing to eat nourishing foods that will boost our gut microbiome health. Dishes that satisfy the needed nutritional elements to optimize gut microbial health and resistance to disease: Breakfast: Oatmeal or muesli with nut milk, chia seeds, nuts or nut butters, blue and black berries (or any fruit), and (optional) maple syrup or honey You can also use yogurt and add granola or any of these toppings! Lunch: Sourdough or multigrain toast with avocado, egg or smoked salmon, sauerkraut or pickled onions Dinner: Salad with greens (any lettuce works!), avocado, tomatoes, red onion/chives/green onion, nuts/seeds, cucumber, sauerkraut, olives, dressed with olive oil and fresh squeezed lemon juice Salmon with roasted vegetables (any veggies you have!), and any grain (farro, quinoa, brown/wild rice, etc.) Snack: An assortment of fruit and nuts or veggies and hummus Beverages: Black…

Does the Gut Microbiome Play a Role in the Individual Response to the COVID-19 Virus? By Emeran A. Mayer, MD with Juliette Frank While the wave of COVID-19 infections is spreading rapidly around the world and taking its devastating human and economic toll, many questions are being asked about the nature of this pandemic. What are its root causes, when and how will it end, and most importantly, why does the impact on infected people range from a barely noticed infection to failure of the respiratory system and death in a small percentage of patients. We already know that there are high risk populations, such as the elderly and those with underlying conditions, in particular the metabolic syndrome - including obesity, diabetes, high blood pressure, and cardiovascular disease, all diseases which are influenced to a large amount by the diet affected patients eat. Because of the greater prevalence of these chronic, metabolic disorders in African Americans and Latinos, there has been a dramatically higher impact of the COVID-19 infection on these segments of the US population. We also know that several mechanisms in the gut are altered in many of these chronic diseases, including changes in the gut microbiome, in intestinal permeability and in low grade activation of the gut associated immune activation. Two important factors play a role in these alterations in the gut: The North American diet and chronic stress. Could it be that these changes in gut health play a role in the vulnerability to the COVID-19 virus, explaining the greater toll that this virus takes on populations with such changes? Even though we probably won’t know all the answers to vulnerability question for a while, one can speculate about the possible role of the gut microbiome and its interactions with the gut associated immune system in determining the trajectory of the disease, once somebody is exposed to the virus. In order to understand this speculation, here is a short primer of the gut microbiome. The gut microbiome is made up of vast ecosystem composed of trillions of microorganisms including bacteria, viruses, protozoa, and fungi. These microorganisms work together to protect our gut and its immune system from invading pathogens, e.g. viruses and bacteria which can cause great harm to our health. However, far from being a peaceful world of coexistence, there is a constant struggle between these micro organisms using antibiotic molecules suppress each other and…

The Health Benefits of Green Tea1,2 By E. Dylan Mayer and Emeran Mayer, MD People have been drinking tea for thousands of years, with the earliest evidence dating back to the 2nd century BC in China. Drinking tea is not only an enjoyable social activity with both relaxing and invigorating effects, but it has also been associated with many health benefits, including mental health. Two of the most popular types of tea are black and green tea. Both come from the same leaves of the Camellia sinensis plant, but the process of making black tea involves extensive oxidization of the leaves, while green tea remains largely unoxidized. This difference is important, as the oxidation process significantly reduces the polyphenol content in black tea, reducing its potential health benefits. Various health benefits of green tea are well known to tea aficionados and have been observed in a significant number of epidemiological studies, in which prevalence of diseases are compared between a tea drinking group of individuals with another one without such habit. For example, a meta-analysis of observational studies found that women who drank the most green tea had a 20-30% lower risk of developing breast cancer.3 Even greater benefits were reported for male green tea drinkers with regard to preventing development of both prostate and colorectal cancers4,5 and there is some evidence for a beneficial effect in inflammatory bowel disorders.6 One of the most extensive epidemiological study about the possible antidepressant effect of has recently been published in BMC Geriatrics.7 The researchers analyzed the data from 13,000 individuals who took part in the Chinese Longitudinal Healthy Longevity Survey between 2005 and 2014. Their analysis showed that consistent and frequent tea drinking was associated with significantly reduced depressive symptoms, an effect that was only significant for older men, and which was also partially influenced by other factors, such as social interactions. The results were similar to those from a study in healthy Korean people, which showed that those habitually drinking green tea, were 21% less likely to develop depression over a lifetime, than those who were non-drinkers.8 Many studies in cells and animal models have resulted in claims about the prevention of cancer and cardiovascular diseases9,10,11,12 along with anti-inflammatory14,18 antiangiogenic, antioxidative, neuroprotective, cholesterol-lowering13 and antibacterial and antiviral effects. Such claims, which have never been proven in well-designed clinical trials in human subjects have spawned not only a progressive increase in green…