The Gary Null Show - 09.30.20

Ginkgo extends neuroprotective effects to the neurons located near the retinas

Gyeongsang National University (South Korea), September 29, 2020

In a recent study, South Korean researchers demonstrated the neuroprotective effects of Ginkgo biloba. They reported that an extract obtained from G. biloba leaves successfully protected retinal ganglion cells (RGC) — the output neurons of the retina — from hypoxic injury both in vivo and in vitro.

The researchers discussed their findings in an article published in the Journal of Medicinal Food.

Ginkgo biloba can prevent glaucoma caused by oxidative stress

The oldest records of G. biloba’s use in TCM suggest that only its seeds were used at first by traditional healers. It took a long time before they discovered the medicinal properties of G. biloba leaves and began using them to treat heart and lung diseases.

When G. biloba reached Western shores, its leaf extracts gained traction for their brain benefits. Standardized extracts of G. biloba leaves have since been used for the treatment of mild to moderate age-related memory impairment, dementia and peripheral vascular diseases.

According to the South Korean researchers, oxidative stress, or excess free radical production, induced by hypoxia — a condition in which tissues do not receive an adequate supply of oxygen — is linked to the pathogenesis of glaucoma. Glaucoma refers to a group of eye conditions that affect the optic nerve and is one of the leading causes of blindness among older adults.

Fortunately, recent findings show that G. biloba leaf extract (GBE) can help reduce oxidative stress as well as treat disturbed vascular circulation. To evaluate the neuroprotective effects of G. biloba, the researchers first induced oxidative stress in rat RGC. They then treated the cells with either a standardized GBE (EGb 761) or a control.

For their in vivo experiment, the researchers induced hypoxic optic nerve injury in rats by using a microserrefine clip with an applicator to clamp the animals’ optic nerves. They then gave the rats various concentrations of EGb 761 via intraperitoneal injection and measured RGC density to estimate cell survival.

The researchers reported that treatment with 1 or 5?mcg/mL EGb 761 significantly increased the survival of RGC after exposure to oxidative stress. In vivo, treatment with 100?mg/kg or 250?mg/kg EGb 761 also significantly improved RGC survival, proving the neuroprotective effects of G. biloba.

Based on these findings, the researchers concluded that G. biloba leaves can be used to protect against hypoxic injury that leads to glaucoma.

 

Dietary folate, magnesium, and dairy products may all help stave off bowel cancer

Service de Gastroenterologie (France), McGill University (Quebec), Erasmus University (Netherlands), September 29, 2020

Folate, magnesium, and dairy products may all help stave off bowel cancer, but there's no evidence that garlic or onions, fish, tea or coffee protect against the disease, finds an overarching analysis of published pooled data analyses in the journal Gut.

In the US alone around 1 in every 20 people is likely to develop bowel cancer at some point during their lifetime. And worldwide, more than 2.2 million new cases and 1.1 million deaths from the disease are predicted every year by 2030.

While deaths from the disease have been falling in most developed countries, the numbers of new cases have been rising in some, including in Canada, the UK, and the Netherlands.

Screening for the disease can pick up the disease at an early treatable stage, but take-up varies considerably from country to country. And as it takes more than 15 years for bowel cancer to develop, a healthy lifestyle likely has a key role in helping to halt or stop its progress altogether, say the researchers.

They therefore trawled relevant research databases for published systematic reviews and meta-analyses (pooled data analyses) of clinical trials and observational studies assessing the impact of dietary and medicinal factors on bowel cancer risk.

The medicinal factors included: aspirin; non-steroidal anti-inflammatory drugs (NSAIDs), such as paracetamol; and statins.

The dietary factors included: vitamins or supplements (magnesium, calcium, folic acid, vitamin A, B, C, E, D, β-carotene and selenium); coffee; tea; fish and omega 3 fatty acids; dairy products; fibre; fruit and vegetables; meat; and alcohol.

They included relevant studies published in French or English between September 1980 and June 2019, but excluded those involving people at high risk of developing bowel cancer. Some 80 articles out of a total of 343 were included in the overarching (umbrella) analysis of pooled data analyses.

The results showed that aspirin is likely protective against bowel cancer, lowering the risk by between 14% and 29% at doses as low as 75 mg/day, with a dose-response effect reported up to 325 mg/day.

NSAID use for up to 5 years was associated with a significant (26% to 43%) fall in the incidence of bowel cancer.

Magnesium intake of at least 255 mg/day was associated with a 23% lower risk compared with the lowest intake, and high intake of folic acid was associated with a 12-15% lower risk, although it wasn't possible to pinpoint a threshold dose from the available data.

Similarly, eating dairy products was associated with 13% to 19% lower risk of the disease. But the small number of available meta-analyses, and the many different research outcomes and variety of dairy products included make it difficult to draw firm conclusions about the quantities required to ward off the disease, caution the researchers.

Fibre intake was associated with a 22%-43% lower risk, while fruit/vegetable intake was associated with up to a 52% lower risk, with added benefit for every additional 100 g/day increase in intake.

Dietary soy intake was associated with a modest, but significant, fall (8-15%) in risk.

But there was no evidence that vitamins E, C, or multivitamins were protective. Similarly, there was no evidence that β-carotene or selenium helped stave off the disease.

The data were weak or equivocal on the impact of tea; garlic or onions; vitamin D either alone or combined with calcium; coffee and caffeine; fish and omega 3; and inconsistent on the protective effect of vitamin A and the B vitamins.

A modest protective effect was found in observational studies for high calcium intake, but a meta-analysis of clinical trial data found no protective effect, and even an increased risk.

Similarly, although meta-analyses of observational studies suggest that statins may lower cancer risk, no positive effect was noted in meta-analyses of clinical trial data.

Most of the available meta-analyses of observational studies reported an increased risk of between 12% and 21% for meat, particularly red and processed meat. Dose-effect studies reported a 10-30% increased risk for each additional 100 g/day of red meat eaten.

Alcohol was associated with a significantly increased risk. The higher the intake, the greater the risk. This was evident even at the lowest level of consumption studied: 1-2 drinks/day.

The researchers caution that the level of evidence is low or very low in most cases, mainly due to wide differences in study design, end points, numbers of participants, etc. And they were unable to define "an optimal dose and duration of exposure/intake for any of the products, even in the case of low dose aspirin and other compounds that have been extensively assessed," they point out.

Nevertheless, they suggest that their findings could help clinicians advise patients on the best diet to lower bowel cancer risk and guide the direction of future research.

Pomegranate improves mitochondria function and counters age-related disorders

Ecole Polytechnique Federale de Lausanne (Switzerland) September 27, 2020

With their vibrant scarlet color and sweet-but-tart flavor, pomegranate has become an increasingly popular (and delicious) addition to salads, dressings, beverages and desserts. They are also a proven superfood, credited by researchers with the potential to prevent and help resolve many disease conditions.

Now, a new Swiss study shows that urolithin A, a molecule produced when pomegranate is digested, could hold the key to rejuvenating cell mitochondria – and even prolonging the quality of your life. Let’s take a closer look at urolithin A – and its amazing restorative potential.

Pomegranate triggers urolithin A to rejuvenates the powerhouse of our cells

Mitochondria are tiny structures inside of cells that have the all-important task of turning fuel into energy. Over time, however, they can degrade and deteriorate.

In young, healthy cells, these aging and damaged mitochondria are swiftly broken down and eliminated. This beneficial process, known as mitophagy, helps to ensure optimal cellular function.

Mitophagy becomes less efficient with age, causing malfunctioning mitochondria to accumulate in cells – where they weaken muscle tissues and impair cellular health. Researchers believe that these deposits of mitochondrial debris can trigger degenerative disorders such as Parkinson’s disease, as well as decreased mobility and frailty in elderly people.

This is where pomegranates come in…

A molecule called urolithin A is produced by the body upon the digestion of two polyphenols – punicalagins and ellagitannins – that exist naturally in pomegranates. In cell and animal studies, this newly-discovered molecule was shown to induce mitophagy, and prevent the accumulation of dysfunctional mitochondria.

In fact, new research supports the ability of urolithin A to actually rejuvenate cell mitochondria – not only increasing muscle function, but extending life.

What did the study show?

In a study published in 2016 in Natural Medicine, researchers found that urolithin A maintained mitochondrial respiratory capacity and extended the lifespan of C. elegans – a short-lived worm commonly used in longevity studies – by a stunning 45 percent.

And that isn’t all.

In another phase of the study, researchers administered urolithin A to aging mice, and found that it improved muscle function by 57 percent and running endurance by 42 percent.

And it was not only aging mice that benefited from urolithin A. The substance increased the running capacity of young, healthy mice – by a dramatic 65 percent.

The research suggests that boosting levels of urolithin A – through consuming pomegranate extracts – can enhance mitochondrial function, thereby improving muscle quality.

Researchers noted that this finding holds particular significance for elderly people. By helping to enhance muscle function, urolithin A may help ward off the loss of mobility and general decline that can accompany weakened muscle tissue.

Calling urolithin A a “promising approach to improving mitochondrial and muscle function in the aging population,” the team called for further research.

Pomegranate has a proven ability to combat heart disease and cancer

The new study is not the first to reveal important health benefits from pomegranates – these tasty members of the berry family have been impressing researchers with their ability to combat serious degenerative diseases.

In a recent review published in Advanced Biomedical Research, the authors noted that pomegranate can help prevent or treat a veritable laundry list of dangerous conditions known to trigger potentially life-threatening diseases – including high blood pressure, high cholesterol, oxidative stress, high blood sugar, atherosclerosis and inflammation.

Interestingly, in some cases pomegranate has been found to work in much the same way as pharmaceutical medications. For instance, pomegranate extracts help to suppress pro-inflammatory COX-2 and tumor necrosis factor-alpha – much as anti-inflammatory drugs do. And, when it comes to regulating blood pressure, pomegranate extracts seem to function like ACE inhibitors, a group of pharmaceutical hypotensive medications.

Pomegranates also have been shown in studies to reduce incidence of tumors, reduce the number and size of cancerous stem cells, and induce apoptosis – or cancer cell death. Pomegranate extracts are currently used to treat a variety of cancers, including those of the prostate, breast, colon, lung and skin.

Finally, pomegranate extracts have protective effects against neurodegenerative conditions. Research has shown that they help to prevent accumulations of beta-amyloid, a protein associated with Alzheimer’s disease.

Pomegranates owe much of their potent disease-fighting powers to their extraordinary antioxidant capabilities.

The juice of a single pomegranate contains more than 40 percent of the RDA of vitamin C – itself a potent antioxidant and immune system booster. Pomegranates are also rich in beneficial amino acids, polyphenols and anthocyanins – natural pigments that give the pulp its intense scarlet color. These colorful flavonoids also contribute to pomegranate’s ability to scavenge free radicals and prevent oxidative damage in cells and tissues.

And, wait, there’s more good news about pomegranates: no side effects or adverse changes have been reported – even in a clinical study in which participants received 1, 420 mgs a day of pomegranate fruit extract.

However, the researchers noted that pomegranate could interact with certain prescription drugs. Before supplementing with pomegranate extracts, consult a trusted, healthcare provider.

You can consume pomegranates in the form of various beverages – such as juice or tea – or nibble the luscious seeds out of hand as a snack. Pomegranate extracts are also available in the form of capsules and tablets.

By rejuvenating fragile, indispensable cell mitochondria, pomegranate can help combat the muscle weakness and frailty often associated with aging – leading to a stronger, longer life.

High-fiber diet, low level inflammation: Sidestepping the effects of radiation

Universities of Gothenberg and Lund (Sweden) and University of South Australia, September 29, 2020

Loved or hated, the humble oat could be the new superfood for cancer patients as international research shows a diet rich in fiber could significantly reduce radiation-induced gut inflammation.

Conducted by the University of Gothenburg, Lund University and the University of South Australia, the preclinical study found that dietary oat bran can offset chronic gastrointestinal damage caused by radiotherapy, contradicting long-held clinical recommendations.

Gastroenterology and oncology researcher UniSA's Dr. Andrea Stringer says the research provides critical new insights for radiology patients.

"Cancer patients are often advised to follow a restricted fiber diet. This is because a diet high in fiber is believed to exacerbate bloating and diarrhea—both common side effects of radiotherapy," Dr. Stringer says.

"Yet, this advice is not unequivocally evidence-based, with insufficient fiber potentially being counterproductive and exacerbating gastrointestinal toxicity. Our study compared the effects of high-fiber and no-fiber diets, finding that a fiber-free diet is actually worse for subjects undergoing radiotherapy treatment. A diet without fiber generates inflammatory cytokines which are present for a long time following radiation, resulting in increased inflammation of the digestive system. Conversely, a fiber-rich diet decreases the presence of cytokines to reduce radiation-induced inflammation, both in the short and the long term."

Intestinal issues following radiotherapy are problematic for many cancer survivors.

"In Europe, approximately one million pelvic-organ cancer survivors suffer from compromised intestinal health due to radiation-induced gastrointestinal symptoms," Dr. Stringer says.

"This is also commonplace in Australia and around the world with no immediate cure or effective treatment. If we can prevent some of inflammation resulting from radiation simply by adjusting dietary fiber levels, we could improve long-term, and possibly life-long, intestinal health among cancer survivors."

Poor bone quality is linked to poor heart health

Queen Mary University of London and University of Southampton, September 28, 2020

New research by Queen Mary University of London and the University of Southampton's Medical Research Council Lifecourse Epidemiology Unit (MRC LEU) has found associations between lower bone mineral density and worse cardiovascular health in both men and women.

Published in the Journal of Bone and Mineral Research, the study used the internationally unique UK Biobank cohort to investigate links between bone and cardiovascular health. They used a combination of imaging and blood biomarker data to investigate the relationship in the largest sample of people reported to date.

Osteoporosis and heart disease are important public health problems. These conditions share a number of risk factors such as increasing age, smoking, and a sedentary lifestyle. Research shows that there may be links between the two conditions even after accounting for shared risk factors. This suggests that there may be biological pathways linking the two conditions, and investigating these links could reveal targets for novel drug therapies. However, current research studies lack objective measures of bone and heart health and are often limited to studies of small numbers of people for relatively short periods of time.

The researchers found that lower bone density was linked to greater arterial stiffness (indicating poor cardiovascular health) in both men and women. They also found that individuals with poor bone health had an increased risk of dying from ischaemic heart disease. These links were not explained by shared risk factors or traditional cardiovascular risk factors. Interestingly, they found that the mechanisms underlying the bone-heart relationship appeared different in men and women.

Dr. Zahra Raisi-Estabragh, BHF Clinical Research Training Fellow from Queen Mary University of London, led the analysis. She said: "Our study demonstrates clear links between bone disease and cardiovascular health. The underlying pathophysiology of the bone heart axis is complex and multifaceted and likely varies in men and women."

Professor Nick Harvey, Professor of Rheumatology and Clinical Epidemiology at the MRC LEU, University of Southampton, who supervised the work added: "The wealth of information available in the UK Biobank permitted a highly detailed analysis of the complex interactions between musculoskeletal and cardiovascular health, helping to elucidate potential underlying mechanism, and informing novel approaches to clinical risk assessment."

Professor Steffen Petersen, Professor of Cardiology at Queen Mary University of London co-supervised the project. He comments: "Increasing our understanding of novel determinants of heart disease, such as the bone-heart axis, is key to improving disease prevention and treatment strategies and for improving population health."

Professor Cyrus Cooper, Director of the MRC LEU, University of Southampton, added: "This study directly complements our program of research investigating the lifecourse determinants of musculoskeletal health and disease. It illustrates the importance for the University of Southampton and the MRC LEU of our ongoing contribution to the leadership of the large, state-of-the-art, multidisciplinary Imaging Study as part of the unique world-leading UK Biobank resource."

Researchers Say THC From Cannabis May Treat Acute Respiratory Distress Syndrome, Study

University of South Carolina, September 24, 2020

Since Covid-19 first became a dangerous pandemic, many have wondered how cannabis use might factor into risk or healing for the deadly disease. While some immediately assumed cannabis was harmful, like tobacco, and others assumed it could cure or preventthe disease, scientists quickly began to explore the question.

Early research focused on the cannabinoid CBD as a potential treatment for cytokine storms and acute respiratory distress syndrome (ARDS) - a symptom in severe cases of Covid-19, which can lead to death. The results suggested that CBD may be an effective treatment, although human studies need to be conducted to confirm.

Now, researchers are exploring whether another popular cannabinoid, THC, might help with treating the novel coronavirus. And they suggest THC may actually be able to prevent Covid-19 from escalating into a fatal condition.

The new research from the University of South Carolina, Columbia investigated whether using THC might be able to prevent Covid-19 deaths. THC is the notorious chemical in cannabis that produces psychoactive effects like feeling ‘high’ or having an elevated mood. But it is also a highly medicinal chemical with potent anti-inflammatory and pain relieving traits.

In this case, researchers were looking to see if THC’s anti-inflammatory powers might be able to fight against cytokine storms and ARDS.

Cytokine storms are a dangerous symptom of Covid-19 (and other severe infections) which happens when the immune system goes overboard in its attempt to fight off an infection. Cytokines are normally part of a healthy immune response - triggering inflammation to fight against an infection. But when the infection is severe enough, our bodies can release way too many cytokines, and thus create a dangerous level of inflammation. This leads to ARDS, where breathing becomes difficult or even impossible. And cytokine storms can also lead to death from organ failure. Several studies point to CBD as a potential treatment for ARDS, and the FDA recently greenlighted clinical trials for a synthetic cannabinoid treatment for ARDS.

In the new research, scientists explored whether THC might be able to treat cytokine storms and ARDS, by studying its effects on mice.

In this animal model, researchers exposed two groups of healthy mice to a bacterial infection called Staphylococcus aureus or SEB. SEB is known to cause cytokine storms and ARDS in mice, and it almost always leads to death for those exposed. In this case, however, the researchers gave one group of mice a treatment of THC right after they infected them with SEB, along with doses 24 and and 48 hours afterward.

Amazingly, 100% of the mice who were given THC before being infected survived having SEB. Meanwhile, 100% of the mice who weren’t given THC died from the ARDS that resulted from their infection.

While some researchers suggested early on that cannabis’ anti-inflammatory effects could potentially be dangerous in early phases of an infection - suppressing the immune system when it should be defending against attack. This study suggests that using THC early in the infection drastically improved the prognosis and avoided damage to the lungs. While the results need to be confirmed by human research, it could be good news for cannabis users who fear ongoing cannabis use could increase their risk of infection with Covid-19. For mice with SEB, THC helped even when administered immediately after the infection.

Researchers also found that THC was also able to significantly suppress the inflammatory cytokines that are involved with ARDS. It also was able to elevate regulatory T cells which help suppress inflammation. Interestingly, researchers also noticed a shift in the expression of miRNA in cells in the lungs - which may play an important role in suppressing cytokine storms, reducing lung injury and preventing death from ARDS.

In a follow up study, the same researchers went a step further, exploring whether the results from the first study are relevant to those suffering from ARDS as a result of Covid-19. While both Covid-19 and SEB lead to cytokine storms and ARDS, it’s not clear that this happens in the same way. So, given the way THC acted on RNA in mice, these researchers decided to perform an analysis comparing gene expression in Covid-19 patients with ARDS and mice with ARDS from SEB. They found similarities suggesting THC may work well in both cases.

The researchers explain that “Collectively, this study suggests that the activation of cannabinoid receptors may serve as a therapeutic modality to treat ARDS associated with Covid-19.”

While this is a very early study, and more studies should be conducted in human populations with Covid-19, the research suggests that cannabis’ active ingredient THC could be able to prevent Covid-19 from escalating to ARDS - or treat it if it does.

Meditation keeps emotional brain in check

Michigan State University, September 29, 2020

 

Meditation can help tame your emotions even if you're not a mindful person, suggests a new study from Michigan State University.

Reporting in the journal Frontiers in Human Neuroscience, psychology researchers recorded the brain activity of people looking at disturbing pictures immediately after meditating for the first time. These participants were able to tame their negative emotions just as well as participants who were naturally mindful.

"Our findings not only demonstrate that meditation improves emotional health, but that people can acquire these benefits regardless of their 'natural' ability to be mindful," said Yanli Lin, an MSU graduate student and lead investigator of the study. "It just takes some practice."

Mindfulness, a moment-by-moment awareness of one's thoughts, feelings and sensations, has gained worldwide popularity as a way to promote health and well-being. But what if someone isn't naturally mindful? Can they become so simply by trying to make mindfulness a "state of mind"? Or perhaps through a more focused, deliberate effort like meditation?

The study, conducted in Jason Moser's Clinical Psychophysiology Lab, attempted to find out.

Researchers assessed 68 participants for mindfulness using a scientifically validated survey. The participants were then randomly assigned to engage in an 18-minute audio guided meditation or listen to a control presentation of how to learn a new language, before viewing negative pictures (such as a bloody corpse) while their brain activity was recorded. The participants who meditated – they had varying levels of natural mindfulness – showed similar levels of "emotion regulatory" brain activity as people with high levels of natural mindfulness. In other words their emotional brains recovered quickly after viewing the troubling photos, essentially keeping their negative emotions in check.

In addition, some of the participants were instructed to look at the gruesome photos "mindfully" (be in a mindful state of mind) while others received no such instruction. Interestingly, the people who viewed the photos "mindfully" showed no better ability to keep their negative emotions in check.

This suggests that for non-meditators, the emotional benefits of mindfulness might be better achieved through meditation, rather than "forcing it" as a state of mind, said Moser, MSU associate professor of clinical psychology and co-author of the study.

"If you're a naturally mindful person, and you're walking around very aware of things, you're good to go. You shed your emotions quickly," Moser said. "If you're not naturally mindful, then meditating can make you look like a person who walks around with a lot of mindfulness. But for people who are not naturally mindful and have never meditated, forcing oneself to be mindful 'in the moment' doesn't work. You'd be better off meditating for 20 minutes."

 

 

Freezing prostate cancer: Study shows notable outcomes with cryoablation

University of California Los Angeles, September 28, 2020 

A less-invasive treatment technique called hemi-gland cryoablation (HGCryo) - destroying the areas of the prostate where cancers are located by freezing them - provides a high rate of effective prostate cancer control, according to a new study published in The Journal of Urology®, Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Freedom from cancer, as documented by biopsy, was found in 82 percent of men who underwent HGCryo, at their 18 month follow-up," according to the research by Ryan Chuang, MD, and colleagues at the University of California, Los Angeles. The importance of utilizing modern magnetic resonance imaging (MRI)-guided prostate biopsy in monitoring the effectiveness of HGCryo is also emphasized as part of this study.

'Hemi-Gland Cryoablation' Eliminates Clinically Significant Cancer in Most Patients

In the HGCryo procedure, using an advanced ultrasound/MRI fusion system, needles are precisely placed in and around the area of the prostate where the cancer is located. Argon gas is then injected to create extremely cold temperatures, destroying the cancer and surrounding area.

According to the study, 61 men with clinically significant prostate cancer (grade 2 or higher) involving one side of the prostate gland, underwent HGCryo. Cryotherapy was performed using general anesthesia; patients were discharged on the same day as the procedure. The results were assessed through follow-up imaging procedures and MRI-guided biopsies.

Biopsies were performed at 6 months in all patients; 27 patients underwent an additional biopsy after reaching 18 months' follow-up. At both times, biopsies showed no evidence of clinically significant prostate cancer in 82 percent of patients. In men who had areas of prostate cancer detected at follow-up, repeated HGCryo or other treatments were effective.

The study assessed three different biopsy approaches for monitoring the outcomes of HGCryo therapy: tracking of prior cancer-positive sites, biopsy targeting of MRI-visible lesions, and systematic biopsy of the entire prostate using a template. "While tracking biopsy was the most sensitive, all three methods were required for maximum cancer detection," Dr. Chuang and coauthors write.

HGCryo provided notable cancer control even in six patients with more advanced prostate cancers (grade 3 or 4). None of the patients died from their cancer, and none developed metastatic prostate cancer.

Postoperative complications of HGCryo were "generally mild and short-lived." There were no serious complications, including urinary incontinence - a common complication after prostate cancer surgery. One patient developed erectile dysfunction , which was successfully treated with medication.

Cryotherapy is an FDA-approved treatment for prostate cancer and is increasingly popular as a less-invasive alternative to surgery. However, there has been limited evidence on its long-term effectiveness in controlling prostate cancer. Most studies of prostate cryoablation were performed before the availability of modern multiparametric MRI scanning of the prostate, which can provide "a targeted path to precise biopsy and focal treatment" in most men with prostate cancer.

As with other types of partial gland ablation (PGA) for treatment of prostate cancer, the findings highlight the importance of follow-up biopsy as "the most important criterion for success" in evaluating the results of HGCryo. Dr. Chuang and colleagues conclude, "As utilization of MRI-guided biopsy increases, with resulting improved accuracy of prostate tissue characterization, numbers of candidates for PGA are expected to rise."

Early introduction of gluten may prevent celiac disease in children

Kings College London, September 28, 2020

Introducing high doses of gluten from four months of age into infants' diets could prevent them from developing coeliac disease, a study has found.

These results from the Enquiring About Tolerance (EAT) Study, published today in JAMA Pediatrics, by researchers from King's College London, Guy's and St Thomas' NHS Foundation Trust, St George's, University of London, and Benaroya Research Institute, Seattle, suggest the early introduction of high-dose gluten may be an effective prevention strategy for the disease, though researchers say further studies are needed before being applied in practice.

Coeliac disease is an autoimmune disease whereby eating gluten causes the body's immune system to attack its own tissues. There are currently no strategies to prevent coeliac disease and treatment involves long-term exclusion of gluten from the diet. Even very small amounts of gluten in the diet of those with coeliac disease can cause damage to the lining of the gut, prevent proper absorption of food and result in symptoms including bloating, vomiting, diarrhea, constipation, and tiredness.

Previous studies exploring early introduction of gluten in infants have varied in the amount of gluten consumed and the timing of the introduction. The EAT study investigated the effects of gluten alongside breastfeeding, from the age of four months. The results were compared to children who avoided allergenic foods and consumed only breast milk until age six months as per UK government guidelines.

Infants in the intervention arm of the EAT study were given 4g of wheat protein a week from four months of age. This was in the form of two wheat-based cereal biscuits such as Weetabix, representing an age-appropriate portion of wheat.

1004 children were tested for antitransglutanimase antibodies, an indicator of coeliac disease, at three years of age. Those with raised antibody levels were referred for further testing by a specialist.

The results showed that among children who delayed gluten introduction until after six months of age, the prevalence of coeliac disease at three years of age was higher than expected—1.4% of this group of 516 children. In contrast, among the 488 children who introduced gluten from four months of age, there were no cases of coeliac disease.

Lead author Professor Gideon Lack, Professor of Paediatric Allergy at King's College London and head of the children's allergy service at Evelina London Children's Hospital said: "This is the first study that provides evidence that early introduction of significant amounts of wheat into a baby's diet before six months of age may prevent the development of coeliac disease. This strategy may also have implications for other autoimmune diseases such as Type 1 diabetes."

Author Dr. Kirsty Logan, Researcher in Paediatric Allergy at King's College London said: "Early introduction of gluten and its role in the prevention of coeliac diseaseshould be explored further, using the results of the EAT Study as the basis for larger clinical trials to definitively answer this question."