I recently attended a continuing education program held at McMaster University and sponsored by The Canadian Society for Orthomolecular Medicine. Dr. John Gannage, MD, who runs an integrative health clinic in the Toronto area, was the presenter. He stressed the urgent need for nutritional interventions as a first line strategy in dealing with these cases.
This program is designed for physicians and health professionals, such as naturopaths, nutritionists and nurses. It addressed the subject of how we can deal with the crisis we face in the area of mental health for children. The rate of autism diagnosis (a developmental disorder) has skyrocketed in the last few decades – 45 years ago, the statistic was one in 10,000 diagnosed with autism; now, autism occurs at the rate of one in 45.
Dr. Gannage talked about some of the causes of this epidemic, which includes increased rates of ASD, ADD, anxiety and depression in children. Toxicity, malnourishment, neuroinflammation, dysbiosis and food intolerances all play a role. Genetic susceptibility plays a part, but epigenetics determines whether those genes are turned on or not, so environmental exposure is the key factor.
The disease sequence starts with a medical history, including the impact of environmental exposure to ancestors/previous generations/in utero plus genetic susceptibility or potential and current environmental exposure.
The most important ecosystem (gut) is disturbed and then the brain is affected, promoting injury/immune response/inflammation/degeneration and eventual aging. Genetics is not the cause – the vast majority is environmental or interaction! For Dr. Gannage, the greatest defence against environmental exposure is use of nutrients and antioxidants, a sentiment with which I wholeheartedly agree.
Why does the gut ecosystem matter? The microbiome in the gut protects from infection, contributes to metabolism, immune regulation and healthy brain chemistry.There are more neurotransmitters in the gut than in the brain. Interestingly, Dr. Gannage believes from his clinical experience that supplemental Gaba will cross the blood-brain barrier if the barrier is damaged (same as tight junctions in gut are damaged with leaky gut). Gaba also hits receptors in gut, so has an effect also on the brain.
Abnormalities in bacterial composition causes colic in babies and permanent changes to brain levels of serotonin, a calming neurotransmitter that is regulated by bacteria in the gut in early life. This affects adulthood amounts of serotonin and cannot be reversed so prevention is crucial. This is alarming in that serotonin is essential not just for general health, also mental wellbeing and is one root cause of problems like ADHD and autism.
The Canadian Medical Association Journal looked at the gut microbiota of healthy Canadian infants. Those exclusively formula fed showed significant differences in gut bacteria (too much c-difficile), especially cesarean delivery (vaginal swab wiped on mouth of infant is solution). There was a lower pH (more acidic) in formula fed babies.
Dr. Gannage highlighted the importance of healing the gut, since the majority of our immune system resides there. He uses the same “4-R” procedure used by holistic nutritionists:
- REMOVE – offending foods, toxins
- REINOCULATE – repopulate healthy flora(fauna) and get enough fiber; probiotics (foods, powders, capsules) also from fermented foods like sauerkraut or miso – but beware these can be high in histamine which can have adverse effects on some plus probiotics with incorrect strain could mean other intolerances; possible fecal microbiota transplant; antimicrobials – nystatin, fluconazole, Grapefruit Seed Extract, Olive leaf extract (anti-microbial effect)
- REPLACE – enzyme therapy for limited time….bacteria produces enzymes, not just the pancreas
- REPAIR – glutamine (not more than 6 wks at a time, be careful in Autism population re: glutamates), N-acetyl-cysteine, Omega 3/6, Vitamin A, Zinc
Almost everyone Dr. Gannage sees is Vitamin D deficient (which needs to be supplemented at high levels year round for most) and testing should be done. Magnesium and Omega-3 fatty acids are also nutrients of concern for deficiency.
A few more notes on dietary goals:
- What heals one thing heals all things, so dietary goals include eating foods that reduce inflammation, removing sugar to prevent blood insulin spikes (this would include fruit juice), heal the gut and support bowel flora with a plant-based, whole-foods diet, increased fiber and aim to go chemical-free.
- We need fiber (average person only gets 25 g.) with 60 g. being ideal if you eat lots fruit/veg; SUGAR alters your gut flora to the point of altered metabolism – obesity, diabetes, metabolic syndrome
- Memory was affected in mice due to high sugar diet – poor cognitive flexibility
There was a lot more detailed clinical information given throughout the day long seminar, including treatment protocols and case studies. The bottom line is that we need to be conscious of pro-oxidants and stress from toxic metals, infection, bowel bio-toxins, EMF exposure, lifestyle, alcohol, tobacco, some prescription drugs including antibiotics (antibiotics in our food supply also since 70% of them go to livestock in U.S., affecting our gut flora in a secondhand manner), overtraining and wrong diet.
What struck me while listening to the presentation was how similar my approach would be as a nutritional practitioner. It is wonderful to see a medical doctor incorporating natural healing as a priority in his treatment plan. We need to use dietary changes and supplementation to overcome the effects of our negative environment. This is what orthomolecular medicine promotes, using food and supplements to correct imbalances and nutritional deficiencies and get to the root of the problem rather than just providing symptom relief with drugs.