Seeding the infant microbiome after a C-section

I was very excited today when I saw that Nature Medicine published a study entitled, “Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer“. I have been waiting to hear about how microbial transfer after a C-section affects babies ever since I found out that Dr. Maria Dominguez-Bello, a prominent human microbiome researcher, was conducting a clinical trial at NYU where infants who were delivered by C-section (rather than vaginally) were then swabbed with their mother’s vaginal microbiota. Though Dr. Dominguez-Bello is an author, this particular paper analyzes a group of mothers and babies living in Puerto Rico, while I believe the NYU trial is on-going. Over the last few years, a number of studies have shown that the gut microbiota of infants delivered by C-section is different from the gut microbiota of infants delivered vaginally, and that over the period of a few years, children delivered by C-section are more likely to suffer from obesity, allergies, and asthma. I’ve even seen this gut bacterial difference in premature infants in my own work.

Swabbing the infants with the maternal vaginal bacteria did not perfectly recapitulate a vaginal delivery, but their gut bacteria did more closely resemble that of vaginally delivered babies compared to those delivered via C-section. The published paper used a small number of subjects, and whether the swabbed infants receive protection from obesity, allergies, or asthma is still to be determined. But benefits have been shown for infants whose mothers labored before undergoing a C-section (for example, imagine the baby was trying to come out of the canal feet first, could not get turned around head first, so then had to removed by C-section). The thought is that these infants were exposed to the vaginal microbiome during labor, even though they did not successfully come out of the vaginal canal (I can’t seem to find a link to this at the moment).

nature_swabbing_image

Swabbing after a Caesarean delivery (Image from Nature Medicine’s Facebook. Kim Caesar/Nature Publishing Group)

Hopefully we will see the effects of the swabbing in the coming years, and if the results are positive, swabbing could become a routine part of the delivery process (or we will use probiotics once we figure which bacteria are most beneficial to the child immediately after birth). The danger associated with swabbing is that some mothers are infected with viruses (Herpes) or bacteria (Group B Streptococcus) that could harm the infant, and these microbes could be transferred to the child through the swabbing. Generally, mothers are given medication (antibiotics or anti-virals) if they test positive for these “bad” microbes before they deliver their baby. However, if a mother does not have adequate pre-natal care (i.e. we don’t know about her infection status), swabbing would be considered risky.

Interestingly, I found this in the paper:

Competing financial interests

New York University has filed a US patent application (number 62161549) related to methods for restoring the microbiota of newborns on behalf of M.G.D.-B.

More links to check out:

  1. http://www.nature.com/news/scientists-swab-c-section-babies-with-mothers-microbes-1.19275?WT.mc_id=TWT_NatureNews
  2. https://www.scienceandsensibility.org/seeding-the-newborns-microbiome-can-we-do-it-should-we-be-doing-it/
  3. http://well.blogs.nytimes.com/2016/02/01/post-cesarean-bacteria-transfer-could-change-health-for-life-study-shows/?partner=rss&emc=rss&smid=tw-nythealth&smtyp=cur&_r=0

 

Looking back at 2015’s posts

In this past year, I have written on a variety of subjects, from reviewing a book about dietary fat, to writing about direct-to-consumer genetic tests, milk, the skin microbiome, food insecurity, BPA in plastics, pesticides in foodDNA ancestry, drugs to treat cystic fibrosis, to sharing recipes and reviewing personal care products. I hope you enjoyed some of these posts, and maybe even found them to be eye-opening!

I hope to post soon about 23andMe’s newest genetic tests.

Lumo Lift: a posture correcting wearable device

IMG_1421I have suffered from back problems from a few years now. It started when I began to work full-time in an office setting, writing code and such. It developed rather quickly. Since then, I’ve been trying all sorts of things to improve my back pain. I do yoga, PiYo, and have used yoga balls and yoga ball chairs. I even invested in an upper back brace to pull my shoulders back and relieve some pain associated with bad posture. Most recently, I tried out a wearable device- the Lumo Lift. It is a small device worn under the clavicle (attaches to clothes with a magnet) that detects whether or not you have deviated from good posture. It buzzes if you have kept up a bad posture for a certain amount of time.

IMG_1492I happen to really like it and I think it works quite well. I do sit on a yoga ball at my desk. I found it is harder to maintain good posture in a regular chair- the device buzzes at me relentlessly when I sit in a chair. But I do feel there is a big difference in my posture if I don’t wear the device- it is a good reminder to sit up straight. It links up wirelessly to my smart phone and records how often I keep posture (with a goal of 4 hours of good posture a day), and it also works as a pedometer (it records how many steps I take each day; it also breaks down all this information into hourly and daily blocks).

For someone who is determined to improve their posture (especially if motivated by back pain), I think this is a great device. It comes with a charger which I leave at the desk.

Anti-Dandruff Shampoo/Conditioners Part II

I wrote this post earlier, but it didn’t get saved! *grumble* >.< But here is my second attempt:

So I’ve been on a hunt to find an effective and non-toxic way to get rid of dandruff. It has not been an easy task! I tried a number of products earlier, but unfortunately I did not find the “right one*. Here is a list of a few more products I tried:

1. Herbal Essences Cleansing Conditioner

IMG_1410I have described this cleansing conditioner in an earlier post- it’s a conditioner that lightly cleanses so you can avoid using shampoo daily, which strips away natural oils. I was really excited to try this- it smelled good and felt very nice and rich and creamy. Unfortunately, it made my dandruff 10x worse. Turns out it has zinc pyrithione in it, which is an anti-dandruff compound. However, it can also make scalps more itchy and make dandruff worse, which is what happened to me.

Rating: 0/0

2. Jellua Squid Ink Active Shampoo and Repair Treatment Cream

IMG_1412I mentioned this duo in an earlier post. It was recommend to me by a hairstylist for treating dandruff. Jellua is a Korean company, and they use squid ink these products, giving the shampoo and conditioner/cream a dark brown color. While I thought this duo worked fairly well, I felt it was too pricey and the conditioner/cream contains methylparaben (a paraben), which I would prefer not to have in any of my hair or body products.

Rating: 4/5

3. Shikai Henna Gold Shampoo

IMG_1423I have been using this product for a long time. It highlights hair using clear (colorless) henna. I use it generally in the summer to brighten up my highlights. Henna is supposedly good for the scalp and hair, and I have found that it keeps my scalp relatively happy (it doesn’t make anything worse, that’s for sure). On the EWG Skin Deep cosmetics database, they have the old formulation listed, which had a lot of possibly toxic/irritating ingredients. The current formulation does not contain these ingredients.

Rating: 3/5

4. Acure Pure Mint + Echinacea Stem Cell Conditioner

IMG_1422This conditioner really helped calm my scalp and seemed to get my dandruff to die down. I love the way this conditioner makes my hair feel. It has a minty smell and my hair feel light and voluminous (it is a volumizing conditioner, after all). My only complaint is that my hair is a little hard to brush after using it. But overall, I am happy with this product.  I may try their other products- they also have a Moroccan organ oil shampoo and conditioner duo.

Rating: 4/5

I searched the internet for more natural anti-dandruff products, and found 2 other recommendations.

1. Pharmaceutical Specialties Free & Clear Shampoo

2. Lavera Anti-Dandruff Shampoo, Organic Cornflower and Sage

I haven’t tried them yet, but I might?

Finding a cure for cystic fibrosis

In the past year, there has been a personalized medicine success story- a “cure” has been found for patients with a rare cystic fibrosis (CF) mutation via the development of a drug called Kalydeco (the pronunciation is similar to “kaleidoscope”). However, a true cure for most patients with CF remains to be found. But in the meantime, there have been some exciting developments aimed at treating most patients with CF.

A nice summary of the most recent developments can be found here. I will try to give my own summary below!

Cystic fibrosis is a disease caused by mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) gene. It is a large gene, and there are many different mutations in the CFTR gene that can lead to cystic fibrosis. It is an autosomal recessive disease, meaning that someone with cystic fibrosis got a mutated CFTR gene from both their father and their mother, who are generally asymptomatic CF carriers. Cystic fibrosis is characterized by a build-up of mucus in the lungs, leading to progressive lung disease. There is also mucus clogging of the pancreatic ducts, leading to various gastrointestinal issues and malabsorption. The average life expectancy is about 37 years. Treatment for CF includes using various inhaled medicines, vibrating vests to help loosen mucus in the lungs, pancreatic enzymes to aid absorption of fats, and often antibiotic treatment for lung infections. Due to malabsorption issues, a high calorie diet is important.

An example of what it is like to care for a child with CF can be found here. Caring for a child with cystic fibrosis is almost a full-time job- they must make their children undergo breathing treatments multiple times every day, make sure they adhere to a high calorie diet, and remember to take their enzymes before eating. They must closely observe their child’s health, especially to their coughing and wheezing, and make sure to keep their child away from anyone who is sick. And they often spend a lot of time seeing doctors or being in the hospital.

There have currently been 3 new drugs developed to treat CF. The first is Kalydeco (also known as Ivacaftor), which I mentioned above. The others are Lumacaftor and VX-661.

There are various mutations that cause CF. Here is a link from the CF Foundation website on the various mutations.

The CFTR gene codes for a protein that is inserted into the apical membrane of lung and intestinal tissue, as well as the vas deferens and the sinuses. The protein’s main function is to act as a chloride channel, and it helps to maintain an airway liquid layer, which in turn helps with mucus clearance. There are five general classes of CFTR mutations. The most common mutation, F508del, is a Class II mutation, meaning that there is an issue in the processing of the CFTR protein- either it is misfolded or targeted for degradation by a proteasome, so there is not enough of the CFTR protein to prevent CF symptoms. The drug Kalydeco is meant to target the G551D mutation (Class III), though it now appears to benefit patients with Class III-V mutations. Kalydeco (Ivacaftor) is a potentiator drug, meaning that it helps the protein (chloride channel) come to the surface of the cell and carry out its functions. The other two drugs, Lumacaftor and VX-661, are CFTR correctors, meaning that they help correct the misfolding of the CFTR protein, as seen in Class II mutations. VX-661 is still quite new, but is supposed to be a similar but better version of Lumacaftor. In many clinical trials going on, both a potentiator and a corrector are given together.

Other drugs in the works to treat CF include 2nd generation modulators. One of these drugs targets sodium channels (the CFTR protein also regulates an epithelial sodium channel (ENaC)). In shutting down ENaC, for example, the water layer can be restored (the layer is too thin in CF patients, resulting in dehydrated mucus).

These CF drugs are for the most part available as part of a clinical trial. Kalydeco is extremely expensive (about $300,000 a year). Insurance is supposed to cover it in most cases. These drugs are not yet available for young children.

This is all exciting news for the CF community- CF is a difficult, lifelong disease, and hopefully treatment will be available for most patients soon, letting them live normal, long lives.

EDIT: 5/13/2015

Orkambi, a combination of ivacaftor (Kalydeco) and lumacaftor, just got FDA approval for use in patients with homozygous F508del mutations! Link to NYTimes article here.

Anti-Dandruff Products: A Review

The winter has been long and a little rough on the scalp, resulting in annoying dandruff.

So I tried out various products, with an eye for products without harsh chemicals.

 IMG_18391. Jojoba Oil

Jojoba oil is supposed to be really good for the skin and scalp. I would put it on my scalp for a few minutes before showering. It makes the hair look extremely oily, so it’s not something you can leave on. It worked okay, but it is a really thin oil, so it easily ran down my face and into my eyes. It probably needs to be used often to eliminate dandruff, but it was too inconvenient and difficult for me to use.

Rating: 3/5

IMG_1840

2. Nature’s Gate Jojoba Shampoo

I thought maybe using a shampoo with jojoba oil in it would be easier and more convenient. It works well as a shampoo, but it still has strong detergents in it, and the dandruff didn’t improve.

Rating: 2/5

IMG_18373. Shea Moisture Raw Shea Butter Deep Treatment Masque with Sea Kelp and Argan Oil

I thought a strong moisturizer for the scalp would be good. I applied large amounts of this product to my scalp after shampooing and left it on for a few minutes. It worked okay in terms of taming the dandruff, but definitely needs to be used on a regular basis. I think I put on too much once because I was unable to wash it out of my hair, and so my hair was a little gross afterwards.

Rating: 4/5

IMG_18414. Neutrogena T/Gel Therapeutic Shampoo (anti-dandruff)

I thought using a real medicated shampoo would help. Unfortunately, as I read in the reviews, it makes dandruff MUCH worse for some people, like me. It made my scalp so incredibly itchy and my dandruff got much worse. May have even left a gross layer of grime in the tub (it has tar in it). I don’t think I can use it anymore.

Rating: 1/5

IMG_1836 5. Macadamia Natural Oil Deep Treatment Masque

I heard of this product on a youtube video before. It’s pricey so I purchased a trial packet. This stuff was amazing- smelled great, felt great. I think it did actually have an effect on my dandruff! It’s a little expensive and now I have a million other products that I need to finish using first before it makes sense to buy it. But I think I will get it soon!

Rating: 5/5

6. Jellua Squidink Active Shampoo and Repair Conditioner

My hairstylist recommended this when I asked her about how to combat dandruff. It’s pretty pricey, but she swears it works! I may try it out in the future. It has squid ink in it. Here’s a link to the company’s site. It can be purchased on Amazon.

Rating: ???/5

I’m back!

Hi everyone,

Sorry for the hiatus. I had to write an insane amount for work, so it didn’t leave room to write for fun.

I’ve got some ideas for my next few posts:
1) anti-dandruff solutions review
2) use of personalized medicine in the search for the cure for cystic fibrosis

Hope to get those out soon!

But as of late I’ve found a cool new resource for healthy, cheap recipes here (it’s a PDF available for free).

Growing Alfalfa Sprouts

I love to grow things at home- it’s really nice to have fresh food (almost) on-demand. It’s not even farm-to-table, it’s kitchen counter to table! In particular, I like to grow alfalfa sprouts. They are crisp and refreshing. The seeds can be purchased in bulk on-line. I have also previously written a post about sprouting mung beans. I purchased a sprouter from Williams and Sonoma for $10 (it is no longer available, but a similar one can be purchased on Amazon). Instructions for growing alfalfa sprouts are below:

Growing Alfalfa Sprouts

  1. Put 1 tablespoon (1 teaspoon also works fine) of alfalfa sprouts in each tier of the sprouter.


    IMG_1789

  2. Stack the tiers on top of the water collection tray.

    IMG_1790

  3. Pour enough water into the top tier to fill it three-quarters of the way.


    IMG_1792

  4. Keep the sprouter on the kitchen counter of the sunlight.
  5. Every 12 hours, empty the water out of the water collection tray and repeat Step 3.
  6. When the alfalfa sprouts have grown to your liking, either simply start eating immediately or store the sprouts in the refrigerator. To store the sprouts, first empty the water out of the collection tray, then replace the collection tray and put the lid on the top tier. Then put the sprouter in the refrigerator to store for later use. 

    IMG_1764

Pesticides in Food

It is always a challenge to keep pests off crops. However, as pests (both plants and animals… probably bacteria and fungi, too) evolve and become resistant to pesticides, oftentimes more toxic pesticides need to be brought into use.

Unfortunately, many pesticides are toxic chemicals, and can be a problem for natural wildlife surrounding farms as well as the farm workers who are exposed to heavy amounts of pesticides (see PANNA‘s webpage on pesticide drift). Approaches such as such Integrated Pest Management can be utilized in an effort to be control pests in a more environmentally-friendly and less toxic way.

A recent paper was just published looking at organophosphate residue (a type of pesticide) in food. Organophosphates, such as parathion and malathion, have cholinergic effects on the nervous system (they activate the parasympathetic nervous system- the one that is responsible for “resting and digesting”). They act on the enzyme acetylcholinesterase (which breaks down acetylcholine, the neurotransmitter used by the parasympathetic nervous system to send messages), inhibiting its action, so too much acetylcholine accumulates. Organophosphates are thus nerve agents. They are a common cause of poisonings, and the antidote pralidoxime (which regenerates acetylcholinesterase) must be given to prevent paralysis of respiratory muscles, along with atropine (a competitive inhibitor of acetylcholine).

A recent article on this study stated the following:

For the past three decades, overall use of OPs [organophosphates] has declined. But recent U.S. Department of Agriculture (USDA) data shows them to be among the top insecticides used on crops that include apples, peaches, and blueberries. According to the latest data from the U.S. Environmental Protection Agency (EPA), more than 33 million pounds of OPs were used in the U.S. in 2007.

Treated crops include broccoli, cantaloupe, grapes, green beans, lettuce, nectarine, oranges, pears, spinach, strawberries, tomatoes, sweet potatoes, mangoes, and onions. So if you’re eating conventionally grown produce grown in the U.S., it’s more than likely that you’re eating some that was treated with OPs. Washing and/or peeling will remove some residue, but not necessarily all of it.

According to the article, the study showed that:

Curl and colleagues analyzed participants’ urine samples for evidence of OPs, then they compared these results from a subset of 720 people to the USDA’s measurements of pesticide residues on the fruit and vegetables the participants reported eating. They found that people who ate conventionally grown produce had high concentrations of OP metabolites in their urine, while people who reported eating organic produce had significantly lower levels. In fact, those who ate the least organic produce had as much as twice the pesticide levels as those who ate organic the most frequently.

To summarize, many conventionally grown fruits and vegetables contain organophosphate residues. But research is still being conducted on the possible negative effects of consuming produce with organophosphate residue.

Thus, as a consumer, we may wonder about the amount of pesticides in our food, and how to avoid them. Organic farming does not permit the use of synthetic pesticides, though “natural” pesticides can be used. But organic produce can be expensive or difficult to find.

The Environmental Working Group has a “Shopper’s Guide to Pesticides in Produce“. Here, they list the “Dirty Dozen” and the “Clean Fifteen”, which are lists of conventionally grown fruits and vegetables with the highest and lowest levels of pesticide residue, respectively. Apples, strawberries, and grapes are currently at the top of the list as having the most pesticide residue detected, while avocados, sweet corn, and pineapples have the least amount of pesticide residue found. In general, skimming through their lists, it appears that fruits and vegetables with the thinnest, most delicate skins have the most pesticide residue, while those with thicker skins have the least residue.

For a more detailed list of pesticides found on food, one can search the database of “What’s on my food?“.

[Disclosure: I have been paid by PANNA in the past (small sums) for some work I did for another group]

Sprouting Mung Beans

Mung beans are these green beans that can be sprouted until a small root emerges, or until they become long white stalks- those are what we know as bean sprouts on Asian dishes such as Pad Thai.

Sprouting mung beans is easy. Mung beans are pretty healthy and easy to prepare. Below are instructions!

Sprouting Mung Beans, Step-by-Step

  1. Place dry mung beans (however many you want) in a clean pot and fill with water, enough to comfortably cover all the beans.

    IMG_1766

  2. Let beans sit in water overnight.
  3. Drain water. Beans should be much bigger now. I put my beans on a steamer insert (it has holes on the bottom for drainage). I poured some water on the beans, then put the steamer insert on top of my pot.

    IMG_1773

  4. Rinse the beans once a day for about another 1-2 days. Roots should start to pop out.

    IMG_1777

  5. I find the beans a little bitter if eaten on their own, so I steam the beans.
  6. Step 4 can be repeated until beans grow to be long and white (though mine turned out to be a mix of green, white, and dark red. I thought they were bitter, so I’d probably steam them, too.)