NUTRITION IN LYME and TICK INFECTIONS Martin D

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 • Gastritis with foreign protein leaking into the blood stream • Examples of immune activation psoriasis, IBD, Celiac Neovascular rashes

Inflammation causes permeable gut Foreign proteins to immune system Crohn’s, Colitis, Celiac

Psoriasis

Immune/Autoimmune • Crohn’s, Celiac, Ulcerative Colitis • Lyme, Bartonella, Mycoplasma • Inflammatory mediators include: Tumor necrosis factor interleukins 2, 6, 10

Immune Activation Neovascular Rash

SNAKE LIKE = INFECTION

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

Canker Sore

Inflammatory Ulcers

Colon Ulcers

Colitis

Celiac vs Food Intolerance • Celiac is Autoimmune to wheat, rye, barley • Gluten, Genetics and Environment • Allergy is Ig. E mediated • Celiac is non Ig. E mediated

Celiac Disease Enzymes lost in disease malabsorption affected: Lactase milk sugar Sucrase table sugar Maltase Simple starch Glucoamylase Complex starch as rice

Maintain Intestinal Integrity • Iron, Zinc, Albumin • Fat soluble vitamins A, D, E, K • B 12 malabsorption in ileum (refer 4 -7)

Alter GI Flora Favorably • • • Minimize Clostridium difficile - colitis Reduce Candida albicans – yeast overgrowth Short chained Fructoligosaccharides (sc. FOS) 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 • Pseudomembranous colits • Treat with Metronidazole and pre/probiotics

Pseudomembranous Colitis

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 • sc. FOS • Sources include banana, garlic, onion, leeks, whole wheat, asparagus and tomato products

Keeps yeast and C difficile in check Lowers the p. H 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………….

Gallstones

Insulin Resistance

Fatty Liver

Sleep Apnea

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 Ped Gastroenterol Nutr 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