Dr Dingle's Blog / cardiovascular

Antibiotics and “The War on Bacteria”

Antibiotics and “The War on Bacteria”

While antibiotics have been lifesaving, the over-prescription of antibiotics has sparked the evolution of drug-resistant strains of life threatening bacteria, resulting in tens of thousands of deaths each year.[1] The US Centers for Disease Control estimate that up to 50% of antibiotics prescribed in the US are unnecessary.[2] Unfortunately, the use of antibiotics is often prescribed for those groups who are more vulnerable to dysbiosis, including infants born via C-section[3] and in those born preterm, compared to term infants born vaginally,[4] potentially compounding the problems. Micro-organisms such as bacteria, fungi, viruses, and parasites cause many of the world’s diseases, yet only bacterial infections are usually susceptible to treatment with commonly prescribed antibiotics.

However, more subtle side effects of antibiotics on the gut microbiome are only just beginning to be discovered. Broad-spectrum antibiotics can impact up to 30% of the bacteria among the human microbiota, resulting in severe loss of species and function[5] and begins immediately following antibiotic administration. The effects can sometimes last for years after its cessation,[6] and may also lead to the total extinction of some beneficial microbial species. As few as three days of treatment with the most commonly prescribed antibiotics can result in sustained reductions in microbiota diversity.[7] A typical two-week course of high-dose antibiotic treatment, as might be used for an ear infection, can wipe out most of the beneficial gut microbes.

These antibiotic-induced changes in the microbiota have been linked to many disease states including increased infections, metabolic disturbances, obesity, autoimmunity,[8] and mental health conditions. Common outcomes of antibiotics the antibiotic-disturbed gut microbiota are diarrhea and infections with Clostridium difficile,[9] particularly in infants.[10]

Early life exposure to antibiotics presents the greatest risk of long-term damage to the gut microbiota and the more you take, the worse it is.[11] In young children, antibiotics may change the development of the “adult” microbiota, and not allow its normal maturation.[12] It has also been hypothesized to cause a delay in microbial maturation from six to 12 months after birth.[13] Early life exposure is also associated with numerous diseases later in life including IBD,[14] obesity,[15] and asthma, as well as the development of immune-mediated[16] metabolic and neurological diseases.[17]

In a meta-analysis of eight studies including 12,082 subjects, antibiotic use in the first year of life was significantly associated with two-fold (200%) increased chance of the child having asthma.[18] One study reported the use of antibiotics in newborns increased the risk of developing asthma by 24 times. Probiotics during the neonatal period were protective and reduced the risk by as much as 86% for childhood asthma for kids at risk.[19] Studies of mice treated with antibiotics in early life revealed altered microbial populations within the gut microbiota and consequently increased the susceptibility of these mice to asthma.[20]

Antibiotic use has also been shown to have long-term effects on brain neurochemistry and behavior. Such use is known to alter the intestinal microbiome with subsequent changes in microbiota to gut-brain axis[21] and result in poorer neuro-cognitive outcomes later in life.[22]

Even treatment with a single antibiotic course was associated with a 25% higher risk for depression and the risk increased with recurrent antibiotic exposures to 40% for two to five courses and 56% for more than five courses of antibiotics. The higher the rates of antibiotic use, the higher the rates of depression.[23] Animal studies have shown that high doses of a cocktail of antibiotics induced lasting changes in gut microbiota associated with behavioural alterations.[24]

Animal studies of early life exposure to antibiotics show lasting immune and metabolic consequences.[25] Administration of low doses of penicillin to mice early in life increases the risk of weight gain and obesity and promotes lipid accumulation by altering the gut microbiota.[26] Mice treated continuously with low-dose penicillin from one week before birth until weaning exhibited higher body weight and fat mass in adulthood, although the microbial structure returned to normal after four weeks of antibiotics cessation.[27] There is also evidence of antibiotics playing a role in the development of IBD in children[28] and that antibiotic usage during the first year of life was more common in those diagnosed with IBD later in life.[29]

Antibiotics and pregnancy

In human studies, mother’s use of antibiotics during pregnancy is consistently associated with cow’s milk allergy,[30] wheeze, asthma,[31] and atopic dermatitis,[32] with the strongest association for antibiotic use in the third trimester of pregnancy.[33] A study of 306 children with asthma showed that mother’s use of antibiotics during pregnancy increased the risk by a whopping four times (390%).[34] Low-dose penicillin in late pregnancy and early postnatal life in the offspring of mice resulted in lasting effects on gut microbiota, increased brain inflammation, and resulted in anxiety-like behaviours and displays of aggression.[35] Similar results have been shown for antibiotic exposure through breastfeeding.[36]

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[1] Fleming-Dutra et al., 2016.

[2] Fleming-Dutra et al., 2016.

[3] Penders et al., 2006.

[4] Forsgren et al., 2017.

[5] Francino, 2016.

[6] Jakobsson et al., 2010.

[7] Shira et al., 2016.

[8] Francino, 2016.

[9] Ng et al., 2013.

[10] Rousseau et al., 2011.

[11] Fouhy et al., 2012; Tanaka et al., 2009.

[12] Bokulich et al., 2016.

[13] Ibid, 2016.

[14] Hviid et al., 2011.

[15] Azad et al., 2014.

[16] Metsälä et al., 2013.

[17] Arrieta et al., 2014.

[18] Marra et al., 2006.

[19] Zhang et al., 2017.

[20] Russell et al., 2012.

[21] Rogers et al., 2016; Tochitani et al., 2016.

[22] Russell et al., 2013.

[23] Lurie et al., 2015.

[24] Bercik, P. et al., 2011; Desbonnet, L. et al., 2015; Fröhlich, E. E. et al., 2016; Wang, T. et al., 2015.

[25] Russell et al., 2013; Cox et al., 2014.

[26] Cox et al., 2014.

[27] Ibid, 2014.

[28] Shaw et al., 2010;  Ortqvist et al., 2017.

[29] Shaw et al., 2010.

[30] Chu et al., 2015.

[31] Stensballe et al., 2013; Kashanian et al., 2017; Mulder et al., 2016; Murk et al., 2011.

[32] Timm et al., 2017.

[33] Zhao et al., 2015; Wang et al., 2017.

[34] Zhang et al., 2017.

[35] Leclercq et al., 2017.

[36] Kummeling et al., 2007.

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The gut healing and gut health power of raw cabbage

The gut healing and gut health power of raw cabbage

Another reason to add some of the cabbage family to your daily diet, preferably raw is because of their gut healing properties and how they promote gut health through the gut microbiome. The Brassica family including cabbage, broccoli, brussel sprouts, kale, arugula (rocket), bok choy, cauliflower, collard greens, radish, turnip and others have been recognized for their gut healing and gut health properties for hundreds of years and modern epidemiologic studies have shown a frequent consumption of cruciferous vegetables is associated with lower risk of cancer, especially cancers of the digestive tract, bladder, breast, prostate, and lung. However, only now are we recognizing that many of these benefits are mediated through the microbiome and that their frequent consumption alters the composition of the microbiome.

Cruciferous vegetables are a rich source of glucosinolates a precursor to the Isothiocyanates (ITC), which exhibit powerful biological functions in fighting cancers, cardiovascular, neurodegenerative diseases and gut healing. The Isothiocyanates are a by product of specific plant enzymes (myrosinase) active during chewing or crushing when broccoli is consumed raw or lightly steamed, however, like all enzymes myrosinase is deactivated by cooking and ingestion of cooked broccoli typically provides only about one tenth the amount of isothiocyanates as that from raw broccoli. So to maximize the gut healing, gut health and overall benefits of these foods they are best eaten raw or just lightly steamed.

Instead when cooked cruciferous vegetables are consumed, gut bacteria are mainly responsible for ITC production in the gut. This is highlighted after taking oral antibiotics, the ITC’s availability and uptake decreases after eating cooked cruciferous vegetable. It also appears that there is considerable difference in the ability of individuals, due to individual differences in gut microbial community, to produce the isothiocyanates. Although, the gut community’s ability is altered over just 4 days. In one study feeding raw or cooked broccoli for four days or longer both changed the microbiota composition and caused a greater production of isothiocyanates. Interestingly, a three-day withdrawal from broccoli reversed the increased microbial metabolites suggesting that the microbiota requires four or more days of broccoli consumption and is reversible.

The lactic acid bacteria appear to have myrosinase-like activity and the fermented Brassica food products, such as sauerkraut and kimchi, are particularly rich in Lactobacillus, and a diet rich in Brassica may promote Lactobacillus growth in the colon.

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Gut health impacts all health conditions

Gut health impacts all health conditions

Your gut microbiome has an astonishing ability to keep you healthy or ill. The list of diseases that we know of that are linked to the intestinal microbiota grows every day and these diseases are usually complex in terms of both how the disease develops and complications. Having the right balance of good microorganisms in our gut and good gut health is not only essential for good digestion but also in the prevention of or reversing chronic diseases, including.

Poor gut health has been linked with a long list of illnesses including



Asthma and Allergies



Multiple sclerosis


Cancers (especially digestive cancers, i.e. bowel and colon and brain tumours)

Inflammatory Bowel Disease including SIBO, Crohn’s and Ulcerative colitis

Metabolic health

Metabolic syndrome

Cardio vascular disease

High blood pressure

Weight Loss

Diabetes 2

Diabetes 1

Depression, Anxiety and Stress

Skin health and ageing

Eczema, Dermatitis and Psoriasis

Immune system function including susceptibility and tolerance to viruses and bacterial infections like cold and flu.

Colic, Constipation and Diarrhea

Celiac disease and Gluten and lactose intolerance

Liver disease

Dental Health


The list goes on. For example, even in the area of mental illness we have conditions such as

Depression, Anxiety and Stress



ADHD & Autism

Focus and memory

Learning, mental productivity and cognitive decline. As well as controlling some of our needs and desires i.e. food cravings and appetite, our relationships and our social interactions.

These are all impacted by gut health. Because of the role of inflammation, oxidation nutrition and the many functions of the gut microbiome there is not a health condition that is not influenced by the gut microbiome either directly or indirectly.

Because of the multiple functions of the microbiota dysbiosis can manifest as many and multiple health conditions often termed comormidity or multi morbidity. It is not one disease it manifests as many. For example, large studies have shown the multi-morbidity of eczema, rhinitis, and asthma. Inflammatory Bowel Disease (IBD) patients will also frequently suffer from rheumatologic manifestations, liver multimorbidities and lung, namely chronic obstructive pulmonary disease and bronchial asthma, bronchitis and other chronic respiratory disorders in the adult population, gallbladder disease, heart disease and associated morbidity and mortality, anxiety, stress and depression, as well as arthritis, psoriasis, and pericarditis. In one study of 47325 patients they reported 20 different immune mediate diseases associated with IBD including some of those mentioned above and celiac disease, type 1 diabetes, rheumatoid arthritis, and ankylosing spondylitis.

This evidence strongly shows any health condition will have many layers of disease occurring throughout the body at any one time that are related but not connected at the time of diagnosis.


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Gut Health Gut Healing an Modern Perspective

Gut Health Gut Healing an Modern Perspective

Arguable the biggest health problem facing us today is gut health rivaling the current obesity crisis and tobacco smoking in its impact on our health. Every health condition is linked to gut health and gut healing either directly or indirectly through inflammation and oxidation. Historically every culture understood this and were involved in extensive practices of gut healing and even our own up until 60 or so years ago. The first thing health practitioners throughout history would do is to start to fix the gut.

Until recently the positive effects of the gut microbiome on our digestive system and health has been severely under rated. Wisdom of Chinese doctors from centuries ago, who somehow knew that the intestines were not merely a digestive organ, but the centre of health and wellbeing. Hippocrates was recorded as saying that all illness begins in the gut. Throughout history from the Egyptians till around 80 years ago medicine and the bowels were frequently mentioned in the same sentence and good health revolved around gut health.

Even today the nomadic Maasai tribes in Africa attribute most illnesses to the effect of “pollutants” that block or inhibit digestion. In these communities the plants are used to cure diseases served mainly as strong purgatives and emetics; they "cleanse" the body and digestive system from polluting substances.

With thousands of studies released each year the gut is known to play a major role in many health conditions including mental health issues, cardiovascular disease, allergies and asthma, autoimmune diseases, some cancers and even diabetes and weight gain. Many of these conditions which are now reaching epidemic proportions have been linked to a dysfunctional gut. Studies have shown a strong link between mental health issues including depression and what is called the gut brain axis. We also know the gut is the centre of our immune system and is strongly influenced by the gut microbiome. As a result the gut has a strong link with allergies and asthma. Peanut allergies for example are not caused by peanuts they are brought about by a dysfunctional gut microbiome.

Antibiotics and many gut medications used for controlling acid reflux have been shown to be devastating to gut health a healthy gut microbiome, as well as many of the chemicals we use around the homes and even the personal care products we apply to our skin. Even our activities either promote gut health and gut healing or harm it. Stress sends messages to the opportunistic (bad) microorganisms in the gut to tell them to start to take over from the good ones. Exercise promotes gut health and healing while no exercise or too much exercise does the exact opposite.

Fortunately, in animal studies we know that many of these conditions can be improved and even reversed if the gut microbiome is repaired. 50% of Parkinson’s Disease has been directly linked with poor gut health while improving the gut microbiome has been shown to dramatically improve symptoms.

The research also shows that while probiotics can be useful in gut healing, repairing the gut microbiome requires an understanding of what encourages a healthy gut microbiome in our diet and lifestyle as well as what causes a dysfunctional microbiome. We now know that all the healthy foods we eat, the vegetables, nuts, seeds, herbs, spices and fruit all feed the gut microbiome which then feeds us and looks after our health. All the studies on healthy diets from the Mediterranean to the original Japanese or the low inflammatory diet (DII) benefit us because they work through the gut to promote gut health and subsequently our health.

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Lifestyle changes can add 14 years or more to your life. Not drugs

Lifestyle changes can add 14 years or more to your life. Not drugs

Americans have a shorter life expectancy compared with residents of almost all other high-income countries despite the fact that they spend more money on their health care (pharmaceuticals) than any other country.

In this study adopting five major health initiatives—regular exercise, a healthy diet, moderate drinking, not getting overweight or obese and not smoking can extend your life by around 14 years. Each of the healthy lifestyles lowers your chances of getting one of the chronic health problems, such as heart disease and cancer.

This study shows that healthier lifestyles would reduce the rate of premature death from heart disease by 75 per cent, and cancer deaths by 50 per cent, the researchers estimate.

This study yet again highlights the need to focus on lifestyle and diet and not on the pharmaceutical model of health. While there is consistent evidence showing their role in extending life and the quality of life there is virtually no evidence to show pharmaceuticals extend life. However roughly 50% of the lobbyists in the capitals are from pharmaceutical companies.



Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population.



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Our society is the sickest it has ever been

Our society is the sickest it has ever been

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Low vitamin D linked with stroke

Low vitamin D linked with stroke

In recent years, more and more evidence shows that lower vitamin D status is associated with several known risk factors of stroke. This study undertook a systematic review and a meta-analysis of Nineteen previous studies and found a between a 62 and 145% increased risk of stroke for people with the lowest Vitamin D levels.
So go out and get some more sun and some rich fatty vitamin D rich foods. Vitamin D is a fat soluble vitamin.
Stroke is the second leading cause of death among people aged 60 years and above, and is causing a substantial global disease burden. Based on the global burden disease (GBD) 2013 study, about 6.5 million people died from stroke and 10.3 million people suffered a stroke in 2013. That is a lot. China had about 2.4 million incidences of stroke each year and bore the heaviest burden of stroke across the world. Other factors include hypertension, diabetes, obesity, and tobacco use.
Vitamin D, which is classically known as a protective factor in bone metabolism, in recent years has been reported to play a vital role in cardiovascular health.
Some evidence also supported the hypothesis that low vitamin D intake may function as a predictor of long-term incidence of stroke
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Low Omega 3 oils not cholesterol is a risk for heart disease.

Low Omega 3 oils not cholesterol is a risk for heart disease.

A recent large study of 2500 participants (mean age 66 years, 54% women), a higher Omega-3 Index was associated with significantly lower risks for total mortality, for non-CVD and non-cancer mortality, and for total CVD events. Those in the highest omega 3 levels compared to those in the lowest had a 34% lower risk for death from any cause and 39% lower risk for incident CVD. These associations were generally stronger for docosahexaenoic acid than for eicosapentaenoic acid. When total cholesterol was compared it was not significantly related with the health outcomes.

Early studies in the 1980s investigating Greenland Eskimos began the research into the benefits of the omega 3 fatty acids. In Greenland, the fatty acid intake from seafood is high and there is a lower prevalence of autoimmune and inflammatory conditions. Omega 3 has been shown in many studies to help inhibit and even reverse inflammation. The omega 3 fatty acids found in walnuts, flaxseed, butternuts, and fish oils have anti-inflammatory properties, decreasing the amount of arachidonic acid in cell membranes.

Several recent studies have linked higher blood levels and/or dietary intakes of the long-chain n-3 polyunsaturated fatty acids (PUFAs) with greater longevity. Blood omega 3 levels were inversely associated with total mortality rates in the Cardiovascular Health Study, and similar results were seen in the Heart and Soul Study. Consistent with this, there is an inverse relationship between the Omega-3 Index and the rate of telomere attrition, a marker of cellular aging.

Omega 3 fatty acids work through a number of mechanisms, each having different effects, to reduce inflammation. As well recent studies suggest that some of the beneficial effects of fish oil are due, in part, to their antioxidant benefit.

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A Pecan a day keeps the diabetes and cardiovascular disease away.

A Pecan a day keeps the diabetes and cardiovascular disease away.

A large amount of evidence has shown a high intake of tree nuts is associated with a reduced risk of cardiovascular disease (CVD), mortality from type 2 diabetes (T2DM), and all-cause mortality.

In this study after 4 weeks on a pecan-rich diet the researchers saw beneficial changes in serum insulin, insulin resistance (HOMA-IR) and beta cell function (HOMA-β) as well as cardiometabolic disease. That is a significant reduction in the risk of diabetes2, heart attacks and stroke.

Cardiovascular diseases (CVD) are a leading cause of death worldwide, and is primarly caused by inflammation and oxidation. Within the past few decades, there has also been a dramatic increase in diet-related chronic diseases related to CVD risk, i.e., diabetes, obesity, and hypertension, in both industrialized and developing nations. The problem is only getting worse even though we spend more money on pharmaceuticals and the medical system than ever before. Increased production of reactive oxygen species, oxidative stress, and inflammation, are the leading causes of type 2 diabetes mellitus (T2DM), arterial hypertension, and dyslipidemia.

A growing body of evidence has shown that a high intake of nuts (all types) is associated with a reduced risk of CVD development, all-cause mortality, and mortality from diabetes. Indeed, a nut-containing diet also contributes to weight control and weight loss despite the large number of calories.

Bioactive compounds present in nuts, include essential fatty acids, vitamins and minerals, fiber, and phytochemicals, have all been shown to reduce inflammation, improving vascular reactivity as well as fasting glucose and insulin sensitivity, and by lowering oxidative stress. Numerous studies have now shown that consumption of nuts is effective in reducing oxidative stress and inflammation. Other studies have shown frequent nut consumption is associated with lower concentrations of inflammation (CRP, IL-6) and some endothelial (the artery lining) markers in clinical trials. In a study of 5,013 participants, a greater intake of nuts was associated with lower amounts of inflammatory biomarkers. Subjects with nut intake of five or more times per week had a 20% nearly 20% reduction in inflammation compared to those who never or almost never consumed nuts. Pistachio nuts, for example, reduce oxidative stress and inflammation. Pistachio kernels have anti-inflammatory and antioxidant properties at lower doses than reported previously and decreased inflammation (TNF-α and IL-1β) in a dose-dependent way. That is, the more the participants consumed, the lower the inflammation.


But not peanuts and cashews

For much more information on how to reverse diabetes and cardiovascular disease (and all chronic illness) “Overcoming Illness” our latest book is a must read.




A Pecan-Rich Diet Improves Cardiometabolic Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial

Diane L. McKay 1,*, Misha Eliasziw 2, C. Y. Oliver Chen 1 and Jeffrey B. Blumberg 1http://www.mdpi.com/2072-6643/10/3/339/htm

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Inflammation increses your risk of heart disease (and everything else)

Inflammation increses your risk of heart disease (and everything else)

Chronic inflammation is known to play a major role in the development of cardiovascular diseases (CVD) and related mortality. Various dietary components also have been implicated in playing a major role in the development of various CVDs and research has shown that whole diet and various dietary components have a direct association with inflammation. Consumption of fruit and vegetables has been shown to reduce levels of inflammation. Increased adherence to healthier dietary patterns characterized by increased intake of plant-based foods such as fruit and vegetables, nuts, and whole grains and adherence to a healthier dietary pattern has been shown to help prevent and to manage CVD. An increased intake of polyphenols, anti-oxidants with ability to decreases oxidative stress and inflammation through scavenging free radicals, found in fruits, vegetables and nuts, has also shown to be associated with decreased risk of overall and CVD-related mortality.

While consumption of red meat has been shown to increase inflammation. In a recent meta-analysis, increased intake of processed meat has been shown to be associated with increased risk of CVD mortality.

The Dietary Inflammatory Index (DII) has also been shown to be associated with various chronic inflammation-related health outcomes such as cancer incidence, all-cause and cancer-specific mortality, respiratory conditions such as asthma and cognitive disorders. A recent meta-analysis from nine studies found individuals in the highest versus the lowest DII category showed an overall 40% increased risk of colorectal cancer.

In this study data from 14 studies showed a 36% increase in the risk of CVD between the highest and lowest DII scores and there was an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score.

Results of this meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality and a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality.

We are running a course on Inflammation, the DII and inflammation for other aspects of our environment and lifestyle to celebrate the release of our new book "Overcoming Illness" which explains all the information behind inflammation and oxidation and how to reduce your risk of all chronic illness for Diabetes to Dementia.

Overcoming Illness the course

7:00 PM - 9:05 PM Tuesday 6th March 2018


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