• Karine

References blogs 0020 to 0029

Updated: Mar 26, 2020

0028 – How to get healthier in confinement

  • https://www.youtube.com/watch?v=fbLYDGXix8I&feature=youtu.be&fbclid=IwAR2zzcPYFwiYL-Z5DgBHUrNTRfQGpL-8jHF7vV-Q7a4DzfGtcGv0uO4EP2o Boosting Immunity Against Corona Virus With Top Doc, Dr Aseem Malhotra. 22 Mar 2020.

Don't stress, adopt of positive mindset and take action

  • https://www.ncbi.nlm.nih.gov/books/NBK513238/ Relaxation Techniques - Box breathing. Jun 2019

  • https://www.frontiersin.org/articles/10.3389/fimmu.2019.00245/full Stress and Immunity. Feb 2019. Stress may lead to disease states or fatal conditions, to persistently high cortisol and impaired anti-inflammatory effects on the immune system, resulting in chronic infection, inflammatory autoimmune diseases, or cancers and other disorders. Inhibits the cross talk of immune cells and signaling networks.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/ Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Oct 2018

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/ How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Sep 2018

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769199/ Effect of Modified Slow Breathing Exercise on Perceived Stress and Basal Cardiovascular Parameters. Jan-Apr 2018

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/ The physiological effects of slow breathing in the healthy human. Dec 2017

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/ The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Jun 2017

  • https://www.ncbi.nlm.nih.gov/pubmed/27995346 The role of deep breathing on stress. Mar 2017

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072593/ The Effectiveness of Daily Mindful Breathing Practices on Test Anxiety of Students. Oct 2016

  • https://www.apa.org/helpcenter/stress. American Psychological Association. Stress Effects on the Body.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736941/ Stress & the gut-brain axis: Regulation by the microbiome. Dec 2017

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604320/ Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Oct 2015

  • https://www.ncbi.nlm.nih.gov/pubmed/22772580/ Chronic psychosocial stress: does it modulate immunity to the influenza vaccine in Hong Kong Chinese elderly caregivers? Aug 2013

  • https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-4-1-2 Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection versus Immunopathology. Mar 2008. Chronic stress suppresses or dysregulates immune function and increases susceptibility to infections and cancer.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/ Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Jul 2004

  • https://www.ncbi.nlm.nih.gov/pubmed/12090368 Psychoneuroimmunology: psychological influences on immune function and health. Jun 2002

  • https://www.ncbi.nlm.nih.gov/pubmed/11139000 Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine. Nov-Dec 2000

  • https://www.nejm.org/doi/full/10.1056/NEJM199108293250903 Psychological Stress and Susceptibility to the Common Cold 29 Aug 1991. The rates of infections and colds increased with increases in stress levels. 74% to 90%, and 27% to 47% respectively.

Sleep tight

  • https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/how-much How much sleep do I need? Apr 2019.

  • https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/inadequate-sleep How does inadequate sleep affect health? Apr 2019

  • https://www.cdc.gov/sleep/about_sleep/chronic_disease.html Sleep and Chronic Disease. Aug 2018

  • https://www.ahajournals.org/doi/10.1161/JAHA.118.008552 Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis. Aug 2018

  • https://www.intechopen.com/books/melatonin-molecular-biology-clinical-and-pharmaceutical-approaches/an-overview-of-melatonin-as-an-antioxidant-molecule-a-biochemical-approach An Overview of Melatonin as an Antioxidant Molecule: A Biochemical Approach. Jun 2018. Melatonin has a free radical scavenger, anti-inflammatory, and antioxidant effects. It prevents degenerative changes in the central nervous system in Alzheimer’s and Parkinson’s and reduces free radical damage to DNA which may lead to cancer and other situations.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768894/ Human immune system during sleep. Dec 2017. Sleep deprivation makes a living body susceptible to many infectious agents. Improve sleep habits to make immune system efficient for a healthy life.

  • https://www.ncbi.nlm.nih.gov/pubmed/27077395 Is Insomnia a Risk Factor for Decreased Influenza Vaccine Response? Jul-Aug 2017. Insomnia can be a risk factor for lowered immunity to the influenza virus.

  • https://www.sciencedaily.com/releases/2017/01/170127113010.htm Chronic sleep deprivation suppresses immune system. Jan 2017. Many people report getting sick when they don't get enough sleep. Shorter sleep duration depresses the immune system.

  • https://academic.oup.com/sleep/article/40/1/zsw019/2952682 Transcriptional Signatures of Sleep Duration Discordance in Monozygotic Twins. Jan 2017. Habitual short sleep dysregulates immune response and provides a potential link between sleep deprivation and adverse metabolic, cardiovascular, and inflammatory outcomes.

  • https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html 1 in 3 adults don’t get enough sleep. Feb 2016.

  • https://www.dreams.co.uk/sleep-matters-club/data-shows-a-shocking-worldwide-lack-of-sleep/ This Data Shows A Shocking Worldwide Lack of Sleep.

  • https://www.ncbi.nlm.nih.gov/pubmed/25642690 Annoyance, sleep and concentration problems due to combined traffic noise and the benefit of quiet side. Jan 2015

  • https://www.sleephealthjournal.org/article/S2352-7218%2815%2900015-7/abstract National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Dec 2014.

  • https://www.ncbi.nlm.nih.gov/pubmed/26483931 Environmental noise and sleep disturbances: A threat to health? Dec 2014

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902880/ Sleep Health: Can We Define It? Does It Matter? Jan 2014.

  • https://news.gallup.com/poll/166553/less-recommended-amount-sleep.aspx In U.S., 40% Get Less Than Recommended Amount of Sleep. Dec 2013

  • https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side Blue light has a dark side May 2012

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/ Sleep and immune function. Jan 2012. Sleep and the circadian system exert a strong regulatory influence on immune functions. Specific role of sleep in the formation of immunological memory.

  • https://www.ncbi.nlm.nih.gov/pubmed/21193540 Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. Mar 2011

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047226/ Exposure to Room Light before Bedtime Suppresses Melatonin Onset and Shortens Melatonin Duration in Humans. Mar 2011

  • https://www.ncbi.nlm.nih.gov/pubmed/21552190 The impact of light from computer monitors on melatonin levels in college students. 2011

  • https://www.ncbi.nlm.nih.gov/pubmed/19139325 Sleep habits and susceptibility to the common cold. Jan 2009. Participants with less than 7 hours of sleep were 2.94 times more likely to develop a cold than those with 8 hours or more of sleep. Poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated with lower resistance to illness.

  • https://www.ncbi.nlm.nih.gov/pubmed/17969458 Sleep and mortality: a population-based 22-year follow-up study. Oct 2007

  • https://www.ncbi.nlm.nih.gov/pubmed/17487258 The public health and safety consequences of sleep disorders. Jan 2007

  • https://www.ncbi.nlm.nih.gov/pubmed/16842544 Blue blocker glasses impede the capacity of bright light to suppress melatonin production. Aug 2006

  • https://www.ncbi.nlm.nih.gov/pubmed/16120101 Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleep and REM sleep. Sep 2005

  • https://www.ncbi.nlm.nih.gov/pubmed/15164896 prospective study of sleep duration and mortality risk in women. May 2004

  • https://www.ncbi.nlm.nih.gov/pubmed/1811316 Relative and combined effects of heat and noise exposure on sleep in humans. Feb 1991

  • https://www.ncbi.nlm.nih.gov/pubmed/1986039 A preliminary study comparing sleep restriction and relaxation treatments for insomnia in older adults. Jan 1991

Go out in the sun to boost your vitamin D levels

  • https://www.who.int/uv/faq/uvhealtfac/en/index1.html The known health effects of UV - Are there beneficial effects of UV radiation? World Health Organization. Some UV radiation is essential to the body as it stimulates the production of vitamin D. Vitamin D plays a crucial role in immune function. 15 minutes of casual sun exposure of hands, face and arms two to three times a week during the summer months is sufficient to keep your vitamin D levels high.

  • https://www.nature.com/articles/s41598-019-46036-8 Nitric oxide acts as an antioxidant and inhibits programmed cell death induced by aluminum in the root tips of peanut (Arachis hypogaea L.). Jul 2019. NO can improve the activities of mitochondrial antioxidant enzymes to scavenge excess ROS.

  • https://thewellesleynews.com/2019/05/09/sunlight-can-make-you-happier-and-less-stressed/ Sunlight can make you happier and less stressed. May 2019

  • https://pubmed.ncbi.nlm.nih.gov/30675873/?from_single_result=30675873 Vitamin D Supplementation to Prevent Acute Respiratory Infections: Individual Participant Data Meta-Analysis. Jan 2019. Vitamin D supplementation was safe and protected against ARIs overall. Very deficient individuals experienced the benefit.

  • https://pubmed.ncbi.nlm.nih.gov/30087817/ Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Jun 2018. Vitamin D deficiency plays a role in cardiovascular disease, cancer, diabetes, osteoporosis....

  • Forest Bathing: How Trees Can Help You Find Health and Happiness. A book by Dr. Qing. April 2018

  • http://sunlightinstitute.org/tag/nitric-oxide/ MOOD AND SUNLIGHT, SAFELY SOAK IT UP. Feb 2018. Around midday, we produce large quantities of vitamin D, and our nitric oxide levels increase.

  • https://journalistsresource.org/studies/society/public-health/daylight-windows-productivity-stress-health-depression/ Daylight, windows and workers’ well-being: Research review. Sep 2017

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593895/ Ultraviolet Radiation-Induced Production of Nitric Oxide: A multi-cell and multi-donor analysis. Sep 2017

  • https://www.ncbi.nlm.nih.gov/pubmed/28601861 Electrical Grounding Improves Vagal Tone in Preterm Infants. Jun 2017

  • https://www.ncbi.nlm.nih.gov/pubmed/28202713 Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. Feb 2017. Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients very vitamin D deficient experienced the most benefit.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877070/ Why We Need More Nature at Work: Effects of Natural Elements and Sunlight on Employee Mental Health and Work Attitudes. May 2016

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871211/ Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies. Apr 2016. Grounding and earthing anti-inflammatory and antioxidant and accelerated immune response following vaccination.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378297/ The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. Mar 2015

  • https://www.sciencedirect.com/science/article/pii/S0022202X15368974 An Unexpected Role: UVA-Induced Release of Nitric Oxide from Skin May Have Unexpected Health Benefits. Jul 2014. UVA causing release of nitric oxide from skin stores, with additional benefits on human health.

  • https://www.dovepress.com/the-effects-of-grounding-earthing-on-inflammation-the-immune-response--peer-reviewed-article-JIR The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. Jun 2014. Electrically conductive contact of the human body with the surface of the Earth produces positive effects on physiology and health, in relation inflammation, immune responses, and prevention and treatment of chronic inflammatory and autoimmune diseases.

  • https://heartmdinstitute.com/q-a/grounding-q-a/ Grounding Q & A. HeartMD Institute. 2013

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/ Vitamin D and the Immune System. Aug 2012. Vitamin D can modulate our immune responses. Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection. Beneficial effects of supplementing vitamin D deficient individuals with autoimmune disease.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283670/ The Nitric Oxide Pathway Provides Innate Antiviral Protection in Conjunction with the Type I Interferon Pathway in Fibroblasts. Feb 2012. Nitric oxide is critical for the protection against DNA viruses and protects the host against viral infection.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265077/ Earthing: Health Implications of Reconnecting the Human Body to the Earth’s Surface Electrons. Jan 2012

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290997/ Benefits of Sunlight: A Bright Spot for Human Health. Apr 2008

  • https://www.ncbi.nlm.nih.gov/pubmed/17903349 Forest bathing enhances human natural killer activity and expression of anti-cancer proteins. Apr-Jun 2007

  • https://www.jaad.org/article/S0190-9622(05)04596-2/fulltext The vitamin D questions: how much do you need and how should you get it? Feb 2006. Vit D effects and the risk/benefit of obtaining vit D from sun exposure versus diet or supplementation.

  • https://www.ncbi.nlm.nih.gov/pubmed/16443165 Nitric oxide as a cellular antioxidant: a little goes a long way. Nov 2005. Nitric oxide is an effective antioxidant.

  • https://www.ncbi.nlm.nih.gov/pubmed/15650465 The biologic effects of grounding the human body during sleep as measured by cortisol levels and subjective reporting of sleep, pain, and stress. Oct 2004

  • http://www.next-up.org/pdf/ESD_Journal_Grounding_the_human_body_to_neutralize_bioelectrical_stress_from_static_electricity_and_EMFs.pdf Grounding the human body to neutralize bioelectrical stress from static electricity and EMFs. 29 Sep 2000

  • https://www.ncbi.nlm.nih.gov/pubmed/10023767 An antiviral mechanism of nitric oxide: inhibition of a viral protease. Jan 1999. Nitric oxide kills or inhibits the replication of a variety of pathogens. NO inhibits protease activity and interrupts the viral life cycle.

Start cooking your own wholesome meals

  • https://www.healthline.com/nutrition/antiviral-herbs 15 Impressive Herbs with Antiviral Activity. Oct 2019. Many herbs help fight viruses and are favored by practitioners of natural medicine. Oregano, sage, basil, fennel, garlic, peppermint, rosemary, ginger...

  • https://www.nature.com/articles/s41392-019-0074-5 Demystifying the manipulation of host immunity, metabolism, and extraintestinal tumors by the gut microbiome. Oct 2019. Involvement of the gut microbiome in host immunity and metabolism, the effects of the microbiome on extraintestinal cancers and the immune response, and strategies to modulate the gut microbiome.

  • https://neurohacker.com/how-the-gut-microbiota-influences-our-immune-system How the gut microbiota influences our immune system. Jul 2019. 70–80% of the body’s immune cells are found in the gut. A healthy microbiota produces molecular signals that support the development of immune cells. A healthy crosstalk between the gut microbiota and the immune system supports protective responses against pathogens, promotes tolerance to harmless microbes.

  • https://www.hindawi.com/journals/jnme/2019/2125070/ A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for “Eating the Rainbow”. Jun 2019. Spices have been shown to have prebiotic potential for the gut bacteria. Red Foods against inflammation and for anti-inflammatory properties, and immune system modulation. Ensuring the consumption of a variety of foods will enable the individual to sample from thousands of phytochemicals that may help to offset an increased risk of chronic disease.

  • https://www.vet.k-state.edu/OneHealth/Vol10-Iss2/microbiome_pigs.html Connecting the Gut Microbiome with Response to Infectious Respiratory Disease in Humans and Pigs. The gut microbiome plays a critical role in providing a protective intestinal barrier, digesting and metabolizing nutrients, and developing as well as maintaining immunity.

  • https://www.health24.com/Medical/Flu/Preventing-flu/your-gut-is-the-cornerstone-of-your-immune-system-20160318 Your gut is the cornerstone of your immune system. Oct 2017. 70 to 80% of your immune tissue is situated in your digestive tract.

  • https://www.ncbi.nlm.nih.gov/pubmed/28799796 Immune modulation by curcumin: The role of interleukin-10. Sep 2017. Curcumin is a natural anti-inflammatory compound able to modulate the disease pathophysiology of conditions such as pain and neurodegenerative diseases, bowel inflammation, and allergy, but also of infections and cancer.

  • https://science.sciencemag.org/content/357/6350/498 The microbial metabolite desaminotyrosine protects from influenza through type I interferon. Aug 2017. Eat more plants for influenza resilience. Antibiotic treatment worsens influenza because the concomitant loss of the microbiota interrupts the production of bioactive metabolites. Plant flavonoids are beneficial during influenza and augment antiviral responses by phagocytic cells.

  • https://www.nature.com/articles/nature18847 The microbiome and innate immunity. Jul 2016. The intestinal microbiome is a signalling hub that integrates environmental inputs, such as diet, with genetic and immune signals to affect the host's metabolism, immunity and response to infection. Aberrations in the communication between the innate immune system and the gut microbiota might contribute to complex diseases.

  • https://gut.bmj.com/content/65/4/575 The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia. Apr 2016. The intestinal microbiota is a protective mediator during pneumococcal pneumonia.

  • https://www.hopkinsmedicine.org/research/advancements-in-research/fundamentals/in-depth/the-gut-where-bacteria-and-immune-system-meet The Gut: Where Bacteria and Immune System Meet. Nov 2015. The composition of the gut changes in different diseases. The body’s immune system interacts with these bacteria.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032839/ Antiviral Natural Products and Herbal Medicines. Jan-Mar 2014. Many natural products and herbal ingredients are observed to possess robust antiviral activity.

  • http://www.eurekaselect.com/124216/article Antiviral Herbs - Present and Future. 2014. TCM has obvious advantages in the treatment of virus infectious disease and has a broad prospect of application. Anti-SARS-CoV and anti-respiratory viruses. TCM is better than using drugs in the treatment of viral diseases.

  • https://academic.oup.com/ajcn/article/96/6/1429/4571488 Effect of fruit and vegetable consumption on immune function in older people: a randomized controlled trial. Nov 2012. Increased fruit and vegetable intake improves the Pneumovax II vaccination antibody response.

  • https://science.sciencemag.org/content/336/6086/1268 Interactions Between the Microbiota and the Immune System. Jun 2012. Resident bacteria profoundly shape immunity.

  • https://www.pnas.org/content/108/13/5354 Microbiota regulates immune defense against respiratory tract influenza A virus infection. Mar 2011. Commensal microbiota composition critically regulates the generation of virus-specific cells and antibody responses following respiratory influenza virus infection.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC538513/ Modulation of Immune Functions by Foods. Dec 2004. Foods are able to modulate immune functions and can normalize the physical state of allergic patients or cancer patients, and may reduce the risk of diseases in healthy individuals.

  • https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/effects-of-dietary-antioxidants-on-the-immune-function-of-middleaged-adults/F3D310A4010D6A8B68C8A9874F8A84A1 Effects of dietary antioxidants on the immune function of middle-aged adults. Feb 1999. Adequate amounts of antioxidants are required to prevent damage to the immune cells themselves. They can be obtained directly from the diet. Strong associations between diets rich in antioxidant nutrients and a reduced incidence of cancer. Focusing on the antioxidant vitamins C and E, Selenium, carotenoids.

  • https://www.centerforfoodsafety.org/issues/311/ge-foods/ge-food-and-your-health GE food & your health. Health risks posed by GMO include Toxicity, Allergic Reactions, Antibiotic Resistance, Immuno-suppression, Cancer and Loss of Nutrition.


  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640516/pdf/jnma00873-0052.pdf Tremendous antimicrobial, especially antiviral activity of compounds in garlic. Profound effects on the immune system.

  • https://www.mdpi.com/2304-8158/8/7/246/pdf Bioactive Compounds and Biological Functions of Garlic. 5 Jul 2019. Garlic exhibits antioxidant, anti-inflammatory, antibacterial, antifungal, immunomodulatory, and many more properties.

  • https://www.ncbi.nlm.nih.gov/pubmed/26764332 Aged Garlic Extract Modifies Human Immunity. Feb 2016. Garlic can influence immunity. 2.56 g AGE/d for 90 d during the cold and flu season. After 90 d, reduced cold and flu severity.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4417560/ Immunomodulation and Anti-Inflammatory Effects of Garlic Compounds. 19 Apr 2015. Garlic stimulates immune cells. Human clinical studies are scarce and weak.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465033/ Garlic for the common cold. 11 Nov 2014. And https://www.ncbi.nlm.nih.gov/pubmed/22419312 Garlic for the common cold. 14 Mar 2012. 24 colds in garlic group vs 65 in placebo, fewer days of illness (111 versus 366), quicker recovery (4.63 versus 5.63).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103721/ Garlic: a review of potential therapeutic effects. Jan-Feb 2014. Issues in existing studies, more standard experiments needed to confirm beneficial effect of garlic.

  • https://www.ncbi.nlm.nih.gov/pubmed/11697022 Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Jul-Aug 2001. Significantly fewer colds (24 vs 65), duration (1.52 vs 5.01 days).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640516/pdf/jnma00873-0052.pdf Antimicrobial and immune modulatory legacy of Echinacea and garlic. Jan 2000. Tremendous antimicrobial, especially antiviral activity of compounds in both herbs. Profound effects on the immune system.

Reduce sugar and carbohydrates and do NOT snack between meals

  • https://academic.oup.com/qjmed/article/112/2/101/5133268 High blood glucose variability is associated with bacteremia and mortality in patients hospitalized with acute infection. Oct 2018. Increased glucose levels variability is associated with increased risk of bacteremia, short and long-term mortality.

  • https://www.ncbi.nlm.nih.gov/pubmed/29727694 A high-sugar diet affects cellular and humoral immune responses in Drosophila. Jul 2018. Innate immunity is the first line of defense against invading pathogens and parasites. A high-sugar diet induced the aberrant activation of the innate immune system, including inflammation.

  • https://academic.oup.com/ajcn/article-abstract/26/11/1180/4732762?redirectedFrom=fulltext Role of sugars in human neutrophilic phagocytosis. Nov 1973. The function but not the number of phagocytes was altered by ingestion of sugars, which implicates glucose and other simple carbs in the control of phagocytosis. On the other hand, a fast of 36 or 60 hr significantly increased the phagocytic index.

Intermittent fasting / time restricting eating

  • https://thesource.com/2018/11/21/fasting-for-72-hours-can-reset-your-entire-immune-system/ Fasting for 72 hours can reset your entire immune system. Nov 2018. Fasting for three days can have a significant improvement in your body’s health. Sgnificant improvement in their health as the white blood cells and other toxins in the body were flushed out by the fast.

  • https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136240 Frequency and Circadian Timing of Eating May Influence Biomarkers of Inflammation and Insulin Resistance Associated with Breast Cancer Risk. Aug 2015. Eating more frequently, reducing evening energy intake, and fasting for longer nightly intervals may lower systemic inflammation and subsequently reduce breast cancer risk. More research needed.

  • https://jandonline.org/article/S2212-2672(15)00205-1/fulltext Intermittent Fasting and Human Metabolic Health. Aug 2015.

  • https://www.ncbi.nlm.nih.gov/pubmed/24739093 Time-restricted feeding and risk of metabolic disease: a review of human and animal studies. May 2014. Time-restricted feeding is associated with reductions in body weight, lower triglycerides, lower LDL, higher HDL, glucose, insulin, interleukin 6, tumor necrosis and improvements in insulin sensitivity. Promise for the use of TRF in modulating a variety of metabolic disease risk factors.

  • https://www.ncbi.nlm.nih.gov/pubmed/24612255 Intermittent fasting promotes bacterial clearance and intestinal IgA production in Salmonella typhimurium-infected mice. May 2014. The changes following metabolic stress induced by intermittent fasting during food deprivation days increased the resistance to S. typhimurium infection by triggering intestinal IgA production and presumably, pathogen elimination by phagocytic inflammatory cells.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106288/ Short-term fasting induces profound neuronal autophagy. Aug 2010. Sporadic fasting might represent a simple, safe and inexpensive means to promote this potentially therapeutic neuronal response.

  • https://www.sciencedirect.com/science/article/pii/S1568163706000523?via%3Dihub Caloric restriction and intermittent fasting: Two potential diets for successful brain aging. Aug 2006. CR and IF benefit neurons including by involving insulin-like signaling, increasing the production of neurotrophic factors and antioxidant enzymes, all of which help cells cope with stress and resist disease.

Exercise most days

  • https://www.ncbi.nlm.nih.gov/pubmed/31193280 The compelling link between physical activity and the body's defense system. May 2019. With near daily exercise, summation effect to enhance immune defense activity and metabolic health. Intense and prolonged exercise can cause transient immune dysfunction by decreasing immune cell metabolic capacity. Inverse relationship between moderate exercise training and incidence of URTI. Regular physical activity is associated with decreased mortality and incidence rates for influenza and pneumonia. Regular exercise training has an overall anti-inflammatory influence.

  • https://www.ncbi.nlm.nih.gov/pubmed/29713319 Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan. Apr 2018. Regular physical activity reduces the incidence of many chronic diseases in older age, including communicable diseases such as viral and bacterial infections. Frequent exercise enhances-rather than suppresses-immune competency.

  • https://www.sciencedaily.com/releases/2018/03/180308143123.htm A lifetime of regular exercise slows down aging, study finds. 8 Mar 2018. Those who have exercised regularly have defied the aging process, having the immunity, muscle mass, testosterone levels, body fat and cholesterol levels of a young person.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803113/ Exercise and Respiratory Tract Viral Infections. Oct 2009. Prolonged, intense exercise causes immunosuppression, while moderate intensity exercise improves immune function and potentially reduces risk and severity of respiratory viral infection. Moderate exercise-induced increases in stress hormones reduce excessive local inflammation and improved outcomes following respiratory viral infection.

  • https://journals.physiology.org/doi/full/10.1152/japplphysiol.00008.2007 Immune function in sport and exercise. Aug 2007. Regular moderate exercise is associated with a reduced incidence of infection compared with a completely sedentary state. However, prolonged bouts of strenuous exercise cause a temporary depression of various aspects of immune function. Intensified training lasting 1 wk or more may result in longer lasting immune dysfunction, which may compromise resistance to common minor illnesses, such as up/respiratory tract infection. Long-term health benefits of regular exercise.

  • https://www.ncbi.nlm.nih.gov/pubmed/1894397 Overtraining increases the susceptibility to infection. Jun 1991. Moderate exercise is good for the immune system, but the demanding training programs of many top athletes may suppress the immune system and thereby increase susceptibility to infections. Exercising hard during the incubation phase of an infection can increase the severity of the illness.

Supplement to optimise your immune system

  • https://academic.oup.com/jid/article/182/Supplement_1/S5/2191448 Micronutrients and Innate Immunity. Sep 2000. Micronutrients such as zinc, selenium, iron, copper, β-carotene, vitamins A, C, and E, and folic acid can influence several components of innate immunity . Deficiencies in zinc and vitamins A and D may reduce natural killer cell function, whereas supplemental zinc or vitamin C may enhance their activity.

Vitamin C

  • https://mp.weixin.qq.com/s/bF2YhJKiOfe1yimBc4XwOA Expert consensus on comprehensive treatment of coronavirus disease in Shanghai 2019 - Shanghai Medical Association. Mar 2020. Large doses of vitamin C are injected intravenously at a dose of 100 to 200 mg / kg per day.

  • https://www.greenmedinfo.com/blog/chinese-medical-team-report-successful-treatment-coronavirus-patients-high-dose-v0? Chinese Medical Team Report Successful Treatment of Coronavirus Patients with High-Dose Vitamin C. Mar 2020. A medical team in China has reported the successful treatment of coronavirus patients with vitamin C. Early application of vitamin C can have a strong antioxidant effect, reduce inflammatory responses, and improve endothelial function. Can improve antiviral levels and prevent and treat acute lung injury and acute respiratory distress.

  • http://orthomolecular.org/resources/omns/v16n12.shtml?fbclid=IwAR3pihhbw_d_4StI9VBCG3aCh0fKBH102Zhv2ckc2MYfNjFU0Inmdjt9HiE Three Intravenous Vitamin C Research Studies Approved for Treating COVID-19. Feb 2020. Intravenous vitamin C is already being employed in China against COVID-19 coronavirus.

  • http://orthomolecular.org/resources/omns/v16n11.shtml Early Large Dose Intravenous Vitamin C is the Treatment of Choice for 2019-nCov Pneumonia. Feb 2020. Coronaviruses, influenza viruses and many other pandemic viral infections are usually associated with an increase oxidative stress leasing to oxidative cellular damage resulting in multi-organ failure. Antioxidants administration therefore has a central role in the management of these conditions. Preliminary clinical studies and case reports show that early administration of high dose IVC can improve clinical conditions of patients in ICU, ARDS and flu.

  • http://orthomolecular.org/resources/omns/v16n07.shtml Hospital-based Intravenous Vitamin C Treatment for Coronavirus and Related Illnesses. Feb 2020. Prompt administration of intravenous vitamin C, in high doses, can make the difference. Abundant clinical evidence confirms vitamin C's effectiveness when used in sufficient quantity.

  • https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-c/faq-20058030 Is it possible to take too much vitamin C? Mar 2020. For most people, an orange or a cup of strawberries, chopped red pepper, or broccoli provides enough vitamin C for the day. For adults, the recommended up/limit is 2,000 mg a day. Too much dietary vitamin C is unlikely to be harmful but megadoses of vitamin C supplements might cause: Diarrhea, Nausea, Vomiting, Heartburn, Abdominal cramps, Headache, Insomnia.

  • https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2717-x Adjuvant vitamin C for sepsis: mono or triple? Dec 2019. Potential role for high-dose i.v. vitamin C for sepsis.

  • https://www.medicalnewstoday.com/articles/325067 What are the best foods for vitamin C? Apr 2019.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201324/ Vitamin C in the critically ill - indications and controversies. Oct 2018. Ascorbic acid (vitamin C) is as a potent anti-oxidant and a modulator of immune cell biology. High-dose vitamin C administration may improve survival in critically ill patients.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057395/ Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials. 5 Jul 2018. Extra doses at the onset of cold reduced cold duration (-0.56) and relieved the symptoms, including chest pain (-0.40), fever (-0.45), and chills (-0.36).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949172/ Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. 29 Apr 2018. Vitamin C supplementation (1 to 2 g/day) reduced the duration (in adults by 8%, in children by 14%) and the severity of the cold.

  • https://www.ncbi.nlm.nih.gov/books/NBK279544/ Common colds: Does vitamin C keep you healthy? 14 Apr 2016. Vitamin C did not prevent colds but shortened the duration by about 10% and milder symptoms, if taken preventively. It didn’t shorten the duration when taken only one ill.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659258/ Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection. Apr 2013. Vitamin C shows anti-viral immune responses against influenza virus.

  • https://www.ncbi.nlm.nih.gov/pubmed/23440782 Vitamin C for preventing and treating the common cold. 31 Jan 2013. Duration of colds was reduced by 8% in adults and 14% to 18% in children with 1 to 2 g/day vitamin C. The severity was also reduced.

  • https://www.ncbi.nlm.nih.gov/pubmed/22429343 A combination of high-dose vitamin C plus zinc for the common cold. 2012. Vitamin C and zinc play important roles in immune defence and people are often deficient. 1000 mg vitamin C plus 10 mg zinc resulted in reduction of rhinorrhoea duration (range 9-27%) and symptom relief was quicker.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024156/?report=reader Complementary and alternative medicine for prevention and treatment of the common cold. Jan 2011. Systematic Reviews were searched from January 1966 to September 2009. For prevention, vitamin C demonstrated benefit, especially in patients subjected to cold stress.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099400/ Vitamin C may affect lung infections. Nov 2007. Preventive effect and therapeutic effect of vitamin C against pneumonia. Vitamin C was tested over and above the normal medication, which included antibiotics.

  • https://www.karger.com/Article/Abstract/90495 Immune-Enhancing Role of Vitamin C and Zinc and Effect on Clinical Conditions. Feb 2006. Both nutrients play important roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity, and duration of infectious diseases. Intakes of up to 1 g of vitamin C and up to 30 mg of zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections.

  • https://www.ncbi.nlm.nih.gov/pubmed/10796569 Vitamin C for preventing and treating the common cold. 2000. Thirty trials. Vitamin C in doses as high as one gram daily for several winter months, had no consistent beneficial effect on incidence of the cold. Modest effect on duration from 0.07% to 39% (weighted difference of 8% to 9%). Larger dose produced greater benefits than lower doses.

  • https://www.ncbi.nlm.nih.gov/pubmed/10543583 The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. Oct 1999. 1000 mg of Vitamin C for the first 6 hours and then 3 times daily thereafter decreased flu and cold symptoms by 85%.


  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949172/ Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. 29 Apr 2018. Zinc supplementation may shorten the duration of colds by 33%, taken within 24 hours of onset of symptoms.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418896/ Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. May 2017. Cold duration was 33% shorter for the zinc groups of the seven trials (zinc acetate -40% and zinc gluconate -28%). No evidence doses >100 mg/day lead to greater efficacy.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359576/ The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis. 25 Feb 2015. Zinc acetate lozenges of about 80 mg/day, started within 24 hours shortened duration of nasal discharge by 34%, nasal congestion by 37%, sneezing by 22%, scratchy throat by 33%, sore throat by 18%, hoarseness by 43%, cough by 46%, muscle ache by 54% but no difference in the duration of headache and fever.

  • https://www.ncbi.nlm.nih.gov/pubmed/23775705 Zinc for the common cold. 18 Jun 2013. Intake of zinc significantly reduced the duration (-1.03d) but not the severity of cold symptoms. Less participants symptomatic after 7 days of treatment (odds ratio 0.45). Lower incidence of colds (0.64) but heterogeneity of the data.

  • https://www.ncbi.nlm.nih.gov/pubmed/22429343 A combination of high-dose vitamin C plus zinc for the common cold. 2012. Vitamin C and zinc play important roles in immune defence and health. Intake of both is often inadequate. Reduction of rhinorrhoea duration (range 9-27%). Symptom relief was quicker.

  • https://www.ncbi.nlm.nih.gov/pubmed/22566526 Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. 10 Jul 2012. Zinc formulations shortened duration of cold (-1.65 days) but heterogeneity was high: -2.63 days in adults, but only -0.26 in children.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273967/ Zinc for the common cold—not if, but when. Nov 2011. Zinc supplements within 24 hours of the onset of a cold significantly reduces duration and severity of symptoms. Effectiveness of zinc for prophylaxis of the cold in children.

  • https://www.ncbi.nlm.nih.gov/pubmed/21328251 Zinc for the common cold. 16 Feb 2011. Zinc administered within 24 hours of onset of symptoms reduces the duration (-0.97) and severity (-0.39) of the cold. When supplemented for at least five months, it reduces cold incidence in children.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024156/?report=reader Complementary and alternative medicine for prevention and treatment of the common cold. Jan 2011. Systematic Reviews were searched from January 1966 to September 2009. Zinc lozenges were effective in 5 of 9 trials, likely owing to dose and formulation issues.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866616/ Zinc intake and resistance to H1N1 influenza. Jun 2010. 1 in 5 people are deficient in zinc. Zinc deficiency decreases immunity. Zinc treatment efficacious for a variety of infections. Zinc stimulates generation of natural killer and cytolytic T cells that kill viruses and bacteria. Suppresses a receptor for viruses. Participants with plasma concentrations of zinc >70 μg/dL had a significantly lower risk of pneumonia.

  • https://www.researchgate.net/profile/Mohammad_Vahedian2/publication/43559997_Effects_of_Zinc_Supplementation_in_Occurrence_and_Duration_of_Common_Cold_in_School_Aged_Children_During_Cold_Season_a_Double-Blind_Placebo-Controlled_Trial/links/0deec526f5a99c9b3a000000.pdf Effects of Zinc Supplementation in Occurrence and Duration of Common Cold in School Aged Children during Cold Season: a Double­Blind Placebo­Controlled Trial. Dec 2009. Lower incidence of cold in zinc group (1.37 vs 3.15 in placebo group) and less antibiotics for bacterial infections (20 vs 47).

  • https://www.ncbi.nlm.nih.gov/pubmed/16982486 The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Oct 2006. Number of colds in the zinc group significantly less than placebo (1.2 vs 1.7 colds) and also shorter duration and decreased severity.

  • https://www.ncbi.nlm.nih.gov/pubmed/15496046 Efficacy of zinc against common cold viruses: an overview. Zinc reduced duration and severity of cold when administered within 24 hours of the onset of symptoms. administered within 24 hours of the onset of symptoms.


  • https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008072 Lung transcriptional unresponsiveness and loss of early influenza virus control in infected neonates is prevented by intranasal Lactobacillus rhamnosus GG. 11 Oct 2019. Lactobacillus rhamnosus considerably improves mice survival after influenza virus infection.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790137/ The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: a systematic review and meta-analysis of randomized controlled trials. 25 Jan 2018. Patients with prebiotics/probiotics supplements show higher vaccine efficacy.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707647/ Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nov 2017. Probiotics and prebiotics are effective in elevating immunogenicity by influencing seroconversion and seroprotection rates in adults inoculated with influenza vaccines.

  • https://www.ncbi.nlm.nih.gov/pubmed/25927096 Probiotics for preventing acute upper respiratory tract infections. Feb 2015. Probiotics were better than placebo in reducing the number of participants experiencing episodes of acute URTI, the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. However, the quality of the evidence was low.

  • https://www.ncbi.nlm.nih.gov/pubmed/25604727/ Bifidobacterium bifidum R0071 results in a greater proportion of healthy days and a lower percentage of academically stressed students reporting a day of cold/flu: a randomised, double-blind, placebo-controlled study. Feb 2015. The proportion of participants reporting a cold on any given day was lower at weeks 2 and 3 with B. bifidum and B. infantis. Daily intake of bifidobacteria provides benefit related to cold/flu outcomes during acute stress.

  • https://www.ncbi.nlm.nih.gov/pubmed/25400245 Consecutive oral administration of Bifidobacterium longum MM-2 improves the defense system against influenza virus infection by enhancing natural killer cell activity in a murine model. Jan 2015. Improved clinical symptoms, reduced mortality, suppressed inflammation in the lower respiratory tract, and decreased virus titers, cell death, and pro-inflammatory cytokines. Significant increases in NK cell activities.

  • https://www.ncbi.nlm.nih.gov/pubmed/25294223 Effects of probiotic Lactobacillus brevis KB290 on incidence of influenza infection among schoolchildren: an open-label pilot study. Dec 2014. Lower incidence of influenza (15.7% vs 23.9%), especially in unvaccinated.

  • https://www.ncbi.nlm.nih.gov/pubmed/24780623 Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. Jul 2014. Significantly fewer numbers of days of illness per person, shorter illness by almost a day, and fewer numbers of days absent from day care/school/work in participants who received a probiotics. Evidence from a number of good-quality RCT that probiotics reduce the duration of illness in otherwise healthy children and adults.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006993/ Probiotics and immune health. May 2014. One of the major mechanisms of probiotic action is through the regulation of host immune response. Probiotics showed therapeutic potential for diseases, such as allergy, eczema, viral infection and potentiating vaccination responses.

  • https://www.ncbi.nlm.nih.gov/pubmed/24717726 Oral administration of Lactobacillus gasseri SBT2055 is effective for preventing influenza in mice. 10 Apr 2014. Weight losses were lower, the virus titer was significantly decreased and also IL-6. The expression of genes critical for the viral clearance was increased. LG2055 effective against influenza virus infection by the down-regulation of viral replication through the induction of antiviral genes expression.

  • https://www.ncbi.nlm.nih.gov/pubmed/24466081 Oral administration of Lactobacillus plantarum strain AYA enhances IgA secretion and provides survival protection against influenza virus infection in mice. Jan 2014. Lactobacillus plantarum AYA promotes IgA production with protective ability, mice surviving longer with influenza virus infection.

  • https://www.ncbi.nlm.nih.gov/pubmed/24329975 Oral administration of Lactobacillus brevis KB290 to mice alleviates clinical symptoms following influenza virus infection. Jan 2014. Prophylactically administered KB290 significantly alleviated deterioration due to infection. Levels of (Ig)A significantly increased as well as interferon (IFN)-α.

  • https://www.ncbi.nlm.nih.gov/pubmed/24124485 Lactobacillus plantarum DK119 as a probiotic confers protection against influenza virus by modulating innate immunity. 4 Oct 2013. DK119 conferred 100% protection against subsequent lethal infection with influenza A viruses, prevented significant weight loss, and lowered lung viral loads in a mouse model. Modulated immunity of dendritic and macrophage cells, and cytokine production, with antiviral effects on influenza virus infection.

  • https://www.ncbi.nlm.nih.gov/pubmed/23594927 Anti-influenza virus effects of both live and non-live Lactobacillus acidophilus L-92 accompanied by the activation of innate immunity. 18 Apr 2013. Virus titres were repressed. Natural killer activity significantly higher. Greater repression of virus proliferation. Enhancement of NK activity by stimulating various antiviral cytokines and chemokines.

  • https://www.ncbi.nlm.nih.gov/pubmed/23535544 Protective efficacy of orally administered, heat-killed Lactobacillus pentosus b240 against influenza A virus. 2013. No effect of b240 on virus growth but regulates antiviral gene expression in mouse lungs.

  • https://www.ncbi.nlm.nih.gov/pubmed/22642647 Oral administration of milk fermented with Lactococcus lactis subsp. cremoris FC protects mice against influenza virus infection. Aug 2012. Survival rate significantly improved with fermented milk. Virus titre significantly decreased. Protect animals against IFV infection.

  • https://www.ncbi.nlm.nih.gov/pubmed/22440853 Efficacy of daily intake of Lactobacillus casei Shirota on respiratory symptoms and influenza vaccination immune response: a randomized, double-blind, placebo-controlled trial in healthy elderly nursing home residents. May 2012. No effect of the probiotic on the respiratory symptoms. No significant difference on vaccination immune.

  • https://www.ncbi.nlm.nih.gov/pubmed/22732975 Lactobacillus plantarum CECT7315 and CECT7316 stimulate immunoglobulin production after influenza vaccination in elderly. Mar-Apr 2012. Consumption of L. plantarum during 3 months after influenza vaccination increased the levels of IgA and IgG antibodies.

  • https://www.ncbi.nlm.nih.gov/pubmed/22098223 Heat-killed Lactobacillus gasseri TMC0356 protects mice against influenza virus infection by stimulating gut and respiratory immune responses. Mar 2012. Symptoms of mice ameliorated significantly; virus titres decreased significantly; mRNA expression of interleukins and others increased significantly. By enhancing gut and respiratory immune responses.

  • https://www.ncbi.nlm.nih.gov/pubmed/21901706 Probiotics for preventing acute up/respiratory tract infections. 7 Sep 2011. 14 RCTs. Probiotics reduced the number of acute URTIs.

  • https://www.ncbi.nlm.nih.gov/pubmed/19615959 A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials. 18 Sep 2009. Influenza-specific antibody titres increased after vaccination.

  • https://www.ncbi.nlm.nih.gov/pubmed/19651563 Probiotic effects on cold and influenza-like symptom incidence and duration in children. Aug 2009. Probiotics reduced fever incidence by 53.0% to 72.7% (single or multiple strain), coughing incidence by 41.4% to 62.1% and rhinorrhea incidence by 28.2% to 58.8%. Fever, coughing, and rhinorrhea duration decreased significantly, by 32% to 48%. Daily dietary probiotic supplementation for 6 months is a safe way to reduce incidence and duration, for children aged 3 to 5.

  • https://www.ncbi.nlm.nih.gov/pubmed/17352961 Oral intake of Lactobacillus fermentum CECT5716 enhances the effects of influenza vaccination. Mar 2007. Increase in the proportion of natural killer cells, in T-hel/type 1 cytokine concentrations and in T-hel/and T-cytotoxic proportions. Significant increase in antigen specific igA. Lower incidence of flu during 5 mo after vaccination.


  • https://www.ncbi.nlm.nih.gov/pubmed/31126553 Echinacea for the prevention and treatment of up/respiratory tract infections: A systematic review and meta-analysis. Jun 2019. Prevention of up/respiratory tract infection of 0.78. Reduction of duration URTI of -0.45 days. Echinacea might have a preventative effect on the incidence of URTI. But methodological heterogeneity.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949172/ Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. 29 Apr 2018. Regarding Echinacea, prophylactic treatment (2400 mg/day) over 4 months appeared to be beneficial for preventing/treating colds.

  • https://www.ncbi.nlm.nih.gov/pubmed/28279802 Prevention of influenza virus induced bacterial superinfection by standardized Echinacea purpurea, via regulation of surface receptor expression in human bronchial epithelial cells. 7 Mar 2017. Echinacea purpurea can reduce the risk of respiratory complications by preventing virus-induced bacterial adhesion and through the inhibition of inflammation super-stimulation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528044/ Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial. Dec 2015. Recovery from illness was comparable Echinaforce Hotdrink and oseltamivir for flu infections. Fewer adverse events (particularly nausea and vomiting) with Echinaforce.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068831/ Echinacea for preventing and treating the common cold. 20 Feb 2014. 24 trials variety of Echinacea preparations based on different species and parts of plant were used. 10 to 20% reduction of colds and 1/7 reduction duration. Heterogeneity of the studies.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056276/ Echinacea for treating the common cold: A randomized controlled trial. 14 Mar 2014. Echinacea reduced duration (-0.53 day) and lower severity but not statistically significant.

  • https://www.ncbi.nlm.nih.gov/pubmed/22502621 Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections. Mar 2012. Mixed results due to the use of different species and/or plant parts for the preparations. Polinacea could enhance the immune response subsequent to the influenza vaccination.

  • https://www.ncbi.nlm.nih.gov/pubmed/22131823 Applications of the phytomedicine Echinacea purpurea (Purple Coneflower) in infectious diseases. Oct 2011. Extracts of Echinacea purpurea display multiple immune-modulatory activities and suppression of the proinflammatory responses of epithelial cells to viruses and bacteria.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058675/ Echinacea—A Source of Potent Antivirals for Respiratory Virus Infections. Jul 2011. Preparations derived from certain species and plant parts, but not all of them, possess potent antiviral activities. All strains of viruses tested (including a Tamiflu-resistant strain) were very sensitive to Echinacea purpurea. Also anti-inflammatory activity in virus-infected cells.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024156/?report=reader Complementary and alternative medicine for prevention and treatment of the common cold. Jan 2011. For treatment, Echinacea purpurea is the most consistently useful variety; effective in 5 of 6 trials.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785784/ Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian Influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). 13 Nov 2009. Flu virus inactivated in cell culture. The extract inhibited the receptor binding activity of the virus, i.e. interferes with the viral entry into cells. Echinacea useful against replication and dissemination.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098742/ Management of up/respiratory tract infections in children. Mar-Apr 2008. 2 of the most commonly used and studied herbs are Echinacea and Andrographis paniculata, both of which are believed to be immunostimulants. Echinacea decreased the odds of developing the common cold by 58% and the duration of a cold by 1.4 days but potential for drug interaction, rash and anaphylaxis. Iron supplementation is remarkably effective when iron deficiency is endemic. Hand washing significantly reduces the incidence of respiratory and gastrointestinal infections in children.

  • https://www.ncbi.nlm.nih.gov/pubmed/16437427 Echinacea for preventing and treating the common cold. 25 Jan 2006. Sixteen trials. No effect for prevention. For treatment, a significant effect was reported in 9 studies, a trend in 1, and no difference in 6.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640516/pdf/jnma00873-0052.pdf Antimicrobial and immune modulatory legacy of Echinacea and garlic. Tremendous antimicrobial, especially antiviral activity of compounds in both herbs. Profound effects on the immune system.


  • https://www.sciencedaily.com/releases/2019/04/190423133644.htm Elderberry compounds could help minimize flu symptoms, study suggests. 23 Apr 2019. Compounds from elderberries can directly inhibit the virus's entry and replication in human cells, and can help strengthen a person's immune response to the virus. Also stimulated the release of certain cytokines, used to coordinate a more efficient response against the invading pathogen. Elderberry's antiviral activity can be attributed to its anthocyanidin compounds.

  • https://www.ncbi.nlm.nih.gov/pubmed/30670267 Black elderberry (Sambucus nigra) supplementation effectively treats up/respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Feb 2019. Elderberry substantially reduced up/respiratory symptoms. Safer alternative to prescription drugs for cold and influenza.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848651/ Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Apr 2016. Less colds (12 vs. 17 in placebo), shorter duration of cold (57 vs 117 days) and lower symptom score (247 vs 583).

  • https://www.ncbi.nlm.nih.gov/pubmed/24409980 An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration. 10 Jan 2014.

  • https://www.ncbi.nlm.nih.gov/pubmed/22972323 Anti-influenza virus effects of elderberry juice and its fractions. 7 Sep 2012. Strong effect on IFV-infected mice and suppressed viral, and increased level of neutralizing antibody, as well as IgA. Strong defense against IFV infection. Beneficial effect by the stimulating immune response and preventing viral infection.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056848/ Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. 25 Feb 2011. Elderberry has antimicrobial activity against bacteria and inhibitory effect on the propagation of human pathogenic influenza viruses.

  • https://www.ncbi.nlm.nih.gov/pubmed/15080016 Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. Mar-Apr 2004. 15 ml of elderberry 4 times a day for 5 days. Symptoms relieved on average 4 days earlier and less medication.

  • https://www.ncbi.nlm.nih.gov/pubmed/11399518 The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Apr-Jun 2001. Effective in vitro against 10 strains of influenza virus. Reduced the duration of flu symptoms to 3-4 days. Higher antibody levels and inflammatory cytokines... In addition to its antiviral properties, Elderberry Extract activates the immune system by increasing inflammatory cytokine production.

  • https://www.ncbi.nlm.nih.gov/pubmed/9395631 Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. Winter 1995. Sambucol reduced hemagglutination and inhibited replication of all strain of influenza viruses tested. Significant improvement of the symptoms, including fever, in 93.3% of the cases within 2 days (vs 6 days). Complete cure achieved within 2 to 3 days in nearly 90% of the SAM-treated group vs >6 days.

American ginseng

  • https://fullscript.com/protocol/cold-and-flu-support Cold and Flu Support: 400mg, once /day, minimum 8-16 weeks in healthy adults as a preventative measure. Reduces duration of colds or respiratory infections by 5-6 days, incidence by 25%, and risk of respiratory symptoms by 48%, reduced severity for sore throat, runny nose, sneezing, nasal congestion, malaise, fever, headache, hoarseness, earaches, and cough.

  • https://www.ncbi.nlm.nih.gov/pubmed/19592479 North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review. 2011. Reduced the number of colds by 25%. Shortened duration of colds or ARIs by 6.2 days. When taken preventatively for durations of 8-16 weeks.

  • https://www.ncbi.nlm.nih.gov/pubmed/18676527 Safety and tolerability of North American ginseng extract in the treatment of pediatric up/respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Aug 2008. The frequency, severity and adverse events were not significantly different.

  • https://www.ncbi.nlm.nih.gov/pubmed/16566675 Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. Mar 2006. No difference in first 2 months. During the last 2 months, significantly fewer incidence of ARI (32% vs placebo 62%), duration shorter (5.6 days vs 12.6 days). Reduced relative risk and duration of respiratory symptoms by 48% and 55%, respectively.

  • https://www.ncbi.nlm.nih.gov/pubmed/16247099 Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing up/respiratory tract infections: a randomized controlled trial. 25 Oct 2005. Less colds in ginseng group (0.68 v. 0.93). The proportion of subjects with 2 or more colds : 10.0% v. 22.8%. Symptom score (77.5 v. 112.3) and duration (10.8 v. 16.5) better with North American ginseng.

Liquorice root

  • https://www.ncbi.nlm.nih.gov/pubmed/27815461 Antiviral and Antitumor Activity of Licorice Root Extracts. 2016. Alkaline extract of licorice root had higher anti-HIV activity than water extracts, but water extract had higher anti-HSV activity. The flavonoid-rich fraction had tumor-specific cytotoxicity.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629407/ The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Antiviral, antimicrobial, anti-inflammatory, antitumor and other activities of liquorice. Potential therapeutic effects as an antiviral or an antimicrobial agent.

  • https://www.ncbi.nlm.nih.gov/pubmed/23643542 Water extract of licorice had anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines. Jul 2013. Licorice (Glycyrrhiza) is a common ingredient of prescriptions which have been proved to inhibit infection of human respiratory syncytial virus. Radix effective against HRSV infection. Radix Glycyrrhizae inhibited HRSV by preventing viral attachment, internalization, and by stimulating IFN secretion.

  • https://www.ncbi.nlm.nih.gov/pubmed/20386921 Glycyrrhizin inhibits highly pathogenic H5N1 influenza A virus-induced pro-inflammatory cytokine and chemokine expression in human macrophages. 13 Apr 2010. A glycyrrhizin preparation complement the arsenal of potential drugs for the treatment of H5N1 disease.

  • https://www.ncbi.nlm.nih.gov/pubmed/19416738 Glycyrrhizin inhibits influenza A virus uptake into the cell. 3 May 2009. glycyrrhizin (GL), the main active component of licorice roots, protects cells from infection with influenza A virus. Reduction in the number of infected cells, reduction in the CCID50 titer by 90%. Antiviral effect limited to an early step in the virus replication cycle. Reduced virus uptake in various GL-treated cells.

  • https://www.ncbi.nlm.nih.gov/pubmed/12814717 Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Jun 2003. We assessed the antiviral potential of ribavirin, 6-azauridine, pyrazofurin, mycophenolic acid, and glycyrrhizin against coronavirus from patients with SARS. Of all the compounds, glycyrrhizin was the most active in inhibiting replication of the SARS-associated virus.

  • https://www.ncbi.nlm.nih.gov/pubmed/9055991 Glycyrrhizin, an active component of licorice roots, reduces morbidity and mortality of mice infected with lethal doses of influenza virus. Mar 1997. Significantly lower virus titers in lung tissues. GR may protect mice exposed to a lethal amount of influenza virus through the stimulation of IFN-gamma production by T cells.

N-acetylcysteine (or NAC) and glutathione

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250560/ N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia. Nov 2018. Treatment with NAC may help to reduce oxidative and inflammatory damage in pneumonia patients.

  • https://www.ncbi.nlm.nih.gov/pubmed/19732754 N-acetyl-L-cysteine (NAC) inhibits virus replication and expression of pro-inflammatory molecules in A549 cells infected with highly pathogenic H5N1 influenza A virus. Feb 2010. NAC inhibits H5N1 replication and H5N1-induced production of pro-inflammatory molecules. Antioxidants like NAC represent a potential additional treatment option that could be considered in the case of an influenza A virus pandemic.

  • https://www.ncbi.nlm.nih.gov/pubmed/15798812 Effect of N-acetyl-L-cysteine on lymphocyte apoptosis, lymphocyte viability, TNF-alpha and IL-8 in HIV-infected patients undergoing anti-retroviral treatment. Oct 2004. N-acetyl-L-cysteine reduces human immunodeficiency virus type 1 (HIV-1) replication and it ameliorates immunological reactivity.

  • https://www.ncbi.nlm.nih.gov/pubmed/12654482 Inhibition of influenza infection by glutathione. Apr 2003. Infection by RNA virus induces oxidative stress in host cells. The antioxidant glutathione offers protection against production of active virus particles. Inhibited expression of viral matrix protein and caspase activation. Decreased viral titer in both lung and trachea. GSH has an anti-influenza activity. Oxidative stress or other conditions that deplete GSH in the epithelium of the oral, nasal, and upper airway may, therefore, enhance susceptibility to influenza infection.

Other herbs and supplements

  • https://www.ncbi.nlm.nih.gov/m/pubmed/27055821/ Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies. 2017. Several herbal remedies were found effective included maoto, licorice roots, antiwei, North American ginseng, berries, Echinacea, plants extracted carnosic acid, pomegranate, guava tea, and Bai Shao. Other effective for prevention or treatment: Oral zinc, vitamin C, probiotics. Earthing might have accelerates immune response following vaccination.

  • https://www.tandfonline.com/doi/abs/10.1080/07315724.2002.10719248 Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases. Jun 2013. Omega-3s possess the most potent immunomodulatory activities, and EPA and DHA are more biologically potent than ALA. They have anti-inflammatory properties with significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729712/ Astragalus polysaccharide enhances immunity and inhibits H9N2 avian influenza virus in vitro and in vivo. Jun 2013. APS treatment reduces H9N2 AIV replication and promotes early humoral immune responses.

  • https://academic.oup.com/jn/article/134/1/257S/4688304 Carotenoid Action on the Immune Response. Jan 2004. Ability of dietary carotenes to prevent infections. Certain carotenoids, acting as antioxidants, can potentially reduce the toxic effects of reactive oxygen species, implicated in the etiology of diseases such as cancer, cardiovascular and neurodegenerative diseases and aging. Possible mechanism by which carotenoids regulate immune function and cancer.

0027 – Natural ways to relieve constipation

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976340/ Chronic constipation. A review of literature. May 2018. Estimated average prevalence of constipation in adults = 16% worldwide, 33.5% over 60 years old. Causes: diet, behavioral, biological and pharmaceutical factors. Low fiber intake, inadequate water intake, sedentary lifestyle, irritable bowel syndrome, failure to respond to urge to defecate. Ahigh-fiber diet can increase stool weight, resulting in a decreased colon transit time, while poor-fiber diet induces constipation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446139/ Management of chronic constipation in adults. Aug 2016. Chronic constipation has an estimated prevalence of up to 24%. Increased intake of dietary fibre, fluid, and exercise should be attempted in most patients. CC associated with low intake of fibre and fluid. Fibres retain water in the colon and add bulk to the stools and increased intake can reduce transit time and alleviate symptoms. Side effects include gas, mainly with soluble fibres. Unless dehydration, increase of water intake does not reduce constipation. 2 litres of water a day enhance positive effects of dietary fibre. Constipation strongly associated with immobility. Physical activity stimulates motility, reducing transit time. Moderate physical activity 30–60 min per day improves stool consistency.

  • https://gi.org/topics/constipation-and-defection-problems/Constipation and Defecation Problems. Updated Mar 2016. Many with as few as three bowel movements each week are healthy. Constipation can also mean straining, small hard stools or a sense of incomplete bowels. Dehydration, changes in diet and activity, and certain drugs are frequently to blame to slow transit of stool.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531555/ American Gastroenterological Association Technical Review on Constipation. Jan 2013. Rome III criteria: 2 of the following symptoms for more than 1/4 of defecations during the past 3 months: Straining, Lumpy or hard stools, Sensation of incomplete evacuation, Sensation of obstruction; <3 defecations/wk. Median prevalence of constipation of 16% in adults and 33.5% over 60. Risk factors: medications, stress, low dietary fiber intake in some but not other studies. No evidence that constipation treated by increased fluid intake unless dehydration. Increased physical activity is associated with less constipation, gas clearance and reduced bloating. Some probiotics may accelerate colonic transit, but limited data. Soluble (psyllium or ispaghula) but not insoluble dietary fiber (wheat bran) supplements improve constipation. Psyllium, soluble dietary fiber improved stool frequency, straining, stool consistency, and sense of incomplete evacuation. Soluble fiber improved constipation. Psyllium works, but not bran, but can result in constipation or diarrhea. No immediate response, follow program for several weeks.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206560/ Epidemiology and burden of chronic constipation. Oct 2011. Chronic constipation can affect from 2% to 27% of the population. Most use prescribed or over-the-counter medication to improve their condition. Constipation is more common in older patients.

  • https://www.ncbi.nlm.nih.gov/pubmed/15089911 Epidemiology of constipation in North America: a systematic review. Apr 2004. Estimated prevalence of constipation in North America range from 12% to 19%. It increases with age, particularly after age 65.

Stay hydrated

  • https://www.mayoclinic.org/diseases-conditions/urine-color/symptoms-causes/syc-20367333 Urine color. Oct 2017. Normal urine color varies depending on how much water you drink. The more you drink, the clearer your urine. Severe dehydration can produce urine the color of amber.

  • https://www.ncbi.nlm.nih.gov/pubmed/24420006 Management of faecal incontinence and constipation in adults with central neurological diseases. Jan 2014. Limited evidence in favour of a bulk-forming laxative (psyllium) and an isosmotic laxative compared to no treatment. Evidence for carbonated (rather than tap) water.

  • https://www.ncbi.nlm.nih.gov/pubmed/23551139 Influence of coffee (Coffea arabica) and galacto-oligosaccharide consumption on intestinal microbiota and the host responses. Jun 2013. Coffee can regulate gut microbiota.

  • https://www.ncbi.nlm.nih.gov/pubmed/21551998 Effects of carbonated water intake on constipation in elderly patients following a cerebrovascular accident. Apr 2011. The intake of carbonated water is effective against constipation in elderly patients.

  • https://www.ncbi.nlm.nih.gov/pubmed/21067233 Conceptual study on maillardized dietary fiber in coffee. Dec 2010. The content of coffee melanoidins includes a substantial part of dietary fiber.

  • https://www.ncbi.nlm.nih.gov/pubmed/19217682 Impact of coffee consumption on the gut microbiota: a human volunteer study. Mar 2009. The consumption of coffee increases the activity and/or numbers of beneficial Bifidobacterium spp.

  • https://www.ncbi.nlm.nih.gov/pubmed/16028566 The importance of good hydration for the prevention of chronic diseases. Jun 2005. Positive effects of good hydration for constipation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780140/ Medical Treatment of Constipation. May 2005. patients should respond to the call to defecate. Increases in physical activity and fluid intake appear not to relieve constipation except in situations of dehydration.

  • https://www.ncbi.nlm.nih.gov/pubmed/14681719 Mild dehydration: a risk factor of constipation? Dec 2003. The most important factors in constipation are reduced physical activity and inadequate dietary intake of fibres and fluids. The improvement of constipation by increasing water intake is effective only when fluid consumption is lower-than-normal (~2500 ml per day).

  • https://www.ncbi.nlm.nih.gov/pubmed/12352219 Effects of carbonated water on functional dyspepsia and constipation. Sep 2002. Constipation decreased significantly after carbonated water and was not significantly different with tap water.

  • https://www.ncbi.nlm.nih.gov/pubmed/9926630 Constipation: an approach to diagnosis, treatment, referral. Jan 1999. When a patient reports constipation, treatment with exercise, hydration, fiber supplementation, and mild laxatives is often effective.

  • https://www.ncbi.nlm.nih.gov/pubmed/10499460 Coffee and gastrointestinal function: facts and fiction. A review. 1999. Coffee stimulates gallbladder contraction and colonic motor activity.

  • https://www.ncbi.nlm.nih.gov/pubmed/9581985 Is coffee a colonic stimulant? Feb 1998. Caffeinated coffee stimulates colonic motor activity, 60% stronger than water and 23% stronger than decaffeinated coffee.

  • https://www.ncbi.nlm.nih.gov/pubmed/2338272 Effect of coffee on distal colon function. Apr 1990. 29% claimed that coffee induced a desire to defecate. Increase in motility index within 4 minutes after ingestion of both regular and decaffeinated coffee in the responders and lasting at least 30 minutes. No increase in the motility after a drink of hot water.

Balance your fibre intake

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976340/ Chronic constipation. A review of literature. May 2018. A high-fiber diet can increase stool weight, resulting in a decreased colon transit time, while poor-fiber diet induces constipation. Increased fiber diet could improve symptoms in patients with normal transit function but not in constipated patients. Increasing fiber consumption may worsen symptoms due to gas. Soluble fiber (i.e., psyllium or ispaghula), but not insoluble fiber (wheat Bran) is associated with the improvement of constipation. Soluble fiber improved constipation symptoms in IBS. But several studies reported that fiber supplements could improve bowel symptoms.

  • https://www.ncbi.nlm.nih.gov/pubmed/27170558 Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults. Jul 2016. Fibre is moderately effective, but also causes moderate gastrointestinal side effects. Further research required.

  • https://www.ncbi.nlm.nih.gov/pubmed/27125883 Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation. Jul 2016. Mixed fibre and psyllium were equally efficacious in improving constipation and QoL. Mixed fibre was more effective in relieving flatulence, bloating and dissolved better.

  • https://www.ncbi.nlm.nih.gov/pubmed/26514720 Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber. Nov 2015. The Adequate Intake for fiber is 14 g total fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415970/ Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 2 Mar 2015. Despite a general consensus that fiber is “good for you,” difference between replacement with dietary fiber from whole foods and a supplements. Only a minority of fiber products provide health benefits. Insoluble fiber provides a mechanical stimulus (wheat bran—softens hard stool in constipation but can exacerbate diarrhea and IBS), whereas a soluble, nonfermented gel-forming fiber retains its high water-holding capacity throughout the large bowel to provide a stool normalizing effect (psyllium—softens hard stool in constipation, firms loose/liquid stool in diarrhea, normalizes stool form in IBS). Wrt fiber supplement, only a soluble nonfermenting, gel-forming fiber has been clinically proven to provide all of the health benefits. Recommended fibre levels of 25 g/d for adult women, 38 g/d for adult men.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291444/ Diets for Constipation. Dec 2014. Fiber increases stool bulk and accelerates colon transit; Fiber produces short-chain fatty acids that increase osmotic load and accelerate colon transit; Short-chain fatty acids decrease pH, which accelerates colon transit; and fiber contains water. All these improve stool consistency and amount. ① Soluble, highly fermentable non-starch polysaccharide fiber (resistant starch, pectin, inulin, and guar gum). ② Intermediate soluble and fermentable fiber (psyllium, ispaghula and oats). ③ Insoluble, slowly fermentable fiber (wheat bran, lignin (flax), and fruits and vegetables). ④ Insoluble, non-fermentable fiber (cellulose, sterculia, and methylcellulose). Generally, water-insoluble fiber is helpful for constipation. Higher dietary fiber intake (fruits, legumes, and vegetables) is associated with a lower incidence of constipation. Water-insoluble fiber with wheat bran and rye bread improves bowel movement frequency and defecation difficulty significantly. However, the water-soluble fiber (psyllium and glucomannan) results are conflicting. Society for Pediatric Gastroenterology, Hepatology, and Nutrition do not support the use of fiber supplements in the treatment of functional constipation. Probiotic Bifidobacteria and lactobacilli produce acids that lower pH in the colon and enhance peristalsis. The altered microbiota may improve gut transit. Some probiotics stimulate motility and peristalsis (Bifidobacteria and Lactobacillus). Some probiotics are helpful for diarrhea, others are useful for constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/23545709 Fiber and functional gastrointestinal disorders. May 2013. Soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.

  • https://www.ncbi.nlm.nih.gov/pubmed/23326148 Effect of dietary fiber on constipation: a meta analysis. Dec 2012. Dietary fiber intake can obviously increase stool frequency in patients with constipation. It does not obviously improve stool consistency, treatment success, laxative use and painful defecation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/ Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. Sep 2012. Constipation and associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber. Of those who stopped fiber completely, the bowel frequency increased from one motion in 3.75 d to one motion in 1.0 d; those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d to one motion per 1.9 d; those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d before and after consultation. For no fiber, reduced fiber and high fiber groups, respectively, symptoms of bloating were present in 0%, 31.3% and 100% and straining to pass stools occurred in 0%, 43.8% and 100%.

  • https://www.ncbi.nlm.nih.gov/pubmed/21737769 Chronic constipation: an evidence-based review. Jul-Aug 2011. The standard advice of increasing dietary fibers, fluids, and exercise for relieving chronic constipation will only benefit patients with true deficiency.

  • https://www.ncbi.nlm.nih.gov/pubmed/21332763 Systematic review: the effects of fibre in the management of chronic idiopathic constipation. Apr 2011. Soluble fibre led to improvements in global symptoms (86.5% vs. 47.4%), straining (55.6% vs. 28.6%), pain on defaecation, and stool consistency, an increase in the mean number of stools per week (3.8 vs 2.9). Evidence for any benefit of insoluble fibre was conflicting.

  • https://www.ncbi.nlm.nih.gov/pubmed/19335713/ Health benefits of dietary fiber. Apr 2009. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal per US Department of Health and Human Services.

  • https://www.ncbi.nlm.nih.gov/pubmed/9663731 Psyllium is superior to docusate sodium for treatment of chronic constipation. May 1998. Psyllium is superior to docusate sodium for softening stools by increasing stool water content, and has greater overall laxative efficacy for constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/7912305/ Bran and irritable bowel syndrome: time for reappraisal. Jul 1994. 55% of patients were made worse by bran whereas only 10% had found it helpful. With the exception of fruit, other forms of dietary fibre were not as detrimental. All symptoms of irritable bowel syndrome were exacerbated by bran. Excessive consumption of bran may actually be creating irritable bowel syndrome.

Eat your fruits, vegetables, nuts and seeds

  • https://www.ncbi.nlm.nih.gov/pubmed/25889554 Dual effectiveness of Flaxseed in constipation and diarrhea: Possible mechanism. Jul 2015. Flaxseed oil and mucilage exhibit laxative and antidiarrheal activities.

  • https://www.ncbi.nlm.nih.gov/pubmed/25109788 Systematic review: the effect of prunes on gastrointestinal function. Oct 2014. In constipation, prunes superior to psyllium for improving stool frequency and consistency.

  • https://www.ncbi.nlm.nih.gov/pubmed/23394990 Kiwifruit modulation of gastrointestinal motility. 2013. Kiwifruit are a highly effective to promote laxation and gastrointestinal motility.

  • https://www.ncbi.nlm.nih.gov/pubmed/24090144 Dried plums and their products: composition and health effects--an updated review. 2013. Direct effects include prevention of constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/21445854 Ripening-associated changes in the amounts of starch and non-starch polysaccharides and their contributions to fruit softening in three banana cultivars. Jun 2011. Banana softening is a consequence of starch degradation and the accumulation of soluble sugars in a cultivar-dependent manner.

  • https://www.nature.com/articles/nrgastro.2011.82 Dried plums (prunes) for the treatment of constipation. Jun 2011. Superior effects of dried plums (prunes) over psyllium in the treatment of constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/21323688 Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Apr 2011. Dried plums more effective than psyllium for the treatment of constipation, and should be considered as a first line therapy.

  • https://www.ncbi.nlm.nih.gov/pubmed/21091293 Effects of chicory inulin in constipated elderly people: a double-blind controlled trial. Mar 2011. Inulin group reported better digestion and reduced defecation difficulties. Supplementation with 15 g inulin improves constipation.

  • https://www.ncbi.nlm.nih.gov/books/NBK92765/ Evaluation of the Nutritional and Metabolic Effects of Aloe vera. 2011. Aloe vera has a long history of traditional use for constipation. Its laxative effect is well established, stronger than the stimulant laxative phenolphthalein. Improve a range of constipation indicators (bowel movement frequency, consistency of stools, and laxative dependence). Lack of sufficient data to establish its safety for use as a laxative.

  • https://www.ncbi.nlm.nih.gov/pubmed/20591206 A double-blind, placebo-controlled, cross-over study to establish the bifidogenic effect of a very-long-chain inulin extracted from globe artichoke (Cynara scolymus) in healthy human subjects. Oct 2010. Daily consumption of artichoke exerted a pronounced prebiotic effect on the human microbiota composition.

  • https://www.ncbi.nlm.nih.gov/pubmed/11401245 Chemical composition and potential health effects of prunes: a functional food? May 2001. The laxative action of prune explained by their high sorbitol content. Prunes contain large amounts of phenolic compounds, which may aid in the laxative action.

Add probiotics and prebiotics to your meals

  • https://www.wageningenacademic.com/doi/10.3920/BM2017.0103 Effect of Bacillus subtilis C-3102 on loose stools in healthy volunteers. Feb 2018. C-3102 significantly improved loose stool consistency and frequency.

  • https://www.ncbi.nlm.nih.gov/pubmed/26232505 Effect of 4'galactooligosaccharide on constipation symptoms. Nov-Dec 2015. Galactooligosaccharide increased bowel movement frequency; relieved straining; and decreased in stool consistency. No side effects.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288092/ Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation. Jan 2015. Patients with FC exhibit different compositions of gut microbiota. Symptoms improvements with VSL#3 (frequency, consistency, bloating) in up to 70% of patients. Gut microbiota associated with GI motility. Some probiotics have been shown to stimulate intestinal motility, may be by decreasing the proliferation of methanogens. However, other probiotics decrease bowel movements, and improve loose stool/diarrhea. But high heterogeneity. More research needed.

  • https://www.ncbi.nlm.nih.gov/pubmed/25599776 Effects of a kefir supplement on symptoms, colonic transit, and bowel satisfaction score in patients with chronic constipation: a pilot study. Dec 2014. Kefir has positive effects on constipation, improves bowel satisfaction and accelerates transit.

  • https://www.ncbi.nlm.nih.gov/pubmed/25099542 The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Oct 2014. Probiotics may improve gut transit time, stool frequency and consistency, with beneficial effects of B. lactis in particular. More research required.

  • https://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377 Probiotics may ease constipation. Aug 2014. Probiotics increased the number of weekly bowel movements by 1.3, and helped soften stools, making them easier to pass. Bifidobacterium appeared to be the most effective. But not enough evidence to recommend a specific probiotic for constipation. Small studies with widely variable results.

  • https://www.ncbi.nlm.nih.gov/pubmed/25056655 Effect of yogurt containing polydextrose, Lactobacillus acidophilus NCFM and Bifidobacterium lactis HN019: a randomized, double-blind, controlled study in chronic constipation. Jul 2014. Yogurt with polydextrose, B. lactis HN019 and L. acidophilus NCFM® significantly shortened transit time after two weeks.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000641/ The Effect of Probiotics on Childhood Constipation: A Randomized Controlled Double Blind Clinical Trial. 2014. Probiotics increased the frequency and improved the consistency at the end of 4th week.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705355/ Fiber and Prebiotics: Mechanisms and Health Benefits. Apr 2013. Inulin and oligofructose, lactulose, and resistant starch are prebiotics, and increase Bifidobacterium, a beneficial bacteria. Galactooligosaccharides, transgalactooligosaccharides, polydextrose, wheat dextrin, acacia gum, psyllium, banana, whole grain wheat, and whole grain corn also have prebiotic effects.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206558/ Chronic constipation: Current treatment options. Oct 2011. Chronic constipation has been reported in 15% to 25% of the general population. Rome III criteria: 25% of bowel movements with at least 2 of the following symptoms: straining; hard or lumpy stools; a sense of incomplete evacuation; a sense of obstruction; or fewer than 3 defecations per week in the previous 3 months. Probiotics for the management of chronic constipation, especially Bifidobacterium and Lactobacillus, to improve stool consistency and frequency and all symptoms. Unclear whether any one particular strain of probiotic is more effective than another. Further research needed.

  • https://www.ncbi.nlm.nih.gov/pubmed/19300120 Probiotics and functional gastrointestinal disorders in children. Apr 2009. Lactobacilli and bifidobacteria increase stool frequency and decrease consistency in normal individuals. But the evidence for efficacy is limited. Fiber supplements, lactose-free diets, and lactobacillus supplementation are effective. Several studies with Lactobacillus GG showed negative results. Bifidobacterium animalis has been shown to be effective.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607002/ Galacto-oligosaccharides and bowel function. Jun 2007. Oligosaccharides act as soluble fibre and have a bifidogenic effect. Galacto-oligosaccharides resembling oligosaccharides occurring naturally in human milk may relieve the symptoms of constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/16169298/ Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Nov 2005. Concentrations of Bifidobacterium and Lactobacillus significantly lower in constipated patients; potentially pathogenic bacteria and/or fungi increased. Constipation associated with changes in flora, intestinal permeability and the immune response.

  • https://www.ncbi.nlm.nih.gov/pubmed/15198901 Supplementation of milk formula with galacto-oligosaccharides improves intestinal micro-flora and fermentation in term infants. Jun 2004. Supplementing infant formula with GOS at 0.24 g/dl stimulates the growth of Bifidobacteria and Lactobacilli in the intestine and stools, similar to human milk. Stool frequency significantly increased with GOS supplemented formula and human milk.

  • https://www.ncbi.nlm.nih.gov/pubmed/9895419 Galacto-oligosaccharides relieve constipation in elderly people. 1998. The defecation frequency per week was higher with GOS and easier defecation, but responses differ individually.

  • https://www.ncbi.nlm.nih.gov/pubmed/9742466 Increased fecal frequency and gastrointestinal symptoms following ingestion of galacto-oligosaccharide-containing yogurt. Jun 1998. Defecation frequency increased with GOS, but flatulence as well.

Supplement with magnesium citrate

  • https://www.webmd.com/vitamins/ai/ingredientmono-998/magnesium Magnesium. Extracted Mar 2020. Magnesium is most commonly used for constipation.

  • https://www.medicalnewstoday.com/articles/322588 Does magnesium citrate work for constipation? Jul 2018. Magnesium citrate works by pulling water into the intestines, which reduces the stool dryness, making it easier to pass. Similar to osmotic laxatives. Magnesium citrate is a simple solution to constipation. But regular use may cause the body to become dependent, making it difficult for a person to pass stools without using it.

  • https://www.ncbi.nlm.nih.gov/pubmed/10634161 Magnesium citrate-bisacodyl regimen proves better than castor oil for colonoscopic preparation. Dec 1999. The cleansing effect of the magnesium citrate-bisacodyl was significantly better than that of castor oil in the colon.

Avoid gluten and dairy products

  • https://en.wikipedia.org/wiki/Non-celiac_gluten_sensitivity Non-celiac gluten sensitivity. Updated 27 Feb 2020. NCGS has prevalence rates between 0.5–13% in the population. Gastrointestinal symptoms may include: abdominal pain, bloating, diarrhea or constipation, nausea, aerophagia, flatulence, gastroesophageal reflux disease, and aphthous stomatitis.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630947/ Non-Celiac Gluten Sensitivity: A Review. May 2019. Grain food consumption is a trigger of gluten related disorders, including non-celiac gluten sensitivity, with symptoms similar to other gluten-related diseases, IBS and Crohn’s. NCGS prevalence up to 13% of the population.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182669/ Recent advances in understanding non-celiac gluten sensitivity. Oct 2018. NCGS characterized by symptoms such as bloating and pain in the abdomen, diarrhea, nausea, aphthous stomatitis, alternating bowel habits, and constipation. According to self-reported data, the prevalence rate of NCGS ranges between 0.5% and 13% in the population.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403030/ An unusual cause of constipation in a patient without any underlying disorders. Spring 2015. NCGS is a cause of constipation. Patient with long standing constipation not responding to any conservative treatment but significant response with gluten free diet.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533146/ The Role of Cow's Milk Allergy in Pediatric Chronic Constipation: A Randomized Clinical Trial. Dec 2012. Constipation can be a manifestation of cow's milk allergy. An elimination diet is advisable in children unresponsive to laxative treatment.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401057/ Lactose intolerance: diagnosis, genetic, and clinical factors. Jul 2012. ~ 75% of the world’s population loses this ability to digest lactose at some point. Some patients can experience constipation due to decreased intestinal motility, possibly caused by production of methane.

  • https://www.ncbi.nlm.nih.gov/pubmed/17956597/ Review article: lactose intolerance in clinical practice--myths and realities. Jan 2008. ~ 70% of the world population has hypolactasia, often undiagnosed. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea.

Exercise regularly

  • https://www.webmd.com/digestive-disorders/exercise-curing-constipation-via-movement Exercise to Ease Constipation. Jun 2018. Exercise is essential for regular bowel movements. One of the key things that leads to constipation is inactivity. Exercise helps constipation by lowering the time it takes food to move through the large intestine. Aerobic exercise stimulates the natural contractions of muscles in your intestines, which help move stools out quickly. After eating, blood flow increases to your stomach and intestines to help your body digest the food. If you exercise right after eating, blood flows away from your stomach and to your heart and muscles instead. Less blood in the GI tract means weaker contractions and the food moves sluggishly through your intestines. This can lead to bloating, gas, and constipation. Getting up and moving can help constipation. A regular walking plan - even 10 to 15' several times a day - can help the body and digestive system work at their best.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206558/ Chronic constipation: Current treatment options. Oct 2011. Regular exercise significantly improve constipation in patients with IBS-C. but not in elderly. 20 to 60' of moderate-to-vigorous activity, 3 to 5 days per week significantly improved the symptoms of IBS. Bulking agents increase stool weight and improve stool consistency by retaining fluid. Psyllium is the most commonly used and has been shown to decrease transit time, improve stool frequency, consistency and weight.

  • https://www.ncbi.nlm.nih.gov/pubmed/21206488/ Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. May 2011. Increased physical activity improves IBS symptoms. Physical activity should be used as a primary treatment for IBS.

  • https://www.ncbi.nlm.nih.gov/pubmed/18461499/ The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial. May 2008. The exercise group reported significantly improved symptoms of constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/16028436 Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Apr 2005. 30 min of brisk walking and 11-min programme. Significant reduction in constipation: incomplete defecations, straining and hard stools. Transit time decreased. In inactive subjects with chronic constipation, regular physical activity improves constipation.

  • https://www.ncbi.nlm.nih.gov/pubmed/1885077 Effect of moderate exercise on bowel habit. Aug 1991. Exercise was performed at 2/3 predicted maximum heart rate. Transit time was dramatically accelerated by moderate exercise (both jogging and cycling), from 51.2h to 36.6h when riding and 34h when jogging.

Don't delay, relax and try squatting

  • https://journals.lww.com/jcge/Fulltext/2019/03000/Implementation_of_a_Defecation_Posture.21.aspx Implementation of a Defecation Posture Modification Device. Mar 2019. DPMDs positively influenced BM duration, straining and complete evacuation of bowels.

  • https://www.forbes.com/sites/brucelee/2019/01/09/got-constipation-here-is-a-move-that-you-may-want-to-try/#5dfd145b480b Got Constipation? Here Is A Move That You May Want To Try. Jan 2019. Using the footstool was associated with 3.6 times the likelihood of people feeling like they fully emptied their bowels and a 77% reduction in straining. When not using the footstool, study participants experienced a 25% increase in bowel movement duration.

  • https://www.eurekalert.org/pub_releases/2019-01/m-osr010919.php. Ohio State research finds toilet stool may solve common bowel issues. Jan 2019. 71% of participants experienced faster bowel movements, 90% percent reported less straining.

0026 - Reframing examples & limiting beliefs

  • https://srcd.onlinelibrary.wiley.com/doi/full/10.1111/cdev.13347 Effort Self‐Talk Benefits the Mathematics Performance of Children With Negative Competence Beliefs. Dec 2019. Children with negative competence beliefs often achieve below their potential in school. Effort self‐talk (“I will do my very best!”) benefited their performance.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691160/ Endorsement and Constructive Criticism of an Innovative Online Reflexive Self-Talk Intervention. Aug 2019. Self-talk can benefit emotions, motivation and confidence.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628429/ Effects of Self-Talk Training on Competitive Anxiety, Self-Efficacy, Volitional Skills, and Performance: An Intervention Study with Junior Sub-Elite Athletes. Jun 2019, Self-talk led to less anxiety and higher self-confidence, self-optimization, self-efficacy and performance. Long-term training was more effective than short-term training.

  • https://e-space.mmu.ac.uk/583488/1/MMU%20Dissertation%20Fae%20Ford.pdf Exploring the impact of negative and positive self-talk in relation to loneliness and self-esteem. April 2015. Positive self-talk associated with self-esteem improvement.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827458/ Purpose in Life Predicts Better Emotional Recovery from Negative Stimuli. Nov 2013. Greater purpose in life predicted better recovery from negative stimuli. It may afford protection from negative events and confer resilience through enhanced automatic emotion regulation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667140/ Too Fat to Fit through the Door: First Evidence for Disturbed Body-Scaled Action in Anorexia Nervosa during Locomotion. May 2013. Participants walked through door-like openings varying in width. Anorexic patients started rotating for openings 40% wider than their own shoulders, while healthy controls started rotating for apertures only 25% wider than their shoulders. The results imply abnormalities in anorexic at the level of the unconscious. Body representation disturbances affect cognition and perception, but unconscious actions as well.

  • https://opus.uleth.ca/bitstream/handle/10133/3202/Kamal%20Chopra.pdf?sequence=1&isAllowed=y Impact of positive self-talk. Jun 2012. Our thoughts affect our emotions, motivation and potential accomplishments. The majority of our self-talk is negative and creates feelings of anger, irritation, frustration, hopelessness and disappointment. Implement positive self-talk into daily interactions to change perspectives, attitudes and reactions to the circumstances.

  • https://www.ncbi.nlm.nih.gov/pubmed/8916623 Self-talk in youth with anxiety disorders: states of mind, content specificity, and treatment outcome. Oct 1996. Negative self-statements significantly predicted anxiety.

  • https://www.ncbi.nlm.nih.gov/pubmed/7787832 Cognitive moderators of outcome following traumatic brain injury: a conceptual model and implications for rehabilitation. Feb-Mar 1995. TBI patients are at risk for developing self-limiting belief systems about their effectiveness in their day-to-day lives, which may restrict their life chances, outcomes, and reduce their quality of life.

  • https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0076564 Psychological Processes Mediate the Impact of Familial Risk, Social Circumstances and Life Events on Mental Health. Oct 1993. A family history of mental health difficulties, social deprivation, and traumatic life-experiences strongly predicted higher levels of anxiety and depression. Strongly mediated by lack of adaptive coping, rumination and self-blame.

  • https://link.springer.com/article/10.1007/BF01176069 Self-referent speech and psychopathology: The balance of positive and negative thinking. Dec 1989. Depressed groups have significantly more negative self-talk and less positive self-talk. The proportions of positive and negative self-speech of a psychologically healthy person 1.6:1.0.

0025 – Reframe your stressful thoughts

  • https://www.ncbi.nlm.nih.gov/m/pubmed/31430032/ Reframing the individual stress response: Balancing our knowledge of stress to improve responsivity to stressors. Sep 2019. Balanced and positive framings of stress improve heart rate and blood pressure. Balanced framing improves subjective ratings of stress.

  • https://www.onlinelibrary.wiley.com/doi/full/10.1002/smi.2893 Reframing the individual stress response: Balancing our knowledge of stress to improve responsivity to stressors. Aug 2019. Balanced and positive framings of stress can improve blood pressure and reduce stress.

  • https://www.sciencedaily.com/releases/2019/08/190826150700.htm New evidence that optimists live longer. Aug 2019 and https://www.pnas.org/content/116/37/18357 Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women. Sep 2019. Individuals with greater optimism are more likely to live longer and to live to age 85 or older. The most optimistic demonstrated an 11 to 15% longer lifespan, and had 50-70% greater odds of reaching 85 years old compared to the least optimistic groups. Optimism may be modifiable using relatively simple techniques or therapies. More optimistic people can regulate emotions and behavior and bounce back from stressors and difficulties more effectively. They tend to have healthier habits, more likely to engage in exercise and less likely to smoke.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/30741121/ Interpersonal positive reframing in the daily lives of couples coping with breast cancer. Mar-Apr 2019. Spouses of breast cancer patients may assist each other's coping by positively reframing their negative experiences. The use of positive words is associated with positive reframing for the speaker and the listener, and lower levels of stress.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342217/#__ffn_sectitle Re-conceptualizing stress: Shifting views on the consequences of stress and its effects on stress reactivity. Mar 2017. Balanced reframing significantly decrease heart rate and blood pressure following stress.

  • http://www.industrialpsychiatry.org/article.asp?issn=0972-6748;year=2016;volume=25;issue=2;spage=179;epage=183;aulast=Singh A cross-sectional assessment of stress, coping, and burnout in the final-year medical undergraduate students. 2016. Perceived stress is associated with depression and anxiety. Acceptance, positive reframing, humour, planning and active coping correlated with lower perceived stress.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380267/ Becoming Happier Takes Both a Will and a Proper Way: An Experimental Longitudinal Intervention to Boost Well-Being. Mar 2015. Expressing optimism and gratitude regularly positively impacts well-being, especially when participants commit to these practices.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374921/ Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality. Sep 2013. 33.7% of US adults perceived that stress affected their health. Both higher levels of reported stress and the perception that stress affects health were associated with worse health outcomes. Those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death. Those who didn’t believe their stress to be harmful were at the lowest risk of dying – even lower than people who didn’t experience a lot of stress.

  • https://www.researchgate.net/publication/254096630_Stress_Coping_and_Psychological_Well-Being_Among_New_Graduate_Nurses_in_China Stress, Coping, and Psychological Well-Being Among New Graduate Nurses in China. Dec 2011. Planning, acceptance and positive reframing correlate with psychological well-being.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/21942377/ Mind Over Matter: Reappraising Arousal Improves Cardiovascular and Cognitive Responses to Stress. Sep 2011. Reappraisal of stressful thoughts results in more adaptive cardiovascular stress responses and decreases negative bias.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/21424944/ Perfectionism and coping with daily failures: positive reframing helps achieve satisfaction at the end of the day. Jun 2011. Positive reframing, acceptance and humour predicted higher satisfaction, and helped dealing with personal failures.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894461/ Optimism and Its Impact on Mental and Physical Well-Being. May 2010. In stressful situations, optimistic people present a higher quality of life, better mental and physical well-being by the promotion of a healthy lifestyle and by adaptive behaviours and cognitive responses, associated with greater flexibility, problem-solving capacity and a more efficient elaboration of negative information.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161121/ Optimism. Feb 2010. Higher levels of optimism are associated with better well-being in times of adversity or difficulty and to higher levels of engaged coping and lower levels of avoidance. Optimism is associated with taking proactive steps to protect one's health. Pessimism is associated with health-damaging behaviors. Optimism is related to better physical health. The energetic, task-focused approach that optimists take also relates to benefits in the socioeconomic world: more persistence in educational efforts and higher later income. They also fare better in relationships.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/19308298/ Changes in stress and coping from a randomized controlled trial of a three-month stress management intervention. 2009. Positive reframing positively affecting perceived stress.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802367/ The biochemistry of belief. Oct-Dec 2009 Beliefs are the preset, organized filters to our perceptions of the world. By reframing our beliefs, we transform ourselves from passive onlookers to powerful creators. Our beliefs provide the script to write or re-write the code of our reality.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901870/ Optimism, Cynical Hostility, and Incident Coronary Heart Disease and Mortality in the Women’s Health Initiative Aug 2009. Optimists (top versus bottom quartile) had lower rates of CHD (43 versus 60/10000) and total mortality (46 versus 63/10000).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719560/ The Role of Mindfulness in Positive Reappraisal. Jul 2009. Positive reappraisal is critical to enable individuals to adapt successfully to stressful life events.

0024 – Cholesterol: good or bad? Part II

Mono-unsaturated fats or "MUFA"

  • https://www.ncbi.nlm.nih.gov/pubmed/27399120 Dietary fat intake and endometrial cancer risk: A dose response meta-analysis. Jul 2016. Higher MUFA intake significantly associated with lower endometrial cancer risk.

  • https://www.ncbi.nlm.nih.gov/pubmed/21308420 Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors. Mar 2011. MUFA promotes healthy blood lipid profiles, blood pressure, insulin sensitivity and glucose levels. Could also ameliorate body composition and risk of obesity and be cardioprotective.

  • https://www.ncbi.nlm.nih.gov/pubmed/20521076 Effects of high-fat and low-fat diets rich in monounsaturated fatty acids on serum lipids, LDL size and indices of lipid peroxidation in healthy non-obese men and women when consumed under controlled conditions. Feb 2011. MUFA beneficial effects on lipid-related cardiovascular disease risk factors.

  • https://www.ncbi.nlm.nih.gov/pubmed/21041432 Adding monounsaturated fatty acids to a dietary portfolio of cholesterol-lowering foods in hypercholesterolemia. Dec 2010. MUFA potential benefits for cardiovascular risk through increases in HDL, large LDL and reductions in CRP.

Omega-3s or "O3"

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591664/ The emerging role of omega-3 fatty acids as a therapeutic option in neuropsychiatric disorders. Jun 2019. Efficacy of O3 in various neuropsychiatric disorders. EPA and DHA critical roles in neuronal cell function and neurotransmission, inflammatory and immune reactions involved in neuropsychiatric disease states.

  • https://nccih.nih.gov/health/omega3/introduction.htm#hed1 Omega-3 Supplements: In Depth. Updated May 2018. O3 can reduce triglycerides, relieve symptoms of rheumatoid arthritis.

  • https://www.ncbi.nlm.nih.gov/pubmed/28900017 Omega-3 fatty acids and inflammatory processes: from molecules to man. Oct 2017. Can inhibit inflammation. Benefit of O3 in rheumatoid arthritis and in stabilizing atherosclerotic plaques.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539209/ Chemopreventive and Chemotherapeutic Effects of Fish Oil derived Omega-3 Polyunsaturated Fatty Acids on Colon Carcinogenesis. Jul 2017. Beneficial role of O3 in preventing colon cancer. Can have synergetic effects with chemotherapeutic agents.

  • https://www.ncbi.nlm.nih.gov/pubmed/27735847 Role of n-3 Polyunsaturated Fatty Acids in Ameliorating the Obesity-Induced Metabolic Syndrome in Animal Models and Humans. Oct 2016. O3 regulate lipid metabolism, energy expenditure and inflammation. May help to reduce incidence of obesity.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4965662/ The Effect of Omega-3 Fatty Acids in Patients With Active Rheumatoid Arthritis Receiving DMARDs Therapy: Double-Blind Randomized Controlled Trial. Jul 2016. Significant relief for rheumatoid arthritis.

  • https://link.springer.com/article/10.1007%2Fs12017-008-8036-z Neurological Benefits of Omega-3 Fatty Acids. Dec 2008. The central nervous system is enriched in O6 and O3 (neuronal membranes). O3 essential for optimal vision and neural development. EPA and DHA may benefit psychiatric and neurological disorders, neurodegenerative conditions and neurological injury.

Omega-6s or "O6" and Hydrogenated fats and trans-fats

  • https://www.arecipeforhealth.net/post/0014-stay-away-from-vegetable-oils. Stay away from vegetable oils. Dec 2019. Vegetable oils are extracted from seeds, heavily processed with chemicals, very harmful for our health.

How good are your cholesterol ratios?

  • http://www.onlineconversion.com/cholesterol.htm Conversion tool between mmol/L and mg/dL

  • https://www.bulletproof.com/diet/healthy-eating/high-cholesterol/ High cholesterol, saturated fats and low-carb diets: what you need to know. Extracted Feb 2019. Optimal cholesterol ratios: TG/HDL <2 (less is better).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453685/ Is High Serum LDL/HDL Cholesterol Ratio an Emerging Risk Factor for Sudden Cardiac Death? Jun 2017. LDL or HDL not associated with risk of SCD, but high LDL/HDL was.

  • https://www.medicalnewstoday.com/articles/316586#Good-vs-bad What is cholesterol ratio and why is it important? Mar 2017. TC/HDL <3.5 optimal, <5 average for men, <4.4 for women.

  • https://www.ncbi.nlm.nih.gov/pubmed/23282768 Total/HDL cholesterol ratio and non HDL cholesterol as predictors for increased intima media thickness. Aug 2012. TC/HDL best determinant of subclinical atherosclerosis.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747394/ Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Sep 2009. TC/HDL and LDL/HDL are risk indicators with greater predictive value than isolated parameters, particularly LDL.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/19249427/ The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women's Ischemia Syndrome Evaluation. Mar 2009. the TG/HDL powerful predictor of all-cause mortality and cardiovascular events. TG/HDL median 2.2, first quartile <1.4.

  • https://www.ncbi.nlm.nih.gov/pubmed/3179802 Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study. Jul 1988. Factors other than total cholesterol or LDL must be considered when evaluating CAD risk. Low levels of HDL as important as high LDL. The best test is TC/HDL.

How does the cholesterol turn "bad" and how to improve your ratios?

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986484/ Inflammation, not Cholesterol, Is a Cause of Chronic Disease. May 2018. The key to longevity and prevention of chronic disease is not the reduction of dietary or serum cholesterol but the control of inflammation that leads to cardiovascular diseases. Control inflammatory mediators via diet, exercise and healthy lifestyle choices.

A poor diet

  • https://www.bmj.com/content/365/bmj.l1451 Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study. May 2019. Higher consumption of processed foods associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. Nutritional composition, additives and contaminants might play a role.

  • https://www.ncbi.nlm.nih.gov/books/NBK305895/ Obesity and Dyslipidemia. Updated Apr 2018. Abnormalities in lipid metabolism common in obese patients (60-70%), with high triglyceride, apoB, small LDL and low HDL, resulting in increased risk of cardiovascular disease. Weight loss improves lipid profile, especially with low carb diets (better results than high carb).

  • https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113605 Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids and Palmitoleic Acid in Adults with Metabolic Syndrome. Nov 2014. Progressive increase in carbs (47 to 346 g/day) with decrease in fats (84 to 32 g/day) did not change the % of SFA in blood. But triglyceride and cholesteryl ester reduced as carbs decreased, and increased as carbs re-introduced, which is associated with adverse health outcomes.

  • https://www.hindawi.com/journals/ijhy/2012/763507/ How Can Diet Influence the Risk of Stroke? May 2012. Dietary interventions for management of risk factors. Fruits, vegetables, tea, cocoa... have antioxidant, anti-inflammatory and antihypertensive effects against lipid peroxidation, atherosclerosis & CVD. O3 reduces risk. Excess carbs consumption may increase risk of insulin resistance, diabetes, stroke, and CVD.

  • https://www.artandscienceoflowcarb.com/books/ The Art and Science of Low Carbohydrate Living, by Volek and Phinney. 2011. Insulin resistance, metabolic syndrome, hypertension, T2 diabetes... are far better controlled by carb restriction than with drugs. Low carb diets could prevent diseases or save lives.

  • http://garytaubes.com/works/books/good-calories-bad-calories/ Why We Get Fat and Good Calories, Bad Calories by Gary Taubes. 2007. Low-fat diets do not promote weight loss and better health. Obesity is caused by food type. Carbs, particularly refined, raise insulin levels, promoting fat storage.


  • https://apps.who.int/iris/bitstream/handle/10665/250278/WHO-NMH-PND-CIC-TKS-16.1-eng.pdf;jsessionid=6D46A0EF21EA51926D230DC4157769BF?sequence=1 Tobacco & Stroke. 2016. Tobacco use is a major risk factor for cerebrovascular disease. 2/5 of stroke deaths under 65 linked to smoking.

High chronic stress levels

  • https://www.arecipeforhealth.net/post/0010-how-full-is-your-stress-bucket How full is your stress bucket? Nov 2019. Chronic stress can result in weight gain, fat storage, insulin resistance, depression, anxiety, insomnia, inflammation, impaired memory, hypertension, atherosclerosis, chronic pain, brain fog, fatigue, increased risk of diseases and accelerated aging.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633295/ Psychological Stress and Cardiovascular Disease. Apr 2009. Overwhelming evidence for deleterious effects of stress on the heart.

High blood pressure

  • https://www.world-heart-federation.org/resources/stroke-and-hypertension/ Stroke and hypertension. May 2017. High blood pressure the most important risk factor for stroke, causes 50% of ischemic strokes.

  • https://www.hindawi.com/journals/ijhy/2012/763507/ How Can Diet Influence the Risk of Stroke? May 2012. Cerebrovascular diseases 2nd cause of mortality in the world and hypertension a main risk factor for strokes.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2475602/ Hypertension and Cerebrovascular Dysfunction. Jun 2009. Hypertension major cause of stroke and a leading cause of dementia. Alters the structure of blood vessels and disrupts the blood supply to the brain, which increases susceptibility to ischemic injury and Alzheimer’s.

Insufficient physical activity

  • https://www.arecipeforhealth.net/post/0015-exercise-to-get-fitter-smarter-and-healthier Exercise to get fitter, smarter and healthier. Dec 2019. Physical inactivity is the 4th leading cause of mortality with 3.2 million deaths worldwide every year and the primary cause of most chronic diseases. Addressing poor nutrition and lack of exercise could decrease the risk for all diseases by up to 70% in the US.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530482/ Physical activity, sedentary behavior time and lipid levels in the Observation of Cardiovascular Risk Factors in Luxembourg study. Aug 2015. Lower screen time and higher intense physical activity associated with improved blood lipid profile (higher HDL, lower triglycerides, LDL) in normal weight adults, but not in those overweight or obese.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857522/ Sedentary Behaviors Increase Risk of Cardiovascular Disease Mortality in Men. May 2011. Being sedentary is a significant CVD mortality predictor. High levels of physical activity lower rates of CVD death. Increase regular physical activity for optimal CV health.

Poor sleep

  • https://www.arecipeforhealth.net/post/0007-10-tips-to-improve-your-sleep 10 tips to improve your sleep. Sep 2019. Sleep deprivation can cause many health issues: stress, fatigue, lowered mood and immune function, hunger and cravings... It increases the risk of developing diabetes, cardiovascular diseases, obesity and depression and is even associated with a shorter lifespan.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2398756/ Associations of Usual Sleep Duration with Serum Lipid and Lipoprotein Levels. May 2008. Both short (<5h) and long sleep (>8h) durations are associated with a high triglyceride or low HDL in women. But lower risk of high LDL among men sleeping >8 h.

  • https://onlinelibrary.wiley.com/doi/full/10.1111/resp.13372 Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database. Aug 2018. Sleep apnoea severity associated with cholesterol and triglycerides levels.

Other factors

  • https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025449 Vitamin D Status and Risk of Stroke. 2019. Lower vitamin D levels do not lead to a higher stroke risk but are instead a consequence of stroke.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129606/ A Renewed Focus on the Association Between Thyroid Hormones and Lipid Metabolism. Sep 2018. Hypothyroidism negatively affects lipid metabolism, which increases the risk for cardiovascular disease and, potentially, mortality.

  • https://www.ncbi.nlm.nih.gov/pubmed/29078842 Folic Acid Supplementation for Stroke Prevention in Patients With Cardiovascular Disease. Oct 2017.

  • https://www.liebertpub.com/doi/abs/10.1089/met.2017.0003?journalCode=met High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome. Jun 2017. Metabolic syndrome increases risk of cardiovascular disease due to insulin resistance, obesity, hypertension, hyperglycemia, low HDL and elevated triglycerides. Vitamin D deficiency could be associated with diabetes and MetS.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920062/ Vitamin D deficiency and incident stroke risk in community-living black and white adults. Jan 2017. Vitamin D deficiency is a risk factor for stroke.

  • https://www.ncbi.nlm.nih.gov/pubmed/26597770 Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke. Feb 2016.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333964/ Progress on diabetic cerebrovascular diseases. Nov 2014. Cerebral vascular diseases can be induced by diabetes and is the main cause of death in diabetics. 20%-40% patients suffer from cerebral blood vessel diseases.

  • https://www.ncbi.nlm.nih.gov/pubmed/22205313 Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies. Dec 2011. Magnesium intake inversely associated with risk of ischemic stroke.

  • https://www.ncbi.nlm.nih.gov/pubmed/8935479 Sunlight, cholesterol and coronary heart disease. Aug 1996. Sunlight deficiency could increase blood cholesterol by allowing cholesterol synthesis instead of vitamin D. Outdoor activity associated with lower blood cholesterol. Sunlight influences susceptibility to a number of chronic diseases, including coronary heart disease.

Who should avoid saturated fats?

  • https://cholesterolcode.com/hyper-responder-faq/ Hyper-Responder FAQ. Extracted Feb 2020. The term “hyper-responder” describe those who have a very dramatic increase in their cholesterol after adopting a low carb diet. Statistics and characteristics.

  • https://emedicine.medscape.com/article/1783664-overview LDL Cholesterol Genetics. Sep 2019. The syndrome of familial hypercholesterolemia shows clear mutations that are inherited and profoundly alter the LDLc level.

  • https://www.youtube.com/watch?v=R0nS8yxQ90E Dave Feldman - Interpreting Common Low Carb Lipid Profiles. Feb 2019. Focus on lean mass hyper-responders and their characteristics.

  • https://www.ncbi.nlm.nih.gov/pubmed/30598326 Apolipoprotein E in lipoprotein metabolism, health and cardiovascular disease. Feb 2019. ApoE4 strong risk factor for development of Alzheimer's. May have application in disorders of lipoprotein metabolism and in understanding cardiovascular risk.

  • https://www.ncbi.nlm.nih.gov/pubmed/30321297 The ApoE ε4 Isoform: Can the Risk of Diseases be Reduced by Environmental Factors? Jan 2019. ApoE4 associated with increased risk of mortality and age-related diseases such as Alzheimer's and cardiovascular diseases. Poor nutrition and physical inactivity associated with increased risks for AD and CVD.

  • https://www.ncbi.nlm.nih.gov/pubmed/29623835 ApoE4 May be a Promising Target for Treatment of Coronary Heart Disease and Alzheimer's Disease. 2018. ApoE4 greatest genetic risk factor of Alzheimer's and increases risk of coronary heart disease. The carriers of the ApoE4 allele have higher cholesterol.

  • https://www.youtube.com/watch?v=UNfWKkhk2v8 Dave Feldman Lean Mass Hyper Responders A Superior Low Carb Profile. Jul 2018. Focus on lean mass hyper-responders and their characteristics.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814817/ A common variant in low density lipoprotein receptor-related protein 6 gene (LRP6) is associated with LDL-cholesterol. Aug 2009. Common polymorphism in the gene underlying coronary artery disease impacts on risk of LDL-C elevation.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423314/ Common and Rare Gene Variants Affecting Plasma LDL Cholesterol. Feb 2008. Familial hypercholesterolaemia – with its high LDL cholesterol levels, xanthomas, and premature atherosclerosis – is caused by genetic mutations.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565152/ Genetic Variation at the LDL Receptor and HMG CoA Reductase Gene Loci, Lipid Levels, Statin Response, and Cardiovascular Disease Incidence in PROSPER. Feb 2008. Genetic variation can affect baseline lipids, response to pravastatin, and CVD risk in subjects placed on statin treatment.

  • https://www.ahajournals.org/doi/full/10.1161/01.cir.91.2.505 Genetic Basis of Lipoprotein Disorders. Jan 1995. More than half of patients with coronary artery disease before age 60 years have a familial lipoprotein disorder. Severe hyperlipidemia (total cholesterol >300 mg/dL or triglycerides >500 mg/dL) usually indicates a genetic disorder, and xanthomas almost always signal an underlying genetic defect. Lipoprotein transport genes implicated in abnormalities (elevated LDL, reduced HDL, increased triglycerides...).

Should you take Statins if you have high cholesterol ?

  • https://www.dietdoctor.com/the-bitter-statin-debate The bitter statin debate. Mar 2019. The debate may not be clear one way or the other.

  • https://www.ncbi.nlm.nih.gov/books/NBK430940/ Statin Medications. Dec 2019. Statins usually well tolerated. Myopathy, rhabdomyolysis, hepatotoxicity and diabetes are the most common adverse reactions. Rhabdomyolysis the most serious but rare. Rarely, transient elevated hepatic transaminases.

  • https://tandfonline.com/doi/full/10.1080/17512433.2018.1519391 LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature. Oct 2018. The assertion that statin treatment is beneficial has been kept alive by individuals who have ignored the results from trials with negative outcomes and by using deceptive statistics. Millions of people, including many with no history of heart disease, are taking statins, despite unproven benefits and serious side effects. Clinicians should abandon the use of statins and instead identify and target the actual causes of CVD.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047411/ Adverse effects of statin therapy: perception vs. the evidence – focus on glucose homeostasis, cognitive, renal and hepatic function, haemorrhagic stroke and cataract. Apr 2018. RCTs and studies show increase in risk of diabetes (0.1%, significantly higher in the metabolic syndrome or prediabetes). Transient increases in liver enzymes in 0.5–2% but not clinically relevant. No increased risk of stroke in individuals without cerebrovascular disease; a small increase in risk in subjects with prior stroke but not confirmed by other studies. The cardiovascular benefits far outweigh the risk of adverse effects.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958441/ Prevention and management of statin adverse effects: A practical approach for pharmacists. Apr 2018. Statin adverse effects, primarily muscle-related, occur in up to 1/3 of patients in clinical practice. Be aware of the benefits and risks. Address factors that may increase the risk of statin-associated myopathy. Most patients with muscle symptoms will be able to tolerate another statin.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019636/ Statins: pros and cons. Dec 2017. Statins inhibit cholesterol synthesis and lower lipids. May have adverse effects: musculoskeletal symptoms, increased risk of diabetes and higher rates of stroke but extremely low frequency. In selected patient populations, the benefits of statins considerably outweigh the potential risks.

  • https://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease-2/ Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease). Updated Nov 2017. For those who took statins for 5 years: 0 life saved, 1 in 104 prevention of heart attack, 1 in 154 prevention of stroke, 1 in 50 develop diabetes and 1 in 10 had muscle damage.

  • https://markets.businessinsider.com/news/stocks/global-cholesterol-lowering-drugs-market-2017-2027-1003018132 Global cholesterol-lowering drugs market 2017-2027. Oct 2017. The market estimated at $19.2bn in 2017.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247776/ Low Cholesterol is Associated with Mortality from Cardiovascular Diseases: A Dynamic Cohort Study in Korean Adults. Jan 2012. Groups with lowest or highest TC (< 160 mg/dL or > 240 mg/dL) were associated with higher CVD mortality. Caution in prescribing statins for people at low CV risk.

0023 – Cholesterol: good or bad? Part I

Videos on dietary fats and cardiovascular diseases

  • https://www.youtube.com/watch?v=1CHGiid6N9Q TEDxEast: The big fat surprise.

  • https://www.youtube.com/watch?v=ldyMTu8_wLY David Diamond, Ph.D.: Assessing the Myth that Elevated Cholesterol Causes Cardiovascular Disease.

  • https://www.youtube.com/watch?v=7gZt9DQqtZI Dr. Ronald Krauss on LDL Cholesterol, Particle Size, Heart Disease & Atherogenic Dyslipidemia

  • https://www.youtube.com/watch?v=v5_RO6Fgurw Vegetable Oils - The Untold Story and the US Dietary Guidelines

Triglycerides and cholesterol

  • https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body. How it’s made: Cholesterol production in your body. Update 31 Jul 2019.

  • https://www.ncbi.nlm.nih.gov/pubmed/27059106 Impact of low-carbohydrate diet on body composition: meta-analysis of randomized controlled studies. Jun 2016. LCD, especially very LCD, effective for decrease in fat mass.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530364/ Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials. Oct 2012. Low-carb vs low-fat diets: lower reduction total cholesterol and LDL, but greater increase HDL and greater decrease triglycerides. Low-carb diets at least as effective as low-fat diets at reducing weight and improving metabolic risk factors.

  • https://link.springer.com/article/10.1007%2Fs11745-008-3274-2 Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Apr 2009. Carb restriction reduced glucose and insulin, fat mass and improved insulin sensitivity, weight loss, triacylglycerol, HDL and total cholesterol/HDL ratio. More favorable other indicators of CV risk: postprandial lipidemia, Apo B/Apo A-1 ratio and LDL particle. Threefold higher saturated fat intake but saturated fatty acids in TAG and cholesteryl ester, palmitoleic acid (marker of lipogenesis) and insulin-resistant significantly decreased. Carb restriction effective to improve MetS and CV risk.

  • https://www.ncbi.nlm.nih.gov/pubmed/14601690/ Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease. Nov 2003. Higher saturated fat and avoidance of starch result in weight loss without adverse effects on blood lipids.


  • https://www.ncbi.nlm.nih.gov/pubmed/30544168 Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis. Mar 2019. Carb-restricted diets showed no significant difference in LDL and improvement of HDL & triglycerides, even more in very-low carb. Carb restriction superior in improving lipid markers compared with low-fat diets.

  • https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0698-8 Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open label, non-randomized, controlled study. May 2018. Nutritional ketosis improved most biomarkers of CVD risk. Increase in LDL but limited to the large LDL. LDL particle size increased, inflammation and blood pressure decreased. Significant improvements in small LDL-P, ApoA1, triglyceride/HDL-C ratio, HDL-C, hsCRP, and LP-IR score.

  • https://www.ncbi.nlm.nih.gov/pubmed/9323584 Effects of medium chain fatty acids (MCFA), myristic acid, and oleic acid on serum lipoproteins in healthy subjects. Sep 1997. MCFA slightly increased LDL but not HDL and decreased apoA-I/apoB (unfavourable). MA raised LDL and HDL.

  • https://www.ncbi.nlm.nih.gov/pubmed/9194762 Relation of high TG-low HDL cholesterol and LDL cholesterol to the incidence of ischemic heart disease. An 8-year follow-up in the Copenhagen Male Study. Jun 1997. High TG-low HDL-C (characteristic dyslipidemia seen in insulin-resistant subjects), was at least as powerful a predictor of heart disease as isolated high LDL-C.

  • https://www.ncbi.nlm.nih.gov/pubmed/3179802 Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study. Jul 1988. Low HDL are as much a risk factor for CAD as high LDL. The best test for predicting CAD is the ratio of total:HDL cholesterol.

Dietary fat is essential for health and well-being

  • https://www.ncbi.nlm.nih.gov/pubmed/18757771 Better memory functioning associated with higher total and low-density lipoprotein cholesterol levels in very elderly subjects without the apolipoprotein e4 allele. Sep 2008. High total cholesterol and LDL associated with higher memory scores for non-carriers of the APOE4 allele.

So why are so many people afraid of saturated fats and cholesterol?

  • https://www.scribd.com/document/321042430/ancel-keys-atherosclerosis-a-problem-in-newer-public-health. Ancel Keys_Atherosclerosis: A Problem in Newer Public Health. From Ancel Keys' 1953 'Six Countries Study'.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1620415/pdf/amjphnation00376-0023.pdf Prediction and Possible Prevention of Coronary Disease. 1953

  • https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2548255 Sugar Industry and Coronary Heart Disease Research. Nov 2016. The Sugar Research Foundation sponsored research in 1965, which singled out fat and cholesterol as the dietary causes of heart disease and downplayed evidence that sucrose consumption was a risk factor. They also sponsored research in the 60s and 70s that cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in heart disease.

  • https://jamanetwork.com/journals/jama/article-abstract/330357 Dietary Fat and Its Relation to Heart Attacks and Strokes. Feb 1961. Central Committee for Medical and Community Program of the American Heart Association. Available knowledge sufficient to warrant a general statement regarding the relation of diet to the possible prevention of atherosclerosis.

  • https://openheart.bmj.com/content/2/1/e000196 Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Feb 2015. Dietary recommendations were introduced for 220 million US and 56 million UK citizens by 1983, in the absence of supporting evidence from RCTs. No differences in all-cause mortality and non-significant differences in heart disease mortality resulting from the dietary interventions (reductions in cholesterol). Government dietary fat recommendations were untested in any trial prior to being introduced.

  • https://academic.oup.com/ajcn/article-abstract/49/5/889/4651908 Food consumption patterns in the 1960s in seven countries. May 1989. Ancel Keys.

  • https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015

  • https://www.ncbi.nlm.nih.gov/pubmed/23674795 Dietary fats and health: dietary recommendations in the context of scientific evidence. May 2013. The replacement of saturated fats with carbohydrates, especially sugars, has resulted in increased obesity and associated health complications. Numerous other factors increase risk of heart disease. Past association between saturated fats and heart diseases most likely due to factors other than SFAs. Change existing dietary recommendations that focus on minimizing dietary SFAs.

  • https://thebigfatsurprise.com The big fat surprise by Nina Teicholz. Why Butter, Meat & Cheese Belong in a Healthy Diet. May 2014. How the past 60 years of low-fat nutrition advice has amounted to a vast uncontrolled experiment on the entire population, disastrous for our health. How the misinformation about saturated fats took hold in the scientific community and the public imagination and how recent findings overturned these beliefs.

  • https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/executive-summary/ Dietary Guidelines 2015-2020 Executive Summary

Saturated fats and cholesterol do NOT cause cardiovascular diseases!

  • https://www.bmj.com/content/366/bmj.l4137.long WHO draft guidelines on dietary saturated and trans fatty acids: time for a new approach? Jul 2019. The 2018 WHO guidelines recommend reducing total intake of saturated fat and to replace it with polyunsaturated and monounsaturated fats. They fail to take into account considerable evidence that the health effects depend on the specific fatty acid and food source. It works against reducing chronic disease incidence and mortality.

  • https://www.ncbi.nlm.nih.gov/pubmed/30544168 Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis. Mar 2019. Carb-restricted diets showed no significant difference in LDL, but better HDL and triglycerides. Even more favorable very-low carb (< 50 g/d). Carb restriction superior in improving lipid markers compared with low-fat diets, and should be considered for populations with cardiometabolic risk.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366352/ Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Feb 2019. CVDs are a leading cause of death globally. Key CVD risk factors: hypertension, dyslipidemia, tobacco use and elevated HbA1c.

  • https://www.cochrane.org/CD011094/VASC_omega-6-fats-prevent-and-treat-heart-and-circulatory-diseases Omega-6 fats to prevent and treat heart and circulatory diseases. Nov 2018. Increasing O6 make little or no difference to deaths or CV events. It reduces blood cholesterol, but little to no difference to triglycerides, HDL or LDL.

  • https://actascientific.com/ASNH/pdf/ASNH-02-0083.pdf Evaluation of Chemical and Physical Changes in Different Commercial Oils during Heating. Jun 2018.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024687/ Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease. Jun 2018. No evidence for role of dietary cholesterol in development of CVD. The 2015–2020 Dietary Guidelines for Americans removed the recommendations of restricting dietary cholesterol to 300 mg/day but still recommending max of 3 eggs /week.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011508/ Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. Jun 2018. Hypertension. Low or moderate physical activity. Obesity. Smoking.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986484/ Inflammation, not Cholesterol, Is a Cause of Chronic Disease. May 2018. Inflammation leads to CVDs, not cholesterol. Reducing incidence of CVD by controlling inflammatory mediators via diet, exercise, and healthy lifestyle choices.

  • https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0698-8 Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open label, non-randomized, controlled study. May 2018. Nutritional ketosis improved most biomarkers of CVD risk. Increase in LDL limited to large LDL. Significant improvements in small LDL-P, ApoA1, triglyceride/HDL-C ratio, HDL-C, hsCRP (inflammation), LP-IR (insulin resistance) and blood pressure.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793267/ Fat, Sugar, Whole Grains and Heart Disease: 50 Years of Confusion. Jan 2018. In 70s, investigators said refined carbs were major factors in heart disease. A switch from SFA to refined carbs does not lower total cholesterol/HDL and does not prevent CHD. Reduced intake of SFA combined with increased PUFA lowers total cholesterol/HDL and may reduce the risk of CHD. Refined carbohydrates, especially sugar-sweetened beverages, increase the risk of CHD.

  • https://www.ncbi.nlm.nih.gov/pubmed/27697938 Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis. Dec 2017. No significant difference in CHD mortality and total fat or saturated fat intake. All RCTs and evidence available at the time of introducing the guidelines (1977 and 1983) and now, show no effect of total or saturated dietary fat on all-cause or heart disease mortality.

  • https://blog.rosemarycottageclinic.co.uk/2017/11/19/carbohydrates-not-animal-fats-linked-to-heart-disease-across-42-european-countries/ Nov 2017 Carbohydrates, not animal fats, linked to heart disease. Raised cholesterol (from consumption of animal fats and proteins) correlated negatively with CVD risk. Carbs correlated with CVD risk. Fat and Protein correlated negatively with CVD risk.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708308/ Added sugars drive coronary heart disease via insulin resistance and hyperinsulinaemia: a new paradigm. Nov 2017. Added sugars increase risk of CHD, diabetes and insulin resistance. CHD worsened with high sugar diet, but reversed with low sugar diet. Overconsumption of added sugars is a principal driver of CHD. Over the past 200 years, added sugar intake increased from 4 to 120 lb/year. Sugar more rewarding than cocaine, and arguably the most widely consumed addictive substance around the world.

  • https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Nov 2017. Epidemiological cohort study in 18 countries with a follow-up of 7.4 years. 135 335 individuals. Higher carb intake associated with increased risk of total mortality but not with risk of CVD or CVD mortality. Intake of each type of fat associated with lower risk of total mortality (saturated fat HR 0.86, MUFA HR 0.81 and PUFA HR 0.80). Total fat and types of fat not associated with CVD, myocardial infarction, or CVD mortality. Saturated fat associated with lower risk of stroke.

  • https://www.ncbi.nlm.nih.gov/pubmed/28750216 Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials. Sep 2017. LCD significantly improved CV risk factors: reduced triglycerides, HBA1C and increased HDL. LCD did not decrease total cholesterol.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408160/ Heart Disease and Stroke Statistics—2017 Update. Sep 2017. Core health behaviors (smoking, physical activity, diet and weight) and health factors (cholesterol, blood pressure BP, and glucose control) contribute to CV health.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686931/ Risk Factors for Coronary Artery Disease: Historical Perspectives. Jul-Sep 2017. The risk factors that can be controlled are High BP; high blood cholesterol levels; smoking; diabetes; overweight or obesity; lack of physical activity; unhealthy diet and stress.

  • https://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30283-8/fulltext Association of dietary nutrients with blood lipids and blood pressure in 18 countries: a cross-sectional analysis from the PURE study. Aug 2017. Intake of total fat and each type of fat associated with higher total cholesterol, LDL, HDL and ApoA1, and lower triglycerides, total cholesterol/HDL, triglycerides/HDL, ApoB/ApoA1. Higher carb intake associated with lower total cholesterol, LDL , ApoB, HDL and ApoA1, and higher triglycerides, total cholesterol/HDL, triglycerides/HDL, and ApoB/ApoA1. Replacement of saturated fats with carbs associated with most adverse effects on lipids. Replacement of saturated with unsaturated fats improved some risk markers (LDL and blood pressure), but worsen others (HDL and triglycerides). ApoB/ApoA1 ratio best overall indication of effect on CVD risk. LDL alone does not capture the effects of nutrients on CV risk.

  • https://www.ncbi.nlm.nih.gov/pubmed/28752053 Dietary sugars, not lipids, drive hypothalamic inflammation. Jun 2017. Combined overconsumption of fat and sugar, not overconsumption of fat alone, leads to inflammatory responses and to dysfunction in the control of energy metabolism.

  • https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0254-5 The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials. May 2017. Replacing SFA with O6 PUFA unlikely to reduce CHD events, CHD mortality or total mortality. Benefits reported in the past due to inclusion of inadequately controlled trials. Results from adequately controlled trials show no effect for major CHD events, total CHD events, CHD mortality and total mortality. Whereas pooled results including inadequately controlled suggested replacing SFA with O6 PUFA reduce risk of total CHD events, but not major CHD events, CHD mortality and total mortality.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365373/ Added Sugars and Cardiovascular Disease Risk in Children. May 2017. Associations between added sugars and increased CVD risk factors present at levels far below current consumption levels. Strong association of added sugars with increased CVD risk through increased energy intake, adiposity and dyslipidemia. Consume ≤25 g (≈6 teaspoons) of added sugars per day and avoid added sugars <2 years of age.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331469/ Primary prevention of cardiovascular disease: A review of contemporary guidance and literature. Jan 2017. The American, European and British guidelines give methods to reduce CVD risk with strong consensus for smoking and exercise.

  • https://www.bmj.com/content/353/bmj.i1246 Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). Apr 2016. Replacement of saturated fat with linoleic acid (vegetable oils) lowers cholesterol but not risk of death from heart disease or all causes.

  • http://www.ncbi.nlm.nih.gov/pubmed/26768850 Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Feb 2016. LC diets (vs LF) led to a greater weight loss and TAG but a greater increase in HDL and LDL.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744652/ Saturated Fats Versus Polyunsaturated Fats Versus Carbohydrates for Cardiovascular Disease Prevention and Treatment. Feb 2016. Effects of saturated fats on CVD risk depend on nutrients that replace them and food matrices. Replacement with PUFAs associated with reduced CVD risk. Replacement with carbs, particularly sugar, associated with no improvement or worsening of CVD risk (due to small, dense LDL). SFAs from dairy foods, particularly fermented, have neutral or inverse associations with CVD. Vegetables, fish, nuts and whole versus processed grains are heart-healthy and should supersede a focus on macronutrient composition.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856550/ The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease. Nov 2015. TC only modestly associated with CHD, and more important is the number and size of LDL particles. SFAs may pose no risk for CHD or possibly even be protective. Advice to reduce saturated fat without regard to nuances about LDL or dietary sources could increase people's risk of CHD. When replaced with refined carbs, specifically added sugars, not favorable, due to changes in LDL, HDL and triglycerides, elevated levels of glucose, insulin, and uric acid, impaired glucose tolerance, insulin and leptin resistance, non-alcoholic fatty liver disease, and altered platelet function. A diet high in added sugars associated with 3-fold increased risk of death due to CVD. To reduce CHD, guidelines should focus on reducing intake of sugars, especially from ultra-processed foods and beverages.

  • https://www.bmj.com/content/351/bmj.h3978. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. Aug 2015. Saturated fats not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but evidence heterogeneous with limitations. Trans fats associated with all cause mortality, total CHD, and CHD mortality.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240601/ Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids and Palmitoleic Acid in Adults with Metabolic Syndrome. Nov 2014. Increase saturated fat intake and decrease carb (32 to 84 g/day fat and 346 to 47g carbs), and then decrease saturated fat and increase carbs: no significant changes in blood SFA. Palmitoleic acid (biomarker associated with adverse health outcomes) in triglyceride and cholesteryl ester significantly reduced as carb intake decreased, and then increased as carb reintroduced. Dietary and plasma saturated fat not related.

  • https://www.ncbi.nlm.nih.gov/pubmed/24723079 Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Mar 2014. No support for CV guidelines encouraging high consumption of PUFAs and low consumption of saturated fats.

  • https://www.bmj.com/content/346/bmj.e8707 Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis Feb 2013. Replacement of dietary saturated fats with O6 linoleic acid (vegetable oil and margarine) led to higher rates of death from all causes, coronary heart disease and CVD.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530364/ Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials. Oct 2012. Vs low-fat diets, low-carb diets show lower reduction in total cholesterol and LDL but a greater increase in HDL and a greater decrease in triglycerides. Low-carb diets at least as effective at reducing weight and improving metabolic risk factors.

  • http://www.springerlink.com/content/1665l525j917h055/?MUD=MP The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. July 2012. No support for high-fat dairy foods contributing to obesity or cardiometabolic risk and inverse association with obesity risk.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247776/ Low Cholesterol is Associated with Mortality from Cardiovascular Diseases: A Dynamic Cohort Study in Korean Adults. Jan 2012. Groups with lowest TC < 160 mg/dL as well as highest >= 240 mg/dL were associated with higher CVD mortality. Caution in prescribing statins for people at low CV risk.

  • https://www.ncbi.nlm.nih.gov/pubmed/22905670 Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on CV risk factors. Aug 2012. LCD significantly decrease body weight, BMI, blood pressure triglycerides, fasting glucose, HBA1C, insulin, CRP and an increase in HDL. No change in LDL. LCD favourable for major CV risk factors.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974193/ Limited Effect of Dietary Saturated Fat on Plasma Saturated Fat in the Context of a Low Carbohydrate Diet. Sep 2010. CRD (12% carb), one with SFA and the other with UFA. Both decreased triacylglycerol and insulin, and increased LDL-C particle size. The CRD-UFA significantly decreased TAG SFA but no change in CRD-SFA despite a doubling in SFA intake. Both significantly reduced palmitoleic acid (decreased de novo lipogenesis). CRD-SFA significantly increased ARA (arachinodic acid) content. CRD-UFA significantly increased EPA and DHA. Dietary saturated fat is efficiently metabolized in the presence of low carbohydrate, and CRD results in better preservation of ARA.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824150/ Saturated fat, carbohydrate, and cardiovascular disease. Mar 2010. Replacement of saturated fats with a higher carbs, particularly refined, can exacerbate the atherogenic dyslipidemia associated with insulin resistance and obesity (increased triglycerides, small LDL particles, and reduced HDL). Dietary efforts to reduce CVD risk should primarily limit refined carb intakes and excess adiposity.

  • https://academic.oup.com/ajcn/article/91/3/535/4597110 Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Jan 2010. Intake of saturated fat not associated with an increased risk of CHD, stroke, or CVD.

  • https://link.springer.com/article/10.1007%2Fs11745-008-3274-2 Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Apr 2009. CRD reduced glucose, insulin, adiposity and more favorable triacylglycerol, HDL-C and total cholesterol/HDL-C ratio. More favorable indicators of CV risk: postprandial lipidemia, Apo B/Apo A-1 ratio, and LDL particles. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated fatty acids in TAG and cholesteryl ester were significantly decreased, as was palmitoleic acid (marker of lipogenesis), compared to the LFD. Insulin-resistance only decreased in the CRD. Markers of MetS connected with dietary carb. Carb restriction effective approach to improve features of MetS and CV risk.

  • https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1745-4506.2001.tb00028.x Health effects of oxidised heated oils. Jun 2006. Fried foods with PUFA oils may pose health risks (incl. atherosclerosis, inflammatory joint disease, digestive issues, cancers, birth defects). Heat degrades PUFA to toxic compounds; saturated and monounsaturated fatty acids resistant to heat‐induced degradation.

  • https://www.ncbi.nlm.nih.gov/pubmed/14601690/ Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease. Nov 2003. In patients with CVD, total body weight, body fat % and triglycerides decreased. HDL and LDL unchanged, but HDL size and LDL size increased.

  • https://www.ncbi.nlm.nih.gov/pubmed/10837285 A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Jun 2000. Glycemic load directly associated with risk of CHD after adjustment for confounding risk factors (from relative risk of 1.00 to 1.98), especially among women with BMI >= 23.

0022 – From vegan to carnivore, and everything in between (part II)

A well-formulated ketogenic nutrition

  • https://coremedscience.com/blogs/wellness/thrive-on-the-keto-diet-by-avoiding-these-common-nutrient-deficiencies Thrive on the Keto Diet By Avoiding These (Common) Nutrient Deficiencies. B7, B9, selenium, choline, vitamins A, E, D, chromium, iodine, magnesium, and molybdenum are among the most common deficiencies on keto. Top foods: meat, poultry, eggs, fish, liver, vegetables, nuts and seeds, avocados...

  • https://hvmn.com/blog/keto-diet/dangers-of-the-keto-diet-debunked Dangers of the Keto Diet Debunked. 2019. Bad fats linked to disease risk are trans & hydrogenated fats from vegetable oils, processed snacks, baked goods and margarine. Keto “side effects” from imbalanced electrolytes. Large amount of water lost, with essential minerals. Nutrient-rich foods: Non-starchy veggies, mushrooms, some fruits, leafy greens, avocados, meat and dairy.

  • https://www.everydayhealth.com/diet-nutrition/ketogenic-diet/what-are-benefits-risks-keto-diet/ A Detailed Guide to the Potential Health Benefits and Risks of the Keto Diet. 2019. Potential risks: kidney stones, vitamin and mineral deficiencies, decreased bone mineral density, and gastrointestinal distress.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174488/ Effects of low carbohydrate diets high in red meats or poultry, fish and shellfish on plasma lipids and weight loss. 2007. High cholesterol and fat don't change blood cholesterol. Triglycerides reduced with PFS diet.

What about carnivores?

  • https://www.healthline.com/nutrition/carnivore-diet All You Need to Know About the Carnivore (al-Meat) Diet. 2019. High intakes not linked to higher risk of heart disease. Processed meat linked to certain types of cancer, including colon and rectal. Carnivore Diet may lead to deficiencies in nutrients. No fiber, which may lead to constipation and suboptimal gut bacteria, which can lead to weakened immunity and colon cancer. Those sensitive to cholesterol should be cautious.

  • https://www.woodpath.com/guide/the-complete-guide-to-the-carnivore-diet The Complete Guide to the Carnivore Diet. 2019. Fluid Adaptation with kidneys releasing sodium. May reduce brain inflammation. Possible deficiencies in vitamin C, E, folate found in plant food. Processed meats may be linked to cancer. Red meat cooked >300 degrees F can be carcinogenic. Heavy burden on the kidneys and the liver. To break down proteins, the urea cycle uses genetically coded enzymes.

  • https://www.woodpath.com/guide/the-complete-guide-to-the-carnivore-diet The Complete Guide to the Carnivore Diet. 2019. For people with IBD or IBS to alleviate symptoms. Possible deficiency in vit C, E, K2 and calcium. Dairy will cover K2 and calcium. Organ meats needed for vit A, folate, mg, manganese. Vitamin C extremely heat sensitive. Lacks Phytonutrients. >35 to 40% of total calories as protein can overwhelm urea cycle, leading to nausea, diarrhea...

  • https://blog.daveasprey.com/carnivore-diet-results/ CARNIVORE DIET RESULTS: WHY IT WORKS FOR SOME PEOPLE BUT DIDN’T FOR ME. Eat organic, grass-fed meat to limit exposure to bad fats, glyphosate, artificial hormones, and antibiotic. Do not burn, char, fry or over-cook meat. Avoid processed meat (risk of type 2 diabetes). Excess insulin promotes oxidation and inflammation, increasing the risk of obesity, diabetes, cancer and heart disease. It also accelerates aging.

The controversy about eating meat

  • https://jamanetwork.com/journals/jama/fullarticle/2759201 Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists. 2020.

  • http://theconversation.com/yes-eating-meat-affects-the-environment-but-cows-are-not-killing-the-climate-94968 Yes, eating meat affects the environment, but cows are not killing the climate. 2019.

  • https://annals.org/aim/fullarticle/2752328/unprocessed-red-meat-processed-meat-consumption-dietary-guideline-recommendations-from. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations Consortium. 2019. Based on observational studies (52 studies - 3.7m people) at risk for confounding. Unprocessed Red Meat & Processed Meat: continue current consumption. Studies showed little or no effect on the risk for major cardiometabolic outcomes, cancer mortality, T2 diabetes, or all-cause mortality.

  • https://www.healthline.com/nutrition/20-mainstream-nutrition-myths-debunked 20 Mainstream Nutrition Myths (Debunked by Science). 2019. Some studies have shown negative effects, but lumping processed and unprocessed meat together. Largest studies (>1 and 0.4 million people) show unprocessed red meat not linked to increased heart disease or T2 diabetes. Burnt meat may be harmful.

  • https://www.ncbi.nlm.nih.gov/books/NBK507972/#_NBK507972_pubdet_CANCER IN HUMANS 2018 In this section, the Working Group summarized the results of existing studies.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394987/ mTOR Signaling in Growth, Metabolism, and Disease. 2018. Deregulated mTOR signaling implicated in progression of cancer, diabetes, and aging.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407540/#__ffn_sectitle Association between red meat consumption and colon cancer: A systematic review of experimental results. 2017 Limitations in existing studies and insufficient evidence to confirm link between red meat and colorectal cancer.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669970/ Red and processed meat consumption and colorectal cancer risk: a systematic review and meta-analysis. 2017. Consumption of red and processed meat associated with risk of colorectal cancer but not rectal cancer. No associations with distal and proximal colon cancer risk.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/28450127/ Carcinogenicity of consumption of red meat and processed meat: A review of scientific news since the IARC decision. 2017. Reviews supporting IARC decision but with a number of gaps.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/26633248/ Meat consumption and cancer risk: a critical review of published meta-analyses. 2016 Increased risk of cancer in subjects consuming large amounts of red and processed meat, but not those eating white meat or poultry.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4128044/ Therapeutic targeting of the mTOR-signalling pathway in cancer: benefits and limitations. 2014. mTOR plays a role in cell growth. Deregulation of mTOR-signalling common in cancer and tumour progression.

Is there anything to do to optimise a paleo diet?

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647066/ Influence of Paleolithic diet on anthropometric markers in chronic diseases: systematic review and meta-analysis. 2019. The Paleo diet may assist in controlling weight, waist circumference and chronic diseases but more RCT necessary.

  • https://www.ncbi.nlm.nih.gov/pubmed/31041449 Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 2019. PD reduced body weight, waist circumference, BMI, body fat percentage, blood pressure, total cholesterol, TG, LDL and CRP and significantly increased HDL. Results variable, must be interpreted with caution. PD has favorable effects on cardiovascular disease risk factors, but more trials needed.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588744/ Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. 2015. Paleo diet resulted in greater improvements in waist circumference, triglycerides, blood pressure, HDL and fasting blood sugar. Additional evaluations needed.

0021 – From vegan to carnivore, and everything in between (part I)

What are the reasons for adopting a specific diet?

  • https://www.organicconsumers.org/news/they-eat-what-what-are-they-feeding-animals-factory-farms They Eat What? What Are They Feeding Animals on Factory Farms. Extracted on 25 Jan 2020. Most of the food animals in the US come from large confined animal feeding operations (CAFOs) that reduce costs by using ingredients that are what animals are designed by nature to eat: Same Species Meat; Diseased Animals, Feathers, Hair, Skin, Hooves, and Blood; Manure and Other Animal Waste; Plastics (replacement for fibres); Drugs and Chemicals; Unhealthy Amounts of Grains.

  • https://www.nature.com/articles/s41398-019-0552-0 The effects of plant-based diets on the body and the brain: a systematic review. 12 Sep 2019. Robust evidence for short- to moderate-term beneficial effects of plant-based diets on weight, energy metabolism and systemic inflammation. But no evidence on cognitive functions, mental and neurological health and respective underlying mechanisms.

How vegans and vegetarians can optimise their diet

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470702/. The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. 6 Mar 2019. Plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12. See details on deficiencies and solutions in the article. A well planned vegetarian and vegan diets may be considered safe if strong awareness for a balanced intake of key nutrients.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/29510788/ Nutritional Considerations for the Vegetarian and Vegan Dancer. 2018. Vegetarians and vegans should ensure sufficient intake of Vitamin B12, D, Omega-3, calcium, and zinc. Diminished bioavailability of iron from plants.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028 Vegan diets: practical advice for athletes and exercisers. 13 Sep 2017. Veganism creates challenges to be accounted for when designing a nutritious diet: the sufficiency of protein, vitamin B12, iron, zinc, calcium, iodine and vitamin D; and the lack of Omega-3 fatty acids EPA and DHA. The strategic management of food and appropriate supplementation can be designed to achieve the dietary needs satisfactorily. See details on deficiencies and solutions in the article.

  • https://www.ncbi.nlm.nih.gov/books/NBK396513/ Might a Vegan Diet Be Healthy, or Even Healthier? 2016 Vegans need to eat a good range of foods for protein. Fortified cereals and yeast for B12. Adequate exposure to sunlight for vitamin. Omega-6:Omega-3 ratio target of 1:1 to 2:1, versus 15:1 to 17:1 in Western diets.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854817/ Plant-Based Diets Are Not Nutritionally Deficient. Fall 2013. No deficiency of protein, iron, calcium, or essential fatty acids. But supplement in vitamin B12 and adequate sunshine for vitamin D. Iron may be lower.

  • https://www.ncbi.nlm.nih.gov/m/pubmed/12868158/ Nutrition and health--potential health benefits and risks of vegetarianism and limited consumption of meat in the Netherlands. 2003 A vegan diet leads to a strongly increased risk of deficiencies of vitamin B12, B2 and minerals such as calcium, iron and zinc.

Vitamin B12

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188422/ Vitamin B12 among Vegetarians: Status, Assessment and Supplementation. 29 Nov 2016. Vegetarian diet very high in fiber, reduces the absorption of some nutrients. Vitamin B12 among vegetarians and sources for sufficient intake.

  • https://www.ncbi.nlm.nih.gov/pubmed/23356638/ How prevalent is vitamin B(12) deficiency among vegetarians? 2 Jan 2013. B12 only available in animal foods, vegans at much higher risk of deficiency. Algae, mushrooms, and fermented soy products contain B12.

Vitamin D

  • https://www.healthline.com/nutrition/vitamin-d-foods-for-vegetarians?slot_pos=article_4&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=authoritynutrition&utm_content=2020-01-21&apid= 6 Good Sources of Vitamin D for Vegetarians. 14 Jan 2020. Exposing face, arms, legs or back to sunlight for 30 minutes twice a week without sunscreen usually sufficient for optimal vitamin D levels, but depends on many factors. Sources: mushrooms, egg yolks.


  • https://www.sciencedirect.com/science/article/pii/S0165032716323916 Vegetarian diets and depressive symptoms among men. 1 Jan 2018. Iron is the most common nutritional deficiency in the world, and vegans and vegetarians are at higher risk. Plant foods contain non-heme iron that is much less absorbable.


  • https://www.ncbi.nlm.nih.gov/pubmed/23595983 Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans.29 May 2013. Low zinc in vegetarians due to plant foods containing phytic acid that inhibit absorption. Supplement or eat mushrooms, chickpeas, kidney beans, tofu, kale, and whole grains.


  • https://www.dietdoctor.com/low-carb/fruits-and-vegetables?utm_source=Diet+Doctor+newsletter&utm_campaign=12fade4161-ENG_DD_WEEKLY_GENERAL_22%2F01%2F20&utm_medium=email&utm_term=0_41db911777-12fade4161-470108977 Do you need to eat fruits and vegetables? Updated 13 Jan 2020. For some people, fruits and vegetables may cause issues due to salicylates, oxalates, histamines, FODMAPS. Meat, fish, and dairy provide essential vitamins and minerals.


  • https://www.ncbi.nlm.nih.gov/pubmed/25599185 Lectins, agglutinins, and their roles in autoimmune reactivities. 2015.

  • https://www.ncbi.nlm.nih.gov/pubmed/10764712 Decreased levels of heat shock proteins in gut epithelial cells after exposure to plant lectins. May 2000.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115436/ Do dietary lectins cause disease? 17 Apr 1999. Legumes have high levels of antinutrients including lectins and phytates, that can increase intestinal permeability (leaky gut). Proteins from animals do not contain anti-nutrients and are higher in nutrition.


  • https://www.ncbi.nlm.nih.gov/pubmed/28043181 Dietary modifications in atopic dermatitis: patient-reported outcomes. Sep 2017.

  • https://www.ncbi.nlm.nih.gov/pubmed/26468350 Non-coeliac gluten sensitivity and reproductive disorders. Fall 2015.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406911/ Non-coeliac gluten sensitivity: piecing the puzzle together. Apr 2015. Gluten can be a trigger of gastrointestinal and/or extra-intestinal symptoms in patients without coeliac disease.

  • https://www.ncbi.nlm.nih.gov/pubmed/19332085 Effects of wheat germ agglutinin on human gastrointestinal epithelium: insights from an experimental model of immune/epithelial cell interaction. 1 Jun 2009.

  • https://www.ncbi.nlm.nih.gov/pubmed/24885375 An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. 23 May 2014.

  • https://www.ncbi.nlm.nih.gov/pubmed/3701733 Arthritis associated with gluten-sensitive enteropathy. Feb 1986.


  • https://www.ncbi.nlm.nih.gov/pubmed/19674804 Phytate degradation by human gut isolated Bifidobacterium pseudocatenulatum ATCC27919 and its probiotic potential. 30 Sep 2009.

  • https://www.ncbi.nlm.nih.gov/pubmed/24529702 A bacterial homolog of a eukaryotic inositol phosphate signaling enzyme mediates cross-kingdom dialog in the mammalian gut. 27 Feb 2014.


  • https://www.ncbi.nlm.nih.gov/pubmed/10726162 Hemolysis of human erythrocytes with saponin affects the membrane structure. Feb 2000.


  • https://www.kidney.org/atoz/content/what-are-oxalate-kidney-stones What are Oxalates and Why are They a Concern for Kidney Disease Patients? Extracted 25 Jan 2020.

  • https://kidneystones.uchicago.edu/how-to-eat-a-low-oxalate-diet/ How To Eat A Low Oxalate Diet. Extracted 25 Jan 2020.

  • https://www.health.harvard.edu/blog/5-things-can-help-take-pass-kidney-stones-2018030813363 5 things that can help you take a pass on kidney stones. 3 Mar 2018.


  • https://www.healthline.com/health/allergies/nightshade-allergies#allergy-vs-intolerance Nightshade Allergy. 12 Apr 2017.


  • https://www.monashfodmap.com/about-fodmap-and-ibs/ FODMAPs and Irritable Bowel Syndrome. Extracted 25 Jan 2020.

  • https://www.healthline.com/nutrition/low-fodmap-diet A Beginner's Guide to the Low-FODMAP Diet. 15 Mar 2017


  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976923/ Omega-3 Fatty Acids and Depression: Scientific Evidence and Biological Mechanisms. 2014.

  • https://www.mja.com.au/journal/2013/199/4/omega-3-polyunsaturated-fatty-acids-and-vegetarian-diets Omega-3 polyunsaturated fatty acids and vegetarian diets. 29 Oct 2013.

  • https://www.ncbi.nlm.nih.gov/pubmed/18589030 Algal-oil capsules and cooked salmon: nutritionally equivalent sources of docosahexaenoic acid. Jul 2008.

  • https://www.ncbi.nlm.nih.gov/pubmed/12936959 Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Sep 2003.

  • https://www.ncbi.nlm.nih.gov/pubmed/12442909 The importance of the ratio of omega-6/omega-3 essential fatty acids. Oct 2002. Excessive omega-6 and high omega-6/omega-3 ratio promote pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases. Increased omega-3 suppress these effects.

Excess consumption of carbohydrates

  • https://www.healthline.com/nutrition/fiber-and-constipation-truth Does Fiber Relieve or Cause Constipation? A Critical Look. 15 Sept 2016

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/ Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. 7 Sep 2012. Constipation and associated symptoms can be reduced by stopping or lowering the fiber intake.

  • https://www.niddk.nih.gov/health-information/communication-programs/ndep/health-professionals/game-plan-preventing-type-2-diabetes/prediabetes-screening-how-why/recommended-tests-identifying-prediabetes Recommended Tests for Identifying Prediabetes. Extracted 25 Jan 2020. 3 blood testing methods to identify prediabetes: A1C, fasting plasma glucose, and 2h post oral glucose challenge.

Fake meat

  • https://newrepublic.com/article/153998/promise-problem-fake-meat-beyond-burger-impossible-foods The Promise and Problem of Fake Meat. 7 Jun 2019.

0020 - What to do when you have the flu?

  • https://en.m.wikipedia.org/wiki/Flu_season. In the US, flu season is October to May. Peaks in February. In Australia, May to October, peak in August.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139312/ Treating Influenza Infection, From Now and Into the Future. 10 Sep 2018. Annual flu epidemics infect 1 billion individuals, 3 to 5 million severe illness and half a million fatalities worldwide. Effectiveness of NAIs limited when delivered over 48 h after symptom onset.

  • https://www.who.int/en/news-room/detail/14-12-2017-up-to-650-000-people-die-of-respiratory-diseases-linked-to-seasonal-flu-each-year Up to 650 000 people die of respiratory diseases linked to seasonal flu each year. 14 Dec 2017.

  • https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) 4 types of influenza viruses, A, B, C and D. A and B cause seasonal epidemics. A(H1N1) caused pandemic in 2009. C is less frequent and usually mild. D affect animals. Worldwide, annual epidemics result in about 3 to 5 million cases of severe illness, and about 290 000 to 650 000 respiratory deaths. People at risk of complications: pregnant women, children <59 months, elderly, individuals with chronic medical conditions or immunosuppressive conditions. Patients not from high risk group should be managed with symptomatic treatment and stay home. Patients at high risk should be treated with antivirals + vaccination.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362519/. Influenza Vaccines: Challenges and Solutions. 11 Mar 2016. Influenza A and B viruses result in annual epidemics, attack rate of 5–10% and 20–30% in adults and in children. 4 pandemics within the past 100 years. Vaccination can reduce illness and lessen severity of infection, particularly in groups at risk for complications. The elderly are most vulnerable but the effectiveness of vaccines in this age group is very poor.

What is the difference between the flu and a cold?

  • https://www.ncbi.nlm.nih.gov/books/NBK279459/ Flu: Overview 18 Dec 2013; Last Update: 7 Nov 2019. Colds are much more common than the flu. Colds start gradually, flu strike quickly and cause more severe symptoms. Cold over within a week, with or without treatment. Flu: fever, a headache, joint pain, and a stuffy or runny nose. Entire body rather than just the airways. These usually improve a lot within one week. Coughing and exhaustion may last longer. Fever between 38°C and 40°C (about 100-104°F) or higher. If you are infected with a particular virus, you will be immune but flu viruses are always changing. Painkillers such as acetaminophen, acetylsalicylic acid and ibuprofen can relieve pain and reduce the fever. Flu medication is also available to be taken within two days after the flu starts to reduce the duration of the flu by up to one day. But often causes nausea and vomiting. Not clear whether it helps to prevent complications. Antibiotics only help if you have a bacterial infection.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5141587/#__ffn_sectitle Influenza. 7 Dec 2016. Influenza A, B, C, and D but only influenza A and B viruses cause important human disease and seasonal epidemics. Sudden onset of fever, myalgia, headache, malaise, dry cough, sore throat, and nasal congestion. Gastrointestinal symptoms including nausea, vomiting and diarrhoea are also common. Antiviral recommended for >65 years old; Individuals with chronic health conditions, reduced immunity, pregnant women, morbidly obese. Most randomised trials of antiviral drugs have shown modest reductions in symptom duration (0.7 days). In healthy adults, vaccines have an overall vaccine efficacy of 60%. Children <6 months not eligible for vaccines. Common side effects of vaccination include cold-like symptoms. Fever, malaise, and myalgia less common. Contraindications: allergic reaction, severe immunodeficiency.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928210/#__ffn_sectitle. Prevention and treatment of the common cold: making sense of the evidence. 18 Feb 2014; Cold symptoms relate to the infected mucosa, typically last 7–10 days. They include sore throat, rhinitis, rhinorrhea, cough and malaise. Best researched treatments showing efficacy: zinc, probiotics, gargling with water, vitamin C, decongestants, OTC NSAID and acetaminophen, honey. Antibiotics have no beneficial effect on the common cold but do increase adverse events.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523090/ New treatments for influenza. 13 Sep 2012. Flu: high fever, chills, sore throat, headache, runny or stuffy nose, weakness, muscle pain and sometimes diarrhea.

Should you get the flu shot?

  • https://www.ncbi.nlm.nih.gov/books/NBK459363/ Influenza. Last Update: 5 Dec 2019. Usually, patients who received vaccine have milder symptoms and less likely to develop complications. No antiviral needed in healthy individuals. Individuals at risk of developing complications should get the flu vaccine.

  • https://www.ncbi.nlm.nih.gov/books/NBK537197/#_NBK537197_pubdet_ Influenza Vaccine. 8 Oct 2019. Influenza A and B viruses result in 3–5 million severe cases and thousands of deaths globally each year. Four pandemics in the past century: 1918, 1957, 1968 and 2009. Vaccine efficacy of 10% to 60%. Lowest efficacy when vaccine strains not well matched to circulating strains. Adverse Effects : Fever; Drowsiness; Myalgia; respiratory symptoms ; headache ; vomiting... Vaccines contain formaldehyde, thimerosal, aluminum salts, gelatin, antibiotics. Not toxic due to the small amounts.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682587/ Influenza Vaccination: Effectiveness, Indications, and Limits in the Pediatric Population. 30 Jul 2019. Vaccine effectiveness in children is variable and suboptimal. No vaccine for infants <6 months. Instead maternal immunization, with efficacy of 50–60%.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446950/ Interim 2018/19 influenza vaccine effectiveness: six European studies, October 2018 to January 2019. 21 Feb 2019. 2018/19 vaccine effectiveness was 32–43%.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160951/ The Future of Influenza Vaccines: A Historical and Clinical Perspective. 30 Aug 2018.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027411/figure/vaccines-06-00028-f001/?report=objectonly Vaccine effectiveness from the U.S. and Canada. June 2018. CDC vaccine effectiveness of x% means that on average the flu vaccine reduces a person's risk of a flu outcome by x%. Effectiveness per age group and year (2011/12 to 2015/16).

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027411/ Immune History and Influenza Vaccine Effectiveness. 21 May 2018. Imperfect effectiveness of flu vaccines due to antigenic mismatch, but even when the match appears good, effectiveness can be low. Vaccines rarely confer complete protection due to variation in vaccine immunogenicity and in individuals’ responsiveness.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861790/ Influenza vaccines: Evaluation of the safety profile. 30 Jan 2018.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5853256/ Flu Vaccine—Too Much of a Good Thing? 9 Feb 2017. Biggest negative effect on efficacy when previous and current vaccines are antigenically similar, and the circulating virus is significantly drifted.

  • https://www.cdc.gov/flu/prevent/general.htm Flu Vaccine Safety Information Flu vaccines have a good safety record. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and extensive research supporting the safety of the vaccines.

  • https://www.who.int/vaccine_safety/committee/topics/influenza/en/ Global Vaccine Safety There are several issues related to influenza vaccines.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070843/ How to treat influenza and colds. Apr 2000. Annual vaccination effectively protects against more serious complications.

What about antiviral medication?

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871211/ 6 Apr 2016. Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies. Currently employed influenza vaccines are only effective when the vaccine strains match the epidemic strains. Zanamivir or oseltamivir can reduce duration of flu by ~1 day when administered within 48 hours, up to 3.5 days when started within 24 hours. The frequent alterations in the viral antigenic structure pose difficulties in the development of vaccine. No fully effective medication or vaccine, seeking for alternative therapies is a reasonable option. Review of studies for maoto, licorice roots, antiwei, North American ginseng, elderberry, echinacea, pomegranate, guava tea, nakai, baicalin, Bai Shao. Zinc, vitamin C, probiotics, seaweed, vitamin D, yeast-based product, aged garlic, lactoferrin. Grounding and earthing anti-inflammatory and antioxidant and accelerated immune response following vaccination.

  • https://www.ncbi.nlm.nih.gov/pubmed/24718923. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. 10 Apr 2014. Reduction in the time to first alleviation of symptoms from 7 to 6.3 days for one drug, from 6.6 to 6.0 days for another.

  • https://www.ncbi.nlm.nih.gov/pubmed/20815736 Early oseltamivir treatment of influenza in children 1-3 years of age: a randomized controlled trial. 15 Oct 2010. Reduce duration of flu by ~1 day when administered within 48 hours, up to 3.5 days when started within 24 hours.

  • https://www.ncbi.nlm.nih.gov/pubmed/16034850 Antibiotics for the common cold and acute purulent rhinitis. 20 Jul 2005. No improvement in symptoms for people receiving antibiotics. Insufficient evidence of benefit for the use of antibiotics for respiratory tract infections. Antibiotics cause significant adverse effects.

The cool benefit of fever!

  • https://en.m.wikipedia.org/wiki/Human_body_temperature 41 °C (105.8 °F): Medical emergency. 40 °C (104 °F): Starts to be life-threatening.

  • https://www.parents.com/health/fever/fever-benefits/ Research shows that letting a fever run its course may reduce the length and severity of such illnesses as colds and flu.

  • https://curiosity.com/topics/how-exactly-does-fever-help-you-get-better-curiosity/ Immune cells called macrophages gobble up invaders. A higher body temperature makes it harder for bacteria and viruses to thrive, and eventually kills them off. T-lymphocytes destroy infection and fever helps more lymphocytes move to the area under attack. Fever is valuable for keeping your body healthy.

Strengthen your immune system

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629403/?report=reader Sleep Habits and Susceptibility to the Common Cold. 12 Jan 2010. Those with <7 hours sleep are 2.94 times more likely to develop a cold than those with ≥ 8 hours. Those with < 92% efficiency 5.50 times more than those with efficiencies ≥98%. Poorer sleep efficiency and shorter sleep duration in the weeks preceding an exposure to a virus associated with lower resistance to illness.

  • https://www.nejm.org/doi/full/10.1056/NEJM199108293250903 Psychological Stress and Susceptibility to the Common Cold 29 Aug 1991. The rates of infections and colds increased with increases in stress levels. Infection rates ranged from 74% to 90%, according to levels of stress, and the incidence of colds ranged from 27% to 47%. Psychological stress associated with increased risk of infection.

Non-Steroidal Anti-Inflammatory Drugs

  • https://www.ncbi.nlm.nih.gov/pubmed/19588387 Non-steroidal anti-inflammatory drugs for the common cold. 8 Jul 2009. NSAIDs did not significantly reduce symptom or duration of colds. They have analgesic effects on headache, ear pain, and muscle and joint pain, but not on throat irritation. No effect on respiratory symptoms, cough and nasal discharge, but the sneezing significantly improved.

  • https://www.ncbi.nlm.nih.gov/pubmed/16154478 Aspirin compared with acetaminophen in the treatment of fever and other symptoms of upper respiratory tract infection in adults: a multicenter, randomized, double-blind, double-dummy, placebo-controlled, parallel-group, single-dose, 6-hour dose-ranging study. Jul 2005. Aspirin and acetaminophen were equally effective against fever and other symptoms of URTI.

  • https://www.ncbi.nlm.nih.gov/pubmed/10638387 Assessment of the efficacy and safety of paracetamol, ibuprofen and nimesulide in children with upper respiratory tract infections. Nov 1999. Nimesulide was better at reducing fever and more rapid than paracetamol or ibuprofen. Better improvement in cough with paracetamol.


  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949172/ Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. 29 Apr 2018. Zinc supplementation may shorten the duration of colds by 33%, taken within 24 hours of onset of symptoms.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418896/ Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. May 2017. Cold duration was 33% shorter for the zinc groups of the seven trials (zinc acetate -40% and zinc gluconate -28%). No evidence doses >100 mg/day lead to greater efficacy.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359576/ The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis. 25 Feb 2015. Zinc acetate lozenges of about 80 mg/day, started within 24 hours shortened duration of nasal discharge by 34%, nasal congestion by 37%, sneezing by 22%, scratchy throat by 33%, sore throat by 18%, hoarseness by 43%, cough by 46%, muscle ache by 54% but no difference in the duration of headache and fever.

  • https://www.ncbi.nlm.nih.gov/pubmed/23775705 Zinc for the common cold. 18 Jun 2013. Intake of zinc significantly reduced the duration (-1.03d) but not the severity of cold symptoms. Less participants symptomatic after 7 days of treatment (odds ratio 0.45). Lower incidence of colds (0.64) but heterogeneity of the data.

  • https://www.ncbi.nlm.nih.gov/pubmed/22429343 A combination of high-dose vitamin C plus zinc for the common cold. 2012. Vitamin C and zinc play important roles in immune defence and health. Intake of both is often inadequate. Reduction of rhinorrhoea duration (range 9-27%). Symptom relief was quicker.

  • https://www.ncbi.nlm.nih.gov/pubmed/22566526 Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. 10 Jul 2012. Zinc formulations shortened duration of cold (-1.65 days) but heterogeneity was high: -2.63 days in adults, but only -0.26 in children.