Millar Functional Medicine

09/22/2024

Health Benefits of Soluble and Insoluble Fiber and Disease Prevention

Greg Millar, DC PhD CPFM
Millar Functional Medicine
Huntsville, Alabama

Fiber is an essential part of a healthy diet. BUT!!! what kind of fiber and how much is very important. We've all heard that we need fiber but other than that we not sure.

This article will provide a good overview on the fundamentals of eating fiber. Fiber is a type of carbohydrate that the body can't digest. Though most carbohydrates are broken down into sugar molecules called glucose, fiber cannot be broken down into sugar molecules, and instead it passes through the body undigested.

There are two main types of dietary fiber: SOLUBLE and INSOLUBLE. Both are important for health, digestion, and preventing diseases. But what's the difference?

SOLUBLE FIBER
Soluble fiber attracts water and turns to gel during digestion. This slows digestion down.

What foods have mostly soluble fiber?

Soluble fiber can be found in many common foods, including:
Oats
Barley
Apples
Citrus fruits
Carrots
Beans and legumes
Brussels sprouts
Sweet potatoes

INSOLUBLE FIBER
Insoluble fiber traps and holds onto water pulled from the intestines. It adds bulk to the stool and appears to help food pass more quickly through the stomach and intestines.

What foods have insoluble fiber?

Foods rich in insoluble fiber include:
Whole wheat
Brown rice
Nuts and seeds
Cauliflower
Green beans
Zucchini
Dark leafy greens
Peppers

Health Benefits of Soluble and Insoluble Fiber and Its Implication in Disease Prevention

You Need a Combination of Soluble and Insoluble Fiber:
Soluble fiber is excellent for supporting cardiovascular health, while insoluble fiber supports healthy digestion and regularity.

A balanced diet that includes a variety of fruits, vegetables, whole grains and legumes will help you meet your fiber needs and reap the benefits of both types.

What is the Optimal Amount of Soluble and Insoluble Fiber One Should Have Per Day? The recommended daily intake of fiber is 25–30 grams (or up to 38 grams), with a good balance between soluble and insoluble fiber.

Many health experts recommend aiming for about a 1:3 ratio of soluble to insoluble fiber.

This can be achieved by eating a variety of fiber-rich foods. Fiber is important for a healthy diet because it has many health benefits, including:

Heart Disease and Fiber:
Dietary fiber can help prevent heart disease in a number of ways, including:

Lowering cholesterol
Reducing inflammation
Lowering blood pressure
Reducing the risk of stroke and type 2 diabetes
Diabetes and Fiber

Dietary fiber can help prevent diabetes in a number of ways, including:

Research has consistently shown that, for people with type 2 diabetes, eating more fiber can help improve blood glucose control. The human body is unable to absorb and break down fiber. Because of this, fiber does not cause a spike in blood glucose the way other carbohydrates can.

Cancer and Fiber:

Fiber can help prevent cancer in a number of ways, including:

Fiber binds to carcinogens and helps to expel them from the body through stool.
Fiber is converted into short-chain fatty acids by bacteria in the colon, which can reduce the ability of cells in the intestine to become cancerous.
Fiber helps to increase the size and frequency of bowel movements, which can dilute the contents and reduce the time harmful chemicals spend in the bowel.
Fiber can help you maintain a healthy weight, which can reduce the risk of many cancers.
Fiber can bind bile acids, which can reduce cholesterol levels and decrease the risk of colorectal cancer growth.
Fiber can change estrogen production, which may lower the risk of breast cancer

Autoimmune Disease and Fiber

Fiber can help prevent autoimmune disease by:

Limiting autoimmune neuroinflammation
Dietary fiber can limit autoimmune neuroinflammation by restricting the activation, polarization, and migration of Th1.
Enriching good bacteria
Resistant starch can enrich good bacteria in the gut, which can help suppress the growth of bacteria that trigger autoimmune disease.
Increasing anti-inflammatory immune cells
Inulin, a type of fiber found in fruits and vegetables like bananas, asparagus, and garlic, can increase the number of regulatory T (Treg) cells, which are anti-inflammatory immune cells.
Intestinal Disorders and Fiber

Fiber can help prevent intestinal disorders by:

Softening stool and preventing constipation: Fiber adds bulk and helps stool move through the intestines more easily.
Reducing pressure in the colon: Fiber can help prevent flare-ups of diverticulitis.
Regulating stool frequency and consistency: Soluble fiber can help with this in people with irritable bowel syndrome (IBS).
Providing a substrate for beneficial bacteria: Fiber feeds the good bacteria in your gut.

Weight Loss and Fiber

Fiber can help with weight loss in a number of ways, including:

Feeling full
Fiber-rich foods can help you feel full longer, which can help you eat less and maintain a healthy weight.
Fiber slows down the speed at which food moves through your stomach and gut.
Soluble fiber absorbs water and slows the absorption of sugars into your bloodstream, which can help your body avoid storing fat.
Fiber feeds good gut bacteria, which can help with weight management

Dr. Millar's Comments:

Strive to obtain 25–30 grams (or up to 38 grams) of fiber per day, with a good balance between soluble and insoluble fiber to improve your health and wellness and decrease the above listed disease risks.

As always, you should consult your healthcare professional prior to beginning any new dietary or lifestyle regimen.

05/09/2024

True. Amazing, but True.

05/05/2024

Is wait a minute. President Trump was impeached because in part he refused to send 400 million dollars of appropriated military assistance to Ukraine. President Biden is doing the same thing by not sending appropiated ammunition to Israel.

The Biden administration has reportedly put a hold on a shipment of ammunition to Israel, sparking concerns within the Israeli government.

03/11/2024

Flaxseed Benefits and High Blood Pressure
Greg MIllar, DC CPFM CCEP

It is well documented that high blood pressure is “the single largest risk factor” for death in the world.
Globally, cardiovascular diseases (CVDs) are the number one cause of mortality. Approximately 18 million people died from cardiovascular disease (CVDs) representing more than 30% of all global deaths.

By the year 2025, an estimated 1.6 billion of the world adult population will have hypertension (high blood pressure). This is an increase of about 60% compared to the year 2000.

The traditional medical solution to lower blood pressure is medication including the following: Beta Blockers (Atenolol, Metoprolol, Nebivolol and Propranolol), Ace Inhibitors (Benazepril, Captopril, Enalapril, Fosinopril and Lisinopril), Calcium Channel Blocker (Cardizem, Felodipine, Nifedipine and Verapamil), Angiotensin Receptor Blockers (Losartan, Olmesartan, Telmisartan and Valsartan) and Diuretics (Lasix, Hydrochlorothiazide, Indapamide and Metolazone).

The problem with the traditional medical treatment is at least 80% of people are non-compliant and stop taking their medication. Not to mention the side effects. And the fact that the average prescription medication only lowers blood pressure an average of between 5mmHg and 10mmHg. Not very good at best.

In functional medicine we take a different approach. That is not to say that some patients do not need prescriptive blood pressure medication. But, lets try natural first. What if taking just two tablespoons of flaxseed per day (not flaxseed oil) could significantly lower your blood pressure?

In an important peer reviewed study from the American Heart Association Journal, Hypertension, it was found that patients who entered the trial with a SBP ≥ 140 mm Hg at baseline obtained a significant reduction of 15 mm Hg in SBP and 7 mm Hg in DBP just from flaxseed ingestion.

The magnitude of this blood pressure decrease is as good as or better than many blood pressure meds listed above.

Flaxseed induced one of the most potent antihypertensive effects achieved by a dietary intervention. Indeed, the drop in blood pressure the researchers saw in the flaxseed study “was greater than the average decrease observed with the standard dose of anti-hypertensive medications.

In the above peer reviewed study patients (110 in total) ingested a variety of foods that contained 30 g of milled flaxseed or placebo each day over 6 months. Plasma levels of the alpha-linolenic acid (ALA) and enterolignans increased 2- to 50-fold in the flaxseed-fed group but did not increase significantly in the placebo group.

Most omega-6 fatty acids in the diet come from vegetable oils, such as linoleic acid (LA), not to be confused with alpha-linolenic acid (ALA), which is an omega-3 fatty acid. The most evident reason for the benefits of flaxseeds and decreased blood pressure is thought be due to a change in plasma oxylipins.
What are oxylipins?

Oxylipins are a group of fatty acid metabolites involved in inflammation and have been implicated in many pro-inflammatory conditions, including aging and cardiovascular disease.The best-characterized oxylipins associated with cardiovascular disease are derived from long-chain omega-6 fatty acid more commonly from linoleic acid. Linoleic acid oxylipins are often pro-inflammatory, associated with atherosclerosis, non-alcoholic fatty liver disease, and Alzheimer's disease. Centenarians have shown reduced levels of linoleic acid oxylipins in their blood circulation. Oxylipins are found pre-formed in animal products, particularly chicken and eggs, and can be made inside the body from j***y oils rich in omega-6, such as cottonseed oil.

Here are oils to avoid and high in linoleic acid (LA): Soy Oil, Corn Oil, Cottonseed Oil, Sunflower Oil, Grapeseed Oil and Canola oil. However, elevated levels of pro-inflammatory, aging-associated oxylipins can be normalized just by eating ground flaxseed.
Studies have shown that flaxseed consumption reduces blood pressure in patients with hypertension: by inhibiting the enzyme that makes these pro-inflammatory oxylipins. Eating flaxseeds inhibits the activity of the enzyme that makes these pro-inflammatory oxylipins, called leukotoxin diols, which in turn may lower blood pressure.
Taking flaxseeds is only one of many natural ways to lower your blood pressure. Come see up to find out more. Don't let high blood pressure kill you or someone you love.

Dr. Millar's Comments:
Although it has been shown that flaxseeds have an influence on oxylipins it has been proposed that the whole is greater than the sum of its parts. Each of the components of interest within flaxseed, ALA, lignans, fiber, and peptides—the omega-3s, the cancer-fighting lignans, all the soluble fiber, and the plant proteins, for instance all contribute towards BP reduction.

Although not all studies have shown significant blood pressure lowering effects of flaxseed consumption, there have been more than a dozen trials by now, involving more than a thousand subjects. When you put them all together there were “significant reductions in both SBP and DBP”—systolic blood pressure (the upper number) and diastolic blood pressure (the lower number) following supplementation with various flaxseed products.

References:
https://www.ahajournals.org/.../HYPERTENSIONAHA.113.02094
https://pubmed.ncbi.nlm.nih.gov/34119421/
https://pubmed.ncbi.nlm.nih.gov/25740909/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477925/
https://www.cochranelibrary.com/.../14651858.../full
https://www.cochranelibrary.com/.../14651858.../full
https://www.cochranelibrary.com/.../14651858.../full
https://www.cochranelibrary.com/.../14651858.../full
https://journals.physiology.org/.../ajpheart.00201.2017
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289399/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552797/
https://pubmed.ncbi.nlm.nih.gov/25789320/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951311/
https://www.frontiersin.org/.../10.../fcvm.2021.645786/full
https://www.ncbi.nlm.nih.gov/.../pubmed.ncbi.../25740909/
https://www.ahajournals.org/.../HYPERTENSIONAHA.114.03179
https://www.sciencedirect.com/.../abs/pii/S1550830721000938
https://www.healthline.com/nutrition/benefits-of-flaxseeds
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707798/
** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.
The information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of general knowledge and information from the research and experience of Dr. Millar and the functional medicine community. Dr Millar can be reached at Millar Functional Medicine 2021 Clinton Ave W, Huntsville Alabama 35805. (256) 539-4000. www.millarfunctionalmedicine.com

02/11/2024

Lipopolysaccharide (LPS) and the Incidence of Cardiovascular Disease

Greg Millar DC CPFM CCEP
Member Alabama Board of Chiropractic Examiners

Arteriosclerosis and atherosclerosis are often confused and sometimes used to mean the same thing, but there's a difference between the two terms.

ARTERIOSCLEROSIS occurs when the blood vessels that carry oxygen and nutrients from the heart to the rest of the body (arteries) become thick and stiff — sometimes restricting blood flow to the organs and tissues. Healthy arteries are flexible and elastic. But over time, the walls in the arteries can harden, a condition commonly called hardening of the arteries.

ATHEROSCLEROSIS is a specific type of arteriosclerosis. Atherosclerosis is the buildup of fats, cholesterol and other substances in and on the artery walls. This buildup is called plaque. The plaque can cause arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.

Although ATHEROSCLEROSIS is often considered a heart problem, it can affect arteries anywhere in the body. Atherosclerosis can be treated. Healthy lifestyle habits can help prevent atherosclerosis.

Mounting scientific evidence over decades has established that atherosclerosis is a chronic inflammatory disorder. Although a variety of inflammatory markers (ie, C-reactive protein) have been associated with atherosclerosis and its consequences, it is important to identify principal mediators of the inflammatory responses.

Among the potentially critical sources of vascular inflammation during atherosclerosis are the components of pathogenic bacteria, especially one that's hard to say but very potent, lipopolysaccharide (LPS). One potentially important source of inflammation is endotoxin (lipopolysaccharide [LPS]).

What is Lipopolysaccharide (LPS):
Lipopolysaccharide (LPS) is a component of the surface membrane of gram-negative bacteria found in the gastrointestinal tract. Gram-negative bacteria include: Escherichia coli, Salmonella, Shigella, Pseudomonus, Helicobactor, Legionella, Wolbachia.

This endotoxin promotes the upregulation of pro-inflammatory cytokines eliciting a strong immune response. The detection of antibodies against LPS indicates infiltration of macromolecule-sized endotoxins into the intestinal barrier and the systemic circulation which is known to contribute to atherosclerosis.

LPS and Leaky Gut:
LPS is one marker among seven markers for increased intestinal permeability aka: Leaky Gut. The additional markers include Zonulin, Anti-Zonulin IgG, Anti-Zonulin IgA, Anti-Actin IgG, Anti-Actin IgA, Anti-LPS IgA and Anti-LPS (IgG + IgM)

Numerous studies clearly demonstrated that elevated serum LPS levels were associated with the development of atherosclerosis.

Treatment Strategy to Eradicate and Lessen the effects of LPS on Cardiovascular Health:
Remember that old saying "To do the same thing and expect a different result is the definition of insanity." That means we have to change a few things like our lifestyle.

The science of functional medicine it has been well established that the following protocol incorporating a program using a simple acronym of the 6Rs: remove, replace, reinoculate, repair, rebalance and re-test has been significantly effective in eradicating the LPS. When applied to various health conditions including atherosclerosis the 6R program can lead to a dramatic improvement in symptoms and sometimes even complete resolution.

The elements of the 6R program are described briefly here:
1: Remove
Remove stressors. Get rid of things that negatively affect your GI tract, including foods (in some cases, gluten) you are sensitive to, parasites, and potential problematic bacteria or yeast. This might involve using an elimination diet to find out what foods are triggering GI symptoms. It may also involve taking medications or herbs to get rid of an infection.

2: Replace
Replace digestive enzymes. Add back things like digestive enzymes, bile acids, and hydrochloric acid that are required for proper digestion and that may be compromised by diet, medications, diseases, aging, or other factors.

3: Reinoculate
Aid beneficial bacteria flourish by eating probiotic-rich foods or taking supplements that contain “good” bacteria, such as Bifidobacteria and Lactobacillus species, and by eating high-fiber foods that supply prebiotics to nourish good microbes.
Include a rich supply of prebiotics are foods. These foods will stimulate the growth of beneficial microorganisms already in the large intestine.

Prebiotics are available in many foods that contain a fiber called inulin, including artichokes, garlic, leeks, onions, chicory, tofu, and other soy products. Grains and seeds such as barley, oats flaxseeds, and chia seeds are also good sources of prebiotics. Another prebiotic source is a supplement ingredient called fructooligosaccharides (FOS).

4: Repair
Help the lining of the GI tract repair itself by supplying key nutrients that heal a compromised gut, such as zinc, antioxidants (such as vitamins A, C, and E), omega-3 fish oils, and the amino acid glutamine.

5: Rebalance
It is important to pay attention to lifestyle choices. Sleep, exercise, and stress can all affect the GI tract. Managing and balancing those factors helps promote optimal digestive tract health.

6: Re-test
Once one applies the therapeutic principles of effective treatment, re-testing is highly recommended to determine if the LPS is no longer present in the systemic circulation.

References:
https://www.sciencedirect.com/.../abs/pii/S1050173821000992
https://www.nature.com/articles/s41569-022-00737-2
https://link.springer.com/article/10.1007/s12265-021-10109-9
https://www.ahajournals.org/doi/10.1161/JAHA.119.013628
https://lipidworld.biomedcentral.com/.../1476-511X-11-139
https://www.ahajournals.org/.../01.ATV.0000147534.69062.dc
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669181/

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

The information in this post is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Millar and the functional medicine community. Dr. Millar encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Dr Millar practices functional medicine at Millar Functional Medicine. (256) 513-4888. www.millarfunctionalmedicine.com

02/05/2024

Why A Test for Apolipoprotein B (apoB) May Be a Better Predictor of Your Heart Disease Risk. Request Your Doctor Check It.

by Greg Millar, DC CCEP CPFM
Millar Functional Medicine - Huntsville

Cardiovascular disease remains the leading cause of death worldwide. There are quite a number of cardiovascular lab markers I commonly check to determine the cardiovascular risk of my patients. One in particular is Apolipoprotein B (apoB). Most patients have never heard of this test. But it's results may save your life.

Unfortunately the standard lipid panel generally includes four things: total cholesterol, high density lipoprotein (HDL) cholesterol, LDL cholesterol, and triglycerides. While LDL, the major cholesterol-carrying serum lipoprotein, is the primary therapeutic target for management and prevention of atherosclerotic cardiovascular disease, there is strong evidence that apoB is a more accurate indicator of cardiovascular risk than either total cholesterol or LDL cholesterol.

If your physician is not including apoB, this is simply "unacceptable" if you are serious about determining your cardiovascular risk. You may in fact have a normal lipid panel but an elevated ApoB and be at an elevated cardiovascular risk. In 2019, the European Society of Cardiology/European Atherosclerosis Society stated that apolipoprotein B (apoB) was a more accurate indicator of cardiovascular risk than low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol.

The Basic Overview of Understanding ApoB
ApoB is a major structural protein found in LDL, and it helps to transport fat and cholesterol throughout the body. Lipoproteins that contain apoB, such as bad cholesterol, are particularly dangerous because they can pe*****te the walls of arteries. ApoB is emerging as the crucial lipoprotein trait for the role of lipoprotein lipids in the etiology of coronary heart disease.

The protein apoB can help predict one's heart disease risk more accurately than a standard lipid panel, which measures cholesterols and triglycerides. But emerging evidence suggests apolipoprotein b (apoB) is an even more accurate marker that can identify potential high-risk patients. These apoB particles can lead to plaque buildup in the arteries, increasing the risk of heart disease and stroke.

“When we measure apoB, we're actually counting all of these particles that cause plaque buildup, and this is a much more accurate way of determining cardiovascular risk due to cholesterol. Higher apoB shortens lifespan, increases risks of heart disease and stroke, and in multivariable analyses that account for LDL cholesterol, increases risk of diabetes.

Effective Plan to Lower ApoB:
Weight Loss
Switching from saturated fats to unsaturated Fats (Monounsaturated--avocado, walnuts, flaxseed, wild salmon, etc.)
Soluble Fibers: Apples, okra, eggplant, oats, berries and barley and psyllium husk
Phytosterols-- nuts and seeds
High fructose corn syrup will raise ApoB
Transfats will raise ApoB
Soy protein lowers ApoB
Dietary Patterns-- Mediterranean Diet with heavy focus on plant based foods
Omega 3

Dr. Millar's Comments:
According to prominent cardiologist, Dr. Mohammed S. Alo, Assistant Clinical Professor of Medicine at Midwestern University in Chicago, Illinois and Assistant Clinical Professor of Medicine at Ohio University. He recommends that Apo B should be UNDER 70. He further states if one is an overachiever and want to live the longest and not have atherosclerotic heart disease, he recommends having your apoB under 55. He states that most studies show that levels below 55 completely arrest and even may in fact reverse plaque and atherosclerosis.

References:
https://pubmed.ncbi.nlm.nih.gov/34677405/
https://pubmed.ncbi.nlm.nih.gov/19491209/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540246/
https://www.ahajournals.org/doi/10.1161/JAHA.122.025858
https://www.ahajournals.org/doi/10.1161/JAHA.122.025858
https://jamanetwork.com/.../jama.../article-abstract/2753612
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462411/
https://www.aafp.org/pubs/afp/issues/2014/0415/od2.html

Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations. This information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Millar and the functional medicine community. Dr. Millar encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

Millar Functional Medicine
2021 Clinton Ave West
Huntsville, Alabama 35805
(256) 513-4888