MM19 Conference Book V1final

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© 2017 Gary W einer, N.D., LAc Adapted from World J Gastroenterol 2014 January 7; 20(1): 6-21 Adapted from World J Gastroenterol 2014 January 7; 20(1): 6-21 5/17/2017 Elemental Diets in the Treatment of Inflammatory Bowel Disease, SIBO and other conditions related to a Disordered Microbiota Disclosures Educational consultant to Integrative Therapeutics, Inc. GARY WEINER, N.D., L.Ac. GI Microbiota distribution Jejunum - 10 2 Streptococcus Lactobacillus Proximal Ileum -10 3 Streptococcus Lactobacillus Duodenum 10 2 Streptococcus Lactobacillus Stomach 0-10 2 Lactobacillus Candida Streptococcus Heliobacter pylori Peptostreptococcus Distal Ileum 10 7 -10 8 Clostridium Streptococcus Bacteriodes Actinomycinae Corynebacteria Colon 10 11 -10 12 Streptococcus Bacteriodes Clostridium Bifidobacterium Enterobacteriaceae 2012 Adapted from Am J Gast roent erol Suppl 2012; 1:15–21 Lumin Food Componsents Symbionts & Commensals Pathobionts Lumin Food Components IgA IgA IgA IgA Symbionts & Commensals Pathobionts Mucus Epithelium Lamina Propria Pattern Recognition Receptors Anti-microbial peptides Mucins IgA IgA IgA IgA Goblet cell Paneth Cell Macrophage Dendrite Cytokines Innate Lymphoid Tight Junctions Blood vessel Mucus Epithelium Lamina Propria TH-0 IL-6 Paneth Cell Dendrite TH-1 TH-17 Activated Macrophages Stromal Cell Goblet Cell Apoptotic Cell MMP’s Myofibroblasts Blood vessel Neutrophils TH-2 © 2017 Gary Weiner, N.D., LAc 26 1
5/17/2017 Alteration of a “normal” microbiome Eubiosis genetics birth geography hygeine stress route Microbiome Complexity & Stability diet nutrition Digestion Train and Stimulate Immune function Protection against pathogens Supply nutrients, energy, vitamins, SCFA drugs Firmicutes Bacteriodes Proteobacteria (Enterobacteriaceae) Actinobacteria Inflammation Altered metabolite production) Oxidative Stress Increased gram negative bacteria Symbionts Commensals Pathobionts Infectious, metabolic, and inflammatory disorders Disease Birth Adult Elderly Age 3 Early onset Adult onset Late Onset © 2017 Gary Weiner, N.D., L.Ac. Adapted from Gast roent erology. 2014 May ; 146(6): 1489–1499. m: Dysbiosis Elemental DECREASE Alpha Helminths diversity Bacteriodes and Firmicutes Clostridia, Ruminococcaceae Bifidobacterium, Lactobaccilus Fecalibacterium Prauznitzii IBD MAP? EBV? Fungal organisms? Increase in gammaproteobacteria Fusobacterium E. coli, specifically AIEC INCREASE Full Definition of ELEMENTAL 1 a : of, relating to, or being an element: specifically: existing as an uncombined chemical element b : (1) : of, relating to, or being the basic or essential constituent of something : FUNDAMENTAL < elemental biological needs > (2) : SIMPLE, UNCOMPLICATED < elemental food > c : of, relating to, or dealing with the rudiments of something: ELEMENTARY < taught elemental crafts to the children > d : forming an integral part : INHERENT < an elemental sense of rhythm > 2 : of, relating to, or resembling a great force of nature < the rain comes with elemental violence > © 2017bGary Weiner, N.D., L.Ac. https://www.merriam-webster.com/dictionary/elemental 14-18% of calories from protein in the form of amino acids, 42-76% calories from carbohydrate in the form of monosaccharaides, and 6-43% of calories Elemental Diet (ED) Unique Properties Macronutrients Proteins Carbohydrates Fats Water Possible to administer as liquid Can be use for tube feeding Soluble pediatric and geriatric use And those unable to masticate Decreased antigens exposed to Intestinal lumen Hypoallergenic Exact composition varies. 14-18% f kcal from protein 42-76% kcal from from carbs Flexible 6-43% from fatty acids. Composition Usually low in fats, some formulas 1-3% All essential and non-essential nitrogen, minerals,, vitamins and fats + up to 30000 kcal/day High + 25 % of hydration requirements nutritional Efficacy Upper SI As Low residu Bypass nee and biliary Little micel low fat FREE FORM AMINO ACIDS © 2017 Gary Weiner, N.D., L.Ac. SIMPLE DIGESTALBE CARBOHYDRATES FATTY ACIDS AS TRIGLYCERIDE VITAMINS AND MINERALS Low Low digestible bulk Residue Reduced stool weight Decreased elimination Minimal Digestion Upper SI assimilation Low residue entering colon Bypass GI secretions Bypass micelle formation d/t low fat Monomeric Free of intact proteins Avoids LCT favoring MCT Favors monosaccharides or easily digestible oligosaccharides © 2017 Gary Weiner, N.D., L.Ac Source of information: Gut,1975,16,68-79 27 2
Page 1 and 2: The California Naturopathic Doctors
Page 3 and 4: The California Naturopathic Doctors
Page 5 and 6: Merging Medicine 19 Schedule Saturd
Page 7 and 8: Merging Medicine 19 Presentations S
Page 9 and 10: Saturday Speakers Gary Weiner, ND,
Page 11 and 12: Saturday Speakers (cont.) Dr. Mi Ju
Page 13 and 14: Sunday Speakers Dr. Michael Traub,
Page 15 and 16: MM19 Exhibitors Allergy Research Gr
Page 17 and 18: MM19 Exhibitors Great Earth Compoun
Page 19 and 20: MM19 Exhibitors Koshland Compoundin
Page 21 and 22: MM19 Exhibitors Professional Formul
Page 23 and 24: MM19 Exhibitors Seroyal Genestra Br
Page 25: The Role of an Elemental Diet in th
Page 29 and 30: for 6 mo, while none of those on th
Page 31 and 32: 5/17/2017 Malnutrition in IBS? Maln
Page 33 and 34: 5/17/2017 ↓ Bacterial translocati
Page 35 and 36: 5/17/2017 Step 2 - Calculate First
Page 37 and 38: 5/17/2017 Address elemental obstacl
Page 39 and 40: 5/17/2017 28 year-old female 35 yea
Page 41 and 42: How the Microbiome Shapes the Syste
Page 43 and 44: 5/16/2017 INNATE VS. ADAPTIVE IMMUN
Page 45 and 46: 5/16/2017 The impact of antibiotics
Page 47 and 48: 5/16/2017 Summary of diet-induced d
Page 49 and 50: 5/16/2017 Probiotic function of spo
Page 51 and 52: 5/16/2017 The effect of 30-days of
Page 53 and 54: Subverted Enteroendocrine System in
Page 55 and 56: 5/16/2017 Enteroendocrine System En
Page 57 and 58: 5/16/2017 5-HT Increase in gastric
Page 59 and 60: 5/16/2017 Endocr Rev. 2012 Apr;33(2
Page 61 and 62: 5/16/2017 JC virus and mis-folded p
Page 63 and 64: 5/16/2017 Effects of Fatty Acids (F
Page 65 and 66: 5/16/2017 Vinegar Mechanism of Vine
Page 67 and 68: 5/16/2017 Progesterone Progesterone
Page 69 and 70: Natural Approach to Urology Dr. Eri
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The Clinical Impact of Gut & Microb
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5/17/2017 Small Intestinal Bacteria
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5/17/2017 SIBO and Psoriasis • 60
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5/17/2017 What do these two have in
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5/17/2017 Rifaximin for rosacea: It
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5/17/2017 Before & 1 mo after rifax
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5/17/2017 Rosacea and LDN Rx Stages
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5/17/2017 SIBO dietary guidelines P
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Meet your Inner Ecosystem; Your key
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5/17/2017 A Bacterial Dominated Pla
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5/17/2017 Microbes in the Microbiom
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5/17/2017 10 Fat or Lean? Gut Micro
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5/17/2017 Microbe-Speak • “Your
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5/17/2017 Stress Channel in Pregnan
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5/17/2017 Other Communicators in th
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5/17/2017 Skin (Cloud) Microbiome
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5/17/2017 Factor #1: Antibiotics An
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5/17/2017 Unhealthy Microbiome = A
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5/17/2017 Best Psychobiotics Microb
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THE ESTROBOLOME: The Influence of t
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5/16/2017 The tumor microenvironmen
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5/16/2017 Microbial Transformation
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5/16/2017 Dietary Influences on Mic
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5/16/2017 Carcinogenesis. 2007;28:1
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5/16/2017 Fiber Intake and Breast C
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5/16/2017 Bio-Activation of Phytoes
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5/16/2017 Bio-Activation of Phytoes
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5/16/2017 Primary References Microb
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Dr. Jennifer Bahr, ND - President D
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