Root cause of disease is multifactorial

Published 12:00 am Sunday, October 13, 2013

The future of our health may lie in the next 1,000 words. The root cause of most disease is multifactorial and prevention is the key.
How can we prevent disease in America’s youth? Is the critical time from conception until 2 years old? Recent epigenetic studies evaluating how lifestyle choices and exposures affect our genetic makeup are proving this to be true, especially during the first few weeks of conception.
Dr. Elizabeth Mumper has looked at this question in relation to Autism spectrum disorders and has proposed some provocative ideas in a new article.
In The North American Journal of Medicine and Science, Mumper presented her eight year data on the health of newborns in her clinic.
More than 250 children were followed past the age of 26 months old and evaluated for Autism. This group of children had zero cases of Autism.
Mumper’s work is a potential guide for our future and our children’s future health.
These results do not mesh with the CDC data of autism rates at 1:50 live births.
Based on her numbers, this group of children should have had 5 cases of Autism. These results are but one study and they need to be analyzed in a future study with a control group. However, if true, should we wait for the results to be replicated in future studies? Unless the prevention strategy is onerous or unethical, I think not.
Mumper boils it all down to seven principles: environmental toxicants, breastfeeding, probiotics for microbiome support, nutritional factors, minimal antibiotic use, avoiding acetaminophen and an alternative vaccine schedule.
Let us look at each piece independently:
• Environmental toxicants: Whether it is airborne pollutants, pesticides or home cleaning agents, the avoidance of chemicals is believed to reduce the risk of neurobehavioral disorders.
• Breastfeeding: We know that a lack of breastfeeding is associated with an increase in many diseases.
This is likely due to the altered gut flora that ensues. Whether Autism is reduced by breastfeeding remains to be independently proven.
• Probiotics: Through genomic analysis we now know that your diet can change your gut flora in one day.
The poor quality of the American diet, coupled with caesarian deliveries, cow’s milk formula feeding and antibiotic use early in life are disrupting and destroying the normal gut ecosystem.
Giving mothers and newborns dietary probiotics is believed to reset the balance and reduce disease in the offspring. Multiple studies have shown reductions in eczema and asthma when mothers consume probiotics.
• Nutritional factors: Mother’s of children with autism reported taking fewer multivitamins and had lower mean folic acid levels during pregnancy.
The MTHFR gene, methyltetrahydrofolate reductase, is a gene that produces an enzyme that helps folic acid do its job.
Folic acid has many functions of which methylating (reading) the DNA and detoxification are critical to health.
Mothers that have a diet loaded with organic vegetables and fruits while taking prenatal vitamins could be overcoming certain gene defects.
• Avoiding antibiotics: Using antibiotics frequently during childhood will alter the healthy gut microbiome in a negative way.
The hygiene hypothesis states that early and frequent microbial exposure helps our native immune systems develop in harmony with the environment.
Antibiotic use and a lack of early microbial exposure have inappropriately stimulated the newborn and childhood immune system.
Excessive antibiotic use is no longer a question of harm as it is linked to many diseases including inflammatory bowel diseases and allergic/sensitivity diseases.
• Avoiding acetaminophen: This medicine is believed to alter the chemical detoxification and sulphation pathways related to glutathione.
At critical times it may be true that acetaminophen has a negative effect on the clearance of chemicals and therefore genes can be affected. There has been much discussion of the link to asthma.
• Vaccine use: a hot and controversial topic.
What to do? Whether you agree with Mumper’s article, assessment or principles is up to you.
I will ask you though, to look at each of the 7 proposed principles and weigh the merits of each. Then ask yourself, “why would I not consider making these adjustments.” Only you can answer that question until more data comes in.
1. Minimizing environmental toxicants: No question here! Consuming organic food is preferable, although cost can be an issue.
Look at the website for the clean 15 and dirty 12. Avoiding household chemicals is a no brainer. Clean with vinegar, watered down bleach and citrus.
Avoid herbicides and pesticides in and around your home (at least during the pregnancy and early years) Avoid medicines where possible.
2. Breastfeed till at least 6 months. There should be no argument here if one is physically able. This is critical for all disease prevention.
Breastfed mothers must eat well, however, poor quality chemically laden foods will pass through to the offspring via the milk, offsetting benefit.
3. Taking Probiotics during pregnancy is a good idea and useful for any newborn that has allergic, autoimmune, developmental or gastrointestinal issues in the first year of life. Yogurt is not likely to be as effective.
4. Nutritional intake: taking prenatal vitamins, eating organic, fermented and fresh foods, avoiding processed foods and additives all seem reasonable.
5. Avoiding antibiotics when possible makes absolute sense. Be involved in the process of disease management.
Ear infections often respond to a careful watch and wait approaches. The data supports this approach with close follow up.
6. Avoiding acetaminophen is a good idea as the research continues to emerge on its safety.
I see very few places where we need to use acetaminophen in childhood. Discuss its use with your physician.
7. Vaccine schedules: Controversial, Dr. Mumper’s group utilized a modified vaccine schedule.
See her schedule in the article. The schedule gets the major vaccines for meningitis, diptheria, pertussis, tetanus and polio in before 7 months of age where the risk is highest.
Others like hepatitis B, chicken pox, rotavirus and MMR are pushed back. Discuss these risks and benefits with your physician. This is a hot button issue.
If Mumper is correct or even partially correct (and I suspect she is), it seems to me that we need to wake up and listen to the voices of the unborn that are at risk of developing a preventable problem.
Using this primer as a blueprint for health while the study is repeated would be prudent.
Evaluate and decide what is right for you and your child, but remember this needs to start before one conceives in order to assure that no mistakes occur during the pre-knowing critical phase of early pregnancy, the first month.

Dr. Chris Magryta is a pediatrician at Salisbury Pediatric Associates.