by Dr. Victor Marchione
July 17, 2014
MD received his Bachelor of Science Degree in 1973 and
his Medical Degree from the University of Messina in
1981. He has been licensed and practicing medicine in
New York and New Jersey for over 20 years.
Dr. Marchione is a
respected leader in the field of smoking cessation and
He has been
featured on ABC News and World Report, CBS Evening News
and the NBC Today Show and is the editor of the popular
The Food Doctor newsletter.
Dr. Marchione has
also served as Principal Investigator in at least a
dozen clinical research projects relating to serious
ailments such as bronchitis, pneumonia, asthma, and
chronic obstructive pulmonary disease (COPD).
Did you know that the key to relieving the terrible pain of
rheumatoid arthritis may lie… in your stomach?
Inside every single human on the planet - including you - there is a
community of millions residing. It's called your
microbiome, and it's made up of
millions of tiny bacteria that work to help keep your body
functioning. In fact, these little creatures are so abundant that
they outnumber your cells by about 10 to one.
These bacteria largely live in your gut and serve a number of
purposes that help your body function properly. We're getting to
know the microbiome a little more, but for the most part, it is
But here's what I can tell you from what we know so far…
We know that these bacteria are largely good bacteria and that they
live comfortably and amicably. They help to break down food, absorb
nutrients, expend energy, and remove waste. They also aid in
combating foreign intruders, so you stay healthy.
After all, there are even more bacteria
living outside you - on every surface - that can make you sick. When
one of these types of bacteria gets inside of you, your microbiome
kills it. Your microbiome plays a major role in your immune system,
constantly providing protection from illness of which you're likely
Your microbiome is largely determined by genetics, but it can be
altered through diet and other lifestyle and environmental factors.
Therefore, it is in flux depending on how you live. When you eat
poorly, smoke, get older, have a hormonal imbalance, or get
infected, your microbiome changes.
An imbalance is created, and this can
cause a number of problems. One of which may be rheumatoid
I recently read about this research team who did some tests on
patients to take a look at their microbiomes. They examined fecal
matter from patients who fell into the following three groups: those
who were healthy; those who had chronic, treated rheumatoid
arthritis; or those who had just been diagnosed with rheumatoid
What they found was that patients with newly diagnosed rheumatoid
arthritis had a substantially higher number of a bacteria strain
Prevotella copri (P. copri)
compared to the healthy individuals and patients with chronic,
treated rheumatoid arthritis.
Furthermore, growth of P. copri was
associated with lower amounts of beneficial gut bacteria.
This is interesting because gut bacteria has been previously linked
to autoimmune disorders and inflammation. And although rheumatoid
arthritis is genetic, it can also be affected by lifestyle and
environmental factors, like the ones I listed earlier. So basically,
the only common denominator for causation of rheumatoid arthritis is
an imbalanced microbiome.
Now, it's very important to mention that this is still in the early
stages of exploration and a lot more work has to be done.
For starters, researchers need to learn
whether or not elevated P. copri is a cause or consequence of
rheumatoid arthritis. Once they learn that, they have to learn how
to treat it. It is conceivable, however, that a probiotic supplement
Currently, the known way to improve or encourage a healthy, balanced
microbiome is through dietary measures.
A healthy, balanced diet is reflected in
your microbiome, and eating foods
with probiotics and prebiotics is a
great way to keep flora energized and effective - and maybe even
prevent the onset of arthritis.
Deardorff, J., "Gut
Bacteria Linked to Rheumatoid Arthritis," Chicago
Tribune web site, July 2, 2014.
Bornigen, D., "Functional
Profiling of the Gut-Microbiome in Disease-Associated
Inflammation," National Institutes of Health web
site, July 31, 2013.
Gut Bacteria Linked to...
by Julie Deardorff
July 2, 2014
has confounded efforts to
identify its trigger.
Mounting evidence points to a
a disturbance in the bacteria
that live in the intestines.
Scientists can't predict what triggers rheumatoid arthritis, a
mysterious and painful autoimmune disorder that causes inflammation
in the joints.
But they're targeting an intriguing new
suspect: the trillions of microbes living and working inside the
Animal models have long suggested that intestinal bacteria can
influence the development of some autoimmune diseases. This may also
be the case with rheumatoid arthritis, according to emerging
research, a finding that could lead to novel treatments and
Though long ignored by researchers,
"these bacteria clearly exert a
great deal of influence on many physiological processes in the
body, including metabolism, digestion and the nutrients we take
in," said Dan Littman, professor of pathology and microbiology
at the New York University School of Medicine and an
investigator at the Howard Hughes Medical Institute.
"The part that's less appreciated is
the profound influence the microbiota can have on the immune
Bacteria and other microbes, such as
viruses and fungi, form the
microbiota that reside in and on
the human body.
These germs outnumber the body's own
cells 10 to 1, helping us break down food and overwhelm infectious
germs. In exchange, we give them a nice place to live.
But when certain bacteria are allowed to proliferate, upsetting the
internal ecosystem, health problems may develop. Changes in gut
bacteria may have a role in everything from obesity and
circadian cycles to irritable bowel syndrome and multiple sclerosis,
Dan Littman's team of scientists was the first to show in
humans that disturbances in the digestive tract may play a role in
autoimmune attacks on the joints, according to 2013 research
published in the open-access journal eLife.
Using a sophisticated DNA analysis technique, the scientists
compared the gut bacteria from fecal samples of patients with
rheumatoid arthritis with those of healthy people. They found a
bacteria known as
was more abundant in patients with newly diagnosed
rheumatoid arthritis than in
healthy people or patients with chronic, treated rheumatoid
Moreover, the overgrowth of P. copri was associated with fewer
beneficial gut bacteria.
"There's a lot of speculation about
autoimmune diseases being associated with changes or
disturbances in the microbiota," Littman said. He called his
team's study results "the clearest association with a particular
microbe to date."
Still, while the connections have been
made in animal models, more research needs to be completed in
Scientists first need to figure out
whether the microbes are a cause or a consequence of the disease,
said Yasmine Belkaid, senior investigator and chief of the
Laboratory of Parasitic Diseases' Mucosal Immunology Section at the
National Institute of Allergy and Infectious Diseases.
Then scientists may need to develop,
"ways to selectively remove
one microbe in a complex microbiota," she said.
Moreover, even if certain bacteria can
trigger the disease,
"we also don't know whether that is
something that can be treated once the disease is out of the
gate," Littman said.
An estimated 1.3 million Americans have
rheumatoid arthritis, in which the immune system attacks tissues,
inflaming joints and damaging organs.
The condition is known to have a strong genetic component. But not
all patients carry the genes, so environmental factors - smoking,
hormones, aging and infections - must be involved too, said
researcher Veena Taneja, an associate professor of immunology
at the Mayo Clinic.
"The gut seems to be the common
link," said Taneja, whose work looks at whether bacteria can be
manipulated to change the course of disease. "The gut microbiome
is influenced by the genes and exposed to these things every
The relationship between bacteria and
the immune system begins at birth as the baby passes through the
birth canal, collecting microbes that will colonize its body.
As the child's environment and food
habits change, so do the bacteria.
"If there is immune system
dysfunction, there can be an imbalance that results in disease
and in inflammation," Littman said.
Dysbiosis, or the abundance of
certain bacteria because of factors such as antibiotics, stress and
diet, can change the profile and trigger inflammation, Taneja said.
If so-called unfriendly bacteria
outnumber good bacteria,
"it leads the body to produce a lot
more of the pro-inflammatory cytokines," or substances secreted
by cells of the immune system, she said.
"We've shown in mouse models that
the presence of certain bacteria is associated with the
pro-inflammatory status of the gut."
According to one theory, if there is an
imbalance in good and bad bacteria,
metabolites are also unbalanced,
This can cause a leaky gut, allowing for
various metabolite or bacterial products to move outside the gut
into the body.
"Outside of the gut, these bacterial
products may be seen as foreign, and the body starts to make an
immune response to them," she said.
It's possible to change the type of bugs
in the digestive tract by altering diet and using antibiotics,
"but not in a way we can control
very well," Littman said.
One day, scientists hope to develop
pills containing particular microbes,
"that will establish themselves and
change the composition of the microbiota from one that may make
someone prone to disease to one that is beneficial," he said.
For now, the best way to alter gut flora
seems to involve permanent dietary and lifestyle changes.
New York chef Seamus
Mullen adopted a strict diet after being diagnosed with rheumatoid
He believes there's a
direct link between food and the variety of bacteria in the gut.
(Brian Harkin/for the
New York chef Seamus Mullen, 40,
was diagnosed with rheumatoid arthritis in 2007 after living with
symptoms for several years. He tried the usual treatments, starting
with anti-inflammatory drugs, biologics and steroids, with no luck.
Finally, he saw a doctor who suspected
his arthritis was driven by an imbalance in his microbiome because
of an infection.
Mullen said he followed a strict yearlong protocol, one that
involved more exercise, more rest and the elimination of refined
sugars and grains. He ate more
fermented foods, which are
in probiotics, took supplements and
low-level antibiotics and avoided meat and poultry unless they came
from grass-fed animals.
Mullen also used acupuncture and
diligently monitored how he was feeling. After nine months, his
blood values had returned to normal for the first time in a decade,
and his arthritic symptoms had receded, he said.
Though he realizes his case is
anecdotal, he's convinced,
"there's a direct correlation
between the foods we eat and the spectrum of bacteria in
our guts," he said.
"Food is a fundamental part of the
journey," Mullen said. "It's not enough to say, 'Oh, I'll have
some ginger today and some greens tomorrow,' and expect a
turnaround in your health.
"To really see change, it requires a wholesale reboot of how
you live your life. Compliance isn't easy, but it's a small
price to pay."