Food Poisoning and Manmade E. coli

Bacteria on food is a problem for diet-compromised people.   

Gut Flora are Required for a Healthy Immune System

Healthy people don't get sick from food poisoning, because their gut flora provide protection.  Gut bacteria control the development of the human immune system by producing interesting compounds, including short chain fatty acids and vitamins.  In response to the gut bacteria, the healthy immune system produces white blood cells that can effectively attack bacteria, and also control this aggressive behavior to spare human cells and avoid unnecessary attacks on beneficial bacteria.

Disrupted Gut Flora Lead to Susceptibility to Disease/Infection

Gut flora can be compromised by what we eat and antibiotics.  Those normally affected by food poisoning are the very young (on formula), the old (constipated) and those treated with antibiotics.  Each of these groups have abnormal gut flora.  Food poisoning is rarely observed in exclusively breastfed babies being introduced to foods, because human milk contains potent antimicrobial polysaccharides (human milk oligosaccharides) that only permit the growth of a few species of Bifidobacteria.  Formula (in any amount) disrupts the normal development of the gut and immune system by stimulating an inflammatory growth of adult gut bacteria, making these babies more susceptible to intestinal and respiratory diseases, including food poisoning.

Constipation, which is more common in older people, reflects a disruption of the gut flora and decreases the effectiveness of the immune system in these individuals.  In most cases the compromised gut flora results from a long history of a restricted diet and  reduced access to environmental sources of bacteria.

Antibiotics are usually ignored as major corruptors of the immune system, even though they are known to produce diarrhea and constipation.  Doctors reluctantly suggest that people taking antibiotics should just eat some yogurt.  This is a silly oversight that severely compromises future health, because probiotics supply only a tiny fraction of the 150 different species of bacteria needed for a healthy body and immune system.

Pathogenic E. coli is Made by Antibiotic Use in Cattle

E. coli is a common and essential resident of the human gut and the best studied bacterium.  This bacterium is not normally resistant to antibiotics nor does it produce deadly toxins.  Antibiotic resistance and toxin production results from treating cattle with antibiotics to increase fat production prior to butchering.

Antibiotics Select for E. coli that Stick to Rectal Surface of Cattle

Pathogenic E. coli are not found throughout cattle fecal material, but rather they are only in the outermost surface layer.  This outer layer of material contains bacteria from the surface of the rectum just as the cow pies are deposited.  E. coli does not normally stick to this surface, because it lacks a protein, such as a hemagglutinin capable of binding to the surface polysaccharides, heparan sulfate.  Antibiotics kill off the bacteria normally residing on the surface.  As a member of the intestinal biofilm community, E. coli continually exchanges DNA/genes with other bacteria in the gut and picks up three useful genes, to become a pathogen:

1. Antibiotic resistance
2. Hemagglutinin for sticking to surfaces
3. Toxin to release nutrients from the intestinal walls.

E. coli with these three genes can colonize the rectal tissue of cattle in feed lots.

Pathogenic E. coli Can be Easily Avoided

We have to work hard as a society to have problems with E. coli.  Pathogenic E. coli results from absurd use of huge quantities of antibiotics just to disrupt the normal gut flora of cattle so that they become unhealthy and store fat in their tissues, i.e. prime beef.  The same effect can also be achieved just by feeding the cattle some short chain fatty acids, or better still avoiding this step by feeding exclusively on grass.  It would also be easy to treat the few cattle that have pathogenic E. coli, so that it doesn't become a problem.  Proper treatment of manure and meat processing would also block transmission of pathogenic E. coli to agricultural crops or meat.  Finally, an Anti-inflammatory Diet and Lifestyle would provide a healthy gut flora and immune system that would make people less susceptible to the pathogen.

Udder Nonsense

Recent articles in the popular press have heralded the genetic engineering of cows with some human milk proteins.  Milk produced by these transgenic cows is advertised as being similar or the same as human  breast milk.

This is like claiming that the udder in the picture is an all natural, low BPA container for fortified water.  

The breakthrough in humanized cow's milk, announced by Chinese researchers in PLoS One, actually documents replacement of cow lysozyme with the corresponding human enzyme.  That does not make the milk human anymore than adding egg white lysozyme would turn the cows into chickens. If it moos like a cow...

Cow's milk-based formula harms infants, because the carbohydrates it contains do not support the normal development of infant gut flora.  The result is gut inflammation, and not normal gut and immune system development.  Even human proteins produced in cows will have characteristic cow sugars attached.  It is these cow sugars on milk proteins that are associated with colic. The chains of sugars (milk oligosaccharides) free and/or associated with milk proteins are different in cows and humans, and cow carbs are a problem in formula.

I think that it is silly to support humanizing cow's milk formula, when the sensible solution is to support breast feeding and licensed human milk banks.  The natural approach is much cheaper and far healthier.  Only human milk and human milk-derived fortifiers should be used for infants (especially preterm) in hospitals.  It is time for the healthcare industry to realize that disruption of gut flora by antibiotics or artificial formula is a health risk.  The data are clear -- cow's milk (including transgenic cow’s milk) in the hospital may be profitable, but it is unhealthy, e. g. contributes to Clostridium difficile and necrotizing enterocolitis infections, and contributes to long term health problems, such as inflammatory and autoimmune diseases.

References:

China Genetically Modifying Cows To Produce Human Breast Milk

Characterization of Bioactive Recombinant Human Lysozyme Expressed in Milk of Cloned Transgenic Cattle

Why Discuss Mother’s Milk on an Inflammation Blog?

Milk Is Perfectly Adapted for Infant Nutrition/Development

I think that I should explain, if it is not obvious, why I keep bringing up breastfeeding/infant nutrition on this blog about diet, inflammation and disease.  The starting point is that infants need nutrition, protection from disease and continued normal development or they won’t be able to reproduce.  That means that milk is the focal point of a lot of natural selection and absence of the natural functions of milk, e.g. use of formula, would be expected to lead to inflammation and disease, which it does.  Analysis of milk and how formula makes infants susceptible to disease and alters normal development, provides an extreme example of the interactions of diet, gut flora and the immune system.

Since this is World Breastfeeding Week and my wife is an Internationally Board Certified Lactation Consultant, I think that writing a few articles on milk is good for my health.

Milk Provides Complete Nutrition, Controls Gut Flora, Promotes Gut Development -- Formula Doesn’t

I find it amazing that supplements are encouraged for exclusively breastfeeding infants.  It doesn’t make sense to suspect that breast milk is inadequate and why is formula fortified with ingredients at ten to a hundred times the levels in breast milk?  The answer is in the infant gut flora and perhaps in poor maternal nutrition/gut flora.

Mother’s Milk Promotes Normal Infant Gut Flora -- Bifidobacteria

The normal infant gut flora is very simple, Bifidobacteria.  Adults have gut flora composed of hundreds of different species of bacteria and infants have just Bifidobacteria.  The name of the infant bacterium should be familiar if you read labels on yogurt.  Bifidobacteria are common probiotics.  That also explains why the diapers of exclusively breast fed babies smell like yogurt.  

Formula Promotes Adult Gut Flora

One bottle of formula kills the Bifidobacteria and replaces it with adult gut bacteria.  The diapers are forever changed, because the adult gut flora is very persistent.  The presence of the adult gut flora also explains why formula has the high levels of supplements.  The adult gut flora consumes the supplements and leaves only tiny amounts for the infant.  All of the breast milk nutrients go to the baby if only Bifidobacteria is present, but after the adult gut flora are established much higher levels are needed and the infant may still be deficient.  Adult, formula-supported gut flora also digest antibodies and other protective factors in mother’s milk.

Supplement Mothers to Improve Infant Nutrition

Modern mothers are also eating modern diets that produce deficiencies.  Chronic diet-based inflammation leads to a compromised ability to produce vitamin D in sunlight.  Nursing mothers with poor diets may not be transferring enough vitamin D to their nursing babies.  Since formula and the adult gut flora that it stimulates, causes gut inflammation, I suspect that formula fed infants are also compromised in their ability to produce their own vitamin D in sunlight.  It makes more sense to supplement mothers than babies.

Formula Is not Breast Milk, It’s Not Even Close

Formula is cheap to produce, but expensive to buy.  Formula is promoted as the next best substitute for milk from a baby’s own mother, but that isn’t true either.  The next best alternative is mother’s milk from a certified human milk bank.  It is available at a reasonable cost.  Hospitals should know better and provide the only appropriate alternative.  Early formula use dramatically increases healthcare costs.

Formula Lacks the Oligosaccharides Needed to Support only Bifidobacter

Fructose oligosaccharides (FOS) and other short chains of sugars are being promoted to support the growth of beneficial gut flora.  These oligosaccharides do promote the growth of adult gut flora, but not just infant Bifidobacteria.  Formula plus FOS and/or other prebiotic oligosaccharides other than those present in human milk support the growth of bacteria that rob nutrients from and degrade the protective components of breast milk.  If the diaper smells like adult gut flora, then the baby was not fed mother’s milk.

Development of Gut and Brain

The newborn gut and brain are only partially developed.  Mother’s milk is needed to supply growth factors to close and differentiate the gut epithelium, and long chain omega-3 fatty acids for brain growth.  Formula may eventually be supplemented with the needed fatty acids, but the growth factors/hormones present in mother’s milk will not be provided in formula.  Recent studies have shown that hundreds of different genes are activated in gut cells from infants fed either breast milk or formula.  Formula leaves the gut leaky and fails to stimulate the development of the immune system that is dependent on interaction with normal infant gut flora.  These dysfunctions partially explain the increased (10X to 100X) gut and respiratory infections resulting from formula use.  The reduced brain development with formula explains the five point reduction in IQ of formula fed infants.

It’s worldwide breastfeeding week.  Support healthy, non-inflammatory gut flora (infant Bifidobacteria) around the globe!

Necrotising Enterocolitis, Low Birth Weight and Formula

Human Milk and Milk Supplements Protect Newborns

Babies born prematurely are at risk of a serious bacterial infection of the intestines, necrotizing enterocolitis (NEC), that can be prevented if formula based on cow’s milk products is avoided and human milk is used for all feedings.

Human Milk Protects Against Formula Based NEC

Feeding low birth weight, premature babies formula made from cow’s milk increases their risk of NEC ten fold.  Replacement of some of the cow’s milk formula with human milk from a milk bank reduces NEC. 

Human Milk and Cow’s Milk Are Very Different

What is present in human milk that protects against NEC?  The major components in milk are proteins, lactose, fats and oligosaccharides (short to medium length chains of sugars.)  Human milk and cow’s milk have the same amount of fat (35 grams/liter) and about the same amount of lactose (65 vs. 45 g/l) and protein (10 vs. 35 g/l).  The big difference is in the amount (5-10 vs. 0.05 g/l) and quality of oligosaccharides.  Human milk has more than 100 times the amount of oligosaccharides as cow’s milk.  That also means that about 10% of the carbohydrates in human milk are non-nutritive human milk oligosaccharides (HMOs).

HMOs Are Not FOS

Human milk oligosaccharides are complex, with over 200 different structures identified so far.  Essentially they are made up of a lactose (a disaccharide consisting of galactose linked to glucose) extended by different numbers of N-acetyllactosamine (lactose with a modified glucose) and a few other sugars attached a various locations.  A different enzyme is used for each modification and the synthesis of these oligosaccharides has not yet been figured out in detail.  More than a dozen different genes are devoted to the synthesis of these oligosaccharides.  These oligosaccharides are not structurally or functionally related to the frucose oligosaccharides used as prebiotics.

HMOs Are Prebiotic and Stop NEC

Human milk oligosaccharides have been tested both for their ability to act as prebiotics to encourage the development of normal baby gut flora and to suppress NEC.  The HMOs were found to be the elusive bifidus factor that stops the development of adult gut flora and facilitates only the development of the Bifidobacterium bifidum monoculture found in exclusively breastfed babies.  HMOs also reduce NEC in the same way as whole human milk.  Another interesting aspect of HMOs is that they modify the oligosaccharides produced on the surface of baby intestinal cells.  Babies fed human milk also secrete HMOs in their urine, indicating that ingested HMOs are absorbed in the intestines and reach the blood stream.

Neonatal Nurseries Should Use Only Human Milk

Human milk is now available to neonatal intensive care nurseries through milk banks and purified components of human milk are also available to supplement feedings for very low birth weight premature babies.  Nursing is still best for baby and mother, but those mothers who choose not to nurse need not compromise the health and development of their babies by using cow’s milk-based formula or supplements.  Every dollar spent on pasteurized donor milk ($3/oz.) reduces costs in neonatal intensive care units by more than ten dollars.  It seems to be time to eliminate the added risks of formula use in hospitals and provide every baby with a healthy start and normal gut flora by only using human milk products in hospitals.

ref.

Lars Bode. 2009.  Human milk oligosaccharides: prebiotics and beyond 

Nutrition Reviews® Vol. 67(Suppl. 2):S183–S191