A Country Doctor Reads: February 23, 2019

Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women’s Health Initiative – Stroke

You can’t cheat the system. Eat sweets and take more or less known risks, but eat artificial sweeteners and go where no one has fully charted the territory:

“In women with no prior history of cardiovascular disease or diabetes mellitus, high consumption of ASB (Artificially Sweetened Beverages) was associated with more than a 2-fold increased risk of small artery occlusion ischemic stroke hazard ratio =2.44 (95% confidence interval, 1.47–4.04.) High consumption of ASBs was associated with significantly increased risk of ischemic stroke in women with body mass index ≥30; hazard ratio =2.03 (95% confidence interval, 1.38–2.98).”

https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023100

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Food Protein-Induced Enterocolitis Syndrome (FPIES) – AAAAI

I took an online Functional Medicine class last week and was intrigued by the concept that food allergies aren’t always IgE mediated (and therefore not all that easy to test for), and they’re apparently not IgA mediated either; I always thought intestinal allergies were…

“There are differences that set FPIES apart from a typical food allergy. Most food allergy reactions happen within minutes or shortly after coming in contact with a food allergen. FPIES allergic reactions are delayed, occurring within hours after eating the trigger food. In most allergies, the immune system overreacts to the allergen by producing Immunoglobulin E (IgE) antibodies. FPIES reactions are thought to involve cells of the immune system rather than IgE antibodies.”

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-protein-induced-enterocolitis-syndrome

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(Interoception) We’ve Lost Touch with Our Bodies – Scientific American Blog Network

I’m more and more fascinated with mind-body medicine and ran into a new word, INTEROCEPTION, in this piece in Scientific American:

“This lack of connection to our bodies can be looked at through a concept called interoception, which describes our awareness of internal bodily signals, including the detection of sensations such as hunger, thirst and heartbeat. Interoception is a process by which our brains/minds make sense of these signals, which serve as a running commentary or mental map of the body’s internal world across conscious and unconscious levels of perception.

Our culture, technology and medicine have progressively made us into poor interoceptors.

Disrupted interoception is now understood to play an important role in mental health conditions including anxiety and mood disorders, eating disorders and addiction, and it is thought to be a feature of most psychiatric disorders. Scientific American has previously explored the role of interoception in eating disorders (“A Broken Sense of Self Underlies Eating Disorders”), emotional awareness (“Emotional Ignorance Harms Health”), and the location and function of such awareness in the brain (“Where Mind and Body Meet”). And results from relatively recent neuroanatomical and neuroimaging studies have shown how dysfunctional interoception can cause or exacerbate anxiety and depression.”

“The history of interoception science goes back to Charles Darwin, who discussed the role of visceral sensations in emotion in The Expression of the Emotions in Man and Animals.”

This type of training is, of course, what Yoga and many forms of meditation and mindfulness are all about.

Which brings me back to my old friend Alexithymia:

Brewer, Cook and Bird wrote in Royal Society Open Science in 2016:

Alexithymia: a general deficit of interoception

“While it was originally assumed that the interoceptive deficit in alexithymia is specific to emotion, recent evidence suggests that alexithymia may also be associated with difficulties perceiving some non-affective interoceptive signals, such as one’s heart rate. It is therefore possible that the impairment experienced by those with alexithymia is common to all aspects of interoception, such as interpreting signals of hunger, arousal, proprioception, tiredness and temperature.”

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