Health & Fitness

The 'Habsburg jaw,' a facial condition of the Habsburg dynasty of Spanish and Austrian kings and their wives, can be attributed to inbreeding, according to new results.

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Brushing teeth frequently is linked with lower risks of atrial fibrillation and heart failure, according to a new study.

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Researchers have observed how stem cell mutations quietly arise and spread throughout a widening field of the colon until they eventually predominate and become a malignancy.

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In this short video health coach Christine Smith, Ph.D., succinctly describes the necessary role choline plays in your health and wellness.

Choline was discovered in 1862, but it was 1998 before the Institute of Medicine declared it an essential nutrient for optimal health. Unfortunately, 90% of the U.S. population does not consume enough of it, likely since popular dietary guidelines limit consumption of the richest dietary sources.

Many are still unaware of the biological importance choline plays and it may be one of the least likely nutrients to be recommended. Choline is not a vitamin or mineral, but an organic water-soluble compound scientists often group with vitamin B complex since the function is similar.

Although your liver has the ability to produce small amounts, you need to consume the majority of the nutrient from the foods you eat. Some people opt to use dietary supplements, but that may not be the best choice. I suggest you optimize your levels by eating choline-rich foods.

Choline Is Essential for Optimal Health

Researchers have linked the intake of higher levels of choline to a range of benefits including a reduced risk for heart disease, prevention of nonalcoholic fatty liver disease (NAFLD) and a 24% reduced risk for breast cancer.

Choline appears to be a key controlling factor in the development of NAFLD. As Smith discusses in the video above, the nutrient is also used in several ways throughout your body, including:

Healthy fetal development — Choline is required for proper neural tube closure, brain development and healthy vision. Research shows children of mothers who get enough choline enjoy better memory due to changes in the development of the hippocampus (memory center) of the child's brain. Choline deficiency raises the risk of premature birth, low birth weight and preeclampsia.

Synthesis of phospholipids — The most common phospholipid is phosphatidylcholine, better known as lecithin, which constitutes between 40 and 50 percent of your cellular membranes and 70 to 95 percent of the phospholipids in lipoproteins and bile.

Nervous system health — Choline is necessary for making acetylcholine, a neurotransmitter involved in healthy muscle, heart and memory performance.

Cell messaging — Choline is one factor in the production of cell-messaging compounds.

Fat transport and metabolism — Choline is needed to carry cholesterol from your liver, and a deficiency could result in excess fat and cholesterol buildup.

DNA synthesis — Choline aids in the process of DNA synthesis with other vitamins, such as folate and B12.

Improved cognitive performance — Researchers1 found a relationship between high dietary choline and better cognitive performance in a study involving men and women from the Framingham Offspring population. In a group of 1,391 men and women, performance factors were better in those who consumed more choline, adding to evidence your nutrition makes a difference in how your brain ages.

Methylation reactions

Healthy mitochondrial function

Choline May Be Primary Driver Behind Liver Disease

Choline deficiency may be a primary trigger behind NAFLD. This is the most common form of liver disease in the U.S., with an estimated prevalence of 30% to 40% in the adult population. Additionally, 80% of NAFLD patients are likely insulin resistant and 90% are deficient in choline; both are factors in the development of NAFLD.

According to Chris Masterjohn, Ph.D., nutritional science, choline deficiency may be a more significant trigger than excess fructose. His Ph.D. is in nutritional science and in his view the rise in NAFLD is largely due to the result of the dietary practice of avoiding liver and egg yolks.

In his review of medical literature, Masterjohn found a link between choline and fatty liver, which was initially discovered in research into Type 1 diabetes. However, the most noteworthy offender in NAFLD is large amounts of fructose consumption, as all of it must be metabolized in your liver and is primarily converted into body fat as opposed to being used for energy like glucose. According to Masterjohn:²

"Physicians and researchers had started pinning the blame on alcohol abuse for fatty liver back in the 1800s, so while research was first highlighting the role of sucrose in fatty liver, other research was doing the same for alcohol.

In 1949, however, researchers showed that sucrose and ethanol had equal potential to cause fatty liver and the resulting inflammatory damage, and that increases in dietary protein, extra methionine, and extra choline could all completely protect against this effect.

Conversely, much more recent research has shown that sucrose is a requirement for the development of fatty liver disease in a methionine- and choline-deficient (MCD) model. The MCD model of fatty liver disease is the oldest and most widely used dietary model.

The MCD model produces not only the accumulation of liver fat, but massive inflammation similar to the worst forms of fatty liver disease seen in humans. What no one ever mentions about this diet is that it is primarily composed of sucrose and its fat is composed entirely of corn oil!

The picture that is clearly emerging from all of these studies is that fat, or anything from which fat is made in the liver, such as fructose and ethanol, are required for the development of fatty liver. But in addition to this [same] factor — overwhelmingly, it appears to be choline deficiency — must deprive the liver of its ability to export that fat."

However, while carbohydrates, healthy saturated fats and unhealthy polyunsaturated fat (PUFA)-rich oils all have the ability to contribute to the buildup of fat in your liver, lipid peroxidation and associated inflammation is primarily driven by PUFA-rich oils such as corn oil. As noted by Masterjohn:³

"Corn oil probably promotes inflammation both by increasing vulnerability to lipid peroxidation because of its total PUFA content and by decreasing tissue levels of DHA because of its high omega-6-to-omega-3 ratio."

Long-Term Risks of NAFLD

NAFLD is also triggered in part by obesity and insulin resistance. Researchers who evaluated the effects of treatment and long-term health conditions associated with NAFLD found they could create the condition in animal models using methionine and choline deficient diets.

NAFLD and nonalcoholic steatohepatitis (NASH) are associated with fatty liver deposits, but are not associated with alcohol consumption. In NAFLD the liver suffers from fatty deposits but has little to no inflammation or cellular damage. NASH may also occur when you have hepatitis. In this condition the liver is inflamed and cellular damage is present.

It may also lead to fibrosis of the liver and then cirrhosis or liver cancer. In one animal study researchers found choline supplementation normalized cholesterol metabolism. This appeared to help prevent NASH and demonstrated an improvement in liver function.

How Much Choline Do You Need?

A Dietary Reference Intake (DRI) has not been established, but the Institute of Medicine set an adequate daily intake value for men, women and children. The daily values are 425 mg per day for women, 550 mg for men and 250 mg for children as a minimum amount to prevent choline deficiency and potential organ damage.

However, requirements may vary depending on your overall diet, genetic makeup and other lifestyle factors. For instance, those who eat a diet rich in saturated fats may require more choline. For the liver to export excess fat it requires choline. This means, the more dietary fat you consume, the greater your need for choline. Individuals who may need to pay special attention to this requirement include:

Best Natural Sources of Choline

In the 1970s many physicians warned their patients to steer clear of eggs and egg yolks to minimize their intake of cholesterol and saturated fat. In reality, both are good for you, and eggs may be one of the most important available health foods. A single hardboiled egg may contain from 113 milligrams (mg) to 147 mg of choline.

This represents 25% of your daily requirement, making it one of the best sources in the American diet. Only grass fed beef liver with 430 mg of choline per 100 grams per serving delivers more.

Other healthy sources include wild-caught Alaskan salmon, organic pastured chicken, shiitake mushrooms and krill oil. Some vegetables, such as broccoli, cauliflower and asparagus offer 31 mg, 24 mg and 23.5 mg respectively per one-half cup serving.

One study in 2011 found 69 choline containing phospholipids in krill oil, including 60 phosphatidylcholine substances, making it one of the best sources of choline. While eggs have a fair amount of phosphatidylcholine, krill oil delivers a higher amount per volume, which is one of the reasons I personally take krill oil capsules each day.

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While your diet is one of the most important tools you can use to take control of your health, certain supplements can be helpful, especially when it comes to improving your mitochondrial function. One particularly powerful supplement in this regard is pyrroloquinoline quinone (PQQ),¹ which has been shown to promote the growth of new mitochondria (mitochondrial biogenesis).

Your mitochondria also require PQQ to catalyze energy producing reactions, and it's critical in protecting your mitochondria from damage. Your mitochondria are the tiny energy producers inside your cells, which is why mitochondrial dysfunction is at the heart of just about all chronic diseases, old age and death.

In order for your body to function properly, it needs sufficient energy and, for that, you need well-nourished, well-functioning mitochondria. PQQ is an important player in this regard.² As noted by Dave Asprey, founder of Bulletproof and author of books on energy, life span and brain power:³

"Anti-aging starts at the cellular level and PQQ is an easy way to protect your cells, all while helping to improve the most mitochondrial-dense parts of your body like your brain and heart."

PQQ Enhances Mitochondrial Density and Function

PQQ is relatively unique in its ability to enhance mitochondrial biogenesis, i.e., the creation of new, healthy mitochondria in aging cells, which is the basis of so many of its health benefits. As reported by Better Nutrition magazine:⁴

"In addition to improving energy production, this characteristic of PQQ shifts some of the aging process into reverse gear. In a study⁵ at the University of California, Davis, researchers gave a small group of men and women PQQ supplements and tested the effects 76 hours later.

Using blood and urine tests, researchers found that PQQ improved mitochondrial performance and reduced chronic inflammation. The effective dose was 0.3 mg of PQQ per kilogram of body weight — 20 mg of PQQ for a 150-pound person, as an example."

One mechanism by which PQQ lowers inflammation, improves mitochondrial function and stimulates mitochondrial biogenesis is by upregulating Nrf2 expression — a biological hormetic that upregulates intercellular antioxidants such as superoxide dismutase and catalase.

PQQ has also been shown to boost the activity of primary life span extension transcriptional factors, which led the researchers to surmise that PQQ may play a "novel role" in longevity.⁶ Indeed, it modulates a variety of signaling pathways, including mTOR, which plays a role in aging and cancer,⁷ and helps repair DNA,⁸ all of which suggests it may help you live longer.

PQQ also enhances NADH,⁹ which is converted to NAD+ as food is broken down into energy.¹⁰ When DNA damage is repaired, NAD+ is used up, and if you run out you can't repair the damage, which is likely the central cause for most of the diseases we are seeing in the modern world now.

How PQQ Protects and Benefits Your Brain

PQQ's ability to shield your brain cells and their DNA from harm also suggests it can be a powerful preventive aid against neurodegenerative diseases. Mitochondrial DNA is quite prone to damage from free radicals and pro-oxidants. Most of the free radicals in the body are produced within the mitochondria themselves, which is why they're so susceptible.

Free radicals are an unavoidable artifact of converting food into cellular fuel, and your food is ultimately metabolized in your mitochondria. PQQ has been shown to protect against this kind of damage. It also activates your mitochondria's built-in repair and replication mechanisms.

In your brain, the practical end result is an overall improvement of neurologic function,¹¹ including improved cognition, learning and memory,¹² and a reduced risk of neurodegenerative diseases. Research¹³ has shown PQQ protects and improves the survival of neurons by stimulating the synthesis of nerve growth factor (NGF) in certain glial cells found in your central nervous system.

It's also been shown to improve the function of beta amyloid-damaged brain cells¹⁴ — a hallmark of Alzheimer's disease — and prevent the formation of alpha-synclein proteins associated with Parkinson's disease.¹⁵

According to a 2012 study,¹⁶ PQQ can even help prevent neuronal cell death in cases of traumatic brain injury. According to the authors of this study, "PQQ may play an important role in recovery post-TBI."

Adding CoQ10 Provides Synergistic Benefits

Both animal and human studies using doses between 10 and 20 milligrams (mg) of PQQ have demonstrated improvement in mental processing and memory on its own, but combining it with Coenzyme Q10 could potentially be even more beneficial.

One study found PQQ in combination with CoQ10 produced better results than either of these nutrients alone, so there appears to be some synergistic effects. I recommend using the reduced form of CoQ10, called ubiquinol, as it is more readily available for your body.

Both CoQ10 and PQQ are fat-soluble, so they're best taken with a small amount of fat in your meal rather on an empty stomach. In addition to being a powerful antioxidant in its own right, CoQ10/ubiquinol also facilitates the recycling (catalytic conversion) of other antioxidants, so when taken in combination with PQQ, you're really turbocharging your body's antioxidant capacity.

PQQ Is a Powerful Antioxidant and Immune Booster

Another reason why PQQ is so beneficial has to do with its powerful antioxidant activity. It's capable of undergoing upward of 20,000 catalytic conversions. A catalytic conversion is when an antioxidant neutralizes a free radical. In other words, PQQ is a remarkably efficient antioxidant. For comparison, vitamin C can only go through four catalytic conversions before it's used up.^17,18

Research has shown PQQ lowers the inflammatory biomarkers C-reactive protein and interleukin-6 in humans at doses between 0.2 mg and 0.3 mg per kg.¹⁹

PQQ also supports your immune function and PQQ deficiency has been linked to immune dysfunction.²⁰ In one study,²¹ PQQ supplementation increased the responsiveness of B- and T-cells (white blood cells that play central roles in your immune response) to mitogens (proteins that induces cell division or mitosis).

PQQ Activates Metabolic Master Switch

The list of potential applications for PQQ is extremely long, as its metabolic effects go well beyond improving mitochondrial function. For example, it helps activate adenosine monophosphate-activated protein kinase (AMPK), which is an important molecular target for metabolic health. 

AMPK is an enzyme inside your body's cells. It's sometimes called a "metabolic master switch" because it plays an important role in regulating metabolism. As noted in the Natural Medicine Journal:²²

"AMPK induces a cascade of events within cells that are all involved in maintaining energy homeostasis … AMPK regulates an array of biological activities that normalize lipid, glucose, and energy imbalances.

Metabolic syndrome (MetS) occurs when these AMPK-regulated pathways are turned off, triggering a syndrome that includes hyperglycemia, diabetes, lipid abnormalities, and energy imbalances …

AMPK helps coordinate the response to these stressors, shifting energy toward cellular repair, maintenance, or a return to homeostasis and improved likelihood of survival.

The hormones leptin and adiponectin activate AMPK. In other words, activating AMPK can produce the same benefits as exercise, dieting, and weight loss — the lifestyle modifications considered beneficial for a range of maladies."

With age, your AMPK level drops naturally, but poor diet can reduce AMPK activity at any age. This enzyme plays a major role in body fat composition, inflammation and blood lipids, so boosting its activity can go a long way toward improving blood sugar control, reducing visceral fat and lowering LDL cholesterol.

AMPK also stimulates mitochondrial autophagy (mitophagy) and mitochondrial biogenesis, as well as five other critically important pathways: insulin, leptin, mTOR, insulin-like growth factor 1 (IGF-1) and proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α).

It is important to note that PQQ will not likely work well, if at all, if you are eating around the clock, as elevated insulin levels will activate mTOR and inhibit AMPK, thus limiting PQQ's ability to increase it.

Other Benefits of PQQ

PQQ has also been linked to several other health benefits, including:

• Improved reproductive outcomes in animals²³ (PQQ deficiency has been linked to abnormal reproductive performance²⁴)
• Reduced risk of nonalcoholic fatty liver disease in offspring when given to obese mouse mothers during pregnancy and lactation²⁵
• Improved sleep (by modulating the cortisol awakening response)²⁶

As you can see, the list of PQQ's health benefits is quite long. And, while PQQ is found in foods such as natto, parsley, green pepper, spinach, papaya, kiwi and green tea,²⁷ the amounts you get from your diet are likely to be insufficient if you want to reap all of its beneficial health effects.

When taking a PQQ supplement, you'll know within a few weeks whether the brand and dosage is working for you. Overall, you should feel better, with greater energy and clearer thinking.

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Despite their tiny size, mosquitoes are dangerous creatures that can act as vectors to spread deadly diseases. More than half the Earth's population live in areas where disease-carrying mosquitoes cause deaths from illnesses like malaria, dengue and yellow fever.

Insecticides have been identified as a primary defense against insects, but the potential for resistance has not gone unnoticed by the World Health Organization. The WHO reports that resistance to pyrethroids, organochlorine, carbamates and organophosphates is widespread through Africa, Southeast Asia, Western Pacific, the Americas and the Eastern Mediterranean.

Additionally, some mosquitoes appear to be developing resistance to agricultural insecticides that continue to kill their predators. This creates an environment for mosquitoes to flourish. When the anopheles mosquito carrying a plasmodium parasite bites a person, it spreads malaria.

The 2018 World malaria report released by the WHO¹ provided a comprehensive update on regional and global data and trends for malaria. They found in 2017 there were an estimated 219 million cases worldwide as compared to 239 million in 2010. The disease was responsible for 435,000 deaths worldwide in 2017, 61% of which were children under the age of 5.²

However, while the number of infections fell over seven years, it rose by 2 million cases from 2016 to 2017. Authors of the report also found 15 countries accounted for 80% of the number of cases and deaths; these were in sub-Saharan Africa and India.

Only India has been reporting progress in reducing cases of malaria. India accounted for 4% of all cases in 2017 but registered a 24% reduction over 2016. Scientists found this was due to a substantial decline in disease following a rejuvenated political effort that prioritized a vector control method and increased domestic funding.

Can Soup Effectively Treat Malaria?

The global impact of malaria-associated mortality was the object of interest in a study published in the Archives of Disease in Childhood.³ A team of researchers asked students at Eden Primary School in London⁴ for samples of homemade soup. The students represented families from a variety of backgrounds. The researchers used 56 total samples of broth, which were tested for the ability to arrest the parasite’s asexual or sexual stage development in vitro.

The Plasmodium falciparum parasite was tested as it's the most prevalent parasite, responsible for 99.7% of the estimated cases in Africa, 62.8% in Southeast Asia and 69% in the Eastern Mediterranean.⁵

Of the broths screened,⁶ five inhibited the P. falciparum asexual blood stage more than 50% of the time in vitro, and two of the broths had an inhibition factor comparable to that seen using a leading antimalarial medication. Four other samples had a recognized ability to block transmission by preventing the male sexual stage development.

The researchers concluded there were broths that induced activity against the malaria parasite’s in vitro growth. They wrote that the study also represented “a successful child education exercise, in teaching about the interface between natural remedies, traditional medicine and evidence-based drug discovery.”

Advantageous Benefits to Wormwood

The researchers were interested in the ingredient artemisinin found in the Chinese herb Qinghao, also known as wormwood. This herbaceous perennial plant has several beneficial effects against a variety of health conditions. It is the key ingredient in absinthe, a liquor used during the 19th century.

The plant commonly grows in Europe, North Africa, North India, Scotland and Scandinavia. It grows up to 3.6 feet or higher with branches that produce light yellow flowers and long green leaves. It has a slightly bitter taste and goes by other common names such as green ginger, grand wormwood, madderwort and wormwood sage.

According to Scientific American Journal, some of the earliest recorded uses date back to ancient Egypt. For more information on the plant, how to use the oil and its benefits in treating the conditions listed below, see my past article, “Discover the Many Benefits of Wormwood to Your Health.” You’ll also find a recipe for wormwood tea.

Lead exposure	Liver disease	Depression
Crohn's disease	IgA nephropathy	Osteoarthritis
Leukemia	Lymphoma	Lyme disease

Malarial Infection Can Be Deadly

Malaria is categorized as severe (complicated) or uncomplicated.⁷ In general, when diagnosed and treated early it can be curable. The clinical symptoms of the disease are triggered during the asexual blood stage of the parasite as it develops in a red blood cell.

Waste and toxic factors accumulate inside the cells that are dumped into the bloodstream as the infected cell ruptures. The infected red blood cells adhere to the vascular endothelium and do not freely circulate in the blood. If infected, these cells, also referred to as erythrocytes, settle in the vessels of the brain. Scientists believe this is a factor in the development of severe disease associated with high mortality.

In the early stages, symptoms are similar to other types of infections, including flu.⁸ The time you are infected with the parasite to the time of the first symptoms is usually seven to 30 days. However, this can differ depending on the parasitic species.

It may take longer for the disease to show up if you are on medication to prevent infection. Symptoms include fever, which is the most common, and signs that often accompany fever, including chills, headaches, sweats and body aches. Additionally, someone with malaria may experience nausea and vomiting, fatigue and a general feeling of sickness.

Any time you develop symptoms of malaria during or after a visit to one of the places the disease may be found, it is important to seek medical help. A blood test will confirm infection and treatment will begin to reduce the potential for severe complications, including anemia and cerebral malaria.

When the small vessels in the brain are damaged by affected erythrocytes, this can potentially cause seizures, brain damage and coma.⁹ In the 2018 WHO¹⁰ report, authors placed a special focus on the effects of the second complication, malaria-related anemia.

When left untreated this condition can result in death, especially in pregnant women and children younger than 5 years. The decline in awareness of malaria-related anemia has resulted in inconsistent reporting. WHO reports that in the 16 high burden African countries, the prevalence of anemia in children who tested positive for malaria was 79%.

Relationship of Plasmodium Parasite Life Cycle to Treatment

The parasite goes through a life cycle that begins in your liver.¹¹ After a mosquito transmits the parasite to your body, it first grows and multiplies in the liver cells before moving into the red blood cells. Once it has invaded an erythrocyte, it reproduces asexually, growing inside the red blood cell and eventually destroying it.

As the red blood cell ruptures it releases young daughter parasites that continue the cycle by invading other red blood cells. This blood stage parasite is responsible for triggering the symptoms experienced with malaria.

The parasite goes through several stages; in one stage they have both male and female forms. When this form of the parasite is consumed by a female anopheles mosquito, the parasite mates inside the mosquito to begin the life cycle. After 10 to 18 days, it migrates into the salivary glands, where it is injected into a new host.

CDC Recommends Artesunate

Authors of the 2018 WHO¹² report analyzed drug resistance to antimalarial medications. They found that despite multidrug resistance, there was decreasing death and disease in the Greater Mekong subregion. Cases of malaria in the African region were not related to resistance to artemisinin-based combination therapies.

The CDC recommends¹³ that anyone in the U.S. diagnosed with malaria be evaluated for parasites that are drug-resistant. Those samples undergo multiple types of testing. The CDC reports there are 1,700 cases of malaria diagnosed in the U.S. each year, many of which are attributed to travel involving visits to countries in which malaria is endemic.

The WHO recommends intravenous artesunate for severe malaria, but the drug is not approved or available in the U.S. For this reason, the CDC provides it under an expanded access investigational new drug protocol in which specific criteria must be met for the medication to be delivered.

Avoid Mosquitoes and Use Other Preventive Strategies

The global fight against malaria is centered on insecticide application and the distribution of insecticide-treated bed nets, along with antimalarial drugs and new malaria vaccines. But mosquitoes and parasites are developing drug resistance, and spraying toxic insecticides is not a safe or sustainable solution.

The Pesticide Action Network (PAN) of Germany has called for safer, nonchemical means of targeting the disease, with significant impacts seen during a pilot program in West Africa. The program began by increasing residents' knowledge and awareness of the sources of malaria.

This included sharing strategies for reducing mosquito breeding sites, as many of the villagers were unaware of the potential existing nearby in areas of food waste, refuse and standing water. Villagers were educated about how to help prevent indoor mosquito infestations via cleaning and garbage removal, as well as how to cover outdoor wells and septic tanks with lids.

Fish were introduced to certain areas to help with mosquito larval control. Clinicians at the local health center were also educated on how to better treat malaria, which led to a significant drop in school absenteeism due to the disease, from up to 30 percent during the years 2009 to 2011 to a low of 4.6 percent in 2012.

When traveling into malaria-endemic areas, consider taking precautions to reduce your risk of being bitten. To discover more about mosquito behavior and what strategies you may use to reduce your risk, see my past article, “How and Why a Mosquito Bites You.”

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