The Argentine doctor Jorge Dottospecialist in geneticstrained in the country and with postgraduate degrees in some of the most recognized training and research centers (such as the mayo clinic and the universities of harvard in the United States and Florencein Italy) launches a forceful phrase: “A 20% of the population has from allergies to food intolerancesthat is to say, he gets up every day feeling bad and goes to bed feeling bad about what he eats and drinks”.
Immediately afterwards, he adds: “Last year the recommendation about when to do the first colonoscopy changed: from 50 years it was lowered to 45 years because polyps and colon cancer occur at an earlier age. And this has to do with what we eat and what we drink”.
That is why Dotto, a specialist in precision medicine and co-founder of Genetics Center that bears his name, wrote the book “what do we eat? food is medicine”.
“From my place – Dotto explains to NEWS– I try to find and understand what genetic variants give a person food intolerances and increased risk of cardiovascular disease, among other disorders. We should incorporate the concept that what we eat has an impact on the bodyincreasing the risk of being overweight, obese, high blood pressure, diabetes, cardiovascular disease, cancer and accelerated aging.
News: And in the daily practice of your work, how does that translate?
Jorge Dotto: We seek to understand why a person has certain symptoms, which are nothing more than warning signs that the body gives that something is not working well. The goal is, instead of covering up the symptom, to understand why that person has heartburn, bronchospasm, migraine, or insomnia. And we have verified that having the genetic profile of the person, with the description of his symptoms and with nutritional interventions, improves the quality of life in a huge number of cases. We see today, we look for ways to improve the person’s quality of life, we refer specialists when necessary. With the final goal that the person can have a healthy longevity.
News: Much of what you describe is what is called nutrigenomics. What is it and how it works?
Dotto: Basically it is that from a saliva sample it is possible to analyze and know what kind of DNA variations the genome has of a person. That information then allows you to eat better. What does nutrigenomics tell us? If a person is lactose intolerant, histamine intolerant, if they have a higher risk of developing celiac disease, or an allergy to wheat. It also allows us to know if there is more danger at the cardiovascular level, because we study specific genetic markers. If so, we refer the person to the cardiologist. It allows us to understand even if a person has a greater ease of gaining body weight and even how that body weight responds to exercise.
News: Do you think the sweeteners Are they healthy or not? Is there a debate about it?
Dotto: The reality is that there is no debate, the scientific evidence is compelling. Sweeteners not only do not help maintain body weight, but rather increase it. Secondly, increase cardiometabolic risk. The same is shown, for example, by a scientific study published in the journal Canadian Medical Association Journal in 2017 and carried out by researchers from the University of Manitoba. The scientists analyzed 2,000 women who consumed sweetener or soft drinks with sweeteners during pregnancy. The dose was one 200-milliliter glass or one serving of liquid sweetener for tea or coffee. At three years, the study authors found that the children were overweight or obese.
The Weizemann Institute of Israel recently released research that sweeteners can irritate the microbiota and even impair glucose tolerance. Another Canadian study shows that they generate chronic inflammation and disrupt the functioning of the immune system, affecting the bacterial balance, which is technically known as dysbiosis. When I look at the microbiomes of people taking genetic tests, made up of the billions of microbes that live in the gut, I notice these unhealthy effects.
News: But there are different types of sweeteners, new ones, such as sorbitol and xylitol…
Dotto: Yes, there are others less well known as well. They are classified as nutritive sweeteners, because they contain few calories and generate energy in the body. High amounts of these sweeteners, especially mannitol and sorbitol, have been associated with increased risk of developing stomach pain, diarrhea, and gas. According to published reports, doses of 10 to 15 grams per day, considered moderate, would be well tolerated by most people.
News: What is the difference between allergies and intolerances?
Dotto: When we talk about intolerance we refer to the difficulty to introduce a substance into the body. For example, in the case of the lactose intolerance there is a gene that is responsible for producing a protein called lactase, to break down sugar. That enzyme does not work well in 65% of the world’s population. It has a natural logic, we are the only species that continues to consume milk and that we invented dairy products after the breastfeeding period ended. So what function does that protein have in evolutionary terms? None. That is why it is turned off in the body and the result is that when people with lactose intolerance consume lactose-rich dairy products, they cannot incorporate them. And they have symptoms, swelling and pain, at the very least. It also has a negative impact on body weight because something that the body does not handle well is deposited in adipose tissue.
News: And the allergies?
Dotto: They are an exaggerated reaction of the immune system to what it recognizes as an “enemy”, which it rejects. It produces an inflammatory explosion in the body.
News: What are the most frequent intolerances?
Dotto: To lactose, to histamine, wheat, cow’s milk. According to the scientific literature, it is estimated that 3% of the population has histamine intolerancetherefore it is three times more common than celiac disease. There are two pathways of histamine inactivation and a third that contributes. Histamine is a neurotransmitter, it is the light bulb that wakes us up every day. When the almost 8 billion people get up every morning, depending on the time zone, histamine is what activates us to go from the transition from sleep to awakening and alertness.
Now, if a person is overloaded with histamine and cannot eliminate it well, cervical contractures appear, headaches, migraines, bad dreams that make people wake up in the middle of the morning or very early, because the The body is constantly competing between sleeping and waking up. But there are even more symptoms.
News: Florid symptomatology.
Dotto: Depends on the person. We have cases that have come to see us after a progression of symptoms of more than two years of evolution, sometimes decades, and that were seen on average by between 10 and 15 professionals, from neurologists to gastroenterologists and allergists, because histamine intolerance also It produces gastrointestinal manifestations such as abdominal swelling, diarrhea, constipation, heartburn, skin rashes, urticaria.
Another classic is that of women who have a very intense premenstrual syndrome.
We have seen four-year-old boys manifest respiratory symptoms such as constant coughing, bronchospasm, and asthma. And it is not an environmental issue but histamine, which also stimulates bronchial constriction. Perhaps the big explanation is that they are eating a lot of bananas and avocados, which are some of the first foods a baby eats when transitioning to solids.
News: What foods are the most irritating?
Dotto: Strawberry, tomato, avocado, spinach, eggplant, some cheeses (especially the most seasoned ones such as brie camembert, roquefort or grated Parmesan cheese), some sausages. Mate, green tea, coffee, chocolate, nuts (particularly walnuts and almonds), kiwi, citrus.
News: It coincides with the list of those that tend to cause more allergies. And several are even healthy.
Dotto: I think that what we have to do is teach a person who sometimes does not have all the symptoms that I mentioned but does have some, so that they understand that there are foods with which you have to learn to manage the dose.
News: What happens when we take antihistamines?
Dotto: In some people the recommended dose can generate a positive effect to improve the symptoms but in others it is not enough, so we do not work prescribing remedies. We begin with the way of eating, with the diet. It seems to me that a person, instead of taking antihistamines as a first measure, should understand what is causing this manifestation in the body and try to work on improving the symptoms and then focus on reducing the risk of future diseases.
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