Disease Informatics: Phytates driving from the backend

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Disease Informatics Phytates driving from the
back-end to Influenza, Encephalitis, Hepatitis,
Anemia at the front-end By RP Deolankar oonnatie_at_
yahoo.com
"What is food to one man may be fierce poison to
others" Lucretius (1st century BC)
Prerequisite http//www.publichealth.pitt.edu/sup
ercourse/SupercoursePPT/25011-26001/25371.ppt http
//www.publichealth.pitt.edu/supercourse/Supercour
sePPT/25011-26001/25381.ppt http//www.publichealt
h.pitt.edu/supercourse/SupercoursePPT/28011-29001/
28921.ppt
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What is Disease Informatics? Brush up The
application of Information Science in defining
the diseases with least error Identifying most
of the targets to combat a cluster of diseases
and Designing a holistic solution to the problem
Be a problem-solver like Dr. Abhay Bang
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Principles of defining the diseases Purpose to
understand exactly what those are so that those
are prevented or reversed Disease Causal Chain
(DiCC) consists of many component causes Many
component causes connotes lot of information
The universally shared features as against
spatiality are generally considered for diseases
definition. However, the most optimum solutions
are spatiality dependent, shared by local people
than universal.
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Identifying the targets DiCC could vary from
patient to patient, made up of events and
risk factors that drive the disease process from
backend event to the frontend event. Event
statistics could help in planning public health
measures Event has scope to branch out to give
rise to frontend events Event may happen as a
result of more than one backend events working
together The software should be derived to set
aside the combination terms (anatomical
physiopathological) from MeSH database of NCBI to
build event database
DiCC Disease Causal Chain
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Designing a holistic solution Frontend event
measures are like clipping the apical buds or
pruning the branches of disease tree Backend
event measures uproot the tree The DiCCs should
be studied as a spatial epidemiological problem
for all the diseases together present in the
locality. DiCC displays several targets and not
just the one DiCC justifies role of
nutraceutical and functional foods
DiCC Disease Causal Chain
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An exemplary case in favor of nutraceutical Failu
re of herbals described in ancient medicine or
new chemical entities to show antiviral
activity in manual or HTS assays does not nullify
the traditionally established utility of a
principle under investigation in preventing viral
disease. Therefore the ability of remedy to
alter DiCC should be investigated. Not having
done this, patients are deprived of several
nutraceuticals and functional foods or lifestyle
modalities capable of preventing or reversing the
disease. They would be subjected to consuming
drugs having tremendous side effects.
Dr. V. Prakash
DiCC Disease Causal Chain
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Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu
AW. Clinical practice guidelines and quality of
care for older patients with multiple comorbid
diseases implications for pay for performance.
JAMA. 2005 Aug 10294(6)716-24.
An exemplary case of multiple morbidity Probiotic
s reversing viral diarrhoea or hormones reversing
viral encephalitis are examples of missing
targets to combat complex viral diseases.
Dysbiosis and endocrine anomaly are backend
events of viral diarrhoea and encephalitis
respectively. Intervention to amend the DiCC so
that the events leading to viral diseases are
bypassed or does not occur (even after exposure
to the viruses) are the solutions to the
diseases.
Prof. Linda Fried
DiCC Disease Causal Chain
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Phytic acid (Widely present in plants) Here we
begin   Inositol hexa-phosphate (IP6) Can have
several isometric forms Can form crosslinks
between phosphate groups Mechanism for Ca and Mg
binding remains uncertain Ability to bind other
ions depends on how much Ca is present Accompanied
with other inositol phosphates (IP4 and IP5)
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Phytic acid contents of different foods About 0.9
to 1.0 in dry whole grains About 0.6-1.6 in dry
legume seeds 3.7 in dry seeds of linseed
(Flax) 4.7 in dry seeds of sesame Spinelli J
(1980). Unconventional Feed Ingredients for Fish
Feed. In Fish Feed Technology, FAO Corporate
Documentary Repository (ADCP/REP/80/11)
Charlotte Eklund-Jonsson (Sweden) Young Scientist
working on phytates
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Phytates (or Phytins) Phytates Salt forms of
phytic acid Store of inositol, phosphate and
metals for use by the seedling Mostly
concentrated in bran portion Assemble into
spheres called globoids
Shridhar K. Sathe Editor of a book on Phytates
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Metal ions bonding with phytic acid Potassium Magn
esium Calcium Manganese Iron and Zinc Six
phosphate moieties of IP6 can bind to six calcium
ions or 5 calcium 1 magnesium etc.
John N.A. Lott, Irene Ockenden, Victor Raboy and
Graeme D. Batten. Phytic acid and phosphorus in
crop seeds and fruits a global estimate. Seed
Science Research (2000) 10, 1133
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Phytic Acid Chelation A powerful chelator Bonds
with free metal ions from solutions Excretion of
free metal ions from intestinal lumen Front-end
events of metal chelation must be known The
chelating potentially initiates Disease Causal
Chains (DiCC) How that could be?
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Iron deficiency at the front-end event due to
Chelation (I)   Exemplary reference Hurrell RF,
Reddy MB, Juillerat MA, Cook JD. Degradation of
phytic acid in cereal porridges improves iron
absorption by human subjects. Am J Clin Nutr.
2003 May 77(5) 1213-9.
 
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Calcium deficiency at the front-end event due to
Chelation (II)   Bhatia A, Khetarpaul N.
Development, acceptability and nutritional
evaluation of 'Doli Ki Roti'an indigenously
fermented bread. Nutr Health. 200115(2)113-20
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Magnesium deficiency at the Front end events due
to Chelation (III) Lopez HW, Leenhardt F, Remesy
C. New data on the bioavailability of bread
magnesium. Magnes Res. 2004 Dec17(4)335-40.
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 Zinc deficiency at the Front end events due to
Chelation (IV) Chiplonkar SA, Agte VV.
Predicting bioavailable zinc from lower phytate
forms, folic Acid and their interactions with
zinc in vegetarian meals. J Am Coll Nutr. 2006
Feb25(1)26-33. (IP3 and IP5 were significant
influencing factors for bioavailable zinc) Saito
A, Nakayama K, Hara H. Mild zinc deficiency and
dietary phytic acid accelerates the development
of fulminant hepatitis in LEC rats. J
Gastroenterol Hepatol. 2007
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Manganese deficiency at the Front end events due
to Chelation (V)   Agte V, Jahagirdar M,
Chiplonkar S. Apparent absorption of eight
micronutrients and phytic acid from vegetarian
meals in ileostomized human volunteers.
Nutrition. 2005 Jun21(6)678-85.
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Front end events of Reduced availability of Iron
 
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Factors (I and II, expanded) driving from Backend
event (Marginal iron status) to iron deficiency
anemia at frontend
 
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Back-ends factors working together
 
 
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Front end events of Reduced availability of
Calcium
John M Pettifor. Nutritional rickets deficiency
of vitamin D, calcium, or both? Am J Clin Nutr
2004 80(suppl) 1725S9S.
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Front end events of Degradation of vitamin D in
the liver
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Founder faculty member of the Department of
Endocrinology, Metabolism Diabetes at the
AIIMS, INDIA
Dr.Narayana Kochupillai
"Based on our clinical experience and limited
studies, we believe vitamin D deficiency is
widespread in northern India," http//www.bmj.com
/cgi/content/full/326/7379/12/b?etoc
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Front end events of Vitamin D deficiency (Avitamin
osis D syndrome, I)
D Finally, a vitamin makes the grade. Several
new studies suggest that the so-called sunshine
vitamin (because its produced in skin exposed to
sunlight) may protect against cancer. One study
showed that as blood levels of vitamin D go up,
womens breast cancer risk goes down. Another
found that fairly large amounts of vitamin D
lowered the risk for pancreatic cancer by about
40. The Top 10 health stories of 2006, from
the Harvard Health Letter
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Front end events of Vitamin D deficiency
(Avitaminosis D syndrome, II)
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The UV Advantage The Medical Breakthrough That
Shows How to Harness the Power of the Sun for
Your Health by Michael F. Holick. I Books
/Marvel, New York
Dr. Michael Holick
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Front-end events of Vitamin D deficiency
(Avitaminosis D syndrome, III)
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant
WB, Madronich S, Garland CF, Giovannucci E.
Epidemic influenza and vitamin D. Epidemiol
Infect. 2006 Dec134(6)1129-40
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Epidemic influenza and vitamin D. Epidemiol
Infect. 2006 Dec134(6)1129-40 1. Cannell JJ 2.
Vieth R 3. Umhau JC 4. Holick MF 5. Grant WB 6.
Madronich S 7. Garland CF 8. Giovannucci E. All
authors are from different institutes
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Disease definition challenged Authors remark in
the conclusion section Is influenza infection a
sign of vitamin D deficiency as much as
Pneumocystis carinii pneumonia is a sign of AIDS?
J. J. Cannell
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Motivation for writing review All of the patients
on my ward had been taking 2,000 units of vitamin
D every day for several months or longer. Could
that be the reason none of my patients caught the
flu? First, the ward below mine was infected,
and then the ward on my right, left, and across
the hall - but no patients on my ward became ill.
My patients had intermingled with patients from
infected wards before the quarantines. The nurses
on my unit cross-covered on infected wards.
Surely, my patients were exposed to the influenza
A virus. How did my patients escape infection
from what some think is the most infectious of
all the respiratory viruses? My patients were no
younger, no healthier, and in no obvious way
different from patients on other wards. J. J.
Cannell
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Front-end events of Vitamin D deficiency
(Avitaminosis D syndrome, III continued) INDAPUR
(INDIA) STUDY Wayse V, Yousafzai A, Mogale K,
Filteau S. Association of subclinical vitamin D
deficiency with severe acute lower respiratory
infection in Indian children under 5 y. Eur J
Clin Nutr. 2004 Apr58(4)563-7. By Prof.
Suzanne Filteau London School of hygiene and
Tropical medicine
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Front-end events of Vitamin D deficiency
(Avitaminosis D syndrome, IV)
Cantorna MT, Woodward B, Hayes CE, DeLuca HF.
1,25-dihydroxyvitamin D3 is a positive regulator
for the two antiencephalitogenic cytokines TGF-ß1
and IL-4. J Immunol 16053145319, 1998.
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Front-end events of Vitamin D deficiency
(Avitaminosis D syndrome, V)
Froicu M, Cantorna MT. Vitamin D and the vitamin
D receptor are critical for control of the innate
immune response to colonic injury. BMC Immunol.
2007 Mar 3085.
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Back end events (expanded) of vitamin D deficiency
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Hypothesis drawn on the basis of Disease Causal
Chains (DiCC) Optimization of Phytic Acid in
the Diets of Indians consuming excessive grains
at the back end reduces some burden of various
diseases at the front end.
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Phytates as nutraceutical   Phytates are
antioxidants Phytates also chelate several
minerals in the lumen of intestine Reducing the
availability of iron to pathogenic flora (Free
iron is required by pathogenic flora of the
gut) Could help in prevention of lead toxicity
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Everything I eat has been proved by some doctor
or other to be a deadly poison, and everything I
don't eat has been proved to be indispensable for
life. But I go marching on. George Bernard
Shaw
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Consumption of dry legumes (dicotyledonous
seeds) 1.                  De-hulling
(Preparation of Dal) 2.                 
Sprouting of seeds 3.                  Soaking
and pressure cooking 4.                  Cooking
dal flour These common practices remove most of
the phytic acid
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Grains are rich in phytates Chemical fertilizers
N, P and K are majors Phytate content shoots up
in chemically fertilized crops Phosphorus is
stored as phytic acid / phytates in plants and
grains Bran portion of grain is rich in several
nutrients as well as phytates People consuming
whole grains consume lot of phytates also
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• Phytates in diet of affluent people
• Phytates reduce enteric toxins
• The toxins function as
• The backend event of several diseases
• Backend event of colorectal cancers and mammary
  cancers
•  
• Hence, affluent people could consider phytates as
  useful entities if consumed in limited amounts.

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Grains are cheapest food but Green revolution
has rendered grains as cheapest food in
India Further yield enhancement due to chemical
fertilization Abundant, hence cheap than animal
foods or fruits and vegetables People of low
socio-economic status consume grains from
fertilized crops excessively Food help during
famine or floods is mostly grains
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Phytates in poor mans diet Poor people in India
eat excessive grains Do not eat foods from other
groups in enough quantities Face problems of
mineral deficiencies Iron, Calcium, Magnesium and
Manganese IP6 present in mature seeds effectively
inhibit Ca and Zn uptake Inositol phosphates
(IP4, IP3 etc) in immature seeds are less
effective in this regard
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Women of India Iron deficiencies are realized in
young women due to their high iron
requirements Outcome of iron deficiency anemia
is Problematic pregnancy and childbirth Poor
reproductive health and Susceptibility to several
diseases Reduced working capacity
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Children and old people Calcium deficiencies are
realized in growing children and old age
people Vitamin D is degraded very fast in
individuals having calcium deficiency This could
be the reason why vitamin D deficiency is common
in sunny country like India Magnesium is also
required for proper metabolism of Vitamin
D Avitaminosis D is a component cause of several
Diseases
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How to curtail phytates? The best solution or at
least the first solution is to curtail level of
phytate intakes. Secondary solutions like
fortification of foods should only be implemented
till the tackling of the basic problem of
anti-nutritional phytates is difficult.
Could phytase be activated by making dough for
roti on previous day?
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• Primary solution
• Education
• Replacing part of high phytate foods with low
  phytate foods (e.g. using protein foods and
  supplements)
• Processing foods to allow action of enzyme
  phytase on foods (Dephytinization)
• Malting Germination (sprouting) of grains
• Use of leavening agent like yeast in preparation
  of cereal dough
• Destroying phytates by solar roasting / steaming
  of grains Encouraging consumption of thalipeeth
  prepared from baked grains in place of Roti or
  Bhakri

Intervention Sukdi type of special preparation
(baked/ autoclaved bran laddooes supplemented
with minerals)
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Secondary solutions Fortification of foods with
critical minerals Salt fortification (?) Using
iron vessels for cooking Use of multi mineral
multi vitamin capsule Implementing lead
detoxification Deworming
Report of an FAO technical meeting Rome, Italy,
20-23 November 1995
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Tertiary solution Research Breed low phytate
grain varieties Breed High Phytase grain
varieties
Bouis HE. Plant breeding a new tool for fighting
micronutrient malnutrition. J Nutr. 2002
Mar132(3)491S-494S
Dr. Howarth Bouis
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Quaternary solution Find separate solutions for
all front-end problematic events (!)
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