ARTIFICIAL SUGAR: High rates of inflammatory bowel disease in young Canadian children 'alarming'

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High rates of inflammatory bowel disease in young Canadian children 'alarming'




ELIZABETH PAYNE, OTTAWA CITIZEN
More from Elizabeth Payne, Ottawa Citizen

Published on: April 18, 2017 | Last Updated: April 18, 2017 7:11 PM EDT
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Matthew O'Halloran, 13, who is taking beginner photography classes, snapped some pictures in the park across from his grandfather's house in Nepean on April 8, 2017. O'Halloran is one of a growing number of Canadian children being diagnosed with inflammatory bowel disease. (David Kawai) DAVID KAWAI / POSTMEDIA

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For Matthew O’Halloran, Crohn’s disease is simply a fact of life. The 13-year-old Brockville teen and his family have not only adapted to the disease he was diagnosed with at age two, but they are committed to raising awareness about it to help reduce stigma.

“We want his peers to know about it and understand it. We want to take away that embarrassment,” said his mother, Jennifer Klatt.

Their efforts to raise awareness about the disease are, unfortunately, timely.

Growing numbers of Canadian children are being diagnosed with inflammatory bowel disease at a young age every year, according to a study published Tuesday in the American Journal of Gastroenterology.

Canada already has one of the highest rates of childhood inflammatory bowel disease in the world, but the rapid growth of the disease among children under five is causing concern among those who treat and care for them.

“The number of children under five being diagnosed with IBD is alarming because it was almost unheard of 20 years ago, and it is now much more common,” says Dr. Eric Benchimol, a pediatric gastroenterologist at the Children’s Hospital of Eastern Ontario.

CHEO is diagnosing 60 to 70 children a year, he said.

Benchimol is the lead author of the study, which shows the number of children under the age of five from five Canadian provinces being diagnosed with inflammatory bowel disease — which includes Crohn’s disease and ulcerative colitis — grew by 7.2 per cent a year between 1999 and 2010. The research was done through the Institute for Clinical Evaluative Sciences, with which Benchimol is a researcher.

And, while overall rates for children under 16 have stabilized across much of Canada, Ontario saw a 5.8 per cent annual increase in diagnoses for all children under 16 during the same time period.

“We are seeing more of it,” at CHEO, said Benchimol. “The numbers are huge — much bigger than they were 10 or 20 years ago. When you talk to some of the older doctors, they never saw it (in children) under five years old, it was completely unheard of and extremely rare under 10.”

The growth in IBD in children under five is not only worrisome, but also largely a mystery. Although some children are at a higher genetic risk of the disease, Benchimol said scientists think something environmental is triggering the disease in young children. What, exactly, is still a matter of hypothesis.

It is likely that some factor in the child’s early life is changing their gut microbiome — the microbe population that lives in people’s intestines and influences their health — said Benchimol.

Possible risk factors, he said, include early antibiotic use, the cleanliness often associated with modern life, especially in cities, or lack of Vitamin D and winter sunlight. None of the theories has been conclusively proven.

Benchimol said parents whose children have been diagnosed with inflammatory bowel disease at a young age always ask why: “Unfortunately, we don’t know. It is probably multiple factors. We still have to figure out how to prevent it.”

For the O’Halloran family, with the diagnosis of Crohn’s — symptoms include diarrhea and abdominal pain — came trying different combinations of food and treatments. Matthew’s mother said the family always offered to get involved in research studies with doctors at the hospital and did as much research as they could to better understand it.

They have also made it a mission to educate teachers, students and others about the disease. Matthew has given several speeches about it at school and raised money for it.

“The more people know about Crohn’s, the less there is a stigma.”

Matthew, who plays hockey and baseball, is now on a treatment that his mother describes as a “miracle drug” for him. He has to stick to a schedule and watch what he eats, “but he doesn’t let it define who he is.”

Researchers noted that diagnosis at a young age can be tough on children and their families. “The psycho-social impact on the family of caring for a young children with a chronic illness is significant.”

Klatt agreed, calling the diagnosis a “life sentence,” and adding: “The staff at CHEO have made our journey bearable.”
 
What made Canada become a country with the highest incidence of inflammatory bowel disease: Could sucralose be the culprit?
Xiaofa Qin, MD PhD
Author information ► Article notes ► Copyright and License information ►
This article has been cited by other articles in PMC.

Inflammatory bowel disease (IBD) (which includes both ulcerative colitis and Crohn’s disease [CD]) emerged and dramatically increased in the past century (1). Early studies revealed that IBD was most prevalent in countries such as the United Kingdom, the United States and those in northern Europe (1). Compared with these countries, the prevalence of IBD in Canada was much lower. This was demonstrated in early epidemiological studies conducted in Canada. According to a review by Mayberry and Rhodes (2), a study published in 1972 reported the incidence and prevalence of CD in Sherbrooke, Quebec, at only 0.7 and 6.3 per 100,000 population, respectively, which were much lower than countries such as the United Kingdom, the United States, Sweden, Denmark, and even Israel and New Zealand at the same time or even decades earlier. However, studies in recent years have suddenly found that Canada has become a country with the highest incidence of IBD (3). For example, the prevalence of CD in Alberta in 1981 was only 44 per 100,000 population (4), compared with 91 per 100,000 in Olmsted County, Minnesota (USA) on January 1, 1980 (5). However, the prevalence of CD in Alberta increased to 283 per 100,000 on July 1, 2000 (3), compared with 174 per 100,000 in Olmsted County in January 1, 2001 (6). It would be valuable to know what caused the dramatic increase of IBD in Canada because it may provide critical information regarding its etiology.

A decade ago, a series of accidental findings made me suspect that the impaired inactivation of digestive proteases due to the inhibition of gut bacteria by dietary chemicals, such as saccharin, play a causative role in IBD as a result of the accelerated degradation of the mucous layer and underlying endothelium (7). It provided an explanation for many puzzles in IBD such as the dramatic increase of IBD in the 1950s and 1960s, and its levelling off since the latter part of the 1970s, as observed in many western countries including Canada (4,7). However, this hypothesis was challenged by the failure to provide an explanation for the recent high incidence of IBD in Canada, which had adopted more stringent standards for the use of saccharin than most other western countries after the finding of carcinogenic effects of saccharin on the bladders of experimental animals in 1977.

If not saccharin, then what caused the remarkable increase of IBD in Canada? I suggest that sucralose may be the culprit. Sucralose is a new, non-nutrient, high-intensity sweetener that has many superior properties. It is approximately 600 times sweeter than sucrose (thus two times sweeter than saccharin). Similar to saccharin, sucralose is heat and pH stable, but without the bitter aftertaste (8). In 1991, Canada was the first country to approve the use of sucralose, and it was allowed to be used as a tabletop sweetener in breakfast cereals, beverages, desserts, toppings, fillings, chewing gum, breath mints, fruit spreads, salad dressings, confectionary, bakery products, processed fruits and vegetables, alcoholic beverages, puddings and table syrups (8). Interestingly, the study by Wrobel et al (9) reported that the incidence of pediatric IBD in Southern Alberta was 2.3 (per 100,000 population) between 1983 and 1987, 2.5 between 1988 and 1992, 5.0 between 1993 and 1998, and 6.5 between 1999 and 2005 (9), indicating a dramatic increase in the early 1990s. Could sucralose cause the increase of IBD in Canada? How?

Similar to saccharin, sucralose can also exert potent inhibition of gut bacteria (10). However, it may have a more pronounced effect on gut bacteria than saccharin in that approximately 65% to 95% of sucralose is excreted through the feces unchanged (10), while a large proportion of saccharin is absorbed and eliminated through urine; the acceptable daily intake of sucralose is 15 mg/kg, but only 5 mg/kg for saccharin. As I suggested a decade ago, regarding the possible risk of saccharin on IBD (7), sucralose may have a similar but stronger impact on gut bacteria, digestive protease inactivation and gut barrier function. This may provide a possible explanation for the more pronounced high incidence of IBD observed in Canada. The use of sucralose is soaring, and is now being used in thousands of food products (10). Therefore, it would be worthwhile to investigate whether possible links between sucralose intake and IBD exist, before it is too late.

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REFERENCES
1. Binder V. Epidemiology of IBD during the twentieth century: An integrated view. Best Pract Res Clin Gastroenterol. 2004;18:463–79. [PubMed]
2. Mayberry JF, Rhodes J. Epidemiological aspects of Crohn’s disease: A review of the literature. Gut. 1984;25:886–99. [PMC free article] [PubMed]
3. Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: A population-based study. Am J Gastroenterol. 2006;101:1559–68. [PubMed]
4. Pinchbeck BR, Kirdeikis J, Thomson AB. Inflammatory bowel disease in northern Alberta. An epidemiologic study. J Clin Gastroenterol. 1988;10:505–15. [PubMed]
5. Gollop JH, Phillips SF, Melton LJ, III, Zinsmeister AR. Epidemiologic aspects of Crohn’s disease: A population based study in Olmsted County, Minnesota, 1943–1982. Gut. 1988;29:49–56.[PMC free article] [PubMed]
6. Loftus CG, Loftus EV, Jr, Harmsen WS, et al. Update on the incidence and prevalence of Crohn’s disease and ulcerative colitis in Olmsted County, Minnesota, 1940–2000. Inflamm Bowel Dis. 2007;13:254–61. [PubMed]
7. Qin XF. Impaired inactivation of digestive proteases by deconjugated bilirubin: The possible mechanism for inflammatory bowel disease. Med Hypotheses. 2002;59:159–63. [PubMed]
8. Knight I. The development and applications of sucralose, a new high-intensity sweetener. Can J Physiol Pharmacol. 1994;72:435–9. [PubMed]
9. Wrobel I, Butzner J, Nguyen N, Withers G, Nelson K. Epidemiology of pediatric IBD in a population-based cohort in southern Alberta, Canada (1983–2005) J Pediatr Gastroenterol Nutr. 2006;43:S54–5.
10. Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS. Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A. 2008;71:1415–29. [PubMed]

:jcoleno::meleshame:
 
Yeah it's the sugar and general diet.

However, this isn't on the government to legislate this. This is the parent's job to regulate what their children eat. Doctors should inform their patients to fix their diet and excercise.

Some will say to restrict or ban things which is an attack on the free market.
 

KULTA

f*ck you im from Mudug
I'm sorry.

You're in my prayers, :it0tdo8:

Im being tested atm for stomach pain but the reason why i said that is the doc told me i could have crohn and that if i have it i'll have to take meds for the rest of my life+ 80% of those with crohn will need sergury atleast once in their lifetime. Sounds depressing tbh.

Imagine taking pills for the rest of your life
 
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