giving and receiving (the art of cooperation and conflict)

Organizing notes and/or…
What I learn (try to figure out and detail) along the way in my study about obesity and the microbiome/gut bacteria …

Newborns, breast milk and HMO’s…

Galactose (molecule) is one of the sugars (a building block for HMO) found in breast milk.

Oligosaccharide from the Greek, oligos, a few, and sácchar, sugar.
Human milk oligosaccharide (HMO) are sugar molecules found only in human breast milk. HMO’s, while indigestible in a newborn, encourage the growth of health promoting bifidobacteria. Think: fertilizer designed for fitness enhancing microbes.

Stuff I find particularly interesting…
Breast feeding promotes a diversity in the microbiome that may set up an individual for protection against future obesity (amongst other things).
Breast milk varies over the period of lactation and the growth of bacteria varies in different populations.

And then there are the short-chain fatty acids (SCFA) …

Butyrate (a most essential SCFA necessary for homeostasis)

SCFA are another product of microbial (friendly gut bacteria) fermentation (of indigestible dietary fibers). This source energy for the cells lining the colon kill pathogens and protects against dysbiosis.

Included in my drawing are the 3 most common examples of SCFA’s which are butyrate↑, propionate↓ and acetate↓↓.

(Yes…fun to draw out  and paint all the ball and stick models.)

Propionate (Greek protos, first and pion, fat) produces glucose in the liver.

 

Acetate (taken up by astrocytes/glial metabolism)

Takeaways…
The right food early in life trains the immune system via the microbiome.
Changes in diet (those SCFA) drive changes in gut microbes. Fiber rich foods (plant based) allow host and microbes to have mutualistic relationship (cooperation).
Microbes harm and/or help us (the host).
Junk food allows for conflict (harm).

…and then there’s hormones…

Insulin (Ribbon diagram) allows the body to use glucose for energy or store for future use.

Ghrelin (ribbon diagram) in the stomach – stimulates appetite and promotes fat storage.

Questions…
Does some food fuel pathogens and promote their growth?
Does some food inhibit or kill pathogens?
Do pathogens play a role in obesity?

#PortraitOfVeronica #GottaHaveArt #ThisStuffIsFrickinComplicated

ps. The title of the post came after a Yoga class the day after the holiday.

---

©2019 ALL RIGHTS RESERVED BY MONICA AISSA MARTINEZ

speaking of diversity…

I’m still in the GI tract, looking at the microbiome as it relates to obesity.

Energetically, I’m in the solar plexus, the space below the rib-cage and behind the naval. This area governs digestion and metabolism. (Note: I have a very different picture of this nowadays.) Symbolically, it is the center holding our willpower and self-esteem. One of my Yoga teachers refers to it as the city of jewels.

Out of balance, the area can carry either excess energy or an energy deficiency. A balanced solar plexus can wake up ones sense of personal power.

The area holds (for you) a bright yellow light. #Fire

I think about optimal well-being which includes the whole person … physical, mental and social well-being (body, spirit and mind).

Here are a few personal details about my cousin …

Veronica has 3 children. They hold space in the composition ↑ as sperm meets egg (3x). Her children are adults (she’s a grandmother).

The day I photograph her, I note long fingernails and dark purple nail-polish. This last week I give the study a manicure and pedicure.

Veronica has numerous tattoos. Three flowers ( 2 blue and 1 🌸) are added to the top, left foot (our right, her left).  FYI…the immune system keeps those tats in place!

Puncture the skin and immune cells kick in. Macrophages (remember the big eater) work to gobble up invaders, in this case, the ink particles. Yes, they hold the color in place! Should the dermal macrophages be destroyed, new ones step in and continue holding that ink. The purple floating shapes ↑ to either side of the flowers – represent this (cool) hand-over system.

For years I’d not seen the small pastel of Veronica as an infant. It was on the wall during our photo shoot. I include a portrait of the portrait ↑ in the drawing as I consider a newborn’s microbiota.

Do you know breast fed babies have a more diverse microbiome while formula fed babies have a less diverse microbiome? Human milk oligosaccharide (HMO) is particularly interesting. The energy rich substrate, individual to each mother, varies throughout the period of lactation. Infants can’t absorb HMO… but microbes can.

I don’t clearly understand until now, how a high-diversity of microbes might lead to better health conditions for an individual. I mostly focus on who we are feeding – the good microbes and/or the bad microbes. And while this does play into things, so does supporting a well diverse population of microbes. With diversity, perhaps no one microbe can cause a problem (reduction in pathogenic infection).

And speaking of diversity…

Each time I’ve spoken to Veronica, she brings up the word diversity. She’s indicates in one way or another, the importance of inclusion and the recognition of a variety of individuals in terms of personal and work environments, organizations…etc. There is so much more to this idea, she says, so much more….

Veronica will be finishing up school very soon and probably a new career adventure to follow soon after.

I’ve completed 11 life-size humans – diverse in so many ways. When I am done with this one – it will be #12!Thanks for trusting me to bring your uniqueness into the mix Veronica.

---

Some thoughts…
This work in particular is valuable to me because right now I look at obesity (and the microbiome) through the lens of Evolution Medicine. I am particularly drawn to the idea of adaptation and how the concept applies to health and wellness.  Though always aware, I am even more clear on how everything we do has a cost and/or trade-off.  I’m more inclined to consider how this applies specifically to the care of the human body and the individual.

My understanding of the microbiome feels like I’m working a complicated puzzle. Things come together one piece at a time. At this point, I almost feel like I could go back to each drawing and add a microbial element.

What the body holds is incredible…I understand  more and more one human study at a time.

#GottaHaveArt

---

©2019 ALL RIGHTS RESERVED BY MONICA AISSA MARTINEZ

pretty close to a PSA …

2 things….
Last week I had a very quick (and very spontaneous) introduction to molecules. (Thanks Joseph!)  I returned to the studio loving the ball-and-stick sculpture-like forms, knowing  they’d show up in the current study (Portrait of Veronica).

and…
This week gut microbes ↓ enter the picture plane. And maybe…so does microbial imbalance aka dysbiosis.

Portrait of Veronica (lower edge of the life-size study)

Understanding Omeprazole is an antacid, I was never at ease hearing Veronica would be on it for the rest of her life.

Omeprazole is what is known as a Proton Pump Inhibitor. PPI’s are among the most widely used (prescription and over-the-counter) medications. They are linked with obesity (among other things). And long term use can be harmful.

I always planned to include something in the composition about antacids. I just had to find the right way to do it.

Enter: Molecules! ↓ Here is omeprazole. I like detailing the form and purposely choose sweet colors  (like candy which many antacids tend to resemble).

FYI, my source for information on antacids is Joe Alcock. If he’s involved, always know the microbiome is involved. He refers to gastric acid juice as the gatekeeper to the microbiome.

Consider stomach acid kills microbes that enter the gut along with food. When gastric acid output is blocked, say…by an antacid, understand the stability (balance) of microbiota is also altered. It appears good bacteria might be reduced while harmful (and opportunistic) bacteria remains.  (Gastric acid also supports absorption of calcium and B12.)

It’s complicated…
#SmallIntestinalBacterialOvergrowth #Dysbiosis #Inflammation #WeightGain

I take a minute to email Joe, who notes there are a few conditions for which life long omeprazole makes sense. For everyone else, he says, PPIs should be a very short term drug.  Read his post and find out why → Killer antacids

You’ll be seeing more molecules in my study…

---

©2019 ALL RIGHTS RESERVED BY MONICA AISSA MARTINEZ

gut. brain.

What do you visualize when you read the phrase Gut-Brain Axis? Or Brain-Gut Connection?

I picture very active brains communicating with very active intestines. Or is it the other way around? Both. It’s a two-way, busy connect especially when you consider the wandering nerve, aka, the vagus nerve. Think: 2-way, information highway. The vagus nerves are paired cranial nerves (CN X) and happen to be my favorite of all the nerves.  Because it is the longest nerve in the body it moves alongside heart and lungs and goes through all the organs of the digestive tract, connecting brain to gut.

I enjoy the challenge of capturing Veronica’s likeness while I work her profile.  I organize and sketch in the brain. The small area of my drawing is detailed into a collaged map of El Paso,TX,  where my cousin lives.

I have fun with the photo ↑ and strategically place color pencils to direct attention to the brainstem, the area of the brain I am working to understand.  I imagine the space to be like a facility loaded with chemicals and chemical messengers / hormones and neurotransmitters. Think: Food intake. Signals and controls. Many and complex. (FYI – purple pencil points to vagus nerve start.)

Some of the hormones involved include adipoectin (a protein hormone that modulates glucose regulation and fatty acid oxidation), and leptin (made by fat cells and decreases appetite).

Veronica, during our initial conversation, noted ghrelin. Ghrelin is a hormone that stimulates appetite. If I understand correctly, it is primarily released in the stomach and signals hunger to the brain. It also plays a role in determining how quickly hunger returns after a meal. And it promotes fat storage. After my surgery, she says, no more ghrelin. No more! What does this mean?  Forever? I ask.  I don’t know, she answers. And now you eat because??
I must live! Ah…survival!

Side note: The hormones that play a role in obesity, do they also play a role in anorexia?

I haven’t brought the microbiome in yet. But I will. Now when I hear gut-brain, I also think of microbes.  FYI…they can influence hunger and satiety.

Anyway…I’m still laying ground work…which is both complicated to figure out and complicated to draw. Both my brain and my hands are keeping busy.

One more thing…
In early posts I highlight the brown adipose tissue (BAT) and the white adipose tissue (WAT). Now I study and set in subcutaneous adipose tissue (SAT) located under the skin and visceral adipose tissue (VAT).

In the image above, ↑ I enhance (darker area) the greater omentum (cool name! for an organ) , an example of VAT. It looks like lace, doesn’t it?  This apron of fatty tissue, connective tissue and lymphatics,  comes down from the stomach and stretches over the intestines. The greater omentum, aka, Policeman of the abdomen, might just be the first line of defense against toxins or infections (microbes).

BTW…yes, there is also a lesser omentum…

Meanwhile… drawing circles/making connections.

---

Keeping a note:
Amylin is a hormone, co-stored and co-secreted with insulin in response to nutrients. It promotes satiety by mediating brain function, including appetite inhibition.

Amylin also plays a role in neural regeneration. It helps regulate glucose metabolism and modulates inflammation. I pull it aside and note it here because of a possible link to Alzheimer’s Disease (Type II Diabetes).

portrait of veronica – new work

I don’t talk about this too much (if at all) but I do believe all of our organs are in constant communication with each other…and with us. Well…they’re not really separate from us. Nor are we separate from our environment…nor from each other.

---

As many times as I’ve drawn the skeletal system, I feel I should have it memorized by now. I don’t. Every body is unique.

Next month will be 4 years since Veronica had bariatric surgery.

I still have the x-ray she sent me of her stomach, post surgery.  I didn’t (and still don’t) recognize the organ though I recognized surrounding tissue. Within minutes of her sending the photo, my cousin and I were on the phone talking. I was surprised (and still am) to learn they’d removed 3/4 of her stomach. I remember 2 thoughts (I kept to myself): How is it possible? And what about the vagus nerve?! I still wonder about the latter.

That evening she told me about the numerous health complications being overweight can cause including high cholesterol, high blood pressure, and heart failure. And we know obesity can lead to a number of cancers. I recall Veronica saying she was on the cusp of becoming diabetic.

She spoke about the side effects of her surgery as well as possible future complications including lockjaw and osteoporosis. Ouch! Is it worth the risk? She responded with a definitive Yes!

Not only was she concerned about her health, she also didn’t like the way she looked. It’s not me! It’s not me! 

Veronica used to call me because she was studying art history. We talked art. With this one phone call I learned a lot about my cousin. I’m sure neither of us imagined a study coming from the conversation. Though I did hold on to the x-ray.

Composition layout.

Fast forward to early this summer…
I mention in an earlier post, a meeting with Dr. Joe Alcock whose area of research is the microbiome. I tell him I want to learn more/work the subject. I’m thinking Microbiome 101 or a…let me introduce you to…sort of composition. Instead he suggests a focus on the obesity aspect.

Putting something into context is really the best way to learn.

Did I mention Veronica is almost done with school? And if things go her way,  she’ll be a surgical technician in the field of bariatrics. On a recent visit to El Paso, we set time aside to meet.  We talk and then I photograph and outline her.

Once again, she shares with me how it felt to be in a heavy body.  And then she moves on to describe the changes since the surgery; her feet are smaller and no more snoring. She happily notes her participation in kickboxing, cross-fit and yoga. I  ran! A 5K!  She has no regrets.

She tells me about the soda she occasionally allows herself. I have to be careful. Carbonation, she explains, expands the stomach. Yes, she’s gained back some of the weight.

What do you miss? What was your favorite (crave) food? Macaroni and cheese, Mexican style, canned milk, tomato sauce, butter and lots of cheese. This detail makes its way into the study.

What influences your food choices? Could it be microbes?

The plan includes a portrait of Veronica while I/you learn more about gut microbes and their link to obesity. (I’ve had a curiosity about microbes and auto-immune diseases for a good while.)

The World Health Organization (WHO) defines obesity as abnormal or excessive fat accumulation that may impair health.
Centers for Disease Control and Prevention (CDC) says 95 million adults (in the USA) live with obesity (47.0% are Hispanic, 46.8% non-Hispanic black, 37.9% are non-Hispanic whites and 12.7% non Hispanic Asians).

---

Joe connected with me during a time when my work was at Sky Harbor Airport.  We finally met in person during the run of my solo exhibition at the UofA medical school. He introduced me to the human microbiome. And because he comes from an evolutionary  medicine background, I am understanding the idea of adaptation, especially where health and disease are concerned. Joe believes fat has a defense function. It helps prevent bacteria from invading us. Obesity has more to do with our bodies relationship to the microbial world.

I have come to the conclusion that microbes are responsible for everything!

Did I mention I feel like I am in over my head…a good sign.

Joe Alcock has a podcast I access directly via SoundCloud → EvolutionMedicine. 
He has several episodes on the topic of obesity. The format usually includes a conversation between him and a colleague.  For me, this sort of back and forth talk makes the complicated stuff a little more accessible.

---

©2019 ALL RIGHTS RESERVED BY MONICA AISSA MARTINEZ