October 17th, 2022

1) Particulate matter(PM) and inflammation during a viral infection notes a worsening response in those with the highest level of exposure to PM 2.5 micron size. This study was prospective and noted "that after the infection, bronchiolitis symptoms peaked roughly within 2 weeks. The positive association between the levels of PM2.5 and PM10 about 2 weeks preceding the symptoms peak corroborates the hypothesis that high levels of PM might increase the viral load reaching the patient's airways.

Growing evidence points out that PM2.5 and PM10 cause airways inflamation by stimulating the release of pro-inflammatory- cytokines (e.g., IL-1, IL-6, IL-8 and IL-33). High levels of airways inflammation are associated with severe bronchiolitis, in turn. These data might explain the positive association found in this study between the severity of bronchiolitis and the levels of PM2.5 and PM10 exposure also in the few days preceding the severity peak. Overall, this study suggests a mediating role of PM in different stages of bronchiolitis." (Milani et. al. 2022)

Avoiding air pollution is a simple measure that has high level positive downstream effects. Hepa filters in your house, increased air circulation, avoiding known sources of PM and living away from highways are all good measures for mitigating risk.

2) In a recent study in the European Journal of Preventative Cardiology, the authors found that decaffeinated, ground, and instant coffee, particularly at 2–3 cups/day, were associated with significant reductions in incident CVD and mortality. Ground and instant but not decaffeinated coffee was associated with reduced arrhythmia. (Chieng et. al. 2022)

Studies like this are really hard to prove causation. This is more likely a reality that caffeinated coffee drinkers have other behaviors that are also cardio-protective or the coffee is replacing a sugar based beverage in the morning or the combination. I am not sure but I am pretty sure that this is not solely a direct coffee effect.

3) Vitamin K2 otherwise known as menaquinone is a vitamin K subtype that has the ability to shuttle calcium to bone instead of to other locales related to inflammation. This is especially important for folks that have coronary artery inflammation. A test for cardiovascular risk is the coronary artery calcium score. Thus, reducing cardiac calcium is a risk reduction. Vitamin K2 is a player in the risk reduction game. (Haugsgjerd et. al. 2022) Many Vitamin D supplements now also contain K2 to address this issue. Natural production of vitamin K2 occurs in our intestines by gut bacteria of the lactic acid variety. From the Linus Pauling Institute: Vitamin K is a fat-soluble vitamin. Originally identified for its role in the process of blood clot formation (“K” is derived from the Danish word “koagulation”), vitamin K is essential for the functioning of several proteins involved in physiological processes that encompass, but are not limited to, the regulation of blood clotting (coagulation). Naturally occurring forms of vitamin K include a number of vitamers known as vitamin K1 and vitamin K2. Vitamin K1 or phylloquinone is synthesized by plants and is the predominant form in the diet. Vitamin K2 includes a range of vitamin K forms collectively referred to as menaquinones. Most menaquinones are synthesized by human intestinal microbiota and found in fermented foods and in animal products.

Know where you are getting your vitamins.

Dr. M


Milani Pediatric Allergy and Immunology
Chieng Eur J Preventative Cardiology
Haugsgjerd BMJ
Linus Pauling Institute