Q: My daughter plays college soccer and ruptured her ACL. The coaches mentioned stem cell injections that some big-name athletes have used to recover from injuries. Should we consider them? Paige R., Chicago

A: Professional athletes are always looking for the fastest way to heal their injuries. In 2010, Yankees pitcher Bartolo Colon was treated for a torn rotator cuff with injections of fat and bone marrow adult stem cells; he's playing for the Mets this season. And in 2011, Denver Broncos' Peyton Manning opted for injections of his own fat stem cells to try to get over a neck injury. Two years later, he had a record-breaking season and took the Broncos to the Super Bowl. But does this mean the injections worked? Nope.

Colon's agent attributes the pitcher's career turnaround to a re-dedication to the game, not the injections, and Manning followed up his stem cell treatment with major surgery and intense rehab (done in secret).

There's just no solid evidence yet that injections of adult bone marrow (or fat) stem cells effectively regenerate and repair damaged tendons or ligaments, and you cannot be certain of what the injections contain or their side effects. They often are delivered in an unregulated environment and aren't FDA-approved.

We suspect your daughter is headed for reconstructive surgery and six months of rehab. Then she needs to learn new ways to move so she reduces stress on her knees. One metastudy found that two ACL-injury-prevention regimens were effective: Sportsmetrics promotes leg and core strength, increases vertical jump height and may improve speed and agility; the Prevent Injury and Enhance Performance (PEP) program, makes a big difference in the flexion strength of the knee. Both improve athletic performance tests and reduce injury rates. Rehab is tough, and there are no shortcuts, but we bet your daughter has the grit to do it!

Q: I had Roux-en-Y gastric bypass surgery last year, and my blood glucose levels were almost normal even before I lost any weight. How is that possible? Marty Z., Jupiter, Florida

A: Congrats, Marty. We hope you're continuing to have such good results. It is amazing that bypassing part of your stomach and intestine could have such an immediate effect on your blood sugar levels, and just recently researchers have figured out why that happens sometimes. It seems to have something to do with the bacteria that live in your digestive tract, also called your gut biome.

Roux-en-Y surgery bypasses most of the stomach and the first part of the small intestine, called the duodenum. That's where a lot of your gut bacteria live and where they influence gut hormones that regulate appetite, insulin use, glucose levels and more. So right away, the surgery decreases levels of hormones that regulate appetite; you can eat less without being hungry. That alone lowers glucose levels and increases the effectiveness of your body's insulin supply.

Also, when you have diabetes, your gut bacteria are thrown out of balance; the bad guys overwhelm the good guys (like bifidobacteria and lactobacillus). And that means the hormones that affect how cells get and use glucose can't do their job. The glucose stays in your bloodstream instead of being used as fuel by your cells. But once a lot of the bad gut bacteria are bypassed, your gut biome snaps back into balance and the bacteria and hormones work together to regulate blood sugar levels.

So we suggest you keep your gut biome balanced and happy with a healthy diet of five or more servings of fruits and veggies a day. Asparagus, garlic, cooked onions and dandelion greens deliver prebiotics that help good-for-you gut bacteria thrive. Fermented foods like nonfat kefir and kimchi contain healthful probiotics. Also, avoid saturated fats and added sugars they just make your biome miserable. And we like daily spore probiotic supplements containing bacillus coagulans GBI-30, 6086 and lactobacillus GG.

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Stem cells for sports injuries; gastric bypass and the gut biome

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