Archives for March 2015

Mar
21
2015

What Alcohol Does To You

The media has praised alcohol  for preventing heart attacks, but let us examine what alcohol does to you. There are other articles in which we hear about alcoholic hepatitis and liver cirrhosis, both of which can be killer diseases. To get some clarification, let us discuss the various facts.

Dr. Finnel points out that 7.9% of all emergency room visits in the US are due to alcohol related conditions (Ref.1). When the causes of deaths that are a consequence to alcohol are listed, the top 8 causes are: cancer of the mouth and pharynx, alcohol abuse disorders, coronary heart disease causing heart attacks, cirrhosis of the liver, traffic accidents, poisonings, falls and intentional injuries. This is not what you read in the news. What you do read about is that one glass of red wine per day would be good for women and up to two glasses of red wine would be good for men to prevent heart attacks and strokes.

Bioflavonoids

It is the bioflavonoids , and among those in particular resveratrol, that are the active ingredients responsible for heart health. Resveratrol is a powerful antioxidant that protects against ischemia-reperfusion injuries. It is responsible for the cardio protective properties of red wine known as the “French paradox” (Ref.2). According to this reference resveratrol contributes to at least 3 processes that stabilize the metabolism.

Toxicity of alcohol

Alcohol toxicity is a complex problem. According to the WHO 5.3% of all deaths worldwide are a consequence  to alcohol. In 2012 the WHO recorded that 7.6% of deaths in males were due to alcohol. In comparison, 4% of female deaths were due to alcohol. Toxicity comes from the breakdown product acetaldehyde, which all cells can convert from alcohol, but liver cells are especially able to do this. According to Ref. 3 alcohol diffuses easily through all of the cell membranes and reaches every organ in the body. The toxicity of acetaldehyde is the reason  for shutting down the mitochondria which affect the energy metabolism and causing cell death. The immune system reacts with inflammation, when it attempts to repair the damage.

So, what are the major problems what alcohol does to you? These are the processes: First fat accumulation (steatosis), next chronic inflammation followed by necrosis (dying of cells) and fibrosis. An example of fibrosis is liver cirrhosis, where non-functioning connective tissue replaces liver cells.

Different tissue sensitivity to alcohol

Certain tissues are more susceptible to alcohol toxicity than others. As the concentration of alcohol is highest in tissues that are in direct contact with alcoholic drinks, cancers related to alcohol consumption develop in the oral cavity, pharynx, larynx, esophagus, and in the colon and rectum. The pancreas is particularly vulnerable to inflammation and fibrotic changes with subsequent degeneration into cancer of the pancreas. The heart tissue and the arteries are very sensitive to alcohol; hypertension, heart attacks, stroke, cardiomyopathy and myocarditis as well as irregular heart beats (arrhythmias) can develop. The brain is very sensitive to toxic effects of alcohol as well. This causes major depression, personality changes with violent behavior, car accidents and injuries.

Other toxic effects of alcohol on organs

Kidney disease (alcoholic nephropathy) is another alcohol caused illness. 5% of breast cancers in northern Europe and North America are directly related to the toxic effects of alcohol (Ref.3). Finally, the liver being so active in detoxifying alcohol is affected by developing liver cirrhosis, which accounts for a lot of premature deaths at a relatively young age (typically in the mid to late 50’s).

Ref. 3 goes on to say that literature exists which claims that 1 to 2 drinks per day would be useful for prevention of heart disease. But the observation of the authors is that people will not discipline themselves to stick to these limits and very quickly enter into the zone of alcohol toxicity. The authors further noted that with regard to causing any kind of cancer there is no safe lower limit; the risk is directly proportional to the amount of alcohol consumed and the risk starts right above the zero point.

The pathologist has the last word

When I studied medicine at the University of Tübingen, Germany I attended lectures in the pathology department where Professor A. Bohle, M.D. demonstrated pathology findings of deceased patients. Dr. Bohle had a special interest in Mallory bodies. These are alcohol inclusion cysts within liver cells that can be stained with a bright red dye.

Histological documentation of toxic effects in livers of corpses

I will never forget when Prof. Bohle pointed out that the livers of this most diverse population whose bodies we had the privilege as medical students to study had a rate of 25% positive Mallory bodies. He wanted to impress on us as medical students to watch out for the alcoholics that are usually missed in general practice. Obviously 25% of the pathology population was affected by the consumption of alcohol. It was Prof. Bohle’s hope that we could perhaps interfere on the primary care level before things went out of control. Many of these corpses belonged to traffic accidents that could have been prevented (now seat belts and alcohol limits are standard, in 1968 they were not).

Alcohol as an aging substance

Consistent use of alcohol on a regular basis will slow down cell metabolism and hormone production significantly. The major effect of alcohol leads to poisoning of the mitochondria in multiple organs, which translates into faster aging and a shortened life expectancy. This in turn results in a change of appearance. An older person who has abused alcohol for a number of years may look 5 to 10 years older than their chronological age.

50% of people above the age of 65 drink daily (Ref.4). Some more statistics: alcohol abuse in elderly men is 4-times higher than in elderly women. 5% to 10% of all dementia cases are related to alcohol abuse. About 15% of older adults are experiencing health risks from abusing alcohol. And about 90% of older adults are using medications and close to 100% of medications can adversely interact with alcohol (Ref.4).

Social pressure

These are the scientific facts , and then there is social pressure when you are invited to a party.

When you are young and invincible, do you care what the science says? You want to have a “good time” and not worry about consequences. The data about long-term exposure and a slowly increasing cancer risk is there. The wine industry will remind you that 1 drink for women and two drinks for men will protect you from heart attacks. They will withhold the cancer information from you, as they don’t really want to hear about that (yes, it’s bad for their business!).

Resisting social pressure and doing what is good for you

Can you have a good time at a party without drinking alcohol? Yes, you can. You can talk and you can listen; you are probably more with it than those who had too much to drink. I like mineral water and hold on to a glass of that.

I explained in a blog before how I was convinced by three speakers at an A4M conference to join those who abstain from alcohol.

Socializing without alcohol is doable. You may at times miss it, but you can warm up even to a crowd that had a few drinks too much. It is about choice: we can choose what we want out of life.

What Alcohol Does To You

What Alcohol Does To You

Conclusion

I have attempted to show you the toxic effects of alcohol. Although alcohol has played an important role in the social lives of millions over the centuries, it is becoming more apparent that alcohol is a cell poison and shortens our lives. The beneficial effect of the 1 or 2 drinks marketed by the beer and wine industry and some cardiologists does nothing to counter the threat in terms of a whole array of cancers at much smaller amounts of alcohol. Fortunately, resveratrol and omega-3 fatty acids as supplements as well as exercise will more than make up for the 1 or 2 drinks that you do not really need. And neither exercise, omega-3 fatty acids, or resveratrol are cell poisons. The choice is yours!

References

Ref. 1: John T. Finnell: “: Alcohol-Related Disease“ Rosen’s Emergency Medicine, Chapter 185, 2378-2394. Saunders 2014.

Ref. 2: “Hurst’s The Heart”, 13th edition, The McGraw-Hill Companies, Inc., 2011. Chapter 54. Coronary Blood Flow and Myocardial Ischemia.

Ref. 3: Ivan Rusyn and Ramon Bataller: “Alcohol and toxicity”, 2013-08-01Z, Volume 59, Issue 2, Pages 387-388; copyright 2013 European Association for the Study of the Liver.

Ref. 4: Tom J. Wachtel and Marsha D. Fretwell: Practical Guide to the Care of the Geriatric Patient, Third Edition, Copyright 2007 by Mosby.

Mar
14
2015

Frail Mitochondrial DNA Equals Frail People

Introduction

New research on mitochondria has shown that “frail mitochondrial DNA equals frail people”. More specifically, researchers from the McKusick-Nathans Institute of Genetic Medicine of the Johns Hopkins University School of Medicine in Baltimore, MD found that mitochondrial DNA content varies according to age (less mitochondrial DNA in older age), sex (yes, women have more than men) and mitochondrial DNA even has an inverse relationship to frailty and a direct relationship to life expectancy. The publication of this paper was in February of 2015.

Mitochondria are the powerhouses within each cell and there are between 10 and several thousand mitochondria per cell, depending on what the power needs of a cell type are.

Each mitochondrion has its own mitochondrial DNA contained in 2 to 10 small circular chromosomes that regulate the 37 genes necessary for normal mitochondrial function.

Johns Hopkins University clinical trial regarding frailty

In order to track mitochondrial DNA and its relationship to frailty and old age, the Johns Hopkins University researchers accessed data from two large clinical trials. One study was the Cardiovascular Health Study (CHS), which took place between 1989 and 2006. The other one was the Atherosclerosis Risk in Communities (ARIC) study spanning from 1987 to 2013. Blood tests with determinations of mitochondrial DNA were available from both studies.

In multi ethnic groups it was apparent that mitochondrial DNA content followed the age of a person.

Researchers defined frailty as a person who had aging symptoms including weakness, a lack of energy in comparison to the past, activity levels that were much lower than before and loss of weight. Persons with frailty according to these criteria in the two studies had 9% less mitochondrial DNA than non frail study participants.

Prevention of  frailty through early intervention

Another subgroup were white participants. Researchers compared their bottom mitochondrial DNA content to the top mitochondrial DNA content. Frailty was 31% more common in the bottom DNA content group. This means that white people are more prone to frailty and they should take steps early on to prevent this.

Mortality data were also examined and it turned out that those study participants who had the highest level of mitochondrial DNA lived 2.1 years longer on average than those with the lowest level of mitochondrial DNA.

The study also found that women in the two clinical trials had 21% more DNA in their mitochondria on average than men.

Prevention of DNA loss from mitochondria

The study did not suggest any preventative steps against mitochondrial DNA loss. But there is ample evidence in the literature that this can be achieved through supplements that can both help multiply mitochondria as well as stimulate the metabolism of mitochondria. Lifestyle changes are also effective.

I am not supporting the specific brands of supplements mentioned in the Dr. Whitaker link, but find the common sense explanations useful, as they explain what the supplements do.

Frail Mitochondrial DNA Equals Frail People

Frail Mitochondrial DNA Equals Frail People

You may find the scientific data too tedious to delve into. Here is a list that may be of help to you to preserve your health and your vitality:

List to help you preserve your health and vitality

  1. Ubiquinol (=CoQ-10) slows down mitochondrial aging.  I take 400 mg per day. CoQ-10 repairs DNA damage to your mitochondria.
  2. Another supplement, 20 mg of PQQ (=Pyrroloquinoline quinone) per day stimulates your healthy mitochondria to multiply. Between the two supplements you will have more energy as optimal mitochondrial function is ensured.
  3. There are simple lifestyle changes you can make: eat less calories as this will stimulate SIRT1 genes, which in turn stimulates your cell metabolism including the mitochondria.

    More supplements to help prevent frailty

  4. Resveratrol, the supplement from red grape skin can also stimulate your mitochondria metabolism. Exercise more and regularly as this will also stimulate your mitochondria to multiply similar to the effects of PQQ. I take 500mg of trans-Resveratrol once daily.
  5. Alpha-lipoic acid is an antioxidant that counters the slowdown of mitochondrial metabolism. I recommend 300mg per day.
  6. L-arginine is an amino acid that is a precursor of nitric oxide (NO). I prefer taking NO as the NEO-40 supplement where nitric oxide is directly released into your system. I take 1 lozenge of Neo-40 twice per day.

Reference

http://www.eurekalert.org/pub_releases/2014-12/jhm-aom121614.php

Mar
07
2015

Drink Your Coffee, But…

I have blogged about coffee drinking several times in the past. Coffee consumption and health benefits have become a news item again because of yet another study. The recent media reports are based on a South Korean study that involved 25,138 men and women with a mean age of 41.3 years.

Here I like to concentrate on aspects regarding coffee consumption that are often lost in the media when studies regarding coffee consumption are discussed. I will break it down into points and then conclude at the end with my recommendations.

1. Calcification of coronary arteries and osteoporosis

The South Korean study published online on March 2, 2015 showed that with up to 4 cups of coffee there was a direct linear relationship between consumption of coffee and prevention of heart attacks. Coronary artery calcium (CAC) deposits were measured by a CAT scan as they are known to be a good measure for a future risk of heart attacks. Less than 1 cup of coffee per day resulted in a 23% reduction of CAC in the coronary arteries compared to controls without coffee consumption. 1 to 2 cups of coffee reduced CAC’s (meaning the risk of heart attack rates) by 34%, while 3 to 4 cups prevented CAC’s and thus heart attacks by 41%. The fun stops at 5 cups of coffee per day as only 19% of CAC’s (heart attacks) were saved. Clearly there is something in coffee that shows detrimental effects, if the dosage is too high.

In the past there was a question as to whether coffee consumption would lead to osteoporosis in women. However, a study showed that there was no correlation between coffee consumption and osteoporosis.

Other studies have clarified this and found that vitamin D3 and K2 are important to remove calcium from the arterial wall and transport calcium into the bone and deposit it there. Vitamin D3 and vitamin K2 seem to override all the other nutrients when it comes to osteoporosis prevention. The other factor in older women is hormone deficiency as they age necessitating bioidentical hormone replacement in addition to vitamin K2 and vitamin D3 to prevent osteoporosis.

2. Whether or not you put sugar into your coffee

is an important question. This is routinely done in Germany where I grew up. The addition of sugar changes the entire game plan, as it is sugar that oxidizes LDL cholesterol, which is directly deposited under the arterial walls. This is the root cause of hardening of the arteries. Coffee alone is beneficial; coffee with sugar is not. I use a tiny amount of KAL Stevia (which does not have the bitter aftertaste) instead of sugar to sweeten my coffee. This sweetens it to the equivalent taste of sugar, but without the detrimental oxidizing effect of sugar. Somebody like me who was conditioned to eat sugar from childhood on in Germany has been left with a “sweet tooth”; so I need to have this tiny bit of stevia as a crutch. Purists may disagree with me. Keep in mind that the Korean study was done without sugar.

3. What’s the difference between real and decaffeinated coffee?

The recent study showed that you need to drink the real thing (caffeinated coffee), if you want to reduce your risk to get the dreaded pigmented skin cancer, melanoma. Decaffeinated coffee did not have this melanoma protective effect. This points to the fact that there are several substances in real coffee and decaffeinated coffee that have different effects. Ref. 2 shows that there was a clear reduction in the risk of developing type 2 diabetes in people who drank either coffee, decaffeinated coffee or tea. Unfortunately many studies do not distinguish clearly between caffeinated coffee and decaf coffee.

4. Micronutrient components of coffee

As this link shows there are many micronutrient components in coffee such as caffeine, diterpenes, chlorogenic acids, and melanoidins. There is about 100 mg of caffeine contained in a tall (240 ml) Starbucks cup of coffee. This will stimulate the nervous system and your adrenal glands getting that energy rush.

Diterpenes consisting mainly of cafestol and kahweol are substances that have been found to increase the LDL cholesterol. The fact that we are dealing with a concoction of mostly beneficial, but also some less beneficial micronutrients in coffee is responsible for the lower beneficial effect of 5 cups of coffee mentioned in the South Korean study. Filtered coffee seems to largely remove these undesirable substances.

This link explains more details about the micronutrients in coffee.

5. Clinical conditions that are partially prevented by coffee consumption

The last link mentioned a study where a large group of people were followed and monitored for Parkinson’s disease. Those who had consumed only 1 cup of coffee per day were compared to controls without coffee consumption. This one cup of coffee per day prevented Parkinson’s disease by 40 to 60%. Similarly, in a study that investigated prevention of type 2 diabetes 4 to 6 cups of coffee per day prevented 28% of type 2 diabetes. In postmenopausal women decaf coffee was also significantly effective in reducing the risk to develop diabetes.

The Linus Pauling Institute link summarized that there were several studies that showed that colorectal cancer could be partially prevented by consuming real coffee (4 or more cups), which lowered the risk by 24% compared to non-coffee drinkers. Another study noticed that 1 to 2 cups per day of decaf coffee reduced the risk for colorectal cancer by 48%.

Cirrhosis of the liver, often due to excessive alcohol use can be prevented by 40% when at least 2 cups of coffee were consumed. More astounding than that is that the risk of death from liver cancer can be reduced by 50% when at least 1 cup of coffee was consumed compared to those who never consumed coffee.

However, liver and colon cancer are not the only ones that can be prevented to a large extent by drinking coffee. Breast cancer, prostate cancer, endometrial cancer, uterine cancer, oral cancer, brain cancer and lung cancer can also be significantly prevented by a regular cup of coffee. As there is a risk of increasing miscarriages in pregnant women, it is best not to consume coffee during pregnancy or at the most limit it to one cup per day. Also, nursing mothers should avoid coffee (even decaffeinated coffee) as caffeine gets transmitted into mother’s milk.

People with high blood pressure may be better off to not drink coffee or to drink decaf coffee, because caffeine has been shown to elevate blood pressure substantially.

6. What are the risks of drinking coffee?

Seeing that coffee is an effective drug-like compound with many benefits, it is worthwhile asking the question: what are the side effects of coffee consumption? There are people who are very sensitive to caffeine. They get over stimulated and experience heart palpitations, a lack of sleep and anxiety. They should refrain from coffee. They may even be over sensitive to decaffeinated coffee that still contains about 3% of caffeine. People with rheumatoid arthritis have been shown to deteriorate with coffee consumption, making this another subgroup of people who should stay away from coffee.

7. What is the process of decaffeinating coffee?

Essentially there are 4 processes of decaffeination that have been developed over time. As this link shows, all of the decaffeination processes are done with the green coffee beans. There are two solvent-based processes and two non-solvent based processes. The latter two are the healthiest: the Swiss water process and the carbon dioxide process. The problems with the older solvent-based processes are the chemicals used to extract the caffeine. They can be harmful to the body.

Organic decaffeinated coffees are manufactured with the environment-friendly Swiss water process.

Drink Your Coffee, But…

Drink Your Coffee, But…

Conclusion

There are some people who simply are too sensitive to caffeine. They should refrain from drinking coffee. Pregnant women and nursing mothers should either severely reduce coffee consumption to one cup per day or refrain from coffee altogether. Those with high blood pressure and rheumatoid arthritis patients better refrain from drinking coffee as well. The majority of us will benefit from coffee consumption, if this is your taste. You may prefer green tea or Oolong tea instead. As I explained above there is compelling evidence in the literature that many cancers, heart attacks, strokes and diabetes can be partially prevented by regular coffee consumption. Decaffeinated coffee can prevent type 2 diabetes to some extent and colorectal cancer as well. The majority of evidence shows that coffee drinking is healthy. So, go ahead and enjoy!

References:

Ref. 1: Ding, Ming; Bhupathiraju, Shilpa N; Satija, Ambika; van Dam, Rob M; Hu, Frank B. “Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies.” Circulation – February 11, 2014; 129 (6); 643-59.

Ref. 2: Huxley R, Lee CM, Barzi F, Timmermeister L, Czernichow S, Perkovic V, Grobbee DE, Batty D, Woodward M. “Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis.” Arch. Intern. Med. – December 14, 2009; 169 (22); 2053-63