Mar
11
2017

Obesity And Diabetes Can Cause Cancer

Dr. Nalini Chilkov gave a talk about how obesity and diabetes can cause cancer. The original title was “Integrative Cancer Care, Increased Rates of Cancer and Cancer Mortality Associated with Obesity and Insulin Resistance, Nutraceutical and Botanical Interventions”. Her talk was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended.

In the following I will present a brief summary of her lecture.

Obesity is a major risk factor for cancer

Obesity causes 14% of all cancer deaths in men and 20% of cancer deaths in women.  This link explains this in more detail. The following 15 cancers were linked to obesity in terms of causation. They are: colon cancer, gastric cancer, gallbladder cancer, ovarian cancer, breast cancer, liver cancer, uterine cancer, endometrial cancer, rectal cancer, pancreatic cancer, cervical cancer, non-Hodgkin’s lymphoma, renal cancer, multiple myeloma and esophageal cancer.

The American Society of Clinical Oncology reported about a meta-analysis involving 82 studies. This involved more than 200,000 women with breast cancer. Premenopausal and postmenopausal women were compared who were obese or normal weight. Premenopausal, obese breast cancer women had a 75% increase in mortality compared to the normal weight breast cancer group. With postmenopausal, obese breast cancer women there was a 34% increase of mortality compared to the normal weight group.

With obese prostate cancer patients there is a similar observation. Obese patients have a more aggressive prostate cancer on the Gleason score and the cancer is in a more advanced stage at the time of diagnosis.

Diabetes increases mortality from cancer

Obesity is a common risk factor for both cancer and diabetes. But diabetes by itself is also increasing mortality of several cancers. In a consensus report details of the relationship between cancer and diabetes have been discussed in detail. The following cancers have been identified to have an increased risk of diabetes: pancreatic, gastric, esophageal, colorectal, liver, gallbladder, breast, ovarian, endometrial, cervical, urinary bladder, renal, multiple myeloma and non-Hodgkin’s lymphoma.

A meta-analysis suggests that cancer patients who are diabetic have a 1.41-fold increased risk of dying compared to those cancer patients who have normal blood sugars. Dr. Chilkov explained in detail what the various mechanism are that account for the faster cancer growth in obese and diabetic patients. High insulin levels is one of the risk factors, so is IGF-1, an insulin-like growth factor. The aromatase enzyme in fatty tissue turns male type hormones into estrogen, which also can stimulate cancer growth.

Carbohydrate restriction diet to prevent obesity

Low carb diets like the Mediterranean diet, the ketogenic diet and the Atkins diet will drop blood insulin and lactate levels. Cancer size and cancer growth are related to insulin and lactate levels. A low carb diet can reduce insulin-mediated uptake of sugar into cancer cells.

Research has shown that cancer metabolism slows down when a 10%-20% carb/high protein diet is consumed by the patient. This reduces the amount of sugar that is taken up by cancer cells. It also reduces insulin, so there is less cancer growth. A ketogenic diet is a more strict way to restrict carbohydrates. Intermittent fasting is also a useful method to reduce carbohydrate intake.

Here is an interesting study that illustrates the power of intermittent fasting. The study involved 2413 patients with early breast cancer who were followed for 7 years. Those breast cancer patients, who consistently did not eat anything between dinner and breakfast for 13 hours or more, had a 36% lower risk of having a cancer recurrence. There was also a 21% lower risk of dying from breast cancer when fasting was done for 13 hours or more overnight.

Supplements to prevent obesity, diabetes and cancer

A low carb diet and in some cases even a ketogenic diet is beneficial as a baseline. A regular exercise program is also useful for general fitness building and cardiovascular strengthening. In addition Dr. Chilkov recommended the following supplements.

  1. To reduce inflammation in the body, Dr. Chilkov recommended taking 2000 to 6000 mg of omega-3 fatty acids per day (molecularly distilled fish oil).
  2. Berberine 500 to 1000 mg three times daily. Dr. Chilkov said that Berberine has anti-cancer properties, improves insulin sensitivity and reduces absorption of sugars in the intestinal tract.
  3. Curcumin inhibits cancer cell division, invasion and metastatic spread through interaction with multiple cell signaling proteins. Several researchers showed that curcumin could lower blood sugar levels by stimulating insulin production from beta cells in the pancreas. Triglycerides, leptins and inflammation in fat cells are also lowered by curcumin. Insulin sensitivity increases through the action of curcumin. Dr. Chilkov recommended 300 mg/day of curcumin for 3 months.
  4. Resveratrol, the bioflavonoid from red wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. This group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol is 1000 to 5000 mg.
  5. Green tea catechins (EGCG) help to normalize the glucose and insulin metabolism. The dosage recommended was 1-3 grams per day.
  6. Reishi mushroom (Ganoderma lucidum) contain polysaccharides with antidiabetic and antiobesity effects. They make gut bacteria produce three types of short-chain fatty acids that control body weight and insulin sensitivity.
Obesity And Diabetes Can Cause Cancer

Obesity And Diabetes Can Cause Cancer

Conclusion

Obesity is a risk factor not only for diabetes, but also for cancer. Chronically elevated blood sugars, increased fasting insulin levels and increased IGF1 levels can cause cancer. In addition they can stimulate tumor growth and increase cancer mortality. It is for this reason that the health care provider should screen all diabetics for cancer. In her talk Dr. Nalini Chilkov gave clear guidelines what supplements will be beneficial to reduce the risk of obesity and diabetes as well as cancer. Start with a healthy, balanced diet. Add an exercise program. Then consider some of the above-mentioned supplements to reduce your risk for cancer, diabetes and obesity.

Jan
28
2017

Cardiovascular Disease And Inflammation

Dr. Mark Houston talked about cardiovascular disease and inflammation – “the evil twins”. He presented this lecture at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. Dr. Houston is an associate clinical professor of medicine at the Vanderbilt University Medical School in Nashville, TN 37232.

New thinking about cardiovascular disease and inflammation

Dr. Houston pointed out that the old thinking about cardiovascular disease has to be replaced with the new thinking. Here are a number of points regarding the new thinking.

  1. Coronary heart disease and congestive heart failure are diseases of inflammation. They are also coupled with oxidative stress, vascular immune dysfunction and dysfunction of the mitochondria.
  2. In the past it was difficult to reduce these cardiovascular diseases. With the new thinking there are now new treatment approaches that help cure cardiovascular disease.
  3. The development of heart disease has a long history. Endothelial dysfunction predates coronary artery disease by many years. This is followed by vascular smooth muscle dysfunction. Inflammation develops and structural changes occur in the small and larger blood vessels with atheromatous deposits (plaques) and final occlusion, at which point you get a heart attack.

Canadian physician Sir William Osler has already stated more than 100 years ago “A man is as old as his blood vessels”.

The old thesis was that cholesterol would lead to deposits that close coronary blood vessels and cause heart attacks. Dr. Houston called this the “cholesterol-centric “ approach. The truth is that with conventional blood tests you are missing 50% of all the high-risk patients that are going to develop heart attacks. They are missing the ones that have chronic inflammation, but normal cholesterol levels.

What was not known in the past was that oxidative stress associated with normal aging can lead to chronic low-grade inflammation. This oxidative stress leads to mitochondrial DNA changes. Associated with it are biochemical changes that cause chronic inflammation, which in turn will affect the lining of the arteries. There is a metabolic change described in the literature as metabolic syndrome, which leads to high blood pressure, hardening of the arteries and eventually heart attacks and strokes. The key today is to include in screening tests all parameters that will predict who is at risk to develop a heart attack or not.

Blood tests to screen for cardiovascular disease and inflammation

Blood tests and health history should be checked for dyslipidemia, high blood pressure (hypertension), hyperglycemia, smoking, diabetes, homocysteinemia, obesity etc. Also, patients with high GGTP (gamma-glutamyl transferase) levels in the blood are more at risk to develop diabetes. This in turn leads to inflammation of the arterial wall and heart attacks. There are 25 top risk factors that are associated with all causes for heart attacks.

Briefly, apart from the 7 factors already mentioned above the physician wants to check for high uric acid levels (hyperuricemia), kidney disease, high clotting factors (fibrinogen levels), elevated iron levels, trans fatty acid levels, omega-3 fatty acid levels and omega-6 to omega-3 ratio, low dietary potassium and magnesium intake with high sodium intake, increased high sensitivity C reactive protein level (hs CRP measuring inflammation). The list to test for cardiovascular disease risk continues with blood tests for vascular immune dysfunction and increased oxidative stress, lack of sleep, lack of exercise, subclinical low thyroid levels, hormonal imbalances for both genders, chronic infections, low vitamin D and K levels, high heavy metals and environmental pollutants.

The speaker stated that he includes a hormone profile and vitamin D levels. He does biochemical tests to check for mitochondrial defects. Micronutrients are also checked as cardiovascular patients often have many nutritional deficiencies. Inflammation is monitored through testing the levels of C-reactive protein (CRP).

In order to assess the risk of a patient Dr. Cohen, a cardiologist has developed the Rasmussen score, which is more accurate than the Framingham score.

The following tests are performed on the patient: computerized arterial pulse waveform analysis (medical imaging), blood pressure at rest and following exercise and left ventricular wall of the heart by echocardiography. Further tests include urine test for microalbuminuria, B-type natriuretic peptide (BNP, a measure of congestive heart failure), retinal score based on fundoscopy, intima-media thickness (IMT, measured by ultrasound on the carotid artery) and electrocardiogram recording (EKG).

Here is what the Rasmussen score means:

  • Disease score 0 to 2: likely no heart attack in the next 6 years
  • Disease score 3 to 5: 5% likely cardiovascular events in the next 6 years
  • Disease score > 6: 15% likely cardiovascular events in the next 6 years

Non-intervention tests to measure cardiovascular health

1. The ENDOPAT test

With this test the brachial artery is occluded with a blood pressure cuff for 5 minutes. Endothelial dysfunction is measured as increased signal amplitude. A pre- and post occlusion index is calculated based on flow-mediated dilatation. The values are interpreted as follows: an index of 1.67 has a sensitivity of 82% and specificity of 77% to predict coronary endothelial dysfunction correctly. It also correlates to a future risk for coronary heart disease, congestive heart disease and high blood pressure.

2. The VC Profile

This test measures the elasticity of the arteries. There is a C1 index that measures the elasticity of the medium and smaller vessels and the C1 index, which measures elasticity of the larger arteries and the aorta. The smaller the numbers are, the less elastic the arterial walls.

3.The Corus CAD score

This is a genetically based blood test. The score can be between 0 and 40. If the score is 40, there is a risk of 68% that there is a major blockage in one or more coronary arteries.

4. Coronary artery calcification

The CAC score correlates very well with major event like a heart attack. There is a risk of between 6- and 35-fold depending how high the CAC score is. The key is not to wait until you have calcification in your coronary arteries, but work on prevention.

Treatment of cardiovascular disease and inflammation

When heart disease is treated the doctor needs to address all of the underlying problems. It starts with good nutrition like a DASH diet or the Mediterranean diet.

Next anti-inflammatory and other supplements are added: curcumin 500 mg to 1000 mg twice a day, pomegranate juice ¼ cup twice per day, chelated magnesium 500 mg twice per day, aged garlic 1200 mg once daily, taurine 3 grams twice per day, CoQ-10 300 mg twice per day and D-ribose 5 grams three times per day. This type of supplementation helps for chest pain associated with angina. On top of this metabolic cardiology program the regular cardiac medicines are also used.

Additional supplements used in the metabolic cardiology program may be resveratrol 500 mg twice per day, quercetin 500 mg twice per day, omega-3 fatty acid 5 grams per day, vitamin K2 (MK 7) 100-500 micrograms per day and MK4 1000 micrograms per day. In addition he gives 1000 mg of vitamin C twice per day. This program helps in plaque stabilization and reversal and reduction of coronary artery calcification.

Case study showing the effect of metabolic cardiology program

Here is a case study of a heart patient that was treated by Dr. Houston. He was a white male, first treated for congestive heart failure as a result of a heart attack in June 2005. Initially his ejection fraction was 15-20%. His medications were: digoxin 0.25 mg once daily, metoprolol 50 mg twice per day, ramipril 10 mg twice per day, spironolactone 25 mg twice per day and torsemide 20 mg once daily. These medications were kept in place, but the metabolic cardiology program was applied in addition. Here are the results of his ejection fraction (EF) values after he was started on the metabolic program:

  • Initial measurement: EF15-20%. Marked shortness of breath on exertion.
  • 3 months: EF 20-25%. He reported improved symptoms.
  • 6 months: EF 25-30%. He said that he had now minimal symptoms.
  • 12 months: EF 40%. He had no more symptoms.
  • 24 months: EF 50%. He reported: “I feel normal and great”.
  • 5 years: EF 55%. He said” I feel the best in years”.

A normal value for an ejection fraction is 55% to 70%.

Cardiovascular Disease And Inflammation

Cardiovascular Disease And Inflammation

Conclusion

Testing for heart disease risk has become a lot more sophisticated than in the past, and the tests have opened up a window to early intervention. Metabolic cardiology is a new faculty of cardiology that assists in the reversal and stabilization of heart disease. It will help high blood pressure patients and stabilizes diabetes, which would otherwise have deleterious effects on heart disease. Metabolic cardiology improves angina patients. It also prevents restenosis of stented coronary arteries. As shown in one clinical example reduced ejection fractions with congestive heart failure will improve. This was achieved solely through the metabolic cardiology program.

As usual, prevention is more powerful than conventional treatment later. To give your cardiac health a good start, don’t forget to cut out sugar, exercise regularly and follow a sensible diet.

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Nov
26
2016

Chronic Shoulder Pain Treatment

This overview is about chronic shoulder pain treatment. A 71- year old health conscious patient was exercising in a gym. When he used the shoulder machine, he suddenly experienced a stinging pain in his left shoulder. The pain seemed to be localized in the upper (superior) portion of the trapezius muscle. With this he also felt pain in his left neck.

This was fitness gone wrong! It can happen, that exercise is overdone or lack of judgment leads to injury. Trainers caution us, when we embark on exercise programs, and yet, it happens! Often the road to recovery is a bumpy stretch, and if the problem is not corrected, it can lead to chronic pain. With this knowledge the patient sought help. The first approach was visiting a

Chiropractor

He sought the help of a chiropractor and had 6 manipulations in the neck and thoracic spine. The spine had good range of motion, but the left shoulder pain in the trapezius muscle stayed.

He found that heat application to the trapezius muscle helped, so he bought an electric heating pad that he applied once or twice a day for pain relief. He also sought the input of his G.P. He was offered

Pain pills

This was the predictable regimen, but the patient was concerned about the side effects of pain pills, and he declined. He had heard of a supplement, called Trilipotropic (from Trophic), which contains 300 mg of choline bitartrate, 300mg of inositol and 300 mg of methionine in one tablet. He learnt at a medical conference that two of these tablets were as effective in relieving the pain as one tablet of Motrin, an anti-inflammatory drug. He took two of these pain relievers from the health food store a couple of times per day alternating with the heating pad to control his pain.

Since the condition improved only marginally, he looked at the option of

Prolotherapy

When the chiropractor mentioned after 5 treatments that he could not treat the pain successfully, the patient decided to try prolotherapy, because he had heard that this would be good for chronic musculoskeletal pain. The naturopath whom he saw examined thoroughly and determined that the patient would be a good candidate for 2 to 4 prolotherapy treatments. After one treatment on the left side along the cervical spine and the left trapezius area the pain was reduced by 30% of what it was before. The second prolotherapy treatment was given again to the left side and also to the right side to keep it symmetrical. The naturopathic physician told the patient that he would see him for follow-up in 4 weeks. The treatment of the right asymptomatic side did not cause any pain, but the left side started flaring up after the second treatment, causing pain that was almost as bad as the original pain. When the patient returned to the naturopath and told him about the flare-up of pain in his left shoulder, he was told that this is what sometimes happens when treatments are not spaced far enough apart. He felt that this should be observed now and reassessed in 6 months in case there was

No progress. It was time to look at other options:

IMS treatments

When the chiropractor had admitted that he could not help removing the pain, he suggested that maybe a physiotherapist trained in intramuscular stimulation treatment (IMS), also known as dry needling could be of help. The patient was waiting for the appointment with the naturopath for prolotherapy when he saw the physiotherapist for IMS treatments. He examined the patient and noticed a persistent trigger point in the upper trapezius muscle, which he thought was causing the chronic pain.

Two IMS treatments relieved the pain by about 50%. But about two or three days later the pain came back to about 75% of the original pain after the gym injury. The appointment for the prolotherapy by the naturopath had taken two months to wait for, so he had already had 3 IMS treatments just before the prolotherapy to get some pain relief. The IMS trained physiotherapist thought that perhaps a few more treatments, up to five or six might be able to take the pain away. So the patient continued treatments on a weekly basis.

Unfortunately the hope for pain relief did not materialize. The pain improved to about 30 to 40% of the original pain, but it always came back just 2 or 3 days later. Fortunately for him he could apply the heating pad and the pain would stay away for 3 to 5 hours. It also responded to taking two tablets of the choline bitartrate/inositol/methionine combination that took the residual pain away for several hours. Self-massaging the trigger point also gave some relief. But occasionally the pain came back with a vengeance and felt like a charley horse that suddenly could occur in his left shoulder making it difficult to move his left arm, particularly when he needed an outstretched arm for ballroom dancing, lifting of heavy objects or for working out in the gym. Even just holding on to the rails of the treadmill when doing a fast walk on the treadmill for half an hour could lead to a flare up of the left shoulder pain. It is frustrating, when there is only temporary relief, but no real cure, but giving up is no option. Often we find more information on the Internet. What came up was

Low-dose laser therapy

The patient remembered having heard of low-dose laser therapy that might be useful in treating chronic pain. This method, called interstitial low-laser therapy was used to treat his trigger point in his left shoulder. A physician who is the president of ISLA –the international society for laser applications- specializing in laser treatment treated him by inserting a cannula into his left trapezius muscle close to the trigger point. He injected a small amount of procaine (local anesthetic), then 5 ml of normal saline. This was followed by three low-laser beam treatments for 10 minutes each, first blue, then green and finally yellow color, all given interstitially after which the cannula was removed.

He was surprised to feel relief almost instantly. There was still a bit of pain from the interstitial needle for about two days, but he noticed that the trigger point in the trapezius muscle had completely vanished. Finally after 6 months of intermittent pain there was relief of about 50% of the original pain. This time the pain in that particular trigger point stayed away, which was encouraging.

But there were two other trigger points that were bothering him. After one month he got a second interstitial low dose laser treatment by the naturopath who had previously given him the prolotherapy into another trigger point, and finally 2 weeks after this, the third laser treatment was given for yet another trigger point. This continued on for another few months. The pain disappeared, then it crept in slowly again, but at a lower level. It became a quest to eradicate the trigger points! Each time the latest trigger point that was still palpable was treated with the same low-dose laser treatment method. It took a total of 9 interstitial treatments to finally reach the point where all of the pain was gone.

It felt strange: the chronic left shoulder pain had disappeared!

Chronic Shoulder Pain Treatment

Chronic Shoulder Pain Treatment

Conclusion

When pain lasts for more than 3 months, it is referred to as “chronic pain” and is often termed neuropathic pain that is difficult to treat. You may have guessed by now that I was the patient in this blog, and so I had a vested interest in getting rid of this pain. I had previously described a similar pain in my lower back that was relieved with just one interstitial low-dose laser treatment at that time and my back has remained pain free since. Shortly after that successful treatment I developed the left shoulder pain from a soft tissue injury in the gym as mentioned. I was fortunate that Dr. Weber could treat me again, this time at his clinic in Lauenförde, Germany on occasion of a Germany trip that I had booked for holiday purposes.

I was lucky that this treatment responded similar to the one in my lower back. The difference was that my left shoulder required a total of nine low-dose laser treatments to be resolved and my pain had lasted a total of 14 months!

It occurred to me that a successful outcome of treating pain requires collaboration between patient and therapist. Call it trial and error. In my case it was only the fourth treatment modality, the low-dose laser therapy that worked permanently.

I feel that the chiropractor did his best to ensure there was no nerve root irritation and told me when he had reached his limits.

The IMS trained physiotherapist treated me before and after the prolotherapy and also told me after a total of 12 visits that he likely could not help me any more than he did.

The naturopath who did the prolotherapy said that he had strengthened the ligaments along the spine on the left side, but that the trigger point from the gym injury likely was not responding to prolotherapy.

The final answer came from the treatment by Dr. Weber in Germany and the naturopath in Kelowna using the same Weber system machine with low-dose lasers. I think that this is an under-recognized treatment modality of musculoskeletal injuries, including sports injuries. You can find treatment providers for low-dose laser therapy throughout the US, Canada and Europe where many physicians and naturopathic physicians use it as part of their pain management methods. The equipment has been FDA approved; Health Canada approved and is approved by the Medical Devices Directive in Europe. Please note that this type of laser (low-dose laser) has nothing to do with laser treatment for cosmetic purposes.

It has to be stressed that chronic pain treatment requires attention to detail, feedback from the patient to the healthcare provider and persistence on behalf of the patient to follow through until the chronic pain is resolved. It also shows that giving up is not an option!

Oct
15
2016

Commuting Affects Your Health

A research report from Great Britain was recently reviewed by CNN; it revealed that commuting affects your health.

The longer we commute to work and back the more downtime we have where we do not move our muscles. But we also are exposed to more unhealthy snacks and sugary drinks that make us deposit more fat. The original research report was published here. What were the elements of this study?

Commuting affects your health, study design

Three consecutive annual waves of the British Household Panel Survey were utilized. These are longitudinal surveys of nationally representative households in Great Britain. The sample years were 2004/2005, 2005/2006 and 2006/2007. There were 15,791 participants in the study. Of these 4,056 were selected for the study. The main mode of travel to work was determined at each time point. The self-reported height and weight was taken to calculate the body mass index (BMI) at baseline and at 2 years. Attention was paid to switches of transportation mode (that is from active to sedentary and vice versa).

Commuting affects your health, results of study

  1. Switching from car commute privately to active travel (walking, bicycling) or public transport resulted in a significant loss in BMI. There were even larger reductions of BMI’s in those who enrolled in the first year in active transportation, because of the longer exposure. Those with the longest journeys who used active transportation had significant weight losses.
  2. A group of 787 people switched from active travel or public transport to the use of their private cars as transportation. This resulted in a significant BMI increase.
  3. The study concluded that any interventions that would allow private car commuters to switch to an active mode of transportation could contribute to the population’s BMI being reduced significantly.

Commuting affects your health, Cambridge experiment

In a 2016 study from Cambridge (Great Britain) a similar experiment was done. They studied traffic patterns in the county of Cambridgeshire. 1143 adults working in the city were compared with 1710 people who used the Cambridgeshire Guided Busway and who were intercepted. A new bus network that is intertwined with pedestrian pathways and cyclists had been open to the public since 2011. Walking and cycling were incorporated into longer commuting journeys where otherwise private car and public commute were used. There was a 1.8-fold increase of active travel after exposure to intervention where the benefit of active travel was explained to people. There was also a 2-fold decrease of commuting solely by car. The weekly cycling commuting time had increased to 1.34-fold compared to the previous level.

Those who had been most inactive in their commute at baseline were the ones who appreciated an active commute most. There was an association of active commuting, greater overall physical activity with an improvement of health and weight loss.

Commuting affects your health, US study

A multi-city study involved the largest 3,914 municipal jurisdictions, which were located in 473 of the most populous U.S. counties. This involved 48 states and the District of Columbia. In order to encourage more active commuting (walking, cycling) pedestrian zones or pedestrian-friendly zones with adjacent bus transportation were developed by many municipalities. A new concept of transit-oriented developments or districts (TODs) was adopted. TODs are higher density areas that are compact. They are mixed use areas, which are located around transit stops. This encourages walking. The study was published in 2016 and showed that the TOD zones had higher occupancy rates and many house owners had no car as they used public transportation only. TOD zones were more populous, people in it had higher income, and they were more racially diverse and younger. The occupants of TOD zones had a 2.1-fold higher rate of using public transportation and they also had a 2.48-fold higher rate of using active transportation to work.

Commuting affects your health, general comments

The majority of commuters in England and Wales spent 56 minutes in their cars going to and from work in 2013. In London this daily commuting time is 79 minutes. The US data are similar.

With a well-developed public transportation system the authorities developed various programs designed to replace at least some part of the commute by active commuting. This is good for your metabolism, it is good for your cardiovascular status and it gets you away from snacking junk foods while you are bored in your car.

In an poll from London, England where more than 1500 commuters were polled 55% reported increased stress levels, 33% reported increased snacking, 29% admitted to fast food consumption, 36% complained about sleeping problems, 41% said that they were doing reduced physical activity and 44% reported that they spent reduced time with their friends and family. 58% felt that flexible work hours would improve their health and wellbeing. Remember that how you are commuting affects your health.

My own experience watching commuting in various cities

Over the years I have traveled extensively in Germany, Austria and the US. In Europe it is interesting how many years ago the pedestrian zones in the old town centers have reshaped the commuting. The U-Bahn (subway) and commuter trains have intermingling networks that shoot you out to pedestrian zones. You are forced to walk before you can catch a connecting bus or tram.

  1. Vienna (Austria) for instance allows you to get out at the U-Bahn station of Stephansplatz, which is a pedestrian zone around the Stephan’s Church (Stephanskirche). There is an amazing array of shops and in a side alley you can even find a Starbucks, if you are so inclined. When you get tired of walking, you hop onto any of the U-Bahn connections. This brings you where you need to be. If you are too far from your goal, hop onto a tram and enjoy the sightseeing. There are also buses that can get you there. It is all covered under the same Vienna card, which I appreciated as a visitor. It is best to park your car in the periphery and use the commuting network to get you to where you want to go.
  1. Munich (Germany) has a lot of cycle paths, which run parallel to the pedestrian paths. I was surprised recently to see business people in black suits cycle to work. Otherwise there are the U-Bahn, S-Bahn, trams and buses that all interconnect.
  2. Münster (North Rhine-Westphalia, Germany) has an extensive network of cycle paths and pedestrian walks. Buses and trams are also constantly running. The old historic town is a pedestrian zone, but anybody can commute to anywhere between walking or using the bus/tram. I was amazed this spring when I visited; there were hundreds of people, young and old who cycled to and from work. The employers are providing huge metal racks where people can attach their bikes to with a lock.
  1. Berlin is another multi level commuting city in Germany. You can use the U-Bahn, S-Bahn (commuter train), bus or tram to get to work. Here is an informative video that explains.  I did not see many cyclists there. But hundreds of people are walking. Yes, there are many pedestrian zones and they interconnect with all of the commuter options. Berlin spreads over a vast area, so the S-Bahn, which is a local commuter train is particularly important. The shorter connecting trips are done by U-Bahn (subway). Buses and trams do the fine-tuning to get to your destination.
  2. Vancouver (BC, Canada) has some cycle pathways in the West end, close to Stanley Park. Otherwise there is a network of buses, the Skytrain, Sea Bus (between North Vancouver and downtown) and the West Coast Express (a commuter train). For the size of the city I think that Vancouver could benefit from studying some of the transportation modalities in Europe to entice the car travelers to use public transportation. When I travel to Vancouver, I use my own car, as it is so much faster to reach any goal. Public transportation is at this point not effectively connecting all the areas in this city.
Commuting Affects Your Health

Commuting Affects Your Health

Conclusion

In the past we often heard that there was nothing that could be done about traffic jams and commuter stress. Think again. Revitalization of city cores all over Europe, Great Britain and in the US has taken the TOD concept to heart and active commuting has become a reality. Whenever you can, use alternatives like cycling, walking and public transit to get to and from work. Studies have even shown that when you become an active commuter you likely will also become more active after work. Even using public transit makes the commute more active, as you are not sitting for an hour or more in your vehicle. You have to get out and walk in order to catch a connection. This all helps to keep you physically more fit than the commuting style, where you sit in a vehicle and possibly dip into junk food. It is not only about body mass index reduction and decreasing your waistline. Active commuting is also a lot less stressful than the passive modality, where traffic jams add to frustration and stress at the beginning and at the end of a workday.

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Sep
17
2016

Seven Steps To Live Over 100 Years

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.

Explanation:

There are two comments I like to make. One is that when you have calm nerves, and your emotions are balanced, your stress hormones are controlled. We know that people who are laid back and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly uneducated about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. Life expectancy can be prolonged by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium. http://www.askdrray.com/life-extended-by-several-decades/

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

People have always been fascinated about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!

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Jul
09
2016

Avoid That Heart Attack

Recently Dr. Mark Hyman mentioned a 7-point program to avoid that heart attack. If you follow the recommendations below, chances are that you do not only avoid heart attacks, but also strokes, high blood pressure, diabetes and obesity.

The Potsdam (or EPIC) study has shown that adhering to 4 simple things can reduce

Diabetes by 93%

Heart attacks by 81%

Strokes by 50%

All cancers by 36%.

What were those 4 points?

  1. Not smoking
  2. Exercising 3.5 hours a week
  3. Eating a healthy diet
  4. And maintaining a healthy weight

So with a few more points added it is no wonder that the figures can be even more impressive.

Other studies have also shown the importance of lifestyle changes to improve health outcomes; the INTERHEART study was based on 30,000 people in 52 countries that were followed along. Researchers found that 90 percent of all heart disease could be prevented by simple lifestyle changes.  I have added another point, regular exercise that has been proven to be very effective in preventing many diseases.

So, what are the 8 points that can assure that our health improves?

  1. Avoid that heart attack with a colorful, plant-based diet

Your dietary intake is important, because it provides all of the building blocks for your body. You want whole foods that are rich in phytonutrients. Often rainbow colors are mentioned, because the more varied your vegetables look, the more balanced the micronutrients, vitamins and minerals in the food items. Below we will learn that we want to avoid processed foods and hydrogenated fats, but we want to increase fiber and omega-3 fatty acids.

  1. Avoid that heart attack by stabilizing your blood sugar

Never eat refined carbs alone, as this goes chases up your blood sugar levels and causes unhealthy insulin reactions. Too much insulin production causes inflammation in the body, which can cause inflammatory bowel disease, arthritis, clogged arteries with heart attacks and strokes and Alzheimer’s disease. You want to balance complex carbs from vegetables with healthy fats and clean protein in every meal. Avoid sugars- no matter whether it is “natural brown” or white sugar and refined carbohydrates. Your pancreas does not differentiate between honey and other sugars, and it will react the same way!

  1. Avoid that heart attack by increasing fiber intake

The more fiber you can tolerate, the better. 50 grams would be ideal, but not everybody can tolerate this due to bloating or a queasy stomach. But even if you can add 5 or 10 grams of fiber per day, this is progress. Fiber decreases LDL cholesterol by intervening with the enterohepatic pathway. Fiber is found in nuts, beans, vegetables, seeds and berries that have lower sugar in them. You can also take a fiber supplement directly like psyllium husk.

  1. Avoid that heart attack by cutting out processed foods

Processed foods and junk foods are popular as they fill you up fast when you are hungry. But they need to be avoided at all costs. Sodas, juices and diet drinks affect your sugar and fat metabolism. The extra calories that come from sugary drinks are the biggest contributors to diabetes, heart disease and obesity. Even 100% fruit juice is not healthy, because all of the fiber is removed and you are drinking sugar water to which your pancreas reacts by producing extra insulin. As already discussed the extra insulin just causes inflammation. May I suggest a homemade lemon juice that you make by squeezing ½ lemon into a glass; add a tiny bit of Stevia for sweetening and sparkling mineral water. This is a healthy drink without sugar. You can drink this as often as you want. Another component of processed food are omega-6 fatty acids. They are in processed foods, because they increase the shelf life in stores. But they cause inflammation in the body unless balanced by omega-3 fatty acids (see below).

  1. Avoid that heart attack by increasing omega-3 fatty acids

Fish and seafood provide you with healthy omega-3 fatty acids. Unfortunately not all fish are healthy. Tuna is a predator fish that accumulates a lot of mercury from the polluted oceans. As a result of this it is not on my fish list. I prefer wild salmon. I also take molecularly distilled fish oil, which has omega-3 fatty acids in it. Many processed foods contain only omega-6 fatty acids, because this is the cheapest way to produce them (they are based on vegetable oils). Also avoid soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Instead you want to eat healthy fats like omega-3 fatty acids contained in nuts and fish. You can also add molecularly distilled, high potency omega-3 fatty acids as a supplement to help restore the balance between omega-6 and omega-3 in your food intake.

  1. Avoid that heart attack by eliminating all hydrogenated fat

Hydrogenated fat like margarine has been shown to cause accelerated hardening of the arteries, which causes heart attacks and strokes. Read labels and eliminate any food that contains hydrogenated fats. If the label indicates that you are dealing with a product containing ”partially hydrogenated oil”, stay away from it as well! Butter from grass fed cows is a healthy fat. Olive oil and coconut oil are both good cooking oils. Olive oil is also good in salad dressings.

  1. Avoid that heart attack by keeping alcohol to a minimum

The problem with alcohol is that it is a cell poison. On the other hand small amounts have been show to reduce heart attacks and strokes (one glass for women, two glasses for men per day). However, due to the cell poison effect even low amounts of alcohol contribute to cancer causation, and as a result of that alcohol remains a problem. If you must consume alcohol limiting the intake to minimal amounts is prudent. In women ovarian cancer can be caused by alcohol and men prostate cancer. In both sexes pancreatic cancer can be caused by alcohol. Higher amounts of alcohol raise inflammation with elevation of blood pressure, heart attacks and strokes. One recommendation: either consume no alcohol or use alcohol in moderation. One glass does not kill you, but several ones may do it over time!

  1. Avoid that heart attack by exercising regularly

Regular exercise is yet another factor that can help you to reduce heart attacks, strokes and cancer even further. I added it as point 8, because it is fundamentally such an important preventative factor. Some studies have shown as much as a 50% drop in many diseases simply by introducing regular exercise.

Avoid That Heart Attack

Avoid That Heart Attack

Conclusion

It is all about lifestyle factors. Pay attention to your diet. Add fiber, subtract sugar. Avoid processed foods, omega-6 fatty acids and hydrogenated fat. Have enough omega-3 fatty acids as fish and supplements. Keep alcohol to a minimum. Your benefits from changing these lifestyle factors, result in huge benefits. You are avoiding 90% of diabetes, 80% of heart attacks, 50% of strokes and 35% of cancers.

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Jun
25
2016

Prevent Unhealthy Aging

We know that stress can age you prematurely, but what do we need to do to prevent unhealthy aging? This is exactly what this review by cardiologist Dr. Joel Kahn has done. It points out that the right lifestyle makes the difference.

Studies showing how to prevent unhealthy aging

Several studies have shown how to avoid getting heart disease, cancer and diabetes.

  1. Kahn reported that in 2001 the Harvard School of Public Health published a study where 84,941 healthy female nurses had been followed who were free of heart disease, cancer and diabetes at baseline. But only 3.4% of the 84,941 women managed to stay healthy after 16 years of the study. The secret? Their body mass index (BMI) was less than 25.0, their diet was high in polyunsaturated fat and fiber, low in trans fat and low in glycemic load, they engaged in regular moderate exercise with a minimum of 30 minutes per day; they did not smoke and they drank ½ an alcoholic drink per day. Their risk to get diabetes was 91% lower than the rest of the study. This shows you how powerful lifestyle choices are.
  2. In 2004 an international study (the INTERHEART study) reported in the Lancet the lifestyle of 15,152 cases that developed heart attacks in 52 countries with 14,820 controls who did not have heart attacks. The researchers found 9 risk factors that accounted for 90 to 95% of the heart attacks. They were smoking, elevated cholesterol risk ratio, diabetes, high blood pressure, abdominal obesity, stress, low intake of fruit and vegetables, high alcohol intake and lack of physical exercise. Obesity was considered a high risk when the waist circumference measured more than 35 inches in a woman or more than 40 inches in a man. All these 9 risks can be eliminated by lifestyle changes.
  3. The 2006 Health Professional Study spanned over 16 years in a group of 40 to 75 year old doctors without a heart attack at baseline. It noted that male doctors who were lacking the 5 heart attack risk factors had 87% less heart attacks than controls without health lifestyles. What were the lifestyle factors? A body mass index (BMI) of less than 25, being a nonsmoker, being physically active for more than 30 minutes a day, having not more than moderate amounts of alcohol intake and having a diet that was more than 40% plant based.
  4. In 2007 a Swedish study reported on 24,000 women after menopause that had no heart attacks initially. After 6 years of follow-up 308 women developed heart attacks. An analysis showed what the risk factors were for those who developed heart attacks. Those who did not have these risk factors reduced their risk of getting a heart attack by 92%. What lifestyle factors were protective? Four factors were identified: a low-risk diet (consisting of high vegetable and high fruit intake, whole grains, legumes, fish and moderate alcohol intake), not smoking, walking or biking 40 minutes daily and a low waist circumference.
  5. In 2008 the Harvard University released a study that was a further follow-up of the Health Professional study with more than 43,000 men and also the Nurses’ Health Study with more than 71,000 women. The question here was what would prevent the development of strokes? The investigators found that in both groups stroke risk could be reduced by 50% when the following 5 lifestyle factors were adhered to: no smoking, keep the BMI below 25, exercise at least 30 minutes daily with moderate activity, don’t exceed a modest alcohol intake, have a diet intake in the top 40% of fruit and vegetables and whole grains.
  6. A 14 yearlong study from the Netherlands was published in 2014, where almost 18,000 men and women without heart disease at the beginning of the study were followed. More than 600 heart attacks occurred throughout the study. People who stuck to 4 lifestyle habits reduced their heart attack rates by 67%; if they adhered to 5 lifestyle factors they reduced the heart attack rate by 83%. The 4 initial lifestyle factors were: doing an average of 30 minutes of physical activity per day, eating a Mediterranean style diet rich in fruit and vegetables and whole grains, not smoking and having more than one alcoholic drink per month. This gave you a reduced risk of your heart attack rate by 67%. Add one more good habit: sleep 7 or more hours per night on average. This reduces the risk of you getting a heart attack by 83%!
  7. A Swedish heart study with initially more than 20,000 men was going on for 11 years. There were 5 lifestyle habits the investigators identified as essential to reduce heart attack rates. Unfortunately only 1% of the study group adopted all 5 lifestyle factors, but they dropped their chance of getting a heart attack or dying of a heart attack by 86%. The lifestyle factors were: a diet rich in fruit and vegetables, legumes, nuts, whole grains and low fat; not smoking, moderate alcohol consumption, thin waistline and more than 40 minutes of physical activity.

Preserving health and vitality to prevent unhealthy aging

There is a clear pattern in all of these large studies. A healthy lifestyle preserves your health by keeping your joints and muscles in good working order. Your heart and lungs are staying well conditioned, because you engage in cardiovascular training every day. This keeps your nitric oxide going, which is an important signaling molecule that in turn reduces your blood pressure.

When we remove disabling diseases like strokes and heart attacks and prevent diabetes from developing, life expectancy is increasing. When people remain physically active even in old age, this translates into fewer disabilities and less frailty. Even Alzheimer’s disease is observed to occur less when good lifestyle habits are adhered to.

Prevent Unhealthy Aging

Prevent Unhealthy Aging

Conclusion

The studies cited here show how lifestyle factors can make a significant difference in preventing heart attacks and strokes. In the past even doctors ignored the risk of smoking. A few years back conventional medicine negated that lifestyle factors could make a difference. Now we have more studies than we need to prove that this is so. It is more important that we adhere to as many of the lifestyle factors identified in these studies to make a real difference in our lives. We also need to set an example to the next generation and to our peers. Adopting healthy lifestyle factors has to become a cultural habit for society at large. This will help reduce healthcare costs, but most importantly this will help you and me to live longer, healthier lives.

Apr
02
2016

Women Win Turning Older

Supercentenarians may teach us something about the question “Why do women win turning older”? Supercentenarians are people who are 110 years or older. Presently there are 53 of them distributed over the world, 51 are females and two are males. According to Ben Dulken and Anne Brunet this is not by chance: in other mammal species females often live longer than their male counterparts. They theorize that stem cells live longer under the influence of estrogen and this may be the explanation for the difference. They wanted to answer the burning question: “Is life expectancy linked to gender and stem cells”?

Observations regarding why women win turning older

Ben Dulken and Anne Brunet describe that several pieces of evidence are important to note.

  1. Castrated males, called eunuchs, live on average 14 years longer than the average male.
  2. Experiments with male mice treated with estrogen increased their lifespan compared to untreated male controls.
  3. Neural stem cells (NSCs) and hematopoietic stem cells (HSCs) have estrogen receptors in females. This leads to extra stimuli during pregnancy, but also during the menstrual cycle in women or the estrus cycle in female mammals.
  4. It gets more complicated: There are non-estrogen regulated stem cell niches in the liver, skin and subcutaneous tissue (important for wound healing and resident muscle stem cells, called satellite cells (SCs). For some reason liver regeneration and wound healing, but also healing of muscle injuries in women and female mammals occurs at a faster pace. Scientists still do not have an answer for this. Theories are that perhaps women with their two X-chromosomes are at an advantage compared to males (only one X-chromosome) with respect to certain wound repair mechanisms.
  5. There is the question whether longevity and self-repair capacity would be related, either through stem cell populations (NSCs, HSCs, SCs), other repair mechanisms or tissue proliferation.
  6. There are gender differences in aging patterns of stem cells. For instance studies in dizygotic twins showed that telomere length of blood cells in the female twin was much longer than in the male twin. This is thought to be due to genetic factors other than hormones, but again favoring the female.
  7. A study in males showed that there is an accumulation of damaged DNA in SC’s of muscle tissue with older age that leads to muscle senescence. In older men there is a delayed response to a specific exercise stimulus with regard to the satellite cell division (SC) when compared to the response in young men.
  8. In females estrogen stimulates telomere growth of stem cells (NSCs and HSCs), which prevents premature stem cell exhaustion.

Effects of diet and exercise on life expectancy

The Potsdam study analyzed 4 healthy behaviors in 23,153 German participants aged 35 to 65 years over 7.8 years. They looked for the development of cancer, heart attacks, strokes and cancer as end points. The 4 healthy behaviors were: to be a lifelong non-smoker , having a body mass index lower than 30, performing 3.5 h/week or more of physical activity, and adhering to healthy dietary principles (high intake of fruits, vegetables, whole-grain bread and low meat consumption).

Those who had adopted all 4 healthy lifestyles reduced the development of serious disease by up to 80%. Dr. David Katz delivered a keynote address at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Integrative Medicine: A Bridge Over Healthcare’s Troubled Waters”. He mentioned the Potsdam study. And he mentioned what the new logic of a healthy lifestyle is: a healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age.

Life Expectancy Linked To Gender And Stem Cells

Life Expectancy Linked To Gender And Stem Cells

Conclusion why women win turning older

It seems that women and female mammals are more protected by nature than males. The previously called ”weak sex” is in fact a lot stronger! This may be the reason that among supercentenarians there are only a few males remaining. But we don’t know how many males take the lifestyle factors of the Potsdam study serious. Males who want to age gracefully have to pay more attention to healthy lifestyles. This leads to longer telomeres and this allows for stem cell and somatic cell renewal. There are still many unanswered questions, but life expectancy is definitely related to how well we preserve stem cells throughout our body. This in turn depends very much on our lifestyle patterns.

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Mar
26
2016

Heart Attacks Can Kill

We rarely hear that heart attacks can kill; we are more likely to hear that a person was brought to the hospital with a heart attack. The doctors placed a stent or two and the person left the hospital two or three days later, fully recovered.

What silent changes occur before a heart attack?

A heart attack does not happen out of nowhere. There can be one or several risk factors present before, like smoking, a lack of exercise, being overweight or obese from eating too much sugar, consuming sugary drinks and eating lots of starchy foods. This will have changed the cholesterol fractions with the bad LDL cholesterol being high and the good HDL cholesterol being low. Triglycerides in this setting are also usually high. The end result is that the lining of the body’s arteries, including the coronary arteries are thickened to the point where blood has a harder time flowing through the opening of the coronary arteries. One day the heart muscle reports severe pain from a lack of oxygen and nutrients. There are essentially three coronary arteries that supply oxygen and nutrients to the heart muscle. For details follow this link.

Often people have 50% to 60% of coronary artery narrowing, but do not know about this. There are tests available that a person could do to check the amount of hardening of the arteries (for instance the IMT test, see below).

What happens after stent placement?

The interventional cardiologist inserts a catheter from a wrist artery or elbow artery backwards through the aorta and from there into each of the openings of the coronary arteries. By injecting a dye X-rays can be made that show the condition of each of the coronary arteries. If a blockage is identified, this can be overcome through angioplasty, where an instrument is used to pierce through the atheromatous deposits and reopen the coronary artery. To prevent re-stenosing, the cardiologist places a wire mesh stent that opens up upon withdrawal of the instrumentation. The end result is that the previously closed off coronary artery is fully functioning again and the stent keeps the previously narrowed coronary artery open. The cardiologist may have to place two or more stents during the same procedure.

A 5-year follow-up study summarized the outcome after stent placements in 1095 patients with 3-vessel coronary artery disease. Percutaneous coronary intervention, a fancy name for saying “angioplasty combined with stent placement” had a 5-year mortality rate of 14.6%, 9.2% heart attack rates and 24.4% reoccurring blockages requiring repeat procedures to reopen the coronary arteries. There were 3% strokes over 5 years demonstrating that not only heart vessels, but also brain vessels were affected by the hardening of the arteries.

What is heart failure?

You may think that the heart would now be entirely back to normal. But this is a gross simplification. The heart functions like a pump, and we know that pumps can fail. In the past when the heart stopped functioning, the person would die. This was the case because there was a complete irreversible closure of one or more coronary arteries. As a result the muscle of one part of the heart, typically involving the left heart chamber would stop functioning. This part of the heart is supplied by the left anterior descending coronary artery. The left heart chamber is the main pump that pushes blood out into the aorta and from there through the whole body. We need the left anterior descending coronary artery to be open and supply nutrients and oxygen to this vital heart pump all the time. When there is a 70% to 80% narrowing of this artery and the heart is not yet failing, there can be life threatening irregular heartbeats, called ventricular fibrillation from a lack of oxygen. This makes the heart muscle contractions no longer effective, as they are no longer synchronized making the heart muscle beat as one unit. This causes acute pump failure and the patients dies. The other possibility is that the patient has a massive heart attack that kills a large portion of the heart muscle off (called myocardial infarction or heart attack). If the patient is not lucky to have immediate access to a hospital with an interventional cardiologist waiting for him or her, even angioplasty and stent placement will not revive the dead portion of the heart muscle and the patient will not survive.

Using a echocardiography the ejection fraction can be determined. This is a measure of how well your heart empties with each heartbeat. Normally it would be between 50 and 70. Below 50 indicates that heart failure is present.

Patients who had a mild heart attack may only have an ejection fraction of 40 and get short-winded with mild activity. Other reasons for mild heart failure can be atrial fibrillation, a common chronic condition in older patients where the atrial chamber is not contracting properly, but fibrillating. Another cause can be inadequate treatment of high blood pressure, so the heart muscle has a hard time keeping up the blood flow against an abnormally high pressure gradient.

Many patients who had a heart attack and were quickly treated with angioplasty and stent insertion have had some minor persistent damage to the heart muscle resulting in abnormal echocardiograms with lowered ejection fractions. In the past without the acute intervention they would likely not have survived. Now due to modern medical technology these patients did survive, but they are left with a mild degree of heart failure, as a certain portion of their heart muscle has died off.

What kills the patient with a heart attack?

As explained above, when the heart muscle no longer is able to function as a pump, the patient dies. This can come from irregular heartbeats, particularly ventricular fibrillation that does not respond to emergency treatment with a defibrillator. This is an electrical device that resets  The reason can also be a heart attack that kills a significant part of the heart muscle. Ventricular fibrillation often occurs when not enough oxygen reaches the heart muscle and the special nerves that coordinate that heart muscle fibers to contract as one unit. Regular monitoring of the carotid intimal-medial thickness (IMT) by ultrasound will give a fairly accurate test for coronary artery hardening as the two are closely related.

A patient in danger of getting into trouble can be referred to a cardiologist and angioplasty and stent placement can prevent further deterioration for the time being. It is much safer to do these procedures electively rather than during an emergency when the patient is in distress.

Prevention of heart attacks, any volunteers?

Following the overview above it becomes apparent that prevention to not get heart disease is the best approach with regard to hardening of the arteries. This can be achieved by doing the following:

  1. You must abandon the Standard American diet. This means no processed food, no refined sugar intake, avoid as much starchy foods as possible. Adopting a Mediterranean diet or a DASH diet is a first step. The DASH diet was developed to help patients with high blood pressure to reduce their blood pressure through the use of this diet. Reducing blood pressure will also reduce the risk of heart disease.
  2. Avoid excessive alcohol intake (more than two drinks per day for men and more than one drink per day for women) as the toxic effect of alcohol kills heart muscle cells. This in turn leads to heart failure.
  3. Regular physical exercise will condition your lungs and heart and improve your cardiac output. By having bigger reserves the person becomes more resilient to developing a heart attack.
  4. Increasing your fiber intake to 30 to 35 grams per day using vegetables and fruit and additional fiber supplements. Common fiber supplements consist of psyllium husk and/or others from the health food store. Take it in the morning with breakfast and with lunch. By avoiding extra fiber at dinnertime you sleep better at night. It turns out that fiber intake is very important to lower LDL cholesterol and triglycerides by interfering with the enterohepatic pathway that leads to recirculation of bile salts rich in these fatty substances. The net results are lower LDL cholesterol and triglyceride levels and higher HDL cholesterol (the good cholesterol) levels.
  5. Take some vitamins and supplements. Vitamin B2, B6, B12 and methyl folate will support methylation pathways. Vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2, 200 micrograms per day will remove calcium out of the arteries and transport it into the bones; this effectively prevents hardening of the arteries and prevents osteoporosis at the same time. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control and delay hardening of the arteries; it helps to lower LDL and increase HDL.
  6. Have your hormones checked. Some doctors do not feel comfortable doing this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles. The essential hormones involved in cardiovascular disease prevention are thyroid hormones, sex hormones and in some aging people also human growth hormone.
  7. Once every 2 years it would be good to measure your heart function as is outlined in this blog.
  8. There are many more factors that have been identified by researchers to contribute to hardening of the arteries.  It is useful to read this and think about which of these factors may apply to your case.
Heart Attacks Can Kill

Heart Attacks Can Kill

Conclusion

I have explained that hardening of the arteries is the cause of heart attacks. This is caused by a multitude of factors including sugar and processed food overconsumption, smoking, excessive alcohol intake, obesity, undertreated high blood pressure and diabetes. Simply doing angioplasties and placing stents will not stop the process of what led to the heart attack in the first place. Almost 15% died within 5 years following those procedures and 9% got another heart attack. They did not change their diets and stayed inactive. There is another sad aspect about clogging of coronary arteries: the more coronary artery flow we lose through hardening of the coronary arteries, the lower our ejection fraction of the heart as a pump has become. When we reach the point of less than 50% of ejection fraction, we enter disability country with clinical heart failure, forcing us to wear continuous oxygen masks and being unable to exercise or walk. Heart failure is as deadly as terminal cancer having a very high mortality rate.

Concentrate on prevention now, because heart disease remains the number one killer. Remember that we can largely prevent heart disease when we follow the steps mentioned above!

More info about heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

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Mar
19
2016

Book Review: “Healing Gone Wrong – Healing Done Right”, By Ray Schilling, MD

This book entitled “Healing Gone Wrong – Healing Done Right” (Amazon, March 18, 2016) is dealing with the practice of medicine then and now. Medical errors, false diagnoses and wrong treatments are nothing new in the history of medicine. It happened in the past, and it is happening now. My first book dealt with anti-aging and was entitled “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1 describes that famous people like President Kennedy, Elvis Presley, Churchill, Beethoven or more recently Michael Jackson have something in common: all of them suffered the consequences of blatant medical mistakes. In Beethoven’s time lead containing salves to plug the drainage holes from removing fluid from his abdomen caused lead poisoning. In this chapter I review also how the illnesses of the above-mentioned celebrities were treated, but then ask the question: “What could have been done better to prevent some of the disastrous treatment outcomes?”

Chapter 2 deals with how modern drugs seem to come and go. We learn that twenty-first century medications that are touted as the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation of “improved” arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3 deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but nothing is done about the causes of their illnesses. This is a scary thought.

Chapter 4 asks the question whether we could learn something from these poor health outcomes in the past, so that we will be able to prevent any disastrous outcomes pertaining to our own health care in the present and future. As we will see, the problem today is still the same as it was in the past, namely that many physicians still like to treat symptoms instead of the underlying cause of an illness. Even though Big Pharma has the seducing concept of a pill for every ill, it is not always in your best interest, when these medications have a slew of side effects. “Gastric reflux” means a mouthful of stomach acid. This is a fact the suffering patient knows already! Big Pharma simply offers the patient with the symptom of gastric reflux a multitude of medications to suppress this symptom. But it is more important to dig deeper to find the reason for the illness and treat the underlying cause.

Chapter 5 concentrates on the brain and how we can keep our brains functioning optimally until a ripe old age. This review spans from prevention of head concussions to avoiding type 3 diabetes (insulin sensitivity from overconsumption of sugar). It manifests itself in Alzheimer’s disease. It is a form of diabetes of the brain that leads to deposits of a gooey substance. Prevention of this condition is also reviewed .

Chapter 6 reviews what we now know about how to keep a healthy heart. Certain ingredients are necessary such as regular exercise, a healthy Mediterranean diet, supplements etc. The good part is that what is good for the heart is also good for the brain. You are preventing two problems (brain and heart disease) at the same time.

Chapter 7 delves into the question why healthy food intake matters. Without the right ingredients of our body fuel, the body machinery will not work properly. The Mediterranean diet is an anti-inflammatory diet that is particularly useful.

Chapter 8 talks about healthy limbs, bones and joints. We are meant to stay active in our eighties and nineties and beyond. No osteoporosis, no joint replacements, no balance problems that result in falls! Learn about how to deal with problems like these in this chapter.

Chapter 9 deals with detoxification. What do we do as we are confronted with pollution, with radiation in the environment and poisons in our daily food? A combination of organic foods, intravenous chelation treatments and taking supplements can help us in that regard.

Chapter 10 deals with reducing the impact of cancer in our lives. A lot of facts have come out in the past 10 years telling us that reduction of sugar and starchy food intake reduces cancer. Curcumin, resveratrol and vitamin D3 supplements also reduce cancer rates as does exercise and stress management. All of this is reviewed here.

Chapter 11 checks out your hormone status. Women need to avoid estrogen dominance; both sexes need to replace the hormones that are missing. By paying attention to your hormonal status and replacing the missing natural hormones with bioidentical ones, most people can add 10 to 15 years of useful, active life!

Chapter 12 is refining some of the thoughts about anti-aging. You will learn about the importance to keep your mitochondrial DNA healthy. Apart from that there are ways how to keep your telomeres longer; certain supplements that are reviewed will help. Also your lifestyle does make a big difference in how old you can turn.

Chapter 13 investigates the limits of supplements. Many supplements are useful, but you do not want to overdo it and get into toxic levels. More is not necessarily better!

Chapter 14 reviews an alternative approach to treating ADHD. Attention deficit and hyperactivity disorder has been over diagnosed, has been neglected and has been over treated with dangerous drugs. An alternative treatment plan is discussed, which includes a combination of therapeutic steps.

Chapter 15 gives you a brief summary of the book.

Kirkus Review

Kirkus Reviews reviewed the book on March 17, 2016: “A retired physician details how various preventative measures can fend off disease and disability in this consumer health guide. Schilling (A Survivor’s Guide to Successful Aging, 2014) had a family medicine practice in Canada for many years before retiring. Although Schilling ventures into some controversial territory in his latest book, it’s generally an engaging, helpful synthesis of ideas that draws on reputable research from the Mayo Clinic and other sources. Overall, it serves as an intensely detailed wake-up call to the importance of preventative health. He largely brings an accessible and even-tempered tone to his narrative, warning readers, for example, that preventative health measures can only aid in “a delay of aging, not ‘eternal living.’ ” A thought-provoking, impassioned plea to be proactive about one’s health.”

Healing Gone Wrong – Healing Done Right

Healing Gone Wrong – Healing Done Right

Conclusion

In this book it becomes evident that it is better to prevent an illness whenever possible rather than to wait for illness to set in and cause disabilities or death. You heard this before: “Prevention is better than a cure” or “an ounce of prevention is better than a pound of cure”. I will give an explanation, based on scientific data that there is indeed evidence to support these notions on a cellular level. The mitochondria, the energy packages within our cells, are the driving force that keep people vibrantly healthy well into their nineties. All this can only happen when the mitochondria function properly. If the mitochondria are poisoned and as a result of toxins malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may be confined to a wheelchair. If you want a life without disabilities, a life without major illnesses and enjoy good health to a ripe old age, you are reading the right book.

The book is written in American English.

Available in the US: http://www.amazon.com/gp/product/1523700904

In Canada: https://www.amazon.ca/Healing-Gone-Wrong-Done-Right/dp/1523700904/  

In other countries the book is available through the local Amazon websites.