Nov
16
2014

Smoking E-Cigarettes Of No Benefit

Electronic cigarettes (e-cigarettes) were invented to help people get away from the carcinogenic content of real cigarettes and they were thought to help people in the process to quit smoking as well.

In the October 2014 issue of the BC Medical Journal a review article is entitled: “Electronic cigarettes: Do we know the benefits vs. the risks?” In it Dr. Roy Purssell, the Chair of the Emergency Medical Services Committee in BC, Canada reviewed the literature about e-cigarettes (Ref.1). He pointed out that several studies have shown that the number of cigarettes used may have declined with the use of e-cigarettes, but the quitting rate on e-cigarettes is not higher than when quitting conventional cigarettes.

Why were e-cigarettes developed?

Originally they were marketed as an alternative to cigarette smoking with the thought that they would only contain the nicotine, but not the myriad of cancer producing chemicals. However, studies now show that this is not the case. As explained earlier people use e-cigarettes, but they often still smoke real cigarettes on the side, in effect just reducing the number of cigarettes smoked per day. Says Dr. Purssell: “Reducing the number of cigarettes smoked per day is much less effective than quitting entirely for avoiding the risks of premature death from all smoking-related causes of death” (also based on Ref. 2).

Chemical composition of e-cigarettes

E-cigarettes are battery-operated vaporizers that give you the feel of smoking a tobacco cigarette. The container inside the e-cigarette can be refilled with “e-juice” that can be bought through the Internet. The liquid contains highly concentrated nicotine, propylene glycol, glycerin, and flavorings (you can choose from cinnamon to cherry flavor and more). The liquid is vaporized by a heating element and the vapor is inhaled. No long-term experiments are available at this time with regard to the safety of these inhaled chemicals in humans. Only short-term experiments are behind the FDA’s declaration that propylene glycol would be “generally recognized as safe” (GRAS) as a food additive. But there is still a difference between inhaling and ingesting propylene glycol, and the same is true for glycerin.

The manufacturers of e-liquid (or e-juice) always put this disclaimer on their products: “Warning: Always keep e-cigarette liquid in a safe place and out of reach from children and pets. Nicotine in its pure form is a poison, and can cause harm if ingested by a child.”

Smoking E-Cigarettes Of No Benefit

Smoking E-Cigarettes Of No Benefit

Toxic effects of e-juice (e-liquid)

From September 2010 to February 2014 there were 2405 reports to the poison control centers in the US about e-cigarette exposures. In the month of February 2013 there were 70 calls, in February of 2014 there were 215 calls, a 300% increase.  More than 50% of these cases involved young children.

In BC, according to Dr. Purssell the Drug and Poison Information Centre received 70 calls between July 1, 2013 and June 30, 2014. 50% of these involved children who were younger than 4 years old. There was no case of serious toxicity. If, however, enough fluid is swallowed, there can be deaths from nicotine overdose, particularly in children and in pets. Seizures can be caused by nicotine overdoses and poisoning of the breathing center in the brain stem.

Nicotine is highly addictive. In children and in adolescents nicotine has a negative effect on brain development. Here is a report from the Minnesota Poison Control Center, which reports poisoning incidences with e-juice that was swallowed by young children and it reports also about adolescents who overdosed on e-cigarettes.

It appears that the nervous system is more sensitive for toxic effects of nicotine at a younger age.

Regulations of e-cigarettes

At this point e-cigarettes are illegal because the FDA is still examining the pros and the cons. The situation in Canada is similar: Under the Canadian Food and Drugs Act regulations it is currently illegal to sell e-cigarettes containing nicotine. The international Union against Tuberculosis and Lung Disease has issued a position statement saying that its preferred opinion is to regulate e-cigarettes as tobacco products. The UK will be following this advice.

Dr. Purssell commented: ”This is a reasonable course of action for a product that delivers a highly addictive substance with negative effects on brain development and can cause serious poisoning.“

While the Internet merchants are busy marketing these products, it is important that the legislators around the globe take swift action to draft policies and regulations now to protect children and adolescents.

Conclusion

In conclusion it can be stated that smoking e-cigarettes will not have any benefits whatsoever. Smokers still smoke, as the addictive substance (nicotine) in e-cigarettes undermines their efforts to quit. It may be true that they are not exposing themselves to lung cancers as much as those who puff away on regular cigarettes, but instead their cardiovascular system is exposed to the nicotine that causes heart attacks and strokes. It sounds very sobering that they just traded one cause of  unnecessary death (lung cancer) for another one (cardiovascular disease leading to strokes and heart attacks).

More information on:

1. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

3. Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/stroke-prevention/

References:

1.BC Medical Journal Vol. 56, no.8, October 2014 (www.bcmj.org)

2.US Department of Health and Human Services. The health consequences of smoking – 50 years of progress: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention and Health Promotion, Office on Smoking and Health, 2014.

Last edited Nov. 16, 2014

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Oct
04
2014

The Problem Are Sugar And Starchy Foods

Fareed Zacharia interviewed Chief Medical Correspondent Sanjay Gupta on CNN on Sept. 10, 2014 regarding why sugar is worse than fat.

I like to explain why it is important to rethink the issues of fat, cholesterol, sugar, starchy foods, longevity, prevention of cardiovascular diseases (strokes, heart attacks) and cancer.

I have blogged about this many times before, but perhaps an overview regarding these issues would be in order.

The Framingham Heart Study indicated first that too much cholesterol in our system was a problem leading to heart attacks and strokes (Ref. 3). As more research was done, the reasons for this have become clearer.

1.Liver metabolism

The liver plays a major role in the metabolism of glucose. Digestion of refined starchy foods starts in the mouth where amylase from the saliva digests the surface of the pasta or white bread you eat. The stomach carries on with this process and the job is finished in the small intestine with the help of pancreatic enzymes (Ref.1). This digestive process is so efficient that within 20 to 30 minutes all of the refined carbs from pasta, donuts and bread appear as sugar in the blood stream. The portal vein system that collects the nutrients from the gut delivers all sugar straight to the liver where it is reassembled into glucagon as the storage form in the liver and skeletal muscles. This would all be good, would we have periods of fasting in between our sugar consumption. Periods of famine are no longer part of modern civilization, but consumerism is. Most of the processed food contains sugar and this leads to excess sugar uptake, which has to be processed by our liver. The end result is production of LDL cholesterol, oxidization of LDL cholesterol by sugar and in the process the production of VLDL (=very low-density lipoproteins) that leads directly to deposits in the arterial walls and clogging of arteries. Triglycerides are also produced, which leads to fat deposits (the cause of the obesity wave all around us).

2. Where does the fat that we see around us come from?

In the past we thought that it was from too much saturated fat and cholesterol in the food that would have caused the accumulation of fat and cholesterol in the body. Now we know that this was an over-simplification. In fact more cholesterol and fat comes from metabolized sugar and with a slight time delay also from starchy foods.

Sugar and starchy foods (like pasta, white rice, white bread, potatoes, grapes, honey etc.) get metabolized by your liver into LDL cholesterol, triglycerides, and fat. This does not mean that you should not pay attention to the total fat content and the quality of fats you eat.

3. The finer points about subfractions of cholesterol

You have heard many times about the good (HDL) and the bad (LDL) cholesterol. Sugar and refined starches do not only lead to the production of LDL cholesterol, but also to oxidized LDL cholesterol, which is very aggressive (VLDL=very low-density lipoproteins) leading directly to deposits in the arterial walls and to clogging of arteries. Your doctor can order a detailed lipid profile test, if you belong into a higher risk group to determine your VLDL level.

It may surprise you to read that many of the foods that were demonized in the past 2 to 3 decades like whole eggs; unprocessed grass-fed red meat, coconut oil etc. are now seen to be good for you.

But there are provisos: supplement with molecularly distilled omega-3 fatty acids, have enough vitamin D3, vitamin K2 and calcium in your diet or supplement with these. This will make sure that calcium will leave the blood stream (not lead to arteriosclerosis) and enter into the bones where it is needed for healthy bone structure. The anti-inflammatory effect of vitamin D3 and of the omega-3 fatty acids will prevent arthritis, strokes, heart attacks and cancer.

The Problem Are Sugar And Starchy Foods

The Problem Are Sugar And Starchy Foods

4. Four major conditions causing heart attacks and strokes

According to Ref. 2 only 4 conditions have been proven over the years to lead to serious hardening of arteries causing strokes and heart attacks: dyslipidemia (high triglycerides, high LDL cholesterol and VLDL), hypertension, cigarette smoking, and/or diabetes (Ref. 3). What has not been appreciated until recently is the fact that sugar and refined starchy foods metabolized by the liver are the culprits in causing plaque in arteries as the oxidized LDL cholesterol is aggressively invading the arterial wall and is inflammatory. A total cholesterol level greater than 5.2 mmol/L (200 mg/dL) has been shown to be associated with increased heart attacks and strokes. Ref. 2 also points out that dietary changes; days of fasting and weight loss have all been shown to stabilize and reduce plaque lesions and reduce heart attacks and strokes. It is the rupture of unstable plaques that lead to attraction of platelets and thrombus formation. It is this localized thrombosis that leads to the closure of coronary arteries or brain vessels causing heart attacks and strokes. According to Ref. 2 there are 9 factors that determine whether we get a stroke or heart attack, the four factors mentioned above (dyslipidemia, hypertension, cigarette smoking, diabetes) and abdominal obesity, lack of physical activity, low daily fruit and vegetable consumption, alcohol overconsumption, and a psychosocial risk. This latter factor includes any kind of chronic stress like interpersonal stress at work or home, depression, financial stress, major life events like marriage, death, divorce, and lack of control. Counseling is useful for support regarding psychosocial risk factors. It is significant to note that according to Ref. 2 several studies have shown that 90% of heart attacks and strokes can be prevented by paying attention to these 9 risk factors. Managing stress effectively and seeking professional help for psychosocial difficulties as well as avoiding the  physical health risks will contribute to good allover health.

Conclusion

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats including omega-3 fatty acids. By taking care of the 4 major causes of heart attacks and strokes and also attending to the additional minor contributors mentioned above you will be able to eliminate 90% of the cardiovascular events. As you change these things you will also prevent many cancers as you changed the body metabolism and chronic inflammation has been taken care of as well as I pointed out in several blogs before. Finally, pay attention to stress management. The body and mind work together.

I have discussed all of these items in detail in my book as well (Ref. 3).

More information on high density and low density carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

References:

1.Townsend: Sabiston Textbook of Surgery, 19th ed.,Copyright 2012 Saunders.

2.Melmed: Williams Textbook of Endocrinology, 12th ed.,Copyright 2011 Saunders.

3. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Sep
24
2014

Two Approaches To Heart Disease

Over the years I noticed that there are two approaches to heart disease that people and physicians seems to subscribe to.

1.The conventional approach to heart disease

The patient essentially ignores health advice, may smoke cigarettes and eat in a lot of fast food restaurants. People who do not care about their heart drink sodas, eat lots of sugar, starch and processed foods. They may think that they are invincible. Famous politicians have subscribed to this type of approach including former vice president, Dick Cheney.

But the big surprise comes when acute chest pain hits and an ambulance has to be called. We are lucky in the industrial countries where a 911 service is available. You call that number when in distress and an ambulance with all the modern equipment will rush to you. The problem though is that you have neglected your arteries for all those years and it is likely that one or two of the three coronary heart vessels are severely narrowed so much that your heart reported chest pain. This pain signals that one area of the heart muscle was not getting enough oxygen and nutrients.

On arrival at the hospital the emergency physician sees you. Nurses put monitors up, attach electrodes to you, and IV-lines are put into your veins, just in case things get worse and they would need to give you quick life-saving medicine intravenously. They have also given you an oxygen mask, and after 30 minutes or so you feel much better. A cardiologist has been called in by the emergency physician and will assess you.

This will very likely be the verdict: “We have to do a coronary arteriogram where I advance a thin catheter through your femoral artery backwards to where the coronary arteries originate from. We can then study each coronary artery separately and determine whether an angioplasty needs to be done.” Upon your questioning he explains that an angioplasty is a procedure where a catheter is advanced through a new clot that often forms during a heart attack and a stent is left behind that will keep the previously blocked off coronary artery open.

Within an hour the procedure will be completed. The cardiologist will explain that he found significant narrowing, such a san 85% narrowing in the anterior descending coronary artery and a second lesion in the right coronary artery with maybe 55% narrowing. He has stented both of these arteries successfully. But he warns you that the stents may close off, if you are unable (or rather unwilling) to change your lifestyle. He also will be very specific with what he meant: Quit smoking immediately, get into a regular exercise program and adopt a strict heart healthy diet like the Mediterranean diet. They would keep you overnight just to observe your heart rhythm and blood pressure. In the morning, if everything is OK he will likely discharge you.

Comment: Unfortunately this scenario is all too familiar to me having worked as a family physician doing my rotations as an emergency physician in a community hospital for 16 years. I found that people tended to NOT think preventatively unless they were forced to. When an acute event like a heart attack happens, a higher percentage of people is committed to prevention, but medical people call this “secondary prevention” as this prevention was only started after a close call. Our sample patient above could have developed a serious arrhythmia (irregular heart beats after a heart attack) and suddenly slipped into a coma and died before the interventional cardiologist could have placed the stents.

Primary prevention is much more powerful and this is what I like to cover next.

Two Approaches To Heart Disease

Two Approaches To Heart Disease (Placement Of Stent Shown)

2. The preventative approach to heart disease

Most people never have to be rushed to the hospital with chest pain. They engage in various ways of “primary prevention”.  So, what exactly is this?

They keep very active, like walking or jogging, dancing, working out in a gym, biking or swimming etc.

They also like a healthier than normal lifestyle: eat at home as much as possible, and many adopt to buy only organic food. Why, you may ask? Organic food does not contain insecticide residues that resemble estrogenic substances (so-called “xenoestrogens” which accelerate hardening of the arteries). But organic food also does not contain GMO (genetically modified food). We know enough about GMO now to indicate to us that autoimmune diseases with inflammation of the arteries and the gut can occur. But the full impact on people’s health will not be known for several more decades. So why experiment with yourself? Buy organic instead. It is known to be safe.

Vitamins and minerals can be very useful supplements that also prevent premature aging of our blood vessels.

Anti-aging research has shown that with aging come various hormone defects. Melatonin is one of the first to go (in your twenties). But melatonin tables that are widely available in drug stores and health food stores can come to your rescue:  3mg of melatonin at bedtime will give you a good night sleep and provide powerful anti-oxidant effects. DHEA is an adrenal gland hormone that can be measured in your blood (or in saliva). In case it is low, it can be easily replaced with supplements. In the 50’s or 60’s women and to a lesser degree men will start to show thyroid under-functions. We call this hypothyroidism. Have your TSH and T4 levels checked and talk to you doctor about whether you need thyroid replacement, if the values are off.

It is somewhat more difficult to explain the rest of the hormones. But you know that women get into menopause and men about 10 to 15 years later will hit andropause, which is the male equivalent of menopause in women.  An easy way to check this out is by doing a hormone panel from just one tube of spit. Yes, it is a saliva hormone panel I am talking about. For women it is estrogen, progesterone, cortisol, DHEA and testosterone that should be analyzed. For men it is testosterone, DHEA, cortisol, estrogen and progesterone. I am aware that these are the same 5 hormones, but I listed them in the order of importance for women and men. In this blog you find more details about bio-identical hormone replacement.

I have followed a primary heart attack prevention program since 2001 and it seems to suit me well.  Just to check things out I had a carotid intima test, which showed no hardening of the arteries. Just two weeks ago my optician took images of the retinal vessels and found hardly any hardening of my retinal arteries. I scored high on a Bruce treadmill protocol in March of 2013 and my lipid VAT values were excellent indicating a low risk for a heart attack.

I have delved into this subject in more detail in my book entitled “A Survivor’s Guide to Successful Aging” (Ref. 1).

Conclusion

Prevention of a disease is always better than curing a disease, this applies to heart attacks as well. While you do something good for your heart, you are at the same time preventing strokes and many degenerative conditions like Parkinson’s disease, Alzheimer’s disease. In addition you also prevent cancer. It really is a good deal!

More information on prevention of heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/prevention-heart-attack/

Reference:

1. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Jul
02
2014

Focus On Health Rather Than Disease

Not too long ago I came across a blog that summarized the “18 Biggest Problems with Modern Medicine”. Although this is a useful list, it occurred to me that these problems could be compressed into about 9 underlying themes. Below I am describing the same type of problems regarding modern medicine in a somewhat abbreviated fashion.

Points 1 to 4 below cover points 1 to 9 of the “18 Biggest Problems with Modern Medicine”:

1. The patient is seen as a complicated machine with parts that could break down. When there is a breakdown of the machinery, symptoms develop, which are quickly fixed with a patented medicine, but without really addressing the underlying problem. 

This type of approach soothes pain, but changes nothing for a chronic illness like MS. Nobody has all the answers to this complicated illness, but we know that it is an autoimmune disease. So it makes sense to avoid foods that could make the patient worse. This is exactly what Dr. Terry Wahls is describing in her YouTube video.

Also, vitamins and supplements for multiple sclerosis that support the immune system would be useful. Vitamin D3 in high doses, but monitoring blood levels by doing 25-hydroxy vitamin D blood tests from time to time would also be useful.

2. A holistic approach to building up health rather than fixing a clinical problem, which belongs to a disease, is not part of modern medicine.

In the past a stomach acid problem was treated with H-2 receptor antagonists like cimetidine or ranitidine. The newer proton pump inhibitors, like omeprazole were added and were supposed to be better in suppressing the acid formation. But they did nothing to cure the ulcer or gastritis problem. The problem often was that chronic stress allowed a bacterium, H.pylori to multiply in the stomach wall causing stomach acid and a burning sensation. This did respond to the antacid medications for a period of time, but came back when the medication was stopped. A simple over the counter licorice compound, called DGL or a simple mastic gum from the health food store can cure the helicobacter infection and cure your peptic ulcer disease without the need for the expensive patented H-2 receptor antagonists or proton pump inhibitors.

Focus On Health Rather Than Disease

Focus On Health Rather Than Disease

3. Everybody with the same disease is treated with the same medical treatment schedule, often agreed on by consensus expert panels. The body’s self-healing capacity or the placebo effect, which is an expression of the same natural healing response, is ignored.

Here is a study that was done on patients with irritable bowel syndrome (IBS) on placebo pills. Placebo pills were 24% more effective than the control group who took no pills in controlling symptoms of IBS. Why not utilize this in conventional medicine?

4. The disease is treated, not the patient; numbers from lab tests count, not clinical signs of the physical examination. What used to be called the “art of medicine” has been abandoned.

The art of medicine is important to establish a rapport with the patient, but also to pick up silent features during the examination that may otherwise be overlooked.

Points 10 to 18 of the“18 Biggest Problems with Modern Medicine” are covered by points 5 to 9 below:

5. Diet, lifestyle, hormone changes (due to chronic stress and older age) are all ignored. If there are the hormone changes of menopause or andropause, only synthetic hormones are given and only for a limited time not exceeding 5 years. Bioidentical hormone replacement invokes butterfly feelings in the physician’s stomach and must therefore be rejected. It’s almost a knee-jerk response. The reason for that is the fear that bioidentical hormones would have the same devastating side effects as the synthetic hormones. However, this is a fallacy, as a young person with fully functioning natural hormones will not come down with nefarious side effects of strokes, heart attacks or cancer.

This link to Dr. Lee’s website explains why bioidentical hormones fit the hormone receptors better than the synthetic concoctions.

6. The thought that the body may have been exposed to toxins (like heavy metals, xenoestrogens etc.) from the environment that are taken up and stored in the body like a sponge and should be detoxified from time to time is foreign thinking to modern medicine except for a small group of dedicated physicians and naturopaths who offer various forms of chelation therapy.

The TART trial has shown that there was a 18% reduction of heart attack rate in the group that received 40 chelation therapy treatments. Chelation therapy can easily be combined with traditional treatment methods, but mostly his option is ignored.

7. Similarly the idea that supplements and vitamins would be essential to support the body in the fight against free radicals that form inside the body every day is not something every doctor will feel comfortable in recommending.

In Ref. 1 (chapter 8) I have cited evidence from a clinical trial that multivitamins elongate telomeres by 5.1% and add 9.8 years of productive life in those who take multivitamins over a long period of time versus those who do not.

8. In the health care industry we are still working in a hierarchical system where the doctor is on top and the patient is on a lower level and dependent. In the future medical system the doctor and the patient are equal partners who try to solve a health problem as a team.

The doctor may have more experience in diagnosing, prescribing and monitoring health problems, but the patient is the one who owns the problem and is encouraged to comply with the prescribed treatment and to report back to the doctor, if there are new symptoms that may lead the doctor to new insights resulting in improving the treatment plan.

9. Big Pharma influences doctors to prescribe their patented medicinesNew drugs and old drugs are sold like the latest invention against the dreaded disease XYZ (you can fill in whatever the diagnosis is). But none of these drugs is effective against a hormone disbalance, stress, a lack of sleep, lack of exercise or malnutrition. The patient’s co-operation is needed to work on these issues.

I have explained in Ref.1 that the metabolic syndrome, which is responsible for much of our modern diseases (diabetes, heart attacks, arthritis, strokes, cancers, Alzheimer’s disease) can be overcome by a combination of steps: paying attention to our food intake, cutting out sugar and high glycemic starchy foods and excessive fats. Regular exercise will help you to build up and maintain muscle mass and at the same time to melt in excessive fat. Yoga, self-hypnosis, meditation and prayer can remedy stress. Bioidentical hormones can replace any hormone deficiencies. Detoxification, vitamins and supplements complete this program, which allows you to successfully age without disabilities. All these steps taken together allow your body to recover and find a new balance where drugs are rarely needed.

Conclusion:

The reason Medicare is so expensive is that life style issues are not often addressed. By only treating symptoms the underlying causes of an illness are not removed. This means that the illness will not be cured. Take for instance heart attacks. If you want to go down the road from angina to heart attack to bypass surgery or stents, you will soon run out of options. The next level of curative medicine approach is a heart transplant after heart attack number 4 or 5. Comprehensive medicine would approach this differently by paying attention to what you eat and motivate you to cut out starchy foods, wheat, and sugar. This would address obesity, which is a problem in many Western countries. You would engage in regular physical exercise. Stress would be overcome in yoga classes or self-hypnosis sessions. Bioidentical hormones would replace your missing hormones based on saliva hormone tests or blood test samples. The heart muscle that has a lot of testosterone receptors would respond to this. As mentioned above a series of chelation treatments to remove heavy metals could also be offered in this combined, comprehensive heart attack prevention program with a reduction of 18% of heart attacks. This all is available now, but regrettably few people make use of it.

References:

1. Dr. Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

Last edited July 3, 2014

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May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

Apr
19
2014

Measuring Your Heart Function

Recently I came across a book by Dr. Steven Masley, cardiologist (fellow of the American Heart Association, see Ref.1). The heart’s function is to pump your blood reliably all your life. It is a complicated organ, but it works well, if we treat it well. Western medicine has taught us that with complicated machinery and tests we can assess how the heart is doing. But until recently there was no reliable easier way to assess our cardiac health function. The purpose of this blog is to summarize a three-pronged approach to measure your heart and blood vessel health. It is described in detail in Ref.1, but I doubt that many people have yet read this important reference book. It is also important to FIRST see your doctor whether you are able to do the Bruce protocol (treadmill test, the third component below). If you neglect to be cleared by your doctor you run the risk of possibly getting angina pains or getting a heart attack.

1. Carotid IMT or carotid intimal-medial thickness test: You measure the degree to which there is hardening of the coronary arteries indirectly by measuring the thickness of the lining of the carotid arteries (carotid IMT or carotid intimal-medial thickness test). Dr. Masley has showed over a period of 10 years and more in many patients at his Health Center that there is a close correlation between the degree of coronary artery hardening and the degree of hardening of the carotid arteries. He stated that his research has shown that “90% of the time, the carotid arteries, the coronary arteries, and even the arteries of your legs all grow plaque at the same time”. The gold standard for checking the condition of your coronary arteries is a heart catheterization as Dr. Masley explains (page 58). But he adds: “IMT testing should be the new gold standard for cardiovascular plaque testing. However, this is not yet the case. Despite its usefulness, 95% of doctors are not ordering this screening test for their patients. You can rest assured that this is a situation I am to change“.

Measuring Your Heart Function

Measuring Your Heart Function

2. A detailed lipid analysis called the VAP test: A detailed laboratory test analyzing your lipid fractions (LDL, HDL, total cholesterol and VAP test). The buoyant HDL fraction, called HDL2 is the key to having a low risk for hardening of the arteries. HDL2 is large, fluffy and is designed to remove garbage from within the lining of the arteries. Also, the cholesterol ratio is another measurement for a low risk for hardening of the arteries when it is less than 3.0. The first two tests assess how much hardening of the arteries there is present and when they are normal, there is a relative reassurance that nothing drastic (like a heart attack or stroke) should happen within the next 10 years provided you keep up a regular exercise program and healthy food intake.

3. Bruce protocol (Treadmill test): The Bruce protocol (treadmill test) is often done by a cardiologists, but can also be done through many gyms, where a trainer with experience in exercise physiology will do it. This functional test measuring cardiac output has been developed many decades back and has withstood the test of time. Here is an overview what this is. As the slope of a treadmill and the speed of the belt are increased, the heart needs to do more work to maintain blood flow to your extremities and vital organs. The trainer or exercise physiologist measures the response of the heart activity in relation to the increase of the exercise load. A complicated formula allows calculating how much your maximal cardiac output is. This test has several variations and can be complicated to understand. Essentially, the higher the numbers you can create, the better. Here is a table with various results of the VaO2max from Bruce protocols and how they are interpreted.

4. Treating abnormalities found with the three basic tests: These are the necessary tools that tell you where you are in regard to your heart function. People with heart failure should not do this third test, because their heart muscle is too weak to sustain this and they would get heart failure meaning that blood gets backed up into the lungs and there could be severe breathing problems leading to a lack of oxygen (anoxia) in the heart tissue, which in turn can cause irregular heart beats (fibrillation of the heart muscle) and a heart attack. Assume that the first two tests were within the normal limit for your age, then the Bruce protocol would give you the maximum heart output at the peak level of your treadmill test. At this point you are measuring directly the cardiac output (in other words what your heart is capable of pumping for you in a certain time unit). This measurement is what physicians call the VaO2 max  or maximal oxygen consumption. This is the best index for maximal heart capacity. If your levels are higher than normal, you have extra reserves with respect to your heart as a pump for times when you need it. If this latter tolerance test shows poor results, it usually means that you were inactive and you would benefit from an exercise program. If the first test shows hardening of the arteries more than is appropriate for your age, you would need to look at your eating habits. At the same time often the VAT values and the cholesterol ratio is off meaning that you are eating the wrong foods and it shows in your blood test results.

5. Advise regarding diet, exercise and relaxation: Dr. Masley’s book has several sections that explain what needs to be done when things are not normal. For instance, the author does not mince words when it comes to eating the right fats and cutting out sugar and starchy foods. For instance on page 199 there is a neat table that lists the fiber content of different foods. We need more fiber to slow down the absorption of sugary substances, which will minimize the insulin response following a meal. Dr. Masley also mentions that omega-3-fatty acids from fish and good seafood choices will balance the omega-6-fatty acids that would lead towards the arachidonic acid pathway, which causes arthritis, inflammation and cancer. There are many more dietary recommendations, too numerous to repeat them all here. Suffice it to say that molecularly distilled omega-3 fish oil, vitamin D 1,500 to 3000 Units daily, and magnesium supplements are all good for you heart. Vitamin K2 gets calcium out of your blood vessels and into the bone (100 micrograms per day). Other worthwhile supplements mentioned in the book are CoQ-10 (50 to 200 mg twice per day), but it would be wise to have blood levels drawn, which should be above 2.5mcg/ml to which the CoQ-10 intake could be titrated. Curcumin and Resveratrol are also recommended. Most of all, it seems that regular physical exercise such as a balanced gym program is the single most effective way to reverse hardening of the arteries as measured by the carotid IMT testing.

Conclusion: Times have changed. It used to be thought that our lives were following a one-way street downwards. During periods of malnutrition, lack of exercise, being sessile and abusing alcohol and drugs this may well be the case. However, we now know that this is reversible. Change to healthier food, start smoothies with organic vegetables in a mixer, get going and walk. Jog or use a gym to get regular exercise. Physical exercise reverses the fat deposits inside the lining of the arteries. The HDL-2 fraction rises and helps counteract the elevated LDL cholesterol. Even the mood of the person who exercises regularly becomes more stabilized. Using these simpler three tests the physicians will not need the more complicated Thallium heart scans, heart catheterization etc. These three tests described above are well worth being done every two years, so that you can monitor what’s going on with your heart and blood vessels in general. What questions do you have? You could ask them below.

More information on heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

References: 1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014.

Last edited Nov. 8, 2014

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Jan
25
2014

Live Your Best Life

While attending the 21st Annual World Congress on Anti-Aging, Regenerative & Aesthetic Medicine the audience was treated to a magnificent speech by the keynote speaker, who you all know from the TV show  “The Doctors”, namely the ER-doctor, Dr. Travis Stork.

He said that there are 4 main ingredients that are necessary to live the “best of your life”.

1. Healthy living starts in the kitchen

You want to make sure that you leave out unhealthy foods. This includes that you also need to cut out sugar. Be aware how important protein is, so you need protein with each meal. This includes legumes, fish, chicken, turkey meat and others. Saturated fat is essential, can improve your health and makes you feel full, but stay away from unhealthy, sugary snacks.

Snacks do not harm your health, but they must be healthy ones like nuts three times per day. To include nuts three times per day lowers your risk of dying by 39% and your rate of heart attacks by 52%.

In order to prove a point about cutting out junk foods, the TV producer convinced Dr. Stork to go on a junk food diet for 7 days to see what would happen. He gained 8 pounds after 6 days, his mood was getting subdued and he started to look forward to his next meal as if he was addicted to the junk foods. But suddenly he could not take it anymore and was concerned about getting sick from this experiment (rightfully so). He told his producer that he had to stop this experiment. He explained that most of his fat accumulation was happening in the abdominal area (visceral fat) and he showed a video that illustrated this further. He explained that the visceral fat is metabolically very active, produces inflammatory agents and causes changes in the heart vessels that eventually lead to heart attacks and strokes.

Live Your Best Life

Live Your Best Life

2. “I need you to start working out!”

We were designed to get moving. Our ancestors were gatherers and hunters, so they were constantly on the move. Our genetics have not changed, but our lifestyle habits are far removed: the sessile habits are not suiting us well healthwise. Translated into modern life this means: sit less; do gardening; use pacing as a technique to move when you are on the phone. Take the stairs instead of the elevator; walk (a minimum of 30 minutes three times per week). Personally, I like to add that our body never takes a holiday, so I think we should exercise 7 days per week.

3. Mind and body are connected

Stress can ruin your health. Happy people are 50% less likely to die prematurely. Laughter heals. A funny video was shared with the audience where a parent ripped a piece of paper into smaller and smaller pieces and the toddler watched with glee and laughed every time when the paper was ripped into two smaller parts. A service dog can be a great companion for disabled individuals, but pets have a positive impact on the health of any individual. They can be of help to reduce stress.

It is known that mind and body are connected. As a result, if your mind and body are balanced, your hormones get balanced and this helps to keep your metabolism in check. If your metabolism is balanced, you will avoid getting diseases like heart attacks, strokes, arthritis, and even cancer.

4. Make sure you get enough sleep

40% of people do not get enough sleep. You can change your sleep behavior. How do you do it?

a)    Have a consistent bedtime/waking time. Set your alarm clock to the same time every morning. Aim for 7 to 8 hours of sleep per night.

b)    Avoid late night caffeine as it prevents a good night’s sleep.

c)    Get active throughout the day; this will prepare you to get tired in the evening.

d)    Towards the end of the day have a to-do-list ready for the next day. This prevents tossing and turning and thinking about what you want to do the following day. You know that it is all written down on the list, so you can relax and get to sleep.

e)    No bright lights in the bedroom, no bright alarm clocks, no control lights of electronic gadgets and have light-blocking window coverings in place. Do not have a TV in the bedroom, also no cell phone, and stay away from the computer for 1 hour before your bedtime.

After you re-programmed your body and mind to a regular sleep rhythm, you automatically get tired when you should and your hormones and body chemistry find a new balance, which contributes to good health.

Dr. Stork stated that we all need to prevent disease. We do this by making health our hobby. There is no need to be obsessed about it. “Just live your best life!”

Conclusion

I summarized Dr. Stork’s presentation from the anti-aging conference, as it struck me how simple it really is to live a healthier life. If we all follow these simple steps, we are a long way into anti-aging, because it gives us the footing we need to further refine it from there.

In many previous blogs I have mentioned these 4 factors that are needed to slow down aging. However, there are other factors that may be needed like bioidentical hormone replacement when there are hormone deficiencies; detoxification, if there is evidence of toxicity; and vitamins and other supplements. Anti-inflammatory and antioxidant vitamins and supplements like CoQ10, vitamin D3 and omega3-fatty acid/DHA supplements are needed to keep LDL from getting oxidized as this is the reason why people die of heart attacks and strokes and get cancer.

I have recently written a book entitled “A Survivor’s Guide To Successful Aging” (being published at Amazon.com in March 2014), which explains the science behind why it is important to cut out sugar and starch. Sugar and starchy foods are the foods that oxidize LDL cholesterol, and ultimately it is the oxidized LDL cholesterol that causes deaths from heart attacks and strokes. In this text I have explained how proper nutrition, exercise, hormone rebalancing, supplements and lifestyle changes will allow you to prevent the major illnesses from setting in thus extending your life expectancy considerably. Included in the book is a chapter (written by my wife, Christina Schilling) that contains 7 days of recipes for breakfasts, lunches, dinners and desserts as well as snacks.

Last edited Oct. 25, 2014

Jan
18
2014

The Super Powers Of Vitamin D

Originally, when vitamin D was found to be the missing ingredient in preventing rickets in growing children the recommended daily allowance (RDA) to prevent rickets was found to be 400 IU of vitamin D. The active metabolite has been identified as vitamin D3 for which the body has receptors on all vital organs (heart, brain, bones, kidneys, liver). In recent years new insights have been gained as it turns out that the RDA’s were set much too low for many diseases that can develop when vitamin D intake is too low, particularly in the aging population. Higher doses of vitamin D3 in the range of 800 to 1000 IU per day have been shown to prevent osteoporosis, falls and fractures in older adults and in nursing home populations. But the immune system of everybody is dependent on higher doses of vitamin D3. Recently (Dec. 12 to 15, 2013) I attended a lecture at the A4M conference in Las Vegas where Dr. Eisenstein reviewed the latest on vitamin D3. It is now known that 2/3 of the US population is deficient for vitamin D as measured by blood tests (less than 25 ng/ml).  The standard test is the 25-hydroxy-vitamin D level (abbreviated as 25(OH)D level). It is now known that you require at least a level of more than 40 to 60 ng/ml of 25(OH)D as measured in the US, which translates to more than 100 to 150 nmol/L measured in metric units in other countries, to prevent cancer.

The Super Powers Of Vitamin D

The Super Powers Of Vitamin D

Metabolism of vitamin D3

90% of the vitamin D3 that we need comes from exposure to sunlight, which transforms a cholesterol metabolite (7-dehydrocholesterol) into the vitamin D precursor (vitamin D3 or cholecalciferol). This is what we absorb from naturally occurring fish oil and oily fish, but otherwise this does not naturally occur in foodstuffs (Ref. 1). Dr. Eisenstein pointed out that it is well known that people living north of the 37th degree latitude lack vitamin D3 because of a lack of sun exposure, particularly in the winter season. People south of the 37th degree latitude have enough sun exposure, but wherever you live, it is advisable to have your vitamin D3 level measured (as 25(OH)D level). If you do not eat enough fish or fish oil, the levels likely are too low as is the case for 2/3 of the US population. Vitamin D3 supplements will have to be taken by those whose levels are too low. Vitamin D3 is further metabolized by the liver and then by the kidneys into the active vitamin D compound, called 1,25(OH)2D3 (which is called “calcitriol”). The main effect of calcitriol is to absorb calcium and phosphate from the intestine into the blood stream. Together with vitamin K2 as explained in a prior blog these minerals are then taken up by the bone to prevent osteoporosis or rickets in the growing child. What has not been known for a long time is that vitamin D3 is also necessary for normal cell metabolism by most of your body cells, but particularly by the vital organs like the brain, the heart, the kidneys, the liver, the immune system and the bone. However, doses of 5000 IU to 10,000 IU of vitamin D3 capsules per day are required for optimal vitamin D3 health. This will lead to levels of below 200 ng/ml of 25(OH)D levels, which have been proven to be safe. According to Dr. Eisenstein no toxicity has been found below 30,000 IU of vitamin D3 per day, but based on other authors a dose of 10,000IU should be adequate for most people. Strangely enough colored people also have to take vitamin D3 supplements as their the higher melanin pigment in the skin filters out UV light so effectively that their 25(OH)D level can be low. Always err on the cautious side and have your vitamin D3 blood level taken.

Vitamin D3 has a characteristic stereotactic configuration (cis-triene structure), which allows it to bind free radicals and function as an antioxidant (Ref.2).

What are some of the clinical effects of vitamin D3?

1. Vitamin D3 has diverse effects on organs systems as Dr. Eisenstein summarized: vitamin D3 lifts depression and has been found to be of particular value for drug resistant depression. Take 5000 to 10,000 IU of vitamin D3 per day.

2. Muscle power increases with vitamin D3, particularly in those who work out regularly.

3. Many fertility clinics pay attention to vitamin D3 levels, as the higher the blood levels of vitamin D3 in a man, the faster this sperms move! And the more vitamin D3 she has on board, the better she ovulates. The end result is a higher pregnancy success rate when both partners take 5000 to 10,000 IU of vitamin D3 per day

4. Also, if a woman takes vitamin D3 during her pregnancy, the first set of teeth in the offspring will have fewer cavities.

5. Brain development in autistic children is much improved with vitamin D3 in higher doses. This needs to be combined with detoxification methods and supervised by one of the DAN physicians.

6.Chronic pain typically improves when vitamin D3 deficiency, which almost always is present in patients with chronic pain, is treated with vitamin D3 supplementation.

7. To prevent flus and colds and other infectious diseases, take higher doses of vitamin D3. When you come down with a flu, it is safe to increase your daily vitamin D3 intake to 30,000 IU of vitamin D3 for a few days until your symptoms improve, then resume your maintenance dose of 5000 IU to 10,000 IU per day.  This year’s dominant flu is the type A, subtype H1N1 – also known as the swine flu. Children should get 50% of the dose regimen detailed for adults when they develop a flu (for children: 15,000IU for three to five days , with tapering to a maintenance dose of 2500 to 5000 IU until blood levels of 25(OH)D are available). Here is a website of Dr. Cannell where he discusses dosages as well.

8. Asthmatic patients do better with vitamin D3 supplements requiring less maintenance anti-asthmatic medicine to keep them balanced with regard to their airways.

9. Chronic low vitamin D3 levels cause brain damage including Alzheimer’s disease. In this context it is important to know that the enzymatic conversion in the liver and kidneys slow down as we age requiring higher doses in older patients. This may have been the reason for the confusion about relatively low doses of 400 IU of vitamin D3 preventing rickets in children versus the need of vitamin D3 in middle aged and older patients where much higher doses are required as already explained.

10. High blood pressure is linked to vitamin D3 deficiency and it is better manageable with medication when vitamin D3 levels are normalized.

11. Live longer with vitamin D3. How is this possible, you might ask: the answer has been found in the telomeres, the shoelace like structures at the end of the DNA strand of each cell. Vitamin D3 lengthens the telomeres and promotes telomere repair; this is associated with a longer life span. Centenarians have longer telomeres. You can measure telomere length, but it is a pricey test, which is not for everyone, contrary to supplementation with vitamin D3 that should be taken by everyone!

12. As already indicated, vitamin D3 strengthens the immune system, but it also modulates the inflammatory response from muscle damage, so athletes can perform better. Patients with multiple sclerosis will improve as it slows down the inflammatory process. But other inflammatory diseases like arthritis, inflammatory bowel disease and even cancer will respond favorably to higher doses of vitamin D3 (20,000 to 30,000 IU of vitamin D3 in these cases). This is information that has not yet percolated into mainstream medicine, but will do so in the next few years (or decades?).

13. Higher percentages of cardiovascular disease are found in patients who have lower than 15 ng/ml  25-Hydroxy- vitamin D3 levels in their blood meaning that vitamin D3 supplementation prevents heart disease (Ref.3).

What are toxic vitamin D levels?

What is known about the safety of vitamin D3, particularly the higher vitamin D3 doses? First, it is wise to have your 25(OH)D blood levels taken from time to time. If any of these levels exceed 200 ng/ml it would be prudent to reduce the vitamin D dose or stop supplementation for a while. Otherwise it has been difficult to establish a toxic range.

This website claims that 40,000 IU of vitamin D3 or more would lead to toxic levels where the blood calcium levels would be increased, which can be measured as hypercalcemia. However, another study done in 2007 showed in MS patients that took 40,000 IU per day and that led to a blood level of 400 ng/ml of 25(OH)D did not lead to increased calcium levels and did not lead to hypercalciuria (too much calcium in the urine). So, all of the papers that either indicated to the public that it would be unsafe or unnecessary to take vitamin D3 seem to have other agendas than communicating the truth. Had it been true that calcium would be released from the bones or calcium were absorbed too much from the gut, this would have caused calcification of the bones, soft tissues, heart and kidneys. Also, kidney stones would have developed. However, a low calcium diet combined with corticosteroid drugs usually leads to a full recovery within a month. Interesting that all of the dire predictions regarding toxic vitamin D3 levels did not materialize. Here is another website discussing vitamin D3 dosing.

I talked to a participant of the conference (who has a fellowship degree of the A4M) about what is really known about vitamin D3 toxicity. He told me that there has been an unintentional overdose where a compounding pharmacy made a mistake, so that a patient accidentally received a dosage of 500,000 Units of vitamin D3 per day for a full three months, before the mistake was uncovered. The patient felt sluggish, but did not have any other symptoms. He was told to stop the vitamin D3 compound. He had an uneventful recovery with no detrimental effects. At this point no overdose of vitamin D3 has been established.

Conclusion

Vitamin D3 is a vital supplement that has been shown to prevent not only rickets in children, but also depression, MS, infections and even many cancers (Ref. 4). As usual there will be many critiques that doubt the validity of the above statements. But I have found that all of these effects described above were confirmed in several sources of various medical information. Keep in mind that negative rumours have a tendency to linger on for years.

More information on vitamin D3 for prevention of osteoporosis and hardening of arteries: http://www.askdrray.com/calcium-vitamin-d3-and-vitamin-k2-needed-for-bone-health/

Vitamin D3 deficiency can cause pancreatic cancer: http://nethealthbook.com/news/insufficient-vitamin-d3-linked-to-pancreatic-cancer/

References

1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed.,  © 2011 Saunders

2. Rheumatic Diseases Clinics of North America – Volume 38, Issue 1 (February 2012) , © 2012 W. B. Saunders Company

3. Wang TJ, Pencina MJ, Booth SL, et al:  Vitamin D deficiency and risk of  cardiovascular disease.   Circulation 117. (4): 503-511.2008.

4. “Recognition and Management of Vitamin D Deficiency”: American Family Physician – Volume 80, Issue 8 (October 2009),  © 2009 American Academy of Family Physicians

Last edited Nov. 7, 2014

Jan
11
2014

From Inflammation To Heart Attacks, Strokes And Arthritis

Have you ever wondered why people who limp from arthritis in their hip also often get heart attacks? And have you ever wondered why people with high blood pressure get strokes and/or heart attacks?

It is not that difficult to understand, although many people do not like to hear the truth.

After the holidays with lots of sweet presents and rich food it is a good time to reflect about the internal connections between our organs.

Let’s follow what foods can do to our system, then you will understand what to do to get out of a trap, where food is not friendly but damaging to your body.

1.    Sugar, omega-6 fatty acids and trans fats enter your system

When you opened the cheap chocolate bars, ate the pastas, the turkey gravy and the ice cream for dessert, your stomach faithfully digested all that food and broke it down into glucose (a simple sugar), omega-6 fatty acids and highly reactive trans fat with free radicals (from deep fried foods, margarine, shortening, pie crusts, cake mixes, frostings and non dairy coffee creamers just to mention a few).  Within ½ hour the sugar molecules from the digested meal will enter your blood stream.

2.    The metabolism sets in

We know from years and years of research that the glucose in the blood triggers the release of insulin from the pancreas, which facilitates absorption of sugar into your liver and muscles where it is stored as glycogen. This is meant to be a storage form of sugar, just in case you do not eat for a few hours, but need energy to burn for your physical activity. When you have saturated the glycogen storage in liver and muscles, your liver metabolizes sugar into fatty acids and triglycerides. There is the transport LDL cholesterol that is supposed to supply the brain and heart with healthy cholesterol for these organs to replace cell membranes. Instead, the LDL cholesterol that is supposed to be balanced by the protective HDL cholesterol gets oxidized from the extra sugar and from the free radicals of the TRANS fats that are now being outlawed by the FDA for exactly that reason. So, the oxidized LDL cholesterol turns into the vicious VDLDL particles, which can be measured as a special blood test by your doctor. The overabundance of omega-6 fatty acids start an internal fire by stimulating the arachidonic acid pathway, which causes inflammation in your arteries, your joints and your immune system.

From Inflammation To Heart Attacks, Strokes And Arthritis

From Inflammation To Heart Attacks, Strokes And Arthritis

3.    The consequences of eating foods which spike your blood sugar levels

The end result is hardening of your arteries and the beginning of arthritis in your joints. Mind you, this does not happen overnight, but when you eat this way decade after decade it takes its toll. Typically in your forties or fifties you will notice some swollen knuckles. Don’t just let this happen. Think that this is a sign that something is festering in you! If you don’t interfere, there could be one wrong move, when you play sports and a meniscal tear in your knee could put an end to the fun. Sure, you will find a reason that the angle of your jump was unfortunate and this was simply enough for your meniscus to tear. But could it be that there were inflammatory changes in your meniscus long before this incident, the meniscal material softened up, dried up because of a lack of proper nourishing synovial fluid? I found when I was in primary care practice that this was what caused the majority of meniscal tears. A normal meniscus does not tear easily, but decades of malnutrition will lead to these hidden changes, where a meniscus can be softened and is prone to damage without a warning.

Arthritis in your joints is similar to the process of what I described regarding meniscal degeneration. An imbalance of the omega-6/omega-3 ratio where people take in 12 to 16 times as much omega-6 fatty acids from processed food compared to omega-3 fatty acids from fish oil or fish consumed, causes inflammation of the joints via the arachidonic acid metabolism.

What about the arteries? It is no secret that many people in their 60’s have suddenly an episode of chest pain that leads to a referral to a cardiologist who will do a heart catheterization. A stent or two may have to be placed because of hardening and narrowing of the coronary arteries. In many trials where people with coronary artery disease were followed laboratory tests showed that these individuals had low 25-hydroxy-vitamin D levels in their blood and the calcium that was meant to make their bones strong, ended up in the arteries. Vitamin K2 is often also missing because of malnutrition.

People with high blood pressure often do not have enough nitric oxide production from their arteries, because they do not eat enough vegetables, they are too sessile and they eat too many sweets and starchy foods. As a result  the liver overproduces triglycerides and fat, and oxidized LDL cholesterol damages the lining of the arteries. Just treating high blood pressure with blood pressure lowering medications will not correct the underlying metabolic disbalance. This is why people who had 2 or three stents for coronary artery hardening will come back 5 or 10 years later and need more stents until they die of a full-blown heart attack. You must stop the underlying metabolic derangement, if you want to prevent further deterioration.

4.    Inflammation takes its toll

But what do the lining of the arteries, the inflamed joints, a degenerative meniscus and heart attacks and strokes have in common? It is the INFLAMMATION that changes the body chemistry. It gets even more complicated, because the extra calories that we consume get stored as visceral fat. This is done automatically when you eat too much sugar and starchy foods as you may have done over the holidays. Remember, our ancestors were hunters and gatherers, and our genetic make-up is still the same. So, when the glycogen stores are full, any surplus sugar gets metabolized by the liver into triglycerides, fatty acids and LDL cholesterol and gets stored as body fat. The most active fat is the visceral fat between our guts and around our body organs. This produces interleukins and other inflammatory cytokines that circulate in the blood causing inflammation in all our arteries.

This is the link between the various manifestations of inflammatory conditions in our bodies. We rarely think of all of these various conditions as being linked. We concentrate on each disaster as it strikes, but think that it is only a one-point-in-time event. We do not see the years of abuse of our bodies that have preceded any of these events.

5.    Disaster strikes in different ways

We usually hear about a person who just got a heart attack. Now it is an emergency!  Nobody thinks about the years of inappropriate food intake and the lack of exercise that led up to this heart attack event.

The same is true for a sudden stroke. The patient arrives at the hospital in an ambulance and cannot move one arm and one leg. Initially the patient may be unconscious. There is too much action required by the emergency personnel to ask the question why it had to come to this. The truth though is that the blood vessel deterioration in the brain vessels that led to the stroke have quietly happened years before the acute event.

And then there is the aging 75-year-old man with a stiffening hip and arthritis in the hands. The inflammation has been quietly developing in the synovial membranes of the joints for more than a decade. The patient probably swallowed anti-inflammatory medications for years for arthritis symptoms, which as you guessed has not changed the underlying biochemistry. But now it has come to the point where a total hip replacement is required, just to be able to continue to walk. I have experienced that scenario in the hospital setting many times. Many patients went through the total hip replacement surgery with no problems. But other patients had their total hip replacement done and they developed a heart attack under the general anesthetic, because unbeknown to the orthopedic surgeon the patient also had severe hardening of the arteries that had not shown up on the pre-surgical electrocardiogram. A stress test or a Thallium heart scan when the patient still could exercise would have shown this hidden cardiac condition before the surgery, so that a cardiologist could have addressed this condition before the surgery. After that the total hip replacement would most likely have been uneventful.

6.Prevention is the key

The lesson to be learned from all of this is: prevent these disasters from happening in the first place. Do the following:

1) Good, balanced nutrition

2) Regular exercise.

3) Take vitamins and mineral supplements for bone health.

4) As you age, have your hormones measured and replace what is missing.

5) Avoid toxins. Use detoxification.

6) Avoid junk foods.

I have covered these topics in many blogs before as indicated in the above links.

Conclusion

Health disasters are mostly not accidental, but are rather caused by not paying attention to the silent metabolic changes based on improper nutrition and a lack of exercise, which could also be termed as a lack of prevention. It takes some time, often even some suffering to understand the deeper meaning of what I discussed above (that prevention is much more powerful on the long-term than curative medicine). I speak from experience having worked in the medical field for more than 30 years. Curative medicine will take care of an emergency, but the underlying inflammation and metabolic derangement will persist, if this is not changed through the steps mentioned above. Treat inflammation and LDL oxidation by modifying your lifestyle. Think prevention!

More information on inflammation medicine: http://www.askdrray.com/chronic-inflammation-causes-cancer-heart-attacks-and-more/

Last edited Nov. 7, 2014

Jan
04
2014

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

Here are impressions from the 21st annual world congress on anti-aging medicine (A4M) in Las Vegas. Every year in mid December Vegas hosts the world A4M conference (from the American Academy Of Anti-Aging Medicine). It took place at the Venetian/Palazzo Resort in Las Vegas, NV from December 13th to 15th, 2013.

There were more than 3,500 attendees who participated in this yearly continuing medical education event in preventive and integrative medicine. Over 50 speakers reviewed various anti-aging topics including aesthetic medicine and stem cell topics. There was also a huge exhibition with over 300 exhibiting companies of health related products and books.

I attended this conference to see what is new in anti-aging medicine. This is the focus of my interest since my retirement in 2010.

Here are some highlights from the conference. I simply present a potpourri of snippets, all of which have some usefulness.

1. Opening remarks by Dr. Ronald Klatz and Dr. Robert Goldman

Dr. Klatz pointed out that the A4M has been very active over the years in lobbying for making supplements more available to the public. In 1995 the A4M was defending melatonin as a harmless sleep aid.  The FDA agreed to allow it to be freely available in health food stores. In 1996 DHEA followed this trend. The A4M exerted pressure on the FDA to allow the sale of Co-Q10 in health food stores. Co-Q10 is an important cardio protective supplement and it became available in health food stores in 1998.

Insulin an aging substance

In 1999 the A4M stated in a public statement that insulin levels matter in obesity and diabetes. Newer research had confirmed this, and insulin is an important aging substance. Those who continue to have high fasting insulin levels, will age faster than the average population. But those who lose weight and exercise will reduce fasting insulin and will no longer age prematurely. The reason for this is that inflammation is the cause of high blood pressure and of cardiovascular disease. This means that heart attacks and strokes are due to the end stage of chronic inflammation in blood vessels.  Reduce or eliminate fasting insulin, reduce inflammation in arteries and you eliminate the risk for heart attacks and strokes.

Stem cells

In 2004 the A4M announced that stem cells could be an important treatment tool. It would allow to treat various end stage diseases so people could live longer. Since then this has become a huge specialty area. There was also a separate pre-conference workshop on stem cells. In 2009 the A4M announced that vitamin D3 was effective beyond bone health. Every cell in the body contains vitamin D receptors.

Adequate vitamin D3 intake

Originally the recommendation was to use 400IU per day  to fight rickets in infants. Now the guidelines have changed that 4000 or 5000 IU of vitamin D3 are necessary every day. This will take care of the multitude of normal body functions. People with the poorest lifestyles have the shortest life expectancy, 66.5 years in Native Americans of South Dakota.  In contrast Asian American women in New Jersey with 91.8 years have the longest life expectancy in the US. It just so happens that in New Jersey most of the 26,000 A4M physicians are practicing. This may be one of the reasons for the impressive longevity figures.  Dr. Katz suggested that we should recommend the following website to people: http://www.worldhealth.net/  This is the official medical news website of the A4M and deals with the latest health recommendations.

Early detection of deficiencies from blood tests

Dr. Goldman added to this that the anti-aging industry is growing rapidly (0$ in 1991; 250 billion $ in 2012; an estimated 345 billion $ in 2018).

He also emphasized that anti-aging treatment is only possible with early blood tests. They will detect any hormone or chemical abnormalities. It is possible to detect the beginning stages of any disease before permanent organ damage sets in. Only with early detection can effective anti-aging treatments be initiated. Prevention is always better than waiting for an emergency to occur. Unfortunately this is what is done in the conventional medical system.

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

2. Hypertension diagnosis and treatment

Dr. Mark Houston (Nashville, TN) talked about new and revolutionary concepts in treating and diagnosing hypertension (high blood pressure). Endothelial and vascular muscle dysfunction are now in the center of the researchers’ attention. The reason for blood pressure to get elevated is from a combination of inflammation, oxidative stress and autoimmune dysfunction of the vascular system. Decades before the blood pressure shoots up, there are vascular and heart abnormalities. 24 hour ambulatory blood pressure monitoring (24hour ABM) is the most reliable test for assessing blood pressure.

Among other things a micronutrient test was suggested as this way a lack of magnesium could be detected. Too little magnesium in the blood has to be treated with magnesium citrate supplements.

Current treatment of hypertension

In terms of treatment it was interesting to note that diuretics and beta-blockers are no longer recommended, because of serious side effects. Instead of these medications the treatment of choice now are calcium channel blockers (Diltiazem etc.) and angiotensin II receptor blockers (Losartan etc.).

3.  Testosterone therapy in men

This was the topic of Dr. Abraham Morgentaler, a professor of urology at Harvard Medical School. He went through various literature citations that showed that there is no relationship between testosterone or DHT (de-hydro-testosterone) and prostate cancer. In a New England Journal of Medicine publication Dr. Morgentaler has shown by doing extensive prostate biopsies on men with or without prostate cancer that testosterone treatment did not cause prostate cancer or make prostate cancer worse. He found that testosterone treatment invariably made men feel better, and they had more energy using testosterone. They also lived longer. He also debunked a recent JAMA publication from November 2013 that stated testosterone replacement would have led to increased heart attacks.

False data about heart attacks

He explained that he called the editor after calculating the raw data and coming to the conclusion that the authors had miscalculated and misrepresented the data, as the risks of heart attacks in men using testosterone were actually half of what the controls without testosterone replacement showed. However, the editor elected to keep the false data in the publication, which has caused confusion with the public and with the medical profession. Here is another rebuttal by Dr. Trutt who came to the same conclusion.

Testosterone replacement cuts heart attack rates

Fact is and this is in agreement with many other medical publications in the US, Europe and around the world that testosterone replacement (with bioidentical testosterone) in a testosterone deficient man will cut the risk for heart attacks and strokes into half of what it would be if he did not replace with testosterone. However, only bioidentical testosterone will show this heart and brain saving effect, as there is a key/lock mechanism between bioidentical testosterone and the testosterone receptors of heart and brain cells and the testosterone receptors in the arterial walls.

4. Keynote speaker

Suzanne Somers was the keynote speaker on the first day of the conference in a talk entitled “Our time has come”. Her books have greatly contributed to the popularity of the anti-aging movement in North America and around the world. She described how important it was for her to take charge of the health care in her own case and to explore alternatives to treat her breast cancer in the past. She allowed a lumpectomy, but she refused chemotherapy which conventional medicine wanted to force on her. Instead she changed her lifestyle completely as summarized in her books, particularly in “Breakthrough”.

Mesenchymal stem cell/fat transplant

She also became one of the pioneers in the US to get the newly FDA approved mesenchymal stem cell/fat cell transplant done on the affected breast to restore the pre-surgical appearance. She made a plea to those who can afford it to bank their stem cells, which was later reiterated by Dr. Terry Grossman, MD whose lecture I did not review here. I noted this key sentence in Suzanne Somers’ speech towards the end: “I work prophylactically to take care of my health”. How often have I wished in the past that every one of my patients would have this attitude!

5. Hormone testing and nutrition

Jim LaValle, an adjunct professor in the College of Pharmacy, University of Cincinnati has more than 27 years of clinical experience in the field of natural therapeutics and functional medicine. He mentioned that many people are toxic from a leaky gut due to faulty nutrition, which in turn will lead to heart disease and kidney disease. Once a patient has heart failure, a leaky gut will make the heart failure worse. Leaky gut leads to multiple autoantibodies, which causes various autoimmune diseases.

Neuroplasticity in the brain

He also stated that neuroplasticity in the brain can restore people’s brain after brain injuries or when autoimmune diseases have attacked the brain. Through lifestyle changes stem cells in the support tissue of the brain, called glia cells, can develop into neural progenitor cells, immature newborn granulocyte cells and eventually into mature nerve cells. In other words the same sequence that occurs in the embryo with brain maturation can also occur in adults. Researchers are only learning now how to approach this difficult subject. He pointed out that there has to be a balance between the gut, the brain and the immune system. As the gut is also an immune organ (Peyer’s patches) where Th1, Th2 and Th17 lymphocytes are produced, it is important to manage your gut through probiotics and through intake of organic foods to get away from anything that disbalances the gut/immune system/brain interaction.

Zinc and hormone disbalance

At the end he briefly touched on two important facts: zinc is a trace element that is important for prevention of a leaky gut as it keeps the cell bridges of the lining of the gut intact. However, when zinc levels are done on patients in the hospital setting, he found that patients are often deficient for zinc, but they are responding very rapidly to zinc supplementation. Stress, which causes high cortisol levels leads to lowered endurance, autoantibodies and allergies. By checking other hormones, which need to be in balance with cortisol the caregiver can recognize what is wrong with a patient and help restore the hormone balance with bioidentical hormones. This will also take care of the leaky gut, the autoimmune diseases and improve asthma in a person who has allergies.

6. Aging and the short telomere connection

William Andrews, PhD has worked in the biotech industry for 28 years and had obtained his Ph.D. in Molecular and Population Genetics at the University of Georgia in 1981. In the last 15 years he has focused on finding ways to extend the human lifespan by interfering with telomere shortening in human cells. He shared some interesting facts with the audience: reproductive cells do not age and their telomeres stay long. In order to age gracefully it helps to know the length of your body’s telomeres.

Measuring telomere length

Dr. Andrews recommended using the HT Q-Fish telomere test, which is a genetic test that gives an average of the telomere status of your body. This test will determine the %-age of short telomeres in the body, which is what is most informative about your biological age and your average life expectancy. There are several methods that are useful to know, which lengthen your telomeres: exercise, omega-3 fatty acid supplements, vitamin D3 in higher doses and not smoking are all known to lengthen your telomeres.

Astragalus

Astragalus, a Chinese herb and extracts (expensive!) derived from this plant have also been shown to increase the length of telomeres. Other factors that help to preserve the length of your telomeres are reducing stress (yoga, meditation, enjoyable music), weight loss through a ketogenic diet, reduction of depression (rebalancing brain hormones), reducing pessimism, and being happy. Did you know that lobsters are blessed with ubiquitous telomerase expression? As a result they turn over 100 years. Humans are not so lucky, but we have access to simple steps that are protecting our telomeres! Dr. Andrews’ company has searched for telomere elongating substances. Through testing of 39 families of chemicals that are stimulating telomerase to elongate telomeres, he found a few that work. However, the main first step should be to concentrate on restoring the diet of our distant ancestors that gave us our genetic make-up.

Western diet

He stated that the Western diet is the worst contributing factor for telomere shortening. The macro and micronutrient difference between our ancestral diet and the modern diets have caused diseases like high blood pressure, heart attacks, stokes, obesity, diabetes, insulin resistance, dementia and cancer. Our modern diets (particularly the high carb/low fat diets) have increased oxidative stress in our bodies from increased reactive oxygen. This reduces our antioxidant reserves. It leads to malfunctioning of the endothelial lining. Other contributory factors are the overfeeding with omega-6 fatty acids from processed foods and cooking oils(such as corn oil and soybean oil and others.). These food infractions lead to a relative lack of the key vitamins A, D, E and K2 that are important to maintain cell function.

7. Telomeres, Aging and Disease

Dr. Mark Rosenberg gave a talk about this topic. He has been involved with drug research in an attempt to elongate telomeres since 1991. This lecture reinforced what Dr. Andrews has said. However, he added a few aspects that are important to mention: “aging promotes aging”; in an aging person there are more circulating free radicals that undermine your health. So it is important, particularly for an older person to take anti-oxidant supplements to stop free radicals from aging you even faster. Dr. Rosenberg has done a lot of research with cancer cells. He noted that the circulation in a cancer or in metastases from cancer is very poor, which is the reason why chemotherapy often does not reach the cancer cells.

Low LDL cholesterol

But he also found in the literature and in his own clinical experience that patients with low LDL cholesterol have increased cancer susceptibility. Dr. Rosenberg mentioned that this was a new paradigm. I have recently discussed this in detail in a previous blog. Briefly, LDL cholesterol is the transport form of cholesterol going from the liver to vital organs like the heart or brain. When LDL is oxidized by free radicals from eating too much sugar and starchy foods that are metabolized into sugar, cells are starved of nutrients and oxygen. This sets the stage for cancer cells to develop, which have a metabolic advantage of being able to produce energy by glycolysis rather than by the aerobic metabolic pathway.

Effect of lifestyle

Smoking and alcohol consumption shorten telomeres and this makes the person more prone to developing cancer.  On the other hand telomerase treatments have been shown to NOT cause cancer, which was a false belief in the past. At this point it is lifestyle changes that are needed to reduce the using up (aging) of telomeres. Resveratrol, vitamin D3, and astragalus all seem to contribute to lengthening of telomeres. The next few years will likely bring more news about this.

Conclusion

I have only been able to give a few highlights of the 21st Anti-aging Congress in Las Vegas. Another highlight was an appearance of Travis Stork, MD from the ER-doctor show on television. He gave a very down-to-earth presentation making 4 points: 1) healthy living starts in the kitchen, 2) “I need you to start working out”, 3) Mind and body are connected (stress can ruin your health) and 4) Get enough sleep (40% do not get enough sleep), because all of your hormone glands are recovering overnight. He concluded by saying: “Make health your hobby!”

Infiniti award for Governor Arnold Schwarzenegger

Another happening later in the conference was the appearance of California’s 38th Governor, Arnold Schwarzenegger. He received the highest honor of the A4M, the 2013 INFINITI AWARD for his leadership role of funding and supporting stem cell research in California.

Each A4M conference seems to have something new to offer every year. There were many other things that I learnt, but in my mind the topics I summarized above stood out from the rest.

More information on:

  1. the use of testosterone and other hormones in male menopause:  http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/
  2. high blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/
  3. telomere lengthening by vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/  In this review I am mentioning a large Chinese study that proved telomere  lengthening with vitamin C and E, but no other vitamins. Other vitamins are still needed as antioxidants to prevent cancer and hardening of arteries.

Last edited Nov. 7, 2014

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