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.

Mar
12
2016

Fiber, An Essential Food Ingredient

The Standard American Diet will not provide enough fiber, an essential food ingredient. The fiber intake in the US population is between 12.5 grams and 16.8 grams on average, which is way below the recommendations of the Institute of Medicine as listed below.

Depending on age and gender the Food and Nutrition Board, Institute of Medicine, National Academies has recommended the following guidelines for adequate daily fiber intake in grams per person.

Institute of Medicine fiber recommendations (gram per person per day)

Males: age 9-13: 21 grams; age14 to 50: 38 grams; age 51 and higher: 30 grams

Females: age 9-18: 25 grams; age 19-50: 21 grams; age 51 and higher: 21 grams

Children: age 1-3: 19 grams; age 4-8: 25 grams

Brief history regarding fiber

Sir Dr. Denis Burkitt, the famous English surgeon, examined bowel movements (stools) of African tribes in comparison to his English countrymen and came to the conclusion in the 1940’s that the Western world needed to remedy constipation problems and cancer of the colon problems by eating more fiber.

He is still right: fiber is mainly treating the constipation (not preventing the cancer), but the chemicals that are also in the vegetables contain a multitude of natural anti-carcinogenic substances, which provide the powerful preventative action against colon cancer and many other cancers. Lycopene, not known at the time of Sir Dr. Burkitt is one of these and is found in tomatoes and tomato products.

Sir Dr. Burkitt’s observation that high bulk foods (like vegetables and green leaves) prevent cancer is as valid today as it was in the mid 1900’s. In the meantime it has become evident that fiber also lowers cholesterol and helps prevent heart attacks and strokes as well.

What are some of the problems with fiber intake?

Here is a typical day for a Standard American diet:

  1. The average breakfast with two toasts, an egg and sausage. This contains 0.7 grams of fiber. The coffee or tea or juice that is consumed contains no fiber.
  2. For lunch you may eat a hamburger in a bun and a helping of French fries. There are 2 grams of fiber in the bun and 3.9 grams of fiber in the French fries, a total of 5.9 grams. Alternatively you may want to eat a pepperoni medium pizza: 0 grams of fiber!
  3. Dinner may consist of one baked potato (3.4 Grams of fiber), beef steak (0 grams of fiber, no matter whether it is an 8 oz. or 10 oz. steak) and mixed vegetables (1 cup, which contains 5 grams of fiber). For dessert you may have a bowl of ice cream (1 gram of fiber). If you eat in a restaurant you also get a bun with butter (0 grams of fiber) plus a small garden salad (0.9 grams of fiber).
  4. Snacks during the morning: medium oat bran muffin: 5 grams of fiber
  5. Afternoon snack: cinnamon roll: 1 gram of fiber.

Grand total of the day for Standard American diet: 22.9 grams of fiber. It depends whether or not you consumed the mixed vegetables and the bran muffin. If you did not eat the mixed vegetables and the bran muffin, you may only have consumed 12.9 grams of fiber. If you had pizza for lunch, you only got 7 grams of fiber that day.

Sources of fiber from foods

You can see from these few examples that processed foods tend to have a lot less fiber than vegetables and fruit. Particularly pastas and bread are devoid of fiber, but very rich in calories. So, if we were serious about wanting to increase our fiber content in the food we eat, we need to ensure enough intake of fruit and vegetables that contain fiber. There are many useful websites that list the fiber content per food item: if you look for the fiber content of a medium sized apple using this website, you find that it contains 4 grams of fiber.

This would be a much better snack than an ice cream with no or very little fiber. Here are more fiber suggestions.

How can we increase fiber intake?

We need to think about the whole nutritional equation, how many calories are in food, how much sugar, how much fat and protein. If we want to increase the amount of fiber we take in, we definitely have to watch the sugar content of the food item in question.

For instance ¼ cup of raisins has 2 grams of fiber in it, but also 29 grams of sugar, translating into 130 calories. Conversely, ½ cup of raspberries contains 4.6 grams of fiber and has only 20 calories. This choice is definitely a winner compared to raisins.

Use the Internet to learn about the fiber content of the various foods while you keep an eye on sugar content and calories as well. The idea is to maximize the fiber content in your food intake by cutting out fiber empty foods and adding fiber rich foods as much as possible.

Example of a fiber rich day

  1. Breakfast: Omelet with green onions, mushrooms and spinach. Garnish this with ½ avocado and two tablespoons of salsa. The spinach/onion omelet with mushrooms has 3 grams of fiber. ½ avocado provides 5 grams of fiber; the salsa adds 0.6 grams of fiber. Breakfast total: 8.6 grams of fiber.
  2. Lunch: Greek salad with turkey breast (4 grams of fiber). Add a snack of one handful (1.5 oz.) of walnuts as desert: 3 grams of fiber. Lunch total: 7 grams of fiber.
  3. Dinner: Small salad, salmon with broccoli and 1 grilled tomato. Fruit salad for desert. Salad: 0.9 grams of fiber; salmon: 0 grams of fiber; ¾ cup of cooked broccoli: 7 grams of fiber; grilled tomato: 0.6 grams of fiber; fruit salad: 3 grams of fiber. Dinner total: 11.5 grams of fiber.
  4. Snacks throughout the day: 1 pear in the morning: 4 grams of fiber; 1 apple in the afternoon: 4 grams of fiber; 1 handful of walnuts: 3 grams of fiber. Snacks total fiber: 11 grams of fiber.

Total of fiber for the fiber rich day: 38.1 grams of fiber.

Fiber math

This is where it is getting interesting. Depending on whether you are a woman aged above or below 50 years or a man aged above or below 50 years, you have different fiber intake requirements as mentioned above. With the fiber rich diet you have exceeded your daily goal easily whether you are a man or a woman above or below 50. You won the race easily. Fiber intake does not mean that you eat fibrous food that tastes like sawdust! This diet example shows you delicious and nutritious food.

But with the American Standard diet you barely reached the goal if you ate your mixed vegetables and the bran muffin and you are a woman above or below the age of 50. 22.9 grams of fiber is not enough for a child between the ages of 4 and 8 and it is definitely not enough for a man above or below the age of 50. This type of math just shows you how deficient our modern Western type food intake is. And if you look at the aspect of it being delicious or even nutritious it leaves a lot to be desired! This is what Sir Dr. Denis Burkitt found when he compared the food intake of civilized English citizens with tribes in the African jungle. He recognized last century that England’s fiber deprived diet compared to the fiber rich diet in Africa was responsible for the much higher colon cancer rates in England. It is only now that we are recognizing the enormity of his investigations.

Cardiovascular significance of high fiber

Apart from reducing colon cancer incidence fiber has also gained recognition for prevention against heart attacks and strokes. It turns out that the enterohepatic pathway is interfered with through the intake of fiber. Cholesterol from bile is bound to fiber in the gut and transported to the sewer instead of being taken up through the enterohepatic pathway, which incudes the portal vein system and the liver. The end result is that triglycerides and LDL cholesterol fall, while HDL cholesterol (the good cholesterol) is raised, and hardening of the arteries slows down significantly. The patient lives longer, heart attack and stroke rates go down, and there is less disability.

Supplement fiber, if you are not getting enough in food

There is good news. Psyllium husk, Metamucil and any other fiber supplement can help you to reach and surpass your daily fiber goal. There is no danger of overdosing as any surplus simply comes out in your stool. You will notice as you increase your fiber intake that your stool volumes go up. Sir Dr. Burkitt actually weighed the stool of patients in Africa and in England: African tribes had voluminous stools, while people in English had much smaller stool volumes. This is how Sir Dr. Burkitt detected the importance of fiber intake.

Let’s assume you are a male aged 45 years and your diet is a bit better than the average Standard American diet with a daily intake of 25 grams of fiber. Your daily goal is 38 grams of fiber, so you are 13 grams short. You can solve this problem. Get a fiber supplement from the health food store where 1 teaspoon contains about 5 grams of fiber. Be careful: fiber is very thirsty and uses up a lot of water. If you use psyllium husk powder, make sure to add about 1 cup of water to 1 ½ teaspoons of the psyllium husk powder or another similar product. Once you added enough water and stirred well you can drink it down. Between fiber gulps drink some more water to dilute any fiber stuck in your esophagus as it goes down into your stomach. Enough fluid intake is crucial, as the fiber binds fluid in your digestive tract. Repeat this procedure (1 ½ teaspoons of psyllium husk powder with lots of water) at lunchtime. You have now added 15 grams of fiber (2×7.5 grams) to your daily 25 grams of fiber: this brings you to a total of 40 grams of fiber, well above your goal of 38 grams. If you plan to use a fiber supplement it is recommendable that you start with small amounts of fiber (maybe just one teaspoon per day) and increase the amount gradually.

Your alternative would be to switch your diet to the fibre rich diet described above where your basic intake was 38.1 grams, just enough to reach your goal. If you want to play it even safer, you may want to add another handful of walnuts (3 grams of fiber) or ¾ teaspoonful of psyllium husk powder with water to bring your total fiber intake to above 41 grams.

With the introduction of the various fiber products that you can buy at the health food store, it is now much easier to manage your total fiber intake.

Fiber, An Essential Food Ingredient

Fiber, An Essential Food Ingredient

Conclusion

In the past few years we heard from cardiologists that heart attacks, strokes and high blood pressure could all be helped by much higher fiber intakes. But the public in general has not listened very well to this message. Gastroenterologists also have been urging people to eat more fiber for colon cancer prevention, but many other cancers are also diminished by regular fiber intake. Breast cancer is one of these cancers responding to extra fiber intake. The bottom line is that we all need to pay attention to what we eat and learn how little fiber there is in many foods. The tables can be found online, and for some of you it may come as a surprise that a healthy bowl of tossed salad has only very little fiber. If the total fiber content in our food does not add up to what we need (see table above), supplement with psyllium husk powder or another fiber supplement. Do not forget to drink plenty of liquids. This is not only help for those who experience constipation. It is powerful prevention of heart attacks, strokes and many cancers.

Feb
06
2016

Effects Of Hormones On The Heart

Since February is heart month, I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group was given testosterone replacement therapy, another was not given replacement therapy and one group was given replacement with testosterone, but normalization of testosterone levels was not achieved.

The various groups were followed for between 4.6 years and 6.2 years. The results were astounding: When results between testosterone treated men were compared to non-treated men there was a 56% reduction of all cause mortality, a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the non-treated control group and the partially treated testosterone group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where testosterone levels are monitored and corrected, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic has been clouded for many years because of the insistence of the medical profession to use horse derived estrogen (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When progesterone is missing, replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally is needed.

Estrogen

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

This study was done on 700 women in early menopause. They were treated with 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following:

  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that is often overlooked. It balances the effects of estrogens, but it can also be metabolized into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. Progesterone production from the ovaries is already reduced when the woman is premenopausal and should be replaced by transdermal bioidentical progesterone cream.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments it was found that GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. This can be done using a similar pen that is used for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day, given before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Melatonin is a hormone that is mostly thought of as the “sleeping hormone”. It is released by the pineal gland and rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease are usually found to have very low blood melatonin levels. Melatonin can be used intravenously in patients who have heart attacks to reduce the amount of damage to the tissue and stabilize the heart rhythm.

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. Another 3 mg can be taken, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middfle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome, enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked as thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.
  4. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  5. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, levels of both hormones can be measured and if low, they can be replaced.
  6. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.

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Jan
31
2016

The Gut and Brain Connection

At the 23rd Annual World Congress on Anti-Aging Medicine (Dec. 11-13, 2015) in Las Vegas there were several lectures pointing out the importance of the gut flora for proper brain function. If you have the wrong gut flora, you can get a number of diseases like diabetes, fibromyalgia, rheumatoid arthritis, multiple sclerosis, muscular dystrophy, some cancers and even obesity. Martin P. Gallagher, MD, DC talked about this in his talk “Gut on Fire, Brain on Fire!”

Function of the microbiome

The microbiome is the sum of all microbial organisms inhabiting the human body, which colonize mainly the colon, but also to a lesser degree the small intestine. Dr. Gallagher stated that the microbiome weighs only 7.1 oz., although in the past have some have estimated its weight to be as high as 3 pounds. The purpose of the microbiome is to help form a gut/blood barrier. It forms a 30-micron thick layer in the GI tract, protects the intestinal lining and metabolizes food remnants, especially from carbohydrates. It also communicates with the immune system. There is a cross talk between the lining of the gut and the and the body’s immune system. The gut bacteria help the body to create stability; they also decrease intestinal permeability.

When inflammation occurs in the gut, the thickness of the biofilm is less than 30 microns. Intestinal permeability increases, which is called “leaky gut syndrome”. This can be the cause of autoimmune diseases and possibly other diseases.

The enteric nervous system

The gut can produce as many neurotransmitters as the brain and spinal cord can synthetize. The enteric nervous system communicates with the brain through the vagal nerve. Serotonin is an important neurotransmitter that has been found to regulate motility of the gut. The control system of the gut can work on its own and override the concerns of the central nervous system.

Parkinson’s disease is a disorder of the enteric nervous system as well as the brain. With Alzheimer’s disease the characteristic lesions found in the brain are also found in the enteric nervous system!

In a mouse experiment a Lactobacillus strain known to be part of the microbiome was shown to heal anxiety and depression related changes in certain parts of the brains of these experimental animals. But when the vagal nerve of these animals was severed, none of these healing changes occurred. This suggests that the gut bacteria are able to communicate to the brain via the vagal nerve. Researchers have coined this connection the “gut-brain axis”. These protective gut bacteria have the ability to protect humans from gastric acidity, from bile acid toxicity, they adhere to the lining of the gut and they persist to reside within the gastrointestinal tract. Probiotics help the immune system to maintain the immunologic memory and to secrete antibodies, called immunoglobulins.

Two strains with benefit to humans are Lactobacillus rhamnosus GG and Saccharomyces boulardii. Probiotics often help against diarrhea. The natural food for gut bacteria in the colon comes from starches of chicory, asparagus, inulin and onions that are indigestible in the stomach and small intestine, but are fermented in the colon to provide food for the bacteria residing there.

Small Intestinal Bacterial Overgrowth (SIBO)

Overgrowth of the small intestine with bacteria that produce endotoxins appears to have significance in both animal models and human disease. Chlamydia species as well as Borrelia burgdorferi (Lyme) can produce toxins that cause hypersensitive of pain in soft tissues in fibromyalgia and animal models of fibromyalgia. SIBO-small intestinal bacterial overgrowth- in experimental animals caused the same hypersensitivity of the soft tissues and also leaky gut syndrome.

Risk factors for SIBO

What causes SIBO is too little stomach acid production, treatment with proton pump inhibitors (powerful anti acid medications) and antibiotics. According to Dr.Gallagher SIBO also occurs in postsurgical patients, in patients with diabetes, and is brought on by alcohol, nicotine, drugs and GMO foods.

Neurogenic inflammation

Normally the blood brain barrier keeps immune cells from the body out of the brain. Only glucose, proteins and lipids are allowed into the brain, but not lipophilic neurotoxins. Neurogenic triggers, when admitted to the brain, will compromise the function of the immune cells of the CNS, called microglia. This can result in memory loss, Alzheimer’s, dementia, seizures, migraines, Parkinson’s Disease, multiple sclerosis, cancer, weakness, numbness, etc.

What triggers inflammation?

Here is a long list of different items that cause inflammation: aging, hormone deficiencies, obesity, diabetes mellitus, cardiovascular disease, fungal infection, the Standard American diet (SAD), pain, trauma and mechanical stress, heavy metals, food allergies, toxins, gut dysbiosis, small intestinal bacterial overgrowth, mal-digestion/absorption, prescription drugs, over-the-counter drugs, recreational drugs and alcohol, lack of exercise and lack of sleep.

Neurotoxic insults start the chain of reactions (heavy metals, nutritional deficiencies, viruses/fungus/bacteria, inflammatory diet, MSG, solvents, pesticides, herbicides, etc.): one or more of these factors destabilize the tight junctions of the blood brain barrier, which leads to neurogenic inflammation. The result is Parkinson’s disease, MS, dementia, chronic pain, behavioral and personality changes, Alzheimer’s disease, ALS and Lyme disease.

What seems to be happening a lot is that there is overgrowth of abnormal bacteria in the small bowel, which produce toxins. These in turn lead to leaky gut syndrome, which allows neurogenic triggers to attack the blood brain barrier. From here it is a short step to neurotoxic insults of the brain overstimulating the microglia, which will produce the diseases listed above.

Healing of brain inflammation

Treatment starts with the Mediterranean diet, which has been shown to have anti-inflammatory properties. People who are gluten sensitive need to eliminate gluten entirely from their food; casein sensitive people need to eliminate dairy products. A triple strength, molecularly distilled fish oil product is taken as a supplement every day with 4 grams or more of DHA/EPA.

Glutathione: One of the most powerful antioxidants and anti-inflammatories is intravenous glutathione. This is given as intravenous chelation therapy, which removes heavy metals. Other chelation agents such as EDTA intravenously may be given alternatively. Dr.Gallagher said that glutathione serves as primary cellular defense against free radicals, is a powerful antioxidant and serves as detoxifying agent against xenobiotics. Xenobiotics are remnants of artificial fertilizers, pesticides and pollutants that are contained in crops we eat.

Dr. Gallagher gives 600mg of glutathione twice per day intravenously for 30 days. In Parkinson’s disease patients whose mid brain is often poisoned by mercury this leads to 42% decline of disabilities and the effect last for 2 to 4 months after this treatment has been stopped. This treatment also protects telomeres, the caps on the ends of cellular DNA as well as mitochondrial DNA. Glutathione is protective of neurons and nerves.

Curcumin: this common Indian spice, found in turmeric is a potent anti-inflammatory. It is a safe natural agent and has also anti-viral and anti-tumor activities. It binds to the vitamin D receptor and works synergistically together with vitamin D3. Solid lipid curcumin particle technology makes curcumin 65-fold more bioavailable; free curcumin is allowed to pass the blood brain barrier. Lower doses achieve the same effect than regular curcumin.

According to a publication using lipidated curcumin the following observations were made: improved vascular function, inflammatory markers reduced by 14%, triglycerides lowered by 14%, oxidative stress reduced, catalase increased and total antioxidant status improved.

Omega-3 fatty acids: omega-3 fatty acids are anti-inflammatory by countering the arachidonic acid pathway that leads to inflammation. It is best administered as triple strength, molecularly distilled fish oil. DHA/EPA are the active ingredients. Chronic inflammation requires 2 to 12 grams daily; irritable bowel syndrome 6 to 12 grams daily; depression, anxiety and insomnia require 2 to 4 grams per day; autoimmune disease, back pain and degenerative joint disease 4 to 12 grams per day.

Gut/brain dysbiosis: For gut/brain dysbiosis Dr. Gallagher recommended to start with a 10-day fruit/vegetable detox program. Milk thistle, glutathione and pancreatic enzymes are used in combination. Lipidated curcumin. Glutamine, prebiotics and probiotics are given for gut support. Molecularly distilled fish oil (DHA/EPA) and vitamin D3 are given as anti-inflammatories. Oral and intravenous glutathione is given to detoxify. Antifungals are given as a combination of glutathione, oregano, olive leaf and silver salts.

The Gut and Brain Connection

The Gut and Brain Connection

Conclusion

Inflammation can start in the gut, lead to leaky gut syndrome and break down the blood/brain barrier. The end result is that the brain also gets inflamed and Alzheimer’s disease and dementia can occur. The sooner treatment is begun, the faster the recovery will be. When the end stage is reached, it is difficult to turn the inflammatory process around. Fortunately there are effective ways to get the inflammation under control with intravenous glutathione in the beginning and subsequent treatment with lipidated curcumin, omega-3 fatty acid and vitamin D3. A permanent switch to a Mediterranean diet is important as well to keep inflammation under control.

A few years back this type of approach would have been considered as “quackery”; now it is the latest information from research into the brain/gut connection. A lot can be done on a preventative basis with lifestyle and nutrition choices. Treatment is possible, but once full-fledged disease is established, a full cure may not be possible.

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Dec
26
2015

Coffee Could Be A Lifesaver

Coffee has long been a subject of heated discussions. It has been praised or condemned. Many studies have been done in the past; some showed health benefits, some did not. A new, larger study was done by the Department of Nutrition, Harvard School of Public Health in Boston, MA to re-examine this issue for both caffeinated and decaffeinated coffee.

Mortality was determined among 74,890 women in the Nurses’ Health Study (NHS), 93,054 women in the NHS 2, and 40,557 men in the Health Professionals Follow-up Study after a medium follow-up of 22.5 years. 19,524 women and 12,432 men died during that time period. Ming Ding is a doctoral student in the Harvard School of Public Health department of nutrition and was the lead author of the study that was published in the medical journal “Circulation”. She pointed out that in the past there were confounding problems: although many studies had shown that both caffeinated and decaffeinated coffee consumption lowered the risk of cardiovascular disease, the results in many studies were blurred. Studies often did not distinguish between smokers and nonsmokers; so a beneficial effect from coffee drinking was wiped out by the cardiovascular risk from smoking.

Ding’s studies took this into account and also other confounding factors like how much sugary soda pop people were drinking and whether or not they were eating well. In addition they normalized for other factors that could interfere like drinking alcohol and eating red meat.

Without normalizing for the factors mentioned above the study results were as follows. Study participants had less than a cup of coffee and three cups a day had a 5% to 9% lower risk of dying than those who drank no coffee. Those who drank more than three cups a day did not see any benefit.

However, when all the confounding factors were removed and the various groups were compared again the following emerged:

  • Less than 1 cup of coffee per day: 6% lower death rates than non-coffee drinkers.
  • 1 cup to 3 cups of coffee per day: 8% lower death rates.
  • 3 to 5 cups of coffee per day: 15% lower death rates.
  • More than 5 cups of coffee per day: 12% lower death rates.

Ming Ding was associated with another research paper that had shown that coffee drinkers have a lower risk of developing type 2 diabetes and heart disease. She found that both caffeinated and decaffeinated coffee reduced the risk of getting diabetes later in life.

When asked about what would be responsible for the reduced death rates with coffee consumption, Ding explained: “There are at least two known chemicals in coffee, namely lignans and chlorogenic acid that could reduce inflammation and help control blood sugar, both of which could help reduce the risk of heart disease”.

Although there seems to be a linear response up to 5 cups of coffee consumption, above 5 cups this linear relationship disappeared. It was not explained whether there was a saturation point reached, whether there was yet another hidden confounding factor or whether there were detrimental effects on the adrenal glands with too much coffee consumption.

Another finding was that it did not matter whether the coffee was regular (caffeinated) coffee or decaffeinated coffee. The results were identical.

Many other studies did not have the large numbers to show whether or not decaffeinated coffee was as effective in preventing heart disease.

Finally, there was another peculiar finding; suicides were down by 20% to 36%, if a person drank at least one cup of coffee per day. But if a person consumed less than 1 cup of coffee per day the suicide rate was 36% higher than the control group with no coffee consumption. This is a rather peculiar finding, particularly for the consumption of less than 1 cup of coffee. But other studies have also shown a decrease in suicide rates with coffee consumption.

Although previous studies had shown a reduction in liver and prostate cancer, after the removal of confounding factors this study did not show any effects on cancer causation or cancer death rates with coffee consumption.

Discussion

The Department of Nutrition, Harvard School of Public Health in Boston, MA has excelled in high quality nutritional studies for decades. But this study is particularly important, because it is so large giving it more statistical power; secondly, the observation time of an average of 22.5 years is longer than most coffee studies in the past. Add to this the removal of the noise (called confounding factors) that interfered with the objective of the study and you end up with a very meaningful result.

The important findings were that both caffeinated and decaffeinated coffee have the same effect of saving lives. Perhaps you want to drink not more than 5 cups of coffee per day. That lowers your risk of premature death by 15%. It is most likely that it is the effect of lowering the rate of diabetes and heart attack rates that is responsible for the risk reduction. At least this was the opinion of the chief investigator. Cancer rates were not lowered by coffee consumption.

I sleep better when I drink decaffeinated coffee, so for me the notion that decaffeinated coffee had the same effect as regular coffee was important.

Coffee Could Be A Lifesaver

Coffee Could Be A Lifesaver

Conclusion

Here is a study that is large enough, went long enough, and showed decisively that both caffeinated and decaffeinated coffee will reduce the death rate by 15% up to 5 cups of coffee per day. This finding was true for both males and females. Coffee seems to also reduce the suicide risk by a mechanism that has not yet been determined. If you want to live 15% longer than your previous life expectancy would have been without coffee, you may now have your coffee and enjoy it!

Dec
19
2015

Beer Belly Bad News

You heard the expression “beer belly”. It is an unflattering term for increased abdominal girth, especially in males. It is quite often that this picture is found in middle-aged men who consume more beer than what is good for them, but they may also mill around the hot dog stands at the ball game instead of being physically active. Any leftover calories are stored as belly fat, which protrudes their stomach as if they were pregnant.

There is a big difference between belly fat and body fat. Belly fat is metabolically much more active. Body fat is more sessile. So, it is the belly fat we need to do something about as this has been shown to be associated with heart attacks, strokes and diabetes.

Originally it was thought that excessive weight would best be measured with the body mass index (BMI). But subsequently it was shown that athletes with well-developed muscles could have BMI’s that were in the overweight (between 25.0 and 30.0) or even obese category (more than 30.0). Also, some people with heavy bones can have excessive BMI values despite them being normal based on other measurements. The new measurement is the old fashioned abdominal girth to hip ratio.

You measure the abdominal girth, the hip girth and divide the abdominal girth by the hip girth. Normally this should be 80% (=0.8) or less for women and 90% (=0.9) or less for men. But a person with a beer belly will have ratios of 1.2 or 1.5. This is where it shows that there is a problem. If you take blood tests of that person you would also find elevated triglycerides, lowered HDL cholesterol (the protective cholesterol) and elevated LDL cholesterol (the bad cholesterol). But it does not stop there. We know from studies that often the insulin level is elevated in the sense of hyperinsulinism. In fact that person has often the metabolic syndrome, which is a characteristic change of the metabolism in an obese person. The blood is thicker with clotting factors floating around, there are inflammatory kinins that circulate and these factors work together on causing hardening of the arteries.

Why is a beer belly dangerous?

There are not only cardiovascular risk on the long-term causing heart attacks and strokes down the road. There is a danger of fat deposits in the liver, called fatty liver disease.

In time this can turn into liver cirrhosis and in some cases develop into liver cancer. Because belly fat causes inflammation in the system including in the lining of the blood vessels, this can in time also affect the immune system, weakening it and eventually allowing cancer to develop. Common cancers that are associated with obesity are breast cancer, ovarian cancer and uterine cancer in women, prostate cancer in men and pancreas and colon cancer in both sexes.

In men beer bellies produce a lot of estrogen, the female hormone. This is so because fat tissue contains the enzyme aromatase that metabolizes male hormones into estrogen. Estrogen in men is only good in traces, but when it is massively produced it will counter testosterone production and will cause heart attacks and strokes.

What can be done about a beer belly?

We need to understand how beer bellies develop. One of the sources of fat from beer bellies is the consumption of foods that contain a lot of fructose. Food manufacturers have been diligent in mixing high fructose corn syrup into sugary drinks and into a myriad of processed foods.

Sugar itself can only be processed and stored until the glycogen stores in the liver and the muscles are filled. The liver metabolizes a surplus of sugar into triglycerides and LDL cholesterol. This is also the case for any fructose that comes from metabolized sucrose (table sugar) and from the high fructose corn syrup popular with the food processing industry. One problem is that fructose can only be processed by the liver, while glucose gests directly taken up by cells with the help of insulin.

The surplus of fructose is mostly used to metabolize into triglycerides and LDL cholesterol before it is stored as fat in fat cells. Unfortunately a lot of the fat will end up between your guts, in the liver as fatty liver and in the beer belly, a metabolically more active form of fat.

The sad part is that in the 1960’s I have seen the German economic wonder (“Wirtschaftswunder”) where many mid fifty to mid sixty business men died as a result of obesity and subsequent heart attacks and strokes. At that time it was thought that Germans having been starved during World War II lived it up in the late fifties and 1960’s to the point where they ate what they could get hold of: cakes, fatty cheeses, whipped cream, fatty foods like pork roasts and beef. They also consumed loads of bread, buns, pasta and sugar. Margarine also became popular with its hydrogenated fatty acids that also contained free radicals. The end result was that they gained weight, did not exercise and developed their beer bellies.

Since the 1980’s when low fat/high carbs became popular to replace saturated fatty acids that were supposed to be responsible for heart attacks, strokes and obesity, obesity continued to steadily increase. Sure, the hydrogenated fatty acids did not help and should be cut out. But the bigger problem was the consumption of high fructose corn syrup and over-consuming high glycemic-index carbohydrates.

Here is the solution of what to do get rid of the beer belly.

  1. Remove sugar and high fructose corn syrup from your diet.
  2. The second effective step is to cut out as many empty starches that you can cut out like white rice, bread, sweets, cookies, cakes, ice cream and pasta. The reason for this is that these starchy foods get metabolized in the gut into sugar, which causes an insulin response. The extra insulin is responsible for developing inflammation in the arteries, which eventually leads to heart attacks and strokes.
  3. Exercise on a regular basis. This will produce HDL cholesterol, the protective cholesterol, which balances LDL cholesterol.
  4. Perhaps the most important step is to rebalance your food intake. With this I mean that you replace high glycemic-index carbs with low glycemic-index carbs. This means you will eat a lot of salads, steamed vegetables, and fruit. This gives you a lot of extra fiber, which your system needs to slow down the rate of sugar absorption, helps you to lower LDL cholesterol and helps you to detoxify your body in the gut where toxins are bound to fiber.
  5. If you are heavily into alcoholic drinks there is another source of refined carbohydrates that gets metabolized into LDL cholesterol, triglycerides and can cause fatty liver disease and liver cirrhosis. A moderate consumption of alcohol (one drink for women per day and two drinks for men per day) lowers the risk of heart attacks and strokes, while excessive alcohol intake increases the risk.
  6. Bioidentical hormone replacement may be something you have not heard about. But if you are a woman above the age of 40 or a man above the age of 50 chances are that your natural hormone production from your testicles or adrenal glands (in a man) or from the ovaries or adrenal glands (in a woman) are no longer keeping up with the demand of regular life. Part of the aging process is that is that the production of our sex hormones slows down shortly before menopause in women and shortly before andropause in men. This will not only manifest itself in hot flashes and sleep disturbance in women or in erectile dysfunction and grumpiness in men; it will eventually lead to a lack of energy metabolism in the heart, the brain and other organ systems that have sex hormone receptors. A lack of hormones translates into yet another cause of heart attacks, strokes and certain cancers. This is an area where conventional medicine disagrees with anti-aging medicine. But it is my experience from years in general practice that heart attacks, strokes, colorectal cancer and pancreatic cancer in both sexes, cancer of the breasts, uterus and ovaries in women and prostate cancer in men are indeed more common when natural hormone production has declined.

On the other hand, when bioidentical hormone replacement is given, the metabolism of all cells will return to normal and the likelihood of not developing all these illnesses at an earlier time is diminishing as well. It is not a panacea for eternal life, but it will add significant longevity without premature disabilities, which is what we all need.

Beer Belly Bad News

Beer Belly Bad News

Conclusion

Although weight gain around the waistline is common these days and increased mortality due to heart attacks, strokes and cancer is common, we do not have to accept this as the new norm. We need to assess our food intake habits, cut out the items that contribute to the beer belly and ask ourselves what other change in lifestyle we need to do to improve our body shape and our energy metabolism. Life is too precious to just throw away years of fruitful living in our golden retirement years. Work on these factors in midlife or even in younger years and you will enjoy disease-free aging.

Dec
05
2015

Processed Meat Causes Cancer

A report from the World Health Organization (WHO) has stated that processed foods are cancer producing. The report also stated that to a lesser degree red meat is also cancer causing. Overall there are 34,000 people per year worldwide who die from cancers that are related to the consumption of processed foods. They are mainly colorectal cancers, pancreatic cancer and prostate cancer.

Seeing deaths from processed meat in perspective

When you relate the 34,000 processed food related cancers to all of the 8.2 million cancer deaths per year worldwide, the cancer numbers related to processed food amount to only 0.41 % of all the cancer deaths in the world, which is a very small percentage. In comparison to these numbers smoking as a cause of cancer is responsible for the death of 1 million people per year. Furthermore, there are 600,000 deaths due to drinking alcohol, and 200,000 deaths due to breathing polluted air. Of course it has to be emphasized that it is important to avoid cancer causes wherever possible!

Nevertheless we are talking about preventative deaths and the public should be informed about what the risks are due to consuming processed meats, cigarette smoking, drinking alcohol and breathing polluted air.

Pancreatic cancer study

A large multi-ethnic study analyzed data from 190,545 men and women at the Cancer Research Center at the University of Hawaii. In an average follow-up time of 7 years there were 482 incidents of pancreatic cancer, and it became obvious that processed meats play a role in the increase of pancreatic cancer. After taking other risk factors into consideration like a positive family history, age, smoking and diabetes mellitus, those patients who consumed the largest amount of processed meats had a 67% increased risk for pancreatic cancer as opposed to those who had the lowest intake of these foods. A diet rich in red meats increased the pancreatic cancer risk by about 50%.

Poultry, fish, dairy products and egg intake showed no pancreatic cancer risk factor, nor did it matter how much fat, saturated fat or cholesterol was consumed over the 7 year observation period.

The lead investigator of the study, Dr. Ute Noethlings, observed that the risk increase is a consequence of meat processing. The main culprit would very likely be carcinogenic substances which are used in processed meat production.

Too much red meat

Grain fed or corn fed and antibiotic treated regular beef changes the gut bacteria and can cause superbugs. The change of the gut flora can lead to inflammation in the gut lining and a condition called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. Residual antibiotics from regular beef and chicken reduce that amount and change the composition of our gut flora.

The changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not have the same effect. To prevent leaky gut syndrome, heart attacks and strokes from developing you can also take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health. But this does not mean that you pop a supplement, and you can blissfully ignore sensible nutrition!

Red meat can cause heart attacks in diabetics

Red meat is one of the sources of protein, but doctors from the Harvard School of Public Health reported in the January edition of Diabetes Care, that a type 2 diabetes diet should go easy on red meat.

Type 2 diabetics are at risk for subsequent coronary heart disease (CHD), and intake of iron rich food was significantly associated with a greater risk of fatal CHD. The results come from a prospective study of 6,161 women from the Nurses’ Health Study.

All of these patients reported a diagnosis of adult onset diabetes, and they were followed between 1980 through 2000, which amounts to an impressive 54,455 person-years follow-up. Attention was paid to the food questionnaires, which were monitored for the consumption of iron and red meat such as beef, pork or lamb as a main dish, also for the use of beef in roast beef sandwiches and mixed dishes, hamburger, hot dog, processed meat and bacon. Note was also taken of other nutrients such as seafood and poultry.
Women with diabetes who ate the most iron in the form of heme found in red meats had a 50% increased risk of total coronary heart disease as compared to those with the lowest intake. The risk ratio with women was more obvious for postmenopausal women when compared with premenopausal women .

While lean beef may be a good protein food to the average population, type 2 diabetics might choose to cut back on red meat and processed red meat sources and replace it with a heart-friendlier choice. Fresh seafood, rich in omega -3 fatty acids, would rank high on the list of a healthy eating plan.

Another prospective study of 72,113 women over 18 years found a definitive relationship between dietary patterns and cancer and heart attacks. A prudent diet with high intakes of vegetables, fruit, legumes, fish, poultry, and whole grains had a very low cancer and heart attack rate. Conversely a Western diet consisting of high intakes of red meat, processed meat, refined grains, French fries, and sweets/desserts led to a higher cardiovascular mortality risk of 22% and a higher cancer mortality risk of 16%.

Processed Meat Causes Cancer

Processed Meat Causes Cancer

Conclusion

Although the World Health Organization has now announced that processed food is carcinogenic, this piece of news is not entirely new. Hopefully it will work its way into the consciousness of the population at large. Meat processors producing sausages, ham and other processed meat varieties will not stop advertising their products in a way to make them sound tasty and delicious for the consumer. Colorful images are geared to make the prospective buyer drool, but this is a make-believe world in the art of commercials. In the end it is the consumer who has to make a decision which food is tasty and also beneficial. Only when the customer makes the choice for health and stops buying foods that border to being nutritionally hazardous products, we will see a true change in health statistics. But while you are thinking about changes, do not forget to quit smoking, cut down your alcohol consumption and perhaps, if possible move to a less polluted area. All of that will help to reduce mortality rates!

More info about pancreatic cancer: Causes of cancer of the pancreas.

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Nov
10
2015

Sugary Soda Drinks Make You Sick

Dr. Frank Hu and colleagues have recently re-examined the old question of what sugary soda drinks do to you. They usually contain high fructose corn syrup, a mixture of 55% fructose and 45% glucose. This sugar mix can be found in sugary soda drinks as well as in many processed foods like fruit spreads. Dr. Hu’s publication is listed in PubMed , but details can be found in this summary.

The study found that one or two cans of sugary soda drinks per day lead to

  • As high as a 26 percent greater risk of developing type 2 diabetes,
  • A 35 percent greater risk of heart attack or fatal heart disease, and
  • A 16 percent increased risk of stroke.

The study also found that there is a difference of how glucose, the main sugar that the body uses for energy is metabolized versus fructose from high fructose corn syrup or the breakdown of table sugar, a disaccharide consisting of glucose and fructose combined as one molecule. Glucose gets directly absorbed from the gut into the blood circulation and with the help of insulin gets further absorbed directly into body cells. In contrast the liver metabolizes fructose into triglycerides, which can cause fatty liver disease and also insulin resistance. Fructose also raises the bad cholesterol (LDL cholesterol). This in turn is a risk factor for developing diabetes, heart attacks and strokes.

It is fructose in sugary drinks and processed foods that are largely responsible for weight gain, metabolic syndrome, diabetes and cardiovascular disease.

The newest finding: heart failure can also be caused by high fructose corn syrup

A study in Sweden has recently shown that sugary drinks can cause heart failure. 4200 Swedish men were followed for 12 years in regards to food habits. The study found that the men who drank at least two sweetened drinks per day had a 23% higher risk of developing heart failure. Dr. Susanna Larsson, a co-author of the study, said: “The takeaway message is that people who regularly consume sweetened beverages should consider limiting their consumption to reduce their risk of heart failure”. Heart failure affects nearly 6 million Americans. It develops either on its own in persons with inadequately treated high blood pressure or in people who had a previous heart attack. It is a condition, which disables the heart to effectively pump enough blood with nutrients and oxygen into the tissues. People who are affected by this condition feel the symptoms: they get short of breath with minimal activity. They also may wake up short of breath in the middle of the night. It is a miserable life, as people with heart failure are severely limited in their activities. Even walking a flight of stairs becomes a struggle or even an impossible task. Total disability is the next step.The key is prevention: do not use high fructose corn syrup, and stay away from sugar in any form; instead use stevia to sweeten your food when needed.

Be careful how you replace saturated fatty acids

Dr. Frank Hu has also participated in a study that spanned over 24 to 30 years and examined the replacement of saturated fat with polyunsaturated fatty acids (PUFA), monounsaturated fatty acids and whole grain carbohydrates. The study involved 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,908 men (Health Professionals Follow-up Study, 1986 to 2010). The diet was assessed with detailed questionnaires every 4 years. 7,667 cases of cardiovascular disease (CHD) occurred during the long observation times. Compared to controls that did not change their diet with respect to saturated fatty acid intake, those who replaced with PUFA had 25% less CHD, those who replaced with monounsaturated fatty acids had 15% less CHD and those who replaced saturated fatty intake with whole grains had 9% less CHD. In contrast, a subgroup that had replaced saturated fatty acid intake with carbohydrates from refined starches/added sugars ended up with a 10% increase of CHD.

Cutting fructose out of diet lowers cholesterol and weight

A new study by Dr. Robert Lustig and colleagues from the University of California, San Francisco showed on 43 children that a change of diet reducing dietary sugar from 28% to 10% and replacing it with other complex carbohydrates led to a significant reduction in triglycerides, cholesterol and blood pressure.

The fructose stimulus was taken away, which stimulates a part in the brain, called nucleus accumbens, where the reward center is located. This is the reason why the more sugar you take in, the more addicted to sugar you become. Not surprisingly when the diet was changed, there were not only internal signs of improving with regard to blood tests, but physically the children showed weight loss just within 10 days as their total calorie intake had reduced. Another observation with regard to fructose metabolism is that ghrelin, the hunger hormone, which usually gets suppressed after a meal, will not get suppressed when you drink a sugary drink with fructose in it. The result is that you do not feel satisfied and you keep on consuming fructose containing drinks resulting in weight gain.

Sugary Soda Drinks Make You Sick

Sugary Soda Drinks Make You Sick

Conclusion

What we eat matters in terms of long-term consequences. This has been shown with refined sugar intake. Don’t lull yourself into the belief that honey is “healthy”. Even though it is a natural product, your body treats it according to its chemical composition: it is sugar, and unfortunately it will get you into health problems naturally. The currently fashionable agave syrup is largely composed of fructose: again, this is bad news for your health! No matter what type of sugar you choose, the long-term consequences have haunting qualities. Consequences of sugar intake are weight gain, diabetes, heart attacks and strokes. When you look at this, you will agree that is not worth to take any of these risks just to satisfy a sweet tooth. Biting into a crisp, sweet apple is enjoyable and has never harmed anybody. Eating a small helping of fruit salad to top off a meal can be a delicious finale to dinner. If you need a sweetener, you are better served using the plant-derived stevia, which is available as a powder or a liquid. Smallest quantities are adequately sweetening foods. Stevia has no calories and none of the consequences of sugar: you’ll enjoy the sweetness without the bitter aftereffects of tooth decay or heart disease!

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Nov
07
2015

Eat Your Avocado

Avocado is in the limelight, because it has been shown to be a super food with many positive effects on people’s health. It helps arthritis, is good for your vision, protects against cardiovascular disease, fights metabolic syndrome, helps in weight maintenance and even protects against some cancers. It contains healthy oils and many vitamins and minerals.

Avocado composition

80% of an avocado is fiber making it a valuable food to prevent colon cancer. Among the minerals it is noteworthy that avocados are rich in boron and potassium. In terms of vitamins it is rich in vitamin E (alpha-tocopherol), vitamin B6, folate, vitamin K and pantothenic acid. It does not contain cholesterol, but contains monounsaturated fat (oleic acid). Oleic acid is the compound in olive oil responsible for lowering your blood pressure. The oils in avocado contain 71% monounsaturated fatty acids, 13% polyunsaturated fatty acids and 16% saturated fatty acids. This mix promotes healthy blood lipids, but also helps in the absorption of fat-soluble vitamins and phytochemicals. In addition to all that avocados contain phytosterols, a number of carotenoids, non-carotenoid antioxidants, alphalinolenic acid (an omega-3 fatty acid) and glutathione.

Cardiovascular disease protection

The combination of fiber and folate in avocado help to reduce LDL cholesterol, which when oxidized can lead to hardening of arteries. The folate reduces homocysteine, which is a risk factor for heart disease. Phytosterols that are similar in structure to cholesterol compete with cholesterol absorption in the gut.

In a 2015 study several diets were compared with regard to LDL lowering potential, either a low fat diet, or two forms of medium fat diets, where one contained one avocado per day. The results were surprising: the low fat diet reduced LDL by 7.4 mg/dL while the avocado diet reduced LDL by 13.5 mg/dL.

The oils in avocados also seem to suppress the appetite center in the brain helping people to eat less and controlling obesity and diabetes.

Arthritis prevention

In a 2014 study hip osteoarthritis was examined for 3 years. An extract from avocados and soybeans was used and found to be protective of osteoarthritis. The anti-inflammatory components of avocado like omega-3 fatty acids, carotenoids, phytosterols and non-carotenoid antioxidants all work together in countering joint inflammation. Boron abundantly contained in avocado also was found to be essential for healthy joints.

Eye protection

Avocado has its own mixture of carotenoids, like alpha- and beta-carotene, lutein, zeaxanthin, neochrome, chrysanthemaxanthin and others. These are contained in the green pulp. They have anti-inflammatory properties. The fatty acid profile of avocados helps to absorb carotenoids, as they are fat-soluble. A two phase clinical study was done that showed that avocado added to salsa or to salad was leading to 5- to 15-fold increased absorption of the carotenoids in salsa and salad when compared to avocado-free salsa and salad.

This is an important observation that we should remember: always eat some avocado with any fruit or vegetable that contains carotenoids, as this will improve the absorption of the carotenoids tremendously.

Why is that so important for eye disease? In a 2008 study a total of 1802 women aged 50 to 79 years from Iowa, Wisconsin, and Oregon were followed who had intakes of lutein and zeaxanthin above the 78th percentile. They were compared to women below the 28th percentiles in the Women’s Health Initiative Observational Study with eye examinations in both groups. The eye specialists examined their eye lenses for nuclear cataracts. The surprising findings was that women with the highest quintile category of diet or serum levels of lutein and zeaxanthin had 32% less nuclear cataracts than women in the lowest quintile of lutein and zeaxanthin.

This shows that carotenoids of avocados have vision protective effects.

Metabolic syndrome and obesity

This 2013 study included 17,567 US adults and part of the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Comparisons were made between avocado eaters and non-avocado consumers. Interestingly, avocado eaters had a much better overall food quality in their diet: more vegetables, fruit, fiber and less added sugar. Calorie and sodium intake were identical in the two groups. But body weight, body mass index and waist circumference were significantly lower in avocado eaters than in the non-avocado control group. The cardio protective HDL cholesterol was significantly higher in the avocado group. The odds ratio for developing metabolic syndrome, the change in metabolism due to obesity was 50% lower in avocado consumers than in non-consumers. All of this is good news for the consumer, if we eat some avocado.

Skin, beauty and anti-aging

We don’t like to develop too many wrinkles, as they are associated with aging. The oils of avocados have been used for some time in skin care products as they stimulate collagen production in the skin and reduce wrinkles. But when you eat avocados, the carotenoid substances (such as lutein and zeaxanthin) serve for skin protection, protecting you from UV light damage. In addition, vitamin E and glutathione, which are also contained in avocado help to scavenge free radicals; they would otherwise prematurely age and wrinkle the skin. The end result is that the development of wrinkles will be reduced, when you consume avocados. The beneficial effects on your blood vessels in combination with protecting your skin will age your body slower, a point that has been noted in the anti-aging literature.

Cancer blocking properties

In the following I will briefly review the findings of several cancer research groups, but this review is by no means complete.

a) Leukemia:

This 2015 study describes a new chemotherapeutic agent, derived from avocado that they named Avocatin B. Avocatin B is active against the difficult to treat acute myelogenous leukemia (AML). It works by targeting mitochondrial components of AML, but does not affect healthy leukocytes or leukocyte progenitor stem cells.

b) Colon and esophageal cancer:

The authors of this study from Iran describe four phytoextracts of avocado for treatment of patients with esophageal cancer and colon cancer. They noted that the phytoextracts have a much lower toxicity than standard chemotherapeutic agents and significantly slow growth of these cancers. They plan to use these phytoextracts as complementary treatments of esophageal and colon cancers.

c) Oral cancers: this paper describes that avocado extracts were shown to be successful in treating oral cancers.

d) Cancer prevention: In this paper it is discussed that the phytochemicals in avocados arrest cancer cells in their cell division cycle and lead to apoptosis, which is natural cell death. The authors believe that eating avocado regularly can help prevent a whole array of different cancers by this mechanism.

Eat Your Avocado

Eat Your Avocado

Conclusion

Avocados are a super food, which has many beneficial effects. Perhaps one of the outstanding effects is prevention of obesity and the metabolic syndrome as discussed. Women may want to eat it because of the beneficial effects on skin and beauty. We all should be interested in wanting to prevent heart attacks, strokes and cancer.

But who does not want to prevent cataract surgery and keep good vision until a ripe old age? It is possible by eating avocados. And would you not want to prevent osteoarthritis? Eat avocados and add some omega-3 fatty acid from distilled fish oil as well to get the full anti-inflammatory effect. Your joints will thank you and let you swiftly move wherever you want to go.

I thought you should know about the health benefits of eating avocados. They make a nice addition to your food, not only as guacamole, but in a wide variety of dishes: use a few slices on your salad, make a tasty dip, and get inspired by recipes that you can easily find on line.

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