Mar
07
2015

Drink Your Coffee, But…

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

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

1. Calcification of coronary arteries and osteoporosis

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

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

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

2. Whether or not you put sugar into your coffee

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

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

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

4. Micronutrient components of coffee

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

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

This link explains more details about the micronutrients in coffee.

5. Clinical conditions that are partially prevented by coffee consumption

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

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

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

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

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

6. What are the risks of drinking coffee?

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

7. What is the process of decaffeinating coffee?

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

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

Drink Your Coffee, But…

Drink Your Coffee, But…

Conclusion

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

References:

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

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

Feb
14
2015

Laser Therapy Going Beyond Skin Deep

There was an interesting workshop alongside of the A4M conference mid December 2014 organized by Jonathan Schwartz who gave an overview of the use of low-dose laser therapy for various clinical applications. It involved the use of the Dr. Michael Weber low-dose laser machine, which has a lot of versatility.

  1. First there are 5 laser light frequencies in the rainbow colors (infrared, red, yellow, green, blue) and the colors have very special characteristics as will be explained further below.
  2. There are a multitude of applicators like skin acupressure point applicators, a shower for hair loss applications, a head adapter, which looks like a crown. With this device red light will penetrate into the brain through the skull bone. There is also a mouth shower and various lengths needle applicators that can be used to access the body intravenously or interstitially (direct tissue approach). At the center of the equipment is the Weberneedle Compactlaser, which can be attached to the various applicators.

Laser characteristics

The blue laser penetrates about 1 cm (0.39 inch) under the skin, a green laser penetrates only 0.5 cm (0.19 inch); like the blue laser the yellow laser penetrates through the skin with a depth of 1 cm (0.39 inch). The red laser has a penetration depth of 2-3 cm (a bit more or less than 1 inch) and the infrared laser penetrates 5-7 cm (2 to 2 1/2 inches).

In addition the various lasers have different inherent qualities: The red laser is good for tissue regeneration, which lends itself for chronic pain. Green and blue lasers have anti-inflammatory effects, which helps in acute pain. The yellow laser can be used for detoxification, has antidepressant qualities and photosensitizes hypericin, a substance derived from St. John’s wort, which is known to have antidepressant qualities. The various types of laser mentioned can be used interstitially, intravenously and just on the skin surface over acupuncture points. Dr. Weber explained that detailed research has revealed that the low-dose energy beam sends out energy that is taken up by the surrounding tissues and cells. The mitochondria of the cells get activated to produce more ATP, which the cells use to heal themselves.

Meeting in Placentia

Forward to a meeting in Placentia, CA on Feb. 7, 2015 where Dr. Michael Weber and several other speakers gave presentations on the use of the Dr. Weber laser system. A number of local doctors who had an interest in learning more about the low-dose laser system were there as well. It was a daylong mini conference.

Three volunteers were used to demonstrate the use of the system. I was volunteering about a chronic left lower back pain that various chiropractors had problems adjusting in the past year. I have a strong family history of arthritis on my mother’s side and my maternal grandmother’s side as well. The health professionals thought that I likely have developed arthritis in the left sacro-iliac joint. Dr. Weber used the interstitial needle, which is 4 cm (1.57 inches) long. The skin was injected with a local anesthetic first, and then the needle was inserted, which I could hardly feel. Now he injected 5 cc of normal saline. This was used, so that the laser light would spreads more into the surrounding area. Dr. Weber explained that he was very close to the SI joint with the tip of the needle on the left. He attached a blue laser to it for 20 minutes and switched it to a green laser for another 20 minutes.

In the meantime the other two volunteers were treated.

One was a physician in the group who had a chronic planter’s fasciitis. He was treated with an intravenous laser application. First a special butterfly was inserted, through which a sterile laser probe could be threaded and then attached. He received a red laser.

The third volunteer had a chronic right knee problem from congenital Osgood Schlatter disease. In him Dr. Weber used an approach of intraarticular injection and he attached a blue laser for 20 minutes, followed by a yellow laser for another 20 minutes. A physician with a California license supervised all of these procedures.

I woke up the following day with no pain in my left lower back, but at the same time the lesser right lower back pain had also disappeared. I figure that due to the fact that my back mobility is back the untreated right side must have normalized as well. It is now 7 days following the procedure and I still have no back pain. Yesterday I saw my local chiropractor in Southern California and he confirmed that my back was much easier to adjust than the month before (Update April 12, 2015: my lower back is still pain free!).

Normally a case like mine would require 5 to 6 weekly treatments before the problem is resolved. Dr. Weber explained that more complicated problems like fibromyalgia would take 15 to 20 treatments in succession or more. The principal is always that you treat where the symptoms are; in the follow-up visit the healthcare practitioner treats the remaining symptoms until all of the symptoms have resolved.

The intriguing fact is that low-dose laser therapy seems to fit right into gap where conventional medicine has failed.

Clinical cases that respond to laser therapy

Dr. Weber has collected clinical cases that improve with laser treatments, such as diabetes, chronic liver diseases, chronic pain syndromes, rheumatoid arthritis, polyneuropathy, chronic inflammatory disease, cancer (with photodynamic therapy), fibromyalgia, high blood pressure, ringing in the ears (tinnitus), macular degeneration, multiple sclerosis, chronic fatigue syndrome, Lyme disease, allergies and eczema. This, however, is just a partial list.

Photodynamic cancer therapy is made possible by the fact that certain substances have absorption spectra that are activated by different wavelength. This amplifies the effect of the natural substance that is used by several folds. For instance Chlorin E6 absorbs a red laser (around 660 nm). A blue laser activates Curcumin. A yellow laser activates Hypericin. Here is a website that explains the principle of phototherapy.

Various cancers can be treated where conventional medicine has so far failed. Examples are lymph metastases from breast cancer, pancreatic cancer, and bladder cancer. I have blogged regarding a combination treatment for breast cancer before, where phototherapy with lasers and immunostimulation were combined. Esophageal cancer is treated through esophagoscopy combined with a laser that activates curcumin, which had been taken orally well before the procedure. Not all of the cases are successful, but the majority of them are.

Otherwise routine low-dose laser applications are used for tendinitis, tennis elbow, sprains and soft tissue injures.

Laser-Therapy-Going-Beyond-Skin-Deep

Laser-Therapy-Going-Beyond-Skin-Deep

You can combine the laser system with prolotherapy. Prolotherapy is done first by injecting hyperosmolar dextrose solution, which is a strong stimulator of stem cells. Using the same needle, but attaching the Weber low-level laser therapy will activate the stem cells and protect them from dying off.

Conclusion

Low dose laser therapy using the Weber Medical technology is a new treatment modality available to the interested physician. I think that it will cause a revolution within medicine. It is scientifically sound and it fits right into the difficult to treat patients; the patients that otherwise would be unlikely to respond. However, they will respond well to these new treatment modalities. Apart from musculoskeletal problems, various cancers will also respond to this. The Mayo clinic is starting a study on treating cancer using phototherapy and the Dr. Weber low-dose laser system.

Jan
30
2015

Prolotherapy And Stem Cell Therapy

This blog is the 5th blog and the last one of a series that dealt with telomeres, lifestyle and stem cells, topics that were on the agenda of the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014). Here are summaries of two talks from this conference that dealt with methods of repairing damage to your joints or bones without surgery. Treatments consist of stimulating local stem cells through a treatment called “prolotherapy” where needles are used to inject concentrated dextrose. I will explain below why this method is effective. A modification of this original prolotherapy is when the effect of it is amplified by growth factors from so-called platelet rich plasma (PRP), which is mixed with the dextrose injection. The ultimate healing jerk occurs when you mix in stem cells with the PRP into the injured tissues. Images before the procedures and images some time after the procedures were shown at both lectures with impressive results.

1. Dr. Fields’ talk was entitled “Repairing joints and spine without surgery: prolotherapy/PRP/stem cell therapy”.

This talk concentrated on the use of prolotherapy with concentrated dextrose and prolotherapy with platelet rich plasma (PRP) with or without the addition of stem cells in the treatment of various musculoskeletal injuries.

When prolotherapy is done by itself 12.5% Dextrose is used to inject into the area of injury. Dr. Fields said that the reason it works is that local stem cells in the injured area are getting activated where the Dextrose is injected and these activated stem cells will do the healing (details explained in an interview with Dr. Reeves). This result can be improved by injecting a small amount of PRP very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are discarded, but the platelet fraction and some of the plasma is used as the PRP preparation. To amplify the effect of the PRP stem cells from bone marrow and from fatty tissue are mixed into the injection. Dr Fields explained that bone marrow is aspirated from the pelvic bone and in the same patient a liposuction is also done to receive adipose tissue. Both tissue samples are put through a cell separator to obtain bone marrow derived stem cells and adipose derived mesenchymal stem cells. Both fractions are combined as they make a superior stem cell mix and are activated by adding platelet rich plasma. This mix was used for bone fractures that were slow to heal, for ruptured tendons, ligaments, Achilles tendons and rotator cuff tears. Dr. Fields showed before-slides and several weeks to months after-slides with MRI scans of the original injuries and the final healed tendons and ligaments. I have never seen such beautiful healing with no residual scar. Stem cells are the specialists of healing such defects because they change into whatever cell type is required and they fill in the defects. This explains the perfect function after the injury is healed following stem cell and PRP injection. It also explains why many athletes who had this done went on to winning more medals after the repair. You do not hear about success stories that often after conventional surgery, because the range of motion and strength suffer from scarring following conventional surgical repairs.

Case histories: several patients with knee injuries that were treated with prolotherapy were shown on video testimonials explaining that their procedures only involved needles in the injured area, that they experienced almost complete pain relief on the day of the procedure and that they could rehabilitate right away.

Slides were also shown of specific knee ligament injuries involving the medial collateral ligament (MCL), the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL). These are very important support ligaments within the knee.

But this was not all: there were lower back injuries with ruptured discs. Conventional medicine would have offered a discectomy, but here these patients were treated with prolotherapy. They experienced a stabilization of the weak areas, spontaneous resorption of the prolapsed disc and stabilization and strengthening of the weak spine. MRI scans of the spinal injury before treatment and several months after the treatment were shown with a complete normalization of the spine. In my work as a Medical Advisor for Workers’ Compensation cases that I was doing for 16 years I have never seen a single case like that.

A similar spinal injury in the neck was shown as well with a testimonial from that person. Again there was minimal pain, immediate rehabilitation and a full range of motion several weeks after the injury had been treated with stem cells.

What is treated with prolotherapy?

Basically all of the major joints can be treated with prolotherapy: the shoulder, knee, back, the neck, ankle, elbow and hip. The types of injuries that are treated are sports injuries, fibromyalgia, sciatica, muscle tears, tendonitis, arthritis, bursitis and temporomandibular joint problems (TMJ).

Dr. Fields also stressed (and so did Dr. Purita, which we will learn below) that activated platelet rich plasma needs to be used to activate stem cells.

Two special cases were presented, namely patellar tendinitis and Achilles tendinitis, which both respond very well to prolotherapy and PRP plus stem cell therapy. This provides complete healing of these otherwise very difficult clinical entities.

An image was shown from the late C. Everett Koop, MD, the former Surgeon General of the Untied States who had this to say about prolotherapy: ““I have been a patient who has benefited from prolotherapy. Having been so remarkably relieved of my chronic disabling pain, I began to use it on some of my patients.” This may yet be the strongest argument to at least consider prolotherapy in otherwise hopeless cases.

2. Dr. Joseph Purita gave a lecture on the “Effects of PRP And Stem Cell Injections”. As explained above PRP stands for platelet rich plasma, which is a “soup” of various growth factors and exosomes =cell-to-cell mediators). He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They can be seen with the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental when stem cell injections with PRP were done in the past (poor survival rate of stem cells). Now it has been detected that photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections. Soft laser stimulation with red, green and blue soft lasers have been shown to improve tissue healing significantly when stem cells and light activated PRP are used. As already described in Dr. Field’s talk the main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). Dr. Purita also explained that nitric oxide and electrical stimulation also help to improve stem cell survival and reduce inflammation. All of these methods are revolutionizing orthopedics where injured tissues can be mended with the help of injecting stem cells, light activated PRP and using laser treatments. Dr. Purita showed very detailed technical aspects of these procedures with various applications. For instance, he showed a slide regarding treatment for osteoarthritis of the knee. All this is contained in the plasma that is used to inject PRP into a joint with degenerative arthritis. When you mix this with bone and adipose tissue derived stem cells and inject it into the knees of a person with degenerative arthritis, you get the ideal remedy to calm down the degenerative process with instant pain relief and the stem cells are transforming into cartilage cells (chondrocytes) building up hyaline cartilage. The end result is a new knee surface where the old and the new repaired knee surfaces are knitted into one seamless unit.

PRP by itself can be used successfully for repairing bursitis of shoulders and rotator cuff tears, muscle tears and sprains, meniscus tears of the knee, mild to moderate osteoarthritis of various joints and spine disorders, particularly facet joint problems.

Prolotherapy And Stem Cell Therapy

Prolotherapy And Stem Cell Therapy

Dr. Purita gave a thorough overview of stem cells. He pointed out that stem cells fulfill two criteria:

  1. They are undifferentiated and they are capable of self-renewal by replication
  2. They can undergo differentiation into specific cell lineages.

From a practical point of view as already mentioned in Dr. Field’s talk there are two sources for stem cells that are important: stem cells derived from adipose tissue (also called MCS or mesenchymal stem cells) and bone marrow derived stem cells, obtained usually from the pelvic bone. When they are mixed and stimulated with PRP they are the miracle mix that will help heal all these injuries.

What does the FDA say to stem cell therapy? “The FDA states it is ok to use these cells as long as they are put back into the same patient and they are minimally manipulated.”

Dr. Purita listed a host of other factors beside platelet rich plasma that supports stem cells, increases their survival on transplantation and stimulates them to differentiate and heal the defect at the recipient site as quickly as possible. Photoactivation of platelet rich plasma with low level lasers (soft lasers) will release exosomes, which are tiny particles, released by platelets and white blood cells. They contain proteins and genetic material required for wound healing and stimulation of stem cells.

Towards the end of the talk Dr. Purita showed an MRI scan of a knee with avascular necrosis (dead bone) before and after treatment with stem cells, PRP and low level laser therapy. There was a complete resolution of the avascular necrosis without any surgery. A second case was shown where the initial MRI scan showed a complete tear of the medium collateral ligament (MCL tear) of the knee and the follow-up scan showed the same ligament intact. This was achieved without surgery, just by treating the patient with an injection of stem cells; PRP and using low-level laser therapy to activate PRP.

Conclusion

Prolotherapy and stem cell therapy are the hottest new treatment modalities for ruptured tendons, ligamentous injuries, and disc herniations in the neck and in the lower back. You will not get this from your primary care physician or from your regular orthopedic surgeon at the present time, because they profit from the conventional procedures. But you owe it to your health to try these alternatives first as they are much less invasive and they involve your own cells that will heal the defects with a very high probability. You still have the option to seek the advice of an orthopedic surgeon, should these alternative procedures fail (which is unlikely). Unfortunately most insurance carriers will not pay for this service at this time.

Disclaimer: Dr. Schilling has no conflict of interest with regard to Regenexx or any of the other companies of which images were shown; they simply displayed the best images with regard to the many illustrations in this blog.

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Jan
22
2015

Life Expectancy Is Influenced By Lifestyle

The previous three blogs have dealt with telomeres, stem cells and lifestyle as a theme. In this blog you find summaries from three talks at the 22nd Annual World Congress on Anti-Aging Medicine In Las Vegas (Dec. 10-14, 2014) that dealt with telomere length and how nutrition can positively influence what our genes express, which ultimately determines how long we live. This is at the center of anti-aging medicine and this is why I dealt with it in some detail.

1) Dr. Theodore Piliszek: “Personalized Genetics: Applying Genomics to General Health, Nutrition, and Lifestyle Modification”

The individual’s metabolism is different from one person to the next. As a result of this, one needs to match the diet one recommends for a patient to that person’s genetic make-up.

The Mediterranean diet has 20% protein, 35% fat, 45% carbs; here is the composition of other diets:

Low carb diet: 30% protein, 30% fat, 40% carbs

Low fat diet: 20-25% protein, 20-25% fat, 50-55% carbs

Balanced diet: 20% protein, 25% fat, 55% carbs

Snack only on low caloric foods; otherwise leptins react and make you hungry. A sweet tooth predisposes you to develop diabetes. Lactose intolerance is more common than previously thought. 30% of type II diabetics presently will develop dementia and Alzheimer’s is now often referred to as type III diabetes. With sugar being present in so many processed foods, this figure will likely jump to 60% in the future!

Methylation is very important for your well being. Here is a quick link to explain methylation in simple terms without getting too much into biochemical nomenclature. Having said this, vitamin B2, B6, B12 are needed for this biochemical process, SAMe is also a supplement that supports methylation.

If you do not have a longevity gene, you need to watch that you stick to organic food, stay active, may be add methylated folate and vitamin B12. Each patient should get a supplement list that is customized.

The health practitioner should ask the patient to keep a food diary for 1 week, which gives the doctor the nutritional profile including what the patient consumes in the way of drinks. Check vitamin D3 blood levels! Adequate levels of vitamin D3 are necessary for the musculoskeletal system and the immune system. Endurance training is important up to age 45. Beyond that age emphasis should be on isometric exercises (weight lifting).

Dr. Piliszek stated that the life expectancy in the US is falling behind many other countries. I did a quick Google check regarding life expectancy around the world as follows: US: 78.7 years; Canada: 81.2 years; France: 82.7, Italy: 82.9; Spain: 82.3; Portugal 80.37; Sweden: 81.7; Denmark: 80.05; Norway: 81.45; Germany: 80.89; Poland 76.8; Russia: 70.56. Seeing that the conference took place in the US, there is a lot of room for the US to improve habits with regard to food intake.

Dr. Piliszek stated that the normal range for hemoglobin A1C is skewed in the medical literature and the recommendations are too high; it should be: 3.8 to 4.9 %. This is very important to know for diabetics and any caregiver who looks after diabetes patients, because if you are satisfied with a hemoglobin A1C of 6.0 as still being “normal”, the diabetic patient dies prematurely of a heart attack or a stroke. Contrary to the National Diabetes Information Clearinghouse (NDIC) recommendation it is important to take note: the new normal range for hemoglobin A1C is 3.8 to 4.9%! A patient whose hemoglobin A1C is 5.5 has diabetes and needs to be treated aggressively to prevent complications associated with diabetes.

2) George Rozakis, MD: “Nutrigenomics”

This talk focused on how one could use nutrition to heal when genetic errors are present in the metabolism. This field is called “nutrigenomics”. It deals with using diet modifications and nutrients to change gene expression. Another way to express this is that with proper epigenetic changes by using the right nutrients for a person with an inherited weakness, using the right nutrients for a person with an inherited weakness can extend life. At the same time you need to avoid nutrients that would harm a person with a certain genetic weakness.

We all have inherited some minor or not so minor genetic errors in the genetic code. We are made up of 50 trillion cells with 30,000 genes and 23 pairs of chromosomes, so there are bound to be a few minor genetic code errors that make us more or less susceptible to develop disease, particularly when our telomeres are shortening with age making self-repair of many of our aging cells difficult, if not impossible.

Genes program our cells to run biochemical reactions within the cells. Correct methylation pathways are important for normal cell function. However, if there is a methylation defect, abnormalities set in and homocysteine accumulates.

With various enzyme defects you need to use appropriate supplements to normalize the metabolic defect. Vitamin B2, B6 and B12 supplementation will often stabilize methylation defects and homocysteine levels return to normal. This is important as severe, familial cardiovascular disease can be postponed this way by several years or more.

In a similar vein Dr. Rozakis mentioned that 92% of migraine sufferers have a defective methylation pathway involving histamine overproduction and they can be helped with a histamine-restricted diet.

Autism, ADHD (hyperactivity) and learning disabilities are other diseases where methylation pathway defects are present. Every patient with autism should be checked for methylation pathway defects, and appropriate supplements and diet restrictions can help in normalizing the child’s metabolic defects. DAN physicians (“defeat autism now”) are well versed in this and should be consulted.

S-adenosylmethionine (SAMe) defects are another type of methylation defect, which is important in certain liver, colon and gastric cancers.

Dr. Rozakis went on to say that methylation defects lead to disbalances between T and B cells of the immune system and are important in autoimmune diseases like lupus or rheumatoid arthritis.

Methylation defects can also cause autoimmune thyroiditis and type 1 diabetes. They can also cause cardiac disease by raising homocysteine levels, which causes dysfunction of the lining of arteries and premature heart attacks.

Epigenetic factors through global methylation defects from vitamin B2, B6 and B12 deficiency cause many different cancers. Hypomethylation is the most common DNA defect of cancer cells.

Mental illness is another area where epigenetic factors play an important role. Depression that responds only partially or not at all to SSRI’s (antidepressants) often responds to L-methylfolate, a simple supplement from the health food store as a supplement. Similar epigenetic approaches can be used to treat psychosis, schizophrenia, bipolar disorder and Alzheimer’s disease.

With skin diseases it has come to light that atopic dermatitis, eczema, psoriasis, scleroderma and vitiligo are related to methylation.

When we age, certain hormones are gradually missing, which leads to menopause and andropause. This leads to impaired cell function, elevated cholesterol, arthritis, constipation, depression, low sex drive, elevated blood pressure, insomnia, irritable bowel syndrome and fatigue. Replace the missing hormones with bioidentical ones and symptoms normalize.

Life Expectancy Is Influenced By Lifestyle

Life Expectancy Is Influenced By Lifestyle

3) Dr. Al Sears: “Telo-Nutritioneering: The latest generation of telomere modulators”.

Shortened telomeres are causing cells to behave like old cells. In the lab we can lengthen telomeres. Telomerase activated animals regrew their brains!! In the human situation the goal is to find ways to preserve the length of our telomeres in all our key organs. Alternatively this can also be reached by inhibiting the breakdown of the enzyme telomerase, which will lead to a lengthening of telomeres. In his research Dr. Sears found at least 123 nutrients, vitamins and natural compounds that will elongate telomeres, often by stimulating telomerase.

Testing for critically short telomeres (HT Q-FISH method) is clinically more important than using average telomere length tests. Dr. Sears said when a patient has been shown to have short telomeres and this patient is started on telomerase stimulating supplements, telomere lengthening can be documented within one month of starting the supplementation. Acetyl-L-carnitine and resveratrol are two substances that reliably elongate telomeres.

Vitamin C will significantly delay shortening of telomeres, which translates into delayed aging. In addition vitamin C has recently been shown to stimulate telomerase activity in certain stem cells. There is an herb, called Silymarin extract, which was found to increase telomerase activity threefold. N-acetyl cysteine is a building block for glutathione, a powerful ant-oxidant. In addition it has been shown to turn on the human telomerase gene. Other telomerase stimulators are green tea extract, ginkgo biloba, gamma tocotrienol (one of the components of the vitamin E group), vitamin D3 and folic acid.

Dr. Sears suggested that we should take the following supplements and vitamins for “telo-nutritioneering” (alphabetically arranged) with recommended dosages:

Acetyl L-carnitine: 1,000 mg daily; alpha tocopherol: 400 IU daily; folic acid: 2 mg to 5 mg daily; gamma tocotrienol: 20 mg minimum daily; ginkgo biloba: 40 mg to 80 mg daily (cycle every 4 to 6 weeks); green tea (EGCG): 50 mg daily; L-arginine: 500 mg to 1,000 mg daily; N-acetyl cysteine: 1,800 mg to 2,400 mg daily; resveratrol: 10 mg to 20 mg daily; silymarin: 200mg twice daily; vitamin C: 540 mg minimum daily; and vitamin D3: 2,000 IU daily.

Even if you are only taking 5 or 6 of these twelve telomerase boosters daily, you are doing well, particularly if you are also watching your lifestyle (regular exercise, not smoking, cutting out excessive alcohol intake and avoiding sugar).

Conclusion

This is only the beginning of rethinking epigenetic treatment approaches. For too long organized medicine has used a “cookie-cutter” approach of diagnosing and treating diseases. Now we are realizing that changes in hormones and shortening of telomeres with aging can cause inflammation and premature deaths. The future of medicine, which has already started, uses nutritional changes, vitamins and supplements, bioidentical hormone replacements and exercise to stabilize cell metabolism and postpone age-related diseases.

Jan
16
2015

Telomere Length A Telltale Sign Of Aging

Dr. Sandy Chang gave a talk at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Telomere measurement as a diagnostic Test in cardiovascular and Age-related disease”, but a shorter title would be “telomere length a telltale sign of aging” (my choosing).

Dr. Chang pointed out that it is now well established that telomere length is directly related to health. The shorter the telomeres are the higher the probability to get the following: early menopause, infertility, diabetes, wrinkles, arthritis, osteoporosis, cardiovascular disease, Alzheimer’s, Parkinson’s, dementia, cancer, stress and a lack of stem cells. In this BMJ study from 2014 it was shown on a large population basis that shorter white blood cell telomeres lead to a higher risk of coronary heart disease causing heart attacks. Decreased telomere length is also associated with the development of breast cancer, cancer of the ovary and uterus, cancer of the prostate and skin cancer.

Because of these connections it makes sense to determine a person’s telomere length. If it is short, do check-ups more often to detect any cancer early when it can still be treated.

Telomere length measurements are now done in many infertility clinics as short telomeres both in the male and female is associated with infertility.

The newest finding and perhaps the most important is that a healthy lifestyle, vitamins and supplements can elongate telomeres while a poor lifestyle leads to shortening of telomeres.

Here are the factors that lead to shortening of telomeres:

– Chronic stress

– Poor diet and nutritional habits

– Chronic inflammatory diseases

– Metabolic disorders

– Lack of consistent exercise/sedentary lifestyle

– Obesity, high BMI and body fat

– Smoking

– Over consumption of alcohol

– Lack of sleep / insomnia

When short telomeres are detected, it is important for the physician to look at lifestyle changes to protect telomeres from decreasing their length even further. This has the potential of preventing dementia and Alzheimer’s when it comes to brain health. It can prevent osteoporosis and metabolic diseases (diabetes, metabolic syndrome). Telomerase is the buzzword today, which is an enzyme that all of our cells have. The purpose why we have telomerase in our cells seems to be helping us build up and repair telomeres. Any substance that preserves telomerase or prevents the breakdown of telomerase will prevent shortening of telomeres and will also prevent the above-mentioned diseases.

These supplements lead to lengthening of telomeres:

-Vitamin C and E

-Omega-3 and polyphenols

-Vitamin A and D3

-All of these help controlling oxidative stress, reduce DNA damage, reduce inflammation and build up telomere length.

-A good diet and nutrition (Mediterranean type diet) will prevent telomere shortening as well and also lead to telomere lengthening.

-T-65, an extract from astragalus has been shown in vitro to lengthen telomeres, but there is no publication yet about in vivo effects in humans.

-Resveratrol is useful to prevent shortening of telomeres as well.

-Exercise also is a simple means to prevent telomere shortening.

Telomere Length A Telltale Sign Of Aging

Telomere Length A Telltale Sign Of Aging

Another talk on telomeres was given by Dr. Harvey Bartnof with the title “Telomere Shortening and Modulation: Case Studies From The Clinic”.

This talk was a comprehensive review of what is known about telomeres, about the fact that many diseases are due to telomere shortening, about animal experiments, ways of how to lengthen telomeres and finally some data on human studies with regard to telomere lengthening.

In the following I will briefly review all of these areas that were discussed. Some of this material overlaps with Dr. Chang’s lecture.

What produces telomere shortening? Dr. Bartnof showed 4 slides that listed all of the conditions and diseases that are associated with telomere shortening. Telomere shortening is associated with twice the risk to die from a heart attack when compared to people with normal telomeres.

a) Known genetic conditions in humans associated with telomere shortening

There are three known genetic conditions due to telomere shortening: A premature aging syndrome, called dyskeratosis congenitalis; patients with this condition die prematurely from cancer, or from bone marrow failure.

People with Werner syndrome who have a genetic telomere loss have a mean life expectancy of only 54 years.

Idiopathic pulmonary fibrosis is another genetic condition with shortened telomeres due to mutations.

b) Telomere shortening associated with these health conditions

Professor Elizabeth Blackburn, PhD who is one of the three researchers who won the Nobel Prize in Physiology and Medicine for their work on telomeres in 2009 stated the following: “Telomere shortness is associated with just about all the major diseases of aging… from cardiovascular disease, death from cardiovascular disease, risks of cardiovascular disease, diabetes, diabetes risks such as insulin resistance, vascular dementia, to osteoarthritis.”

An enormous amount of clinical investigations have been done since in cohort groups like people with diabetes, high blood pressure, obesity and cancer.

There is natural shortening of telomeres due to the aging process. When we compare telomere length of body cells of a 20-year old and call this 100%, the telomeres of a 100-year old person are on average only 40%. A study from the Karolinska Institute found in a group of matching twins where one twin had shortened telomeres, this twin had a 2.8 times greater risk of death than the twin with normal telomere length.

However, as already mentioned a number of other factors can lead to shorter telomeres like chronic stress in workers who look after Alzheimer patients, being of the Caucasian race (compared to African-American), having had less education, chronic unemployment, depression, pessimism, single people versus married people, phobic anxiety in women and hostility in men, poor sleep and too little sleep, migraine headaches in women, low physical activity, smoking cigarettes and alcohol consumption. The list does not stop here. Other conditions are associated with telomere shortening like heroin abuse, exposure to smog, polycyclic aromatic hydrocarbons and lead, cardiovascular disease, diabetes, cancers, osteoporosis, osteoarthritis, rheumatoid arthritis, cirrhosis of the liver, inflammatory bowel disease, chronic obstructive lung disease, Alzheimer’s disease, Parkinson’s disease, chronic kidney disease and disability in the elderly.

c) Effects of medications on telomere length

Antidepressants used against depression have a telomere lengthening effect, but NSAID’s, aspirin and interferon-alpha shorten telomeres. Other telomere shortening effects come from cancer chemotherapy.

d) Telomerase activation elongates telomeres

Successful experiments in various mouse strains showed that special strains that were telomerase deficient, could be reconstituted to normal by reinserting telomerase: atrophied organs regrew back to normal size and function. In humans it was shown that increased physical activity elongated telomeres, so did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet, marine omega-3 fatty acid supplementation, higher fiber intake, bioidentical estrogen in women and testosterone in men, relaxation techniques like yoga and meditation. The Astragalus-derived telomerase activator TA-65 has been shown in animal experiments to elongate telomeres. The human data about TA-65 is still spotty or not available (it is also very expensive and may be unnecessary given the fact that so many other agents are known to lengthen telomeres).

e) Human data on telomere lengthening

Much can be achieved by changing one’s lifestyle: cut out toxins like cigarette smoking and alcohol abuse. Get involved in a regular exercise program, which has been shown to increase HDL cholesterol and to elongate telomeres. Adopt a Mediterranean type diet including olive oil; take vitamin E, D, C and supplements with resveratrol and murine omega-3 fatty acids, all of which elongate telomeres. Get enough sleep (7 to 8 hours per night) and do yoga and meditation. Avoid distress and tone down your stress level to eustress (normal stress level associated with every day living). An older person should use bioidentical hormones to replace missing hormones. All of this taken together will create a milieu in your body where telomeres get elongated and you live longer without disease. Several clinical conditions were mentioned where baseline telomere length was assessed initially and was found to be too short; simple lifestyle changes were then initiated, which were able to improve telomere length and treat these diseases successfully. In addition TA-65 (also termed T-65) was given in some of these cases, but in a subsequent discussion Dr. Bartnof admitted that he could not comment on how effective TA-65 by itself was as it was only one component of many other effective telomerase stimulators given. Till further research is out on this substance, it may be just very costly without spectacular benefits on its own.

Conclusion

I gave a summary of the talks by Dr. Chang and Dr. Bartnof regarding telomeres, but these were not the only talks about telomeres, although quite representative for the others. Both speakers pointed out how powerful lifestyle is for our body functions as this is what lengthens our telomeres and allows us to live longer, disease-free lives. Stem cells also have telomeres, but they are on average longer than the rest of the body cells (called somatic dells). An improved lifestyle will keep our stem cells in good shape, so they are there when needed to replace aging somatic cells.

The new logic of a healthy lifestyle is:

A healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age. In the next few weeks I will blog about more topics from the 22nd Anti-Aging Conference in Las Vegas. Stay tuned.

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

Mar
01
2014

Smoking Remains A Health Hazard

Recently new statistics came out that show that 48.8 million people in the US (19% of the population) still smoke. 22 % of the population are male, 17% female. Smoking is responsible for 20% of all deaths in the US (1 in 5 deaths). It is interesting to note that in the older age group (above the age of 65) only 8% are smoking, but 22 % of the 25 to 44 year old group is smoking. Among the American population Native Americans have the highest percentage of smokers (32% are smokers). 10% of Americans of Asian descend smoke. Blacks, Whites and Hispanics are placed in between them and the American Indians. Finally, people who can least afford it (who are below the poverty level) have the highest percentage of smokers (29% smoke) while 18% of people above the poverty level smoke. Education seems to have a protective effects when it comes to smoking: of the least educated group of people 45% are smokers while only 5% with postgraduate education smoke.

Effects of cigarette smoke on the body

As this link shows the concoction of various ingredients in the smoke of cigarettes causes various parts of the body to react differently to these chemicals. Here is a rundown of diseases caused by smoking cigarettes.

1. Lung cancer: This is the most common cause of death in women who smoke, more common now than breast cancer. 90% of lung cancers in women are due to smoking. The same was true in males, but as a group they now smoke less than in the past.

2. Other cancers:  cervical cancer, kidney cancer, pancreatic cancer, bladder, esophageal, stomach, laryngeal, oral, and throat cancers are all caused by smoking. Recently acute myeloid leukemia, a cancer of the bone marrow has been added to the list of smoking related cancers.

3. Abdominal aortic aneurysm: As cigarette smoke destroys elastic tissue, it is no wonder that the loss of support of the wall of the aortic artery leads to the development of large pouches, which eventually rupture with a high mortality rate due to massive blood loss.

4. Infections of lungs and gums: Smokers are prone to infections of the lungs (pneumonia) and of the gums (periodontitis).

5. Chronic lung diseases: emphysema, chronic bronchitis, asthma.

6. Cataracts: lack of perfusion of the lens leads to premature cataract formation.

7. Coronary heart disease: hardening of the coronary arteries, which leads to heart attacks, is very common in smokers.

8. Reproduction: reduced fertility in mothers, premature rupture of membranes with prematurely born babies; low birth weight; all this leads to higher infant mortality. Sudden infant death syndrome is found more frequently in children of smoking moms (Ref. 1).

9. Intermittent claudication: after decades of smoking the larger arteries in the legs are hardening and not enough oxygen reaches the muscles to walk causing intermittent pausing to recover from the muscle aches. If it is feasible a cardiovascular surgeon may be able to do a bypass surgery to rescue the legs, often though this is not feasible and the patients lower legs or an entire lower limb may have to be amputated.

10. Others: osteoporosis is more common in smokers; poor eye sight develops due to age-related macular degeneration that sets in earlier and due to tobacco amblyopia, a toxic effect from tobacco on the optic nerve; hypothyroidism is aggravated by smoking and menopause occurs earlier.

Smoking Remains A Health Hazard

Smoking Remains A Health Hazard

What happens in the lung tissue in smokers?

Ref. 1 gives a detailed rundown of the changes in the lung tissue as a result of exposure to cigarette smoke. The various components of cigarette smoke lead to an activation of special white blood cells, called monocytes that after stimulation turn into tissue macrophages. In addition neutrophils (regular white blood cells) also get stimulated. Between them they produce cytokines and chemokines and the neutrophils secrete elastase that digests elastic tissue in the lungs. Breakdown products of the elastic tissue serve as a powerful stimulus to the immune system to mount an autoimmune response. After some time of being exposed to cigarette smoke the immune system considers part of the lining of the lungs as foreign and cytotoxic lymphocytes attack the lining of the air sacs (alveoli). Lung specialists consider chronic obstructive pulmonary disease (COPD or emphysema) to be an autoimmune disease (Ref.1).

The sad part is that when this condition has progressed far enough, even quitting smoking may be too late to stop the autoimmune disease by itself as the body has been sensitized and the immune system is convinced that the altered lung tissue should be attacked. Add to this that carcinogenic substances and toxins in cigarette smoke damage the DNA of all cells and the energy producing mitochondria, and the stage is set for the combination of chronic inflammation and the release of free radicals to cause all of the diseases mentioned above.

Quit smoking still important

It is extremely important to quit as soon as possible to avoid the full-fledged sensitization of the immune system against ones own lung tissue. Studies have shown that 36% of survivors of heart attacks will successfully quit, 21% of healthy men with a known risk of cardiovascular disease will quit when asked to do so and 8% of pregnant women will quit. When a physician examines a patient in the office and asks a smoker to quit smoking 2% of these smokers will respond and still not smoke 1 year after this doctor’s visit. This may not sound like much, but it is an encouraging effect. Perhaps the most important fact is what I mentioned in the beginning of this blog: the least educated group of people smoked the most (45%) while the most educated people smoked the least (5% of people with a postgraduate education). My hope is that the Internet and other educational media will contribute to education to convince people how important prevention is.

Pharmacological assistance to quit smoking

Nicotine replacement therapy can involve any of 2- and 4-mg nicotine polacrilex gum, transdermal nicotine patches, nicotine nasal spray, the nicotine inhaler or nicotine lozenges. Discuss with your doctor what may be best in your case. Typically one of these products is used for 3 to 6 months.

Bupropion is an antidepressant with a nicotinic acetylcholine receptor affinity. Bupropion is useful to help with the withdrawal from nicotine addiction, which occurs in depressed or non-depressed people. It strictly has to do with the stimulation of the nicotinic acetylcholine receptor.  Typically the dose is 150 mg of a sustained released bupropion tablet per day for 7 days prior to stopping smoking, then at 300 mg (two 150-mg sustained-release doses) per day for the next 6 to 12 weeks. 44% quit at 7 weeks versus 19% of controls. A newer nicotine partial receptor stimulator, varenicline, has been compared to bupropion. It was slightly more effective in helping people to get off cigarettes. Varenicline is started at a dose of 0.5 mg per day for 3 days, then 0.5 mg twice daily for 4 days, followed by a maintenance dose of 1 mg twice daily. If nausea is a problem, lower doses can be used. Varenicline has been approved for a 3-month period with an option of a second 3-month period, if relapse occurs. Discuss with your doctor what is best for you.

According to Ref. 1 a combination therapy of bupropion and nicotine patch was more effective than either one alone.

Will power, hypnotherapy

Hypnotherapy to quit smoking has been popular, but is not as effective as it is often claimed. Will power, measured by the “placebo” response is quite effective given the fact that nicotine is very addictive and yet 19% in the placebo group were able to quit on their own. According to Ref. 1 varenicline treatment for 12 weeks produced abstinence for 9 to 52 weeks and was compared to bupropion and placebo. The abstinence rates were 23%, 15%, and 10% for varenicline, bupropion, and placebo. This means that will power was still 2/3 as effective as bupropion and 43% as effective as varenicline. Don’t underestimate will power!

Conclusion

The best scenario is to never start smoking. The second best is to quit as soon as possible. Unfortunately, the third scenario of continuing to smoke is still very prevalent worldwide. I have seen the damage done first hand in practicing medicine, which motivated me to never smoke. But I am aware of the difficulties of quitting because of the highly addictive nature of cigarette smoking. Where is the support from governments on this? The problem is that the government benefits from taxation of cigarettes. Nevertheless it is laudable that there are government sites through the CDC to help you quit smoking.

At the end we are all responsible for our own health. If you are presently smoking, psych yourself up for the day that you will quit. Quitting means that you are deciding actively to live longer. Studies have shown that it takes often several attempts before you eventually quit successfully.More information on some of the topics mentioned:

1. Lung cancer and other cancers: http://nethealthbook.com/cancer-overview/overview/epidemiology-cancer-origin-reason-cancer/

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

3. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

Reference

1. Mason: Murray and Nadel’s Textbook of Respiratory Medicine, 5th ed.© 2010 Saunders

Last edited Nov. 7, 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

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Dec
21
2013

Buying Into High Carb, Low Fat Myth Makes You Sick

If you are like most people, you probably still think that “healthy grains” like wheat are good for you and are “essential for a well balanced diet”. Ever since Kellogg’s introduced cereal for breakfast and the bagel was invented as a mid morning snack, which has captured the tastes of millions, the Agro Industry and the food industry have lobbied to have “healthy grains” in the food pyramid or on your plate. The very thought of “the daily bread” is deeply ingrained in our culture.

Other agencies like the Heart Foundation, the Academy of Nutrition and Dietetics (formerly “American Dietetic Association“) and the American Medical Association have reiterated this statement over and over until both the public and physicians accepted this as the truth. However, the scientific data does not support this point of view!  It has been a myth!

We are gradually learning that there has been a big misinformation campaign going on as far back as 1984 (and before) when a consensus panel came up with revised normal values for cholesterol and we as the medical profession were told (myself included) to treat high cholesterol levels much earlier and more aggressively than in the past with statins.

Big Pharma is still pushing for this. Now that I am retired for more than three years I can freely write about what is really going on. The truth has already leaked out, but it is not yet common knowledge.

I like to review the switch from the old school of thought that a high carb/low fat diet would be healthy to the new school of thought that a low carb/high healthy fat diet is healthy. Before you panic, sit back, relax and read what I am saying.

Buying into High Carb, Low Fat Myth Makes You Sick

Buying Into High Carb, Low Fat Myth Makes You Sick

A brief history of the high carb/low fat diet recommendation

It was the Framingham Study, which is an ongoing study since 1948 where a large group of people was followed for decades to sort out what causes heart attacks and strokes and how one could develop a program of prevention. This objective at the beginning of the study was very noble and promising. However, as time went on the results from the Framingham Study that were published intermittently appeared to be more and more confusing.

First there was the lipid theory that was based on the observation that high lipids (called triglycerides) and high cholesterol in the blood would cause heart attacks and strokes. It was assumed that it must have been the fats in the diet that would have caused this. Based on this thinking the lipid theory of arteriosclerosis was formulated, a theory trying to explain how heart attacks were caused.

If this theory were true, a lowering of the blood lipids and cholesterol should have lowered the rates of heart attacks and strokes. Many large trials were done and the statins were developed to lower cholesterol. In a recent blog I have explained that this has not lowered the mortality rates from heart attacks and strokes, but instead of admitting that the researchers made a mistake, many are still doggedly holding on to the dogma of the lipid theory. The truth is that the lipid theory has not been proven to be true; the recommendation of a high carb/low fat diet has also not worked out to save lives by preventing heart attacks and strokes. In fact the opposite is true: older people with high cholesterol live longer and have less Alzheimer’s disease than those with lower cholesterol levels in the blood as Ref. 1 has explained in detail. Dr. Perlmutter mentioned a study from the Netherlands (Ref. 1, page78) involving 724 individuals who on average were 89-year old that were followed for 10 years. Those with high cholesterol lived longer than those with low cholesterol, exactly the opposite of what the lipid theory predicted! Specifically, for each 39% increase in cholesterol there was a 15% decrease in risk of mortality. Think about it: the brain and the heart have LDL receptors on their cell surfaces for a reason. The reason is that both vital organs burn fat and need cholesterol to build up the membranes of the brain and heart cells.

Despite this compelling evidence Big Pharma is in denial and you will still find the lipid theory of arteriosclerosis heavily mentioned on the Internet as the only “valid” explanation for how heart attacks and strokes would be caused.

Inflammation as the alternative explanation of arteriosclerosis

Since the mid 1990’s the first reports surfaced to explain that about 50% of patients with normal cholesterol levels still develop heart attacks. In these patients the C-reactive protein, an inflammatory marker, was very high indicating that an inflammatory process likely caused their illness.

Subsequently further research was able to show that the LDL cholesterol, when oxidized by sugar was responsible for clogged arteries in these patients. It also became apparent that diabetics have a much higher risk to develop heart attacks than patients with normal blood sugars. This led to the conclusion by several different research teams that the lipid theory was wrong and needed to be abandoned.

Instead a new theory has developed that explains that heart attacks and strokes develop in patients where free radicals have damaged LDL cholesterol. This oxidizes LDL cholesterol and leads to hardening of the arteries (arteriosclerosis). Sugar from increased carbohydrate intake has a lot to do with this: it leads to glycation of protein causing glycation end products (abbreviated as AGE’s).

This is an appropriate name as it really is the cause of premature aging, of developing wrinkles, of getting premature hardening of arteries and having a 50-fold risk of free radical formation. This in turn will lead to more tissue aging. LDL used to be thought of as the “bad cholesterol” (I myself have used that term in the past). LDL is now known to be the friendly and important transport form of cholesterol, which is sent from the liver to the brain and heart cells that need it for their metabolism. If LDL is oxidized, however, it becomes useless and the heart and brain cannot absorb cholesterol for membrane synthesis via the LDL receptors. The end result is that vital organs like the heart and the brain do not get enough oxygen and nutrients, which leads to heart attacks and strokes. The free radicals that are released from oxidized LDL cholesterol and that circulate in the blood cause an inflammatory response in the lining of the arteries all over the body, which you know as hardening of the arteries (arteriosclerosis).

This may sound complicated, but all you need to remember is that sugar and starch consumption lead to accelerated hardening of arteries in your body, which causes heart attacks and strokes.

Reassessment of what a heart healthy, brain friendly diet is

The above-mentioned research findings require a complete re-thinking of what a healthy diet would be. The villain turned out to NOT be saturated fat (meat, eggs, butter and avocado), but rather TRANS fat (margarine, hydrogenated polyunsaturated fatty acids) and I agree with the FDA that this should be abolished.  Trans fat is full of free radicals oxidizing LDL cholesterol, which we just learnt is causing hardening of arteries. It is sugar and starches that turned out to be the main villain. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you also as they lead to inflammation through the arachidonic acid system in the body. Conversely flaxseed oil, omega-3 fatty acids (EPA and DHA) derived from fish oil are very protective (anti-inflammatory) oils, as is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well.

The new “heart and brain healthy diet” consists of no refined carbohydrates (sugar and starch), but about 45% complex carbohydrates (organic vegetables like broccoli, spinach, cauliflower, Brussels sprouts, peppers, onions, garlic, peppers, Swiss chard, zucchini, asparagus etc.), 20 % protein and 35% saturated and other fats like omega-3 (1:3 mix with omega-6) fatty acids and monounsaturated fats (like olive oil or coconut oil).

According to Ref.1 you can even eat butter, lard and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Dr. Perlmutter (Ref.1) points out that even extreme diets like the Inuit diet with 80% saturated fat and 20% protein leads to longevity with healthy arteries. The patients who died in the many trials including the Framingham Study did so, because of free radicals from sugar, starch and wheat. Wheat contains the addictive gliadin molecule (part of gluten), which makes people eat more sweets and starchy foods. The liver turns the extra calories into visceral fat deposits that in turn cause the release of cytokines like tumor necrosis factor alpha (TNF alpha) and COX-2 enzymes.

This causes inflammation, heart attacks, strokes and cancer.

Contrary to what Big Pharma wants you to know cholesterol is an anti-inflammatory, LDL is a cholesterol transporter (provided it is not oxidized) and HDL is protective of hardening of the arteries as long as the “ratio of total cholesterol to HDL cholesterol” is less than 3.4 for males and 3.3 for females. This is the cholesterol risk ratio used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2).

Paradigm shift in causation of heart attacks and strokes, but also of cancer, and neurological diseases

As pointed out in Ref. 1 there has been a paradigm shift in our thinking about what causes inflammation and what causes all of the major diseases including premature aging. Many physicians are not up to date in this new thinking although it has been in the medical literature since about 1995. In my colleagues’ defense I like to say that they are busy people and they do not always have the time to do their continuing education. However, it is imperative that the public learns about this paradigm shift as it affects literally everyone. In my YouTube video on the home page of www.nethealthbook.com I have talked about this new thinking in the summer of 2012. Now we are learning that there is an anti-inflammatory, cholesterol containing, fat rich diet without refined carbs, but containing ample complex carbs, which is a modified zone diet or a modified Mediterranean diet that will prevent all these diseases. At the same time it is a weight loss diet as cholesterol and fat in your diet stops the liver from producing lipids and triglycerides and helps you to lose weight. Critics will say that it sounds too good to be true, but I agree with Dr. Perlmutter and Dr. Davis, both of whom have provided ample evidence that it is true. Try some of their recipes. Just read Ref. 1 and 2, where recipes are listed in the back part of their books. Or try the recipes I listed for one day in this blog. I am publishing a book entitled “A Survivor’s Guide To Successful Aging” through Amazon.com, which will come out later in early 2014 where you can find recipes for 1 week in the last chapter.

Conclusion

There has been a paradigm shift in the thinking of how hardening of the arteries is caused. Now it is known that an inflammatory process causes it. It is an overindulgence in sugar, starch and wheat products that causes the liver to produce lipids, cholesterol and leads to the “wheat belly” and the “grain brain”. All of this causes cytokines to bring about an inflammatory reaction that affects the lining of arteries causing heart attacks, strokes, but also Parkinson’s disease, MS, autism, asthma, arthritis, epilepsy, Lou Gehrig disease and Alzheimer’s disease (Ref.1). The inflammation does not stop there. If you keep up the high carb/low fat diet, it will lead to various cancers (Ref. 1 and 3). The solution is a diet high in healthy fats (I would call it a low carb/medium high healthy fat diet) as outlined above consisting of 30 to 35% healthy fat, 20% of protein and 45 to 50% of complex carbs, but none of the refined carbs. I have followed such a diet since 2001. I am enjoying that I can now eat  a reasonable amount of healthy fats, which I was not aware of being allowed before I read Ref. 1 and 3, but I continue with the antioxidant vitamins and anti-inflammatory supplements to prevent LDL oxidization. I hope that many of you can benefit from prevention so you can enjoy a healthy life without being a victim of illness or disability.

More information on:

1. arteriosclerosis: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

2. paradigm shift regarding hardening of the arteries: My book “A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling” explains the content of this blog in much more detail.

References

1. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Nov. 7, 2014

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