Oct
06
2018

Health Risks After Hurricanes

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders  work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Sep
15
2018

Moderate Carb Intake Has The Lowest Mortality

A 25-year long study has shown that a moderate carb intake has the lowest mortality. A comprehensive study from the US has followed more than 15,000 men and women for 25 years. They were between 45-64 years when they entered the study and they were from diverse socioeconomic backgrounds. The authors chose mortality as an end point. Dr. Sara Seidelmann is a clinical and research fellow in cardiovascular medicine from Brigham and Women’s Hospital in Boston. She was the lead author of this study. The research group used food questionnaires and analyzed the carb content in the food. They also determined what percentage of the food composition was of animal origin or plant origin.

Research study finds moderate carb intake has the lowest mortality

The main findings of the study were that less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. On the other hand, more than 70% of carbs in the diet also had increased mortality rates of 1.2-fold. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%. Dr. Seidelmann explained that in terms of life expectancy the result of the study could be summarized as follows. A 50-year-old person had another 33 years to live when carb intake was in the moderate range. The low-carb person had only another 29 years to live (4 years less than the moderate carb person). The high-carb person lived another 32 years, 1 year less than the moderate carb person.

Plant-derived versus animal-derived fat and protein

The study showed that there was increased longevity when carbohydrates were exchanged for proteins and fats from plant sources. Mortality was 18% less for this group. Conversely, when carbs were replaced for animal-derived fat or protein mortality was 18% more!

Dr. Seidelmann noted that this study was coming from a US based population. In the case of an Asian group they would consume much more carbs on average, but they would replace a lot of the animal fat and protein with fish. Fish is a healthier source of protein and fat than beef or pork.

A moderate carb intake group that used protein and fat from animal sources was compared to plant sources. When protein and fat had the origin from lamb, beef, pork, and chicken the mortality over 25 years was higher. When protein and fat came from vegetables, such as nuts, peanut butter, seeds and whole-grain breads there was a lower mortality rate.

Other studies comparing the effect of animal protein versus plant protein

  1. A 2016 study that had gone on for 49 years was involving 131,342 participants. Animal protein intake showed an association with higher mortality from heart attacks and strokes. 3% of energy from processed red meat was now substituted by an equivalent amount of plant protein. This reduced the all-cause mortality by 34%, for unprocessed red meat by 12% and for egg by 19%.

 

  1. Red meat is cancer-producing. Several studies have shown this. When red meat is digested, cancer-causing substances are released that can be the cause of cancer in the lining of the stomach and the colon. The above link says we should limit red meat consumption to 65 grams (2oz.) per day or 2 servings (130 grams or 4 oz.) 3 to 4 times per week. We should avoid eating more than 455 grams (1 pound) of lean red meat per week.

Triglycerides are an independent risk factor for heart attacks

In this publication evidence is also present that triglycerides are an independent risk factor that can cause heart attacks.

When you eat too many carbs, the body produces the excess you don’t need into triglycerides, and it deposits its subsequently as fat in fatty tissue.  Physical activity burns up some of the triglycerides. But when we eat too much refined sugar and starchy foods, there will be an excess of triglycerides putting our blood vessels and our hearts at risk.

Regular exercise prevents disease and premature deaths

Many studies have shown that regular exercise prevents heart attacks and premature deaths. We even know the mechanism of why this is so. Exercise releases nitric oxide ((NO) from our blood vessels, which widens the arteries. This also prevents high blood pressure. Exercise elevates the protective HDL cholesterol. When regular exercisers were compared to a non-active group they had a 41% lower risk of death. All-cause hospitalizations were down by 21% and cardiac hospitalizations were down 32%.

Discussion

  1. Barry Sears is the inventor of the Zone Diet. I attended a lecture in 2001 at an Anti-Aging Conference in San Diego. Dr. Sears was the keynote speaker at this conference. He stressed that a diet with 55% of complex carbs would be the best diet. It is interesting that Dr. Seidelmann in the study mentioned in beginning of this blog found the same thing. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%.
  2. The second point that is important to note is that it matters whether we eat protein derived from animals or from plants. Even small steps help. When we reduce our animal protein intake by only 3% of the energy intake, and replace it by plant protein, there is a significant reduction in mortality.
  3. Exercise is rarely mentioned in relation to diets. But exercise needs to be included every day and you will experience a reduction of cardiac hospitalizations of 32% as mentioned above.
Moderate Carb Intake Has The Lowest Mortality

Moderate Carb Intake Has The Lowest Mortality

Conclusion

A moderate carb intake, as is the case in the Mediterranean diet and in the Zone Diet of Barry Sears, has the lowest mortality rate. Complex carbs (in vegetables) are absorbed much slower. As a result the risk for heart attacks is much lower. The opposite is true for refined carbs from sugar. They cause heart attacks and strokes with premature mortality. Dr. Sara Seidelmann led a study at the Brigham and Women’s Hospital in Boston that lasted 25 years. Less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. These diets are paleo-type diets, the Atkins diet and the ketogenic diet. More than 70% of carbs in the diet also had increased mortality rates of 1.2-fold.

The healthiest diet

People who consumed a diet where carbs were between 50% and 55% had the lowest mortality rate (Zone Diet). Another finding of this study, which was confirmed by others is that animal-based protein is unhealthier than plant-based protein. Even replacing 3% of energy from an animal-based diet with plant-derived protein delayed mortality significantly.

If you want to live longer and stay healthy you need to critically evaluate what you eat.

Aug
25
2018

The Downside Of Living To 100

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

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Jun
16
2018

Writing A Medical Book

In my 40’s when I was practicing medicine, I was dreaming about writing a medical book. This was in the mid 1980’s and I was busy seeing 30 to 40 patients a day. I would never have found the time to write a medical book at that time. I thought, perhaps I could show how patients could stay younger for longer by adopting the right life style in order to stay well. Fast forward 3 decades, and the medical book writing began. But instead of one book the project turned into 4 books. There were too many topics to cover to fit them all in one book.

Prior to writing a medical book

First of all, in 2002 I published a large website. Its structure is like a book on the Internet: Net Health Book . It contains descriptions of the major diseases, mental and physical, and their current treatment modalities. I still maintain this work. Furthermore, I started another website in 2003, a weekly blog, called “Ask Dr. Ray” . This is a compilation of interesting research. Some medical research papers can get too scientific. For this reason I translated it into easier language. The topics tend to be anti-aging topics. This blog comes out Saturdays.

Retirement hobby

When I retired in 2010 I revamped my websites. In the process the web developer suggested I should add to Net Health Book a blog (nethealthbook.com/news) where I review current health news that I find interesting. This is a weekly blog, which I publish on Wednesdays. All of this is still going on, and it gave me lots of opportunities to write and publish on a smaller scale. In addition, I finally started publishing books.

A Survivor’s Guide To Successful Aging

My first book came out with Amazon in 2014. I had joined the A4M (American Academy of Anti-Aging Medicine) in the early 2000’s. The lectures at their conferences were very open-minded and pointed out details of what one could do to delay aging and avoid premature deaths. My own experience with changing our diet in 2001, starting bioidentical hormone replacement and changing my lifestyle became topics that were part of this book. I dedicated this book “to those who are willing to work on prevention in order to achieve a longer life without disabilities”. This is still the basis of prolonging your life.

Lifestyles can be deleterious

I start out in this book describing the obesity wave and how this changes the metabolism (metabolic syndrome). I used statistics from the Framingham Heart Study to show the detrimental effects of various lifestyles on mortality. Subsequent chapters deal with food, exercise, stress and missing hormones as life-shortening factors. There is a separate chapter on vitamins and supplements. They as a group can create 5.1% longer telomeres, which translated into 9.8 years of longer life expectancy (see also a study by Dr. Xu  in the book). Subsequently it describes how a change of your lifestyle can have a positive impact. Changing your eating habits and exercise activity will make a tremendous positive difference on the long term.

Successful Aging in the Kitchen

The book ends with an appendix, written by my wife: “Successful Aging in the Kitchen”. You are presented with recipes for 7 breakfasts, 7 lunches and 7 dinners. In addition she has provided 7 healthy desserts for you. Bon Appétit!

Healing Gone Wrong, Healing Done Right

In another book, which got appeared in 2016 I gave a few examples of how famous people were failed by medicine. It started already in the past: Ludwig van Beethoven’s physicians did harm instead of healing their patient. However, this is happening now as well: physicians mismanaged the health care of Elvis Presley, Churchill, Michael Jackson and JF Kennedy. The physicians treated symptoms, but they never properly attended to the causes of the ailments of their patients. The end result was premature death in all of them. Churchill who had good genetics made it to age 90, but during his last 15 years he suffered of severe disabilities.

Treatment of symptoms will fail, treatment of causes succeed

These examples of famous people’s health problems resemble to what happens to today’s patients in various office settings. Their symptoms are mostly being treated, but their causes often not. Simply treating symptoms will not work on the long term. It did not work in the past, and it does not work now.

Other chapters in this book

Other chapters in this book deal with preventing disease, keeping a healthy brain and keeping a healthy heart. Next I discuss why food matters, followed by the health of limbs and joints. Subsequently I am discussing how to keep toxins out. The next chapter deals with how to reduce the impact of cancer. It is always important to diagnose cancer as early as possible as removal by surgery has the highest success rate at an early cancer stage. The next chapter is entitled: “Stable hormones key to health”. If any of your hormones are missing (particularly around the age of menopause and/or andropause) it is time for nature identical hormone replacement. The next chapter gives you general thoughts on anti-aging. This is followed by “supplements yes, but do not overdo it”.

Alternative treatment for ADHD

A final chapter gives you an example of an alternative treatment for ADHD, where the idea of not just treating symptomatically, but treating causes is included. References and an index are also provided for the book.

Prostate Cancer Unmasked

Furthermore, I did not intend to write this book. But in early 2016 my PSA (prostate specific antigen) level jumped from 3 to 8.6. For years it had been in the 1.5 areas, then slowly increased to 3. But 8.6 was too high for comfort! I had an MRI scan done, which showed one lesion in my left prostate, which was suspicious for prostate cancer. I was referred to a urologist at the Vancouver Prostate Centre, one of the top clinics in Canada. But I had already researched the literature and came across research by Dr. Gary Onik from Ft. Lauderdale who warned me about the pitfalls of “standard therapy”.

The conservative urologist in Vancouver

The urologist in Vancouver told me that without a positive biopsy he cannot accept that the shadow on my MRI scan would be prostate cancer. And the only way they do a prostate biopsy was by random trans-rectal biopsies. He also wanted to include me in a random clinical trial where they would compare active intervention with active surveillance. I politely declined the trans-rectal prostate biopsy and the inclusion into a trial.

Assessment by Dr. Onik

I booked a flight to see Dr. Onik in Ft. Lauderdale. His method is well researched and orchestrated.

Initial assessment

He assesses you with a rectal ultrasound and he sees the prostate on a TV screen. He said right away that I had three separate lesions, one in the left as shown on the MRI scan and two in the right lobe, which was missed by the MRI scan. False negative lesions are common on MRI scans, which can become a source of cancer recurrence.

3-dimensional prostate biopsy

The following day he booked me for a 3-dimensional prostate biopsy via the perineal approach. The perineum is easy to sterilize, so there is no risk of septicemia. A metal grid with holes for biopsy needles was used to get 96 biopsies of my enlarged prostate. For a normal size prostate, Dr. Onik said about 60 biopsy needles are normal. You don’t feel anything, because you are asleep.

Cryoablation prostate surgery

Next was the cryoablation surgery of the 3 prostate cancer lesions. This happened one month after the biopsy. I was seen at the hospital in Ft. Lauderdale. The same grid from the biopsy was used to relocate exactly where the cancer lesions were. The pathologist had confirmed them as Gleason 6 and 7 prostate cancers. This was treated with Argon sounds and frozen twice. I felt nothing, because I was under a general anesthetic. But Dr. Onik told me that everything went very well. Some cancer was too close to the neurovascular bundle, so he used the NanoKnife, an invention where nano-size holes get blasted into cancer cells, but it leaves normal tissue intact.

I needed to do self-catheterization for about one month to empty my bladder, as there was a lot of swelling from the prostate hypertrophy and the surgery. But eventually my normal water works returned.

Follow-up blood work

My follow-up PSA blood work 3 months after the surgery was down to 1.0. Prior to the surgery the Oncoblot test was positive for prostate cancer. A repeat Oncoblot test 3 months after the surgery was now negative for prostate cancer. I realize that not every physician accepts this new cancer-screening test, but I felt a lot better to know that all the cancer markers were now gone.

9 cancer treatments reviewed

In my book I described a total of 9 prostate cancer treatments and their 10-year survival statistics. None of the other treatment methods were as good as Dr. Onik’s statistics. I believe it is linked to the precision of the 3-dimensional biopsy and the surgery being done through the same grid. If you do not perform the surgery this way, you miss cancer lesions and this becomes the source of failure 10 years down the road. My book details all these alternative treatments. It also has a section on lifestyle modifying factors. I needed to write this book as a service to any man who suddenly is faced with a possible diagnosis of prostate cancer.

Unmasking prostate cancer

Like me he needs to unmask the cancer. Is it really there? How far advanced is it? Which way to safely biopsy it (definitely NOT through the rectum for fear of blood poisoning=septicemia)? What is the best method to remove it? I came to the conclusion that Dr. Onik’s method was best for me. But with the information in this book you can decide what is best for you.

Medical Questions Answered

Finally I wrote my 4th book. From more than 4400 medical questions that I have answered on the site Quora.com I selected the most popular questions for this book. The editorial board of Quora said that I own the publishing rights for my answers. The questions were rephrased without changing the meaning. I selected more than 120 questions under 44 different headings.

Here are some of the areas that are covered: Acne, the best home remedies. Aging: can it be reversed? What is the limit for a human? Alcohol: how does it affect your body? Alzheimer’s disease: which foods promote brain health? Arthritis: what can you do about osteoarthritis? Back pain: what can I do about it? Cancer: why can cancer still not be cured? There are as well 15 other answers about cancer. Depression: will my depression ever go away? Diabetes: will a 600-calorie diet help diabetes control?

Further topics discussed

Diet: I want to get rid of sugar in my diet. How can I do this long-term? Other answers about diet are included. Exercise: How useful is cardiovascular exercise? Gut disease: Is “gluten free” food healthy? Heart disease: What can I do to clean out my arteries and reduce my risk for heart disease? Hormones: Is estrogen present in the male body? Life Expectancy: What is the theoretical life expectancy of humans? Lifestyle Habits: Can good habits change your life completely? Pain: Pain relief for a headache or other pain: Aleve, Advil or Tylenol? Pregnancy: Best age for a successful pregnancy? Prostate Cancer: How dangerous is prostate cancer? Does it kill you? Schizophrenia: What complementary approach may help a patient with schizophrenia? Sleep: What happens when you go to bed late every night? And many other answers under this topic.

And the book finishes with these topics

Sugar: will I be OK living without sugar? Vaccinations: Is there a connection between vaccinations and autism? Vitamins and supplements: Are taking vitamins and supplements healthy or are they harmful? Weight loss: I am working out every day, but I am not loosing weight. What should I do? There are many more answers under this topic. Younger for longer: What are three things I can do every day to stay younger for longer?

These are only a few selections of all of the topics dealt with in this book.

Writing A Medical Book

Writing A Medical Book

Conclusion

I have reviewed briefly why I published the books mentioned above. My prostate cancer book developed out of the necessity that I had to deal with my newly diagnosed prostate cancer in 2016. I felt that the review process I went through would be good for those men who have to face a similar situation. The anti-aging book comes from my interest in anti-aging medicine. “Healing Gone Wrong, Healing Done Right” developed from the observation that physicians in the past and often even now tend to only treat symptoms. But if a cause can be found, this should be treated, as this often leads to a permanent cure.

Treating symptoms only will not improve the patient’s condition

Treating symptoms only will not improve the patient’s condition. “Medical Questions Answered” is a collection of medical topics where I answered various medical questions. It was a way for me to cover a vast array of medical topics. Some of the topics are dealt with in depth (acne for instance); others are very short. I have also two medical blogs that come out on Wednesdays and Saturdays. I hope that some of that medical information will be useful to you.

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Apr
21
2018

3 Cups Of Coffee Stop Clogged Arteries

There is a new coffee study that says 3 cups of coffee stop clogged arteries. The study appeared in the Journal of the American Heart Association on March 24, 2018. It was part of the cross sectional Brazilian Longitudinal Study of Adult Health. This study took place from August 2008 to December 2010. It followed 15,105 civil servants, aged 35 to 74 years. They were living in 6 Brazilian cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitoria). The final study sample comprised 4426 individuals who underwent CAC measurements.

CAC score

CAC stands for “coronary artery calcium”. Other tests in the past have shown that CAC is a very sensitive test that quantitates the calcification status of coronary arteries. The CAC score is also known as Agatston score. It also predicts how likely it is that a person with a high CAC count will develop a heart attack down the road. A score of 100 or less is considered to be a low risk for developing a heart attack later in life. If the score is between 100 and 400, it is a moderate risk. A score of more than 400 ranks as a high risk to develop a heart attack.

Study design

Upon entering the study the participants had an extensive entrance exam and interview. Part of this was a nutritional and lifestyle questionnaire. This told the examiners whether the patients were smokers or not. Their age ranged between 35 and 74 years. Participants took a CAC test. 4426 individuals who underwent CAC measurements became part of the study. The participants’ blood pressure and body weight were additional measurements.

Results of the study

There was a negative correlation between the amount of coffee consumed on a daily basis and the CAC score. Specifically, the following observation emerged regarding daily coffee consumption and the risk of a higher than 100 CAC score.

  • Less than 1 cup per day: odds ratio 0.85
  • 1 to 3 cups per day: odds ratio 0.73
  • More than 3 cups per day: odds ratio 0.33

These results show clearly that there is an inverse relationship between coffee consumption and risk of developing coronary artery hardening. Those who consume 3 or more cups of coffee have a lower coronary artery disease risk.

The risk to develop coronary artery calcification in coffee drinkers (3 or more cups) is 67% lower. The comparison group are non-coffee drinkers.

Discussion of the results

The research paper from Brazil compares their results with many other research facilities and concludes that others had very similar conclusions. For instance, a 2014 publication pointed out that consuming more than 5 cups of coffee per day had no association with heart disease and did not cause any increased mortality.

The 2015–2020 Dietary Guidelines for Americans recommends consuming 3 to 5 cups of coffee per day, which reduces the risk of getting diabetes type 2 or cardiovascular disease.

Korean study using CAC scores

One other relevant Korean study that involved 25,138 participants is also of note. The participants consumed 3 to 5 cups of coffee per day. They also underwent CAC tests. The coffee drinkers had a 41% lesser prevalence of CAC score in comparison to non-coffee consuming controls. The authors of the present study said that the Korean study was comparable to their own findings.

Comparison of study to previous literature

Mortality data and coffee consumption

In a large Harvard study that I discussed on Nov. 18, 2017 the end point was mortality data. There too, was a dose response curve. With 3 to 5 cups of decaffeinated or regular coffee there was a reduction of death rates by 15%. Less coffee consumption produced less reduction of mortality.

Stroke data and coffee consumption

In another review on March 4, 2013 I reviewed a 10-yer study that looked at the effect of 1 to 2 cups of coffee per day in 32,600 women. There was a 25-32% reduction of strokes compared to non-coffee or tea consuming controls. I also reviewed a Finnish study that consisted of 29,133 smokers (smoking 5 cigarettes a day) aged 50 to 69 who were stroke free when entering the study. It ended in 1993 and the study had lasted for at least 5 years. Drinking two cups of black tea or 8 cups of coffee reduced the stroke risk by 21 to 23%.

Stroke mortality and coffee consumption

In the Annals of Internal Medicine (June 17, 2008) researchers have found that coffee consumption can be beneficial to reduce stroke mortality. A study using the data from 41,736 male and 86,214 female subjects is quite informative. Researchers followed these people over 18 years in the male group and over 24 years in the female group. The risk of all-cause mortality decreased significantly with increasing coffee consumption in the male as well as in the female group. Men had a relative risk reduction of 20% in comparison to those with the lowest level of coffee consumption. Women with intermediate to high consumption of coffee had a relative risk reduction of 10% to 30 % when compared to the group that drank less than 1 cup of coffee per day. The end point here was risk of death from stroke.

3 Cups Of Coffee Stop Clogged Arteries

3 Cups Of Coffee Stop Clogged Arteries

Conclusion

Coffee has a number of anti-oxidant bioflavonoids that help increase survival. The main study reviewed measured the effects of coffee consumption by calcium scores of the coronary arteries. This is a specific way to look at the relative risk to come down with a heart attack in the future. Other ways to measure the beneficial effect of coffee are mortality as the end point, stroke or stroke mortality. I have reviewed some studies that used all of these end points. It is interesting to observe that consumption of 3 to 5 cups of coffee has such a beneficial effect. It does not matter whether it is regular or decaffeinated coffee. Both have the identical effect. This has been shown by a recent Harvard study.

Coffee and tea make you live longer

Coffee keeps the arteries open for longer, if we consume 3 to 5 cups of coffee per day. This allows our brain to think longer and allows our heart to beat for many more years. It is time to stop the research and to apply what was found: 3 to 5 cups of coffee per day. If tea is what you prefer, you are in luck. Everything I said about coffee also applies for green and black tea. There is one word of caution. Using copious amounts of sugar in your coffee or tea will most likely cancel some or all of the benefits. Cream and sugar-laced Frappuccino or Chai Lattes are calorie bombs and not conducive to good health. I use stevia instead of sugar to sweeten my coffee.

Mar
24
2018

Prevent Plugged Arteries

There are several ways to prevent plugged arteries, which will translate into less heart attacks and strokes. The message is simple: if you get less heart attacks and strokes, you will live longer. Below I am examining ways to prolong life by various ways to prevent plugged arteries.

You probably heard of plaque formation in the arteries. This is the process where a combination of fat, calcium, cholesterol and cell waste forms a deposit (plaque) under the lining of the arteries.

The end result is that the blood won’t be flowing freely through the affected arteries. This can cause a heart attack or a stroke. Essentially, this is the point where a clot forms in the narrowed passage of the artery. It is also the point, when the clinicians make a diagnosis of a heart attack or a stroke.

Let’s examine what leads to plaque formation in the arteries.

Trans fats

Trans fats are contained in fried foods like French fries, in margarines and other butter substitutes. As margarine is a common ingredient of cakes, cookies, pastries and pies, these are all bad news for our heart health. I consider them off limits. If you eat those foods, you build up plaque in your arteries, which leads to premature heart attacks and strokes.

Lack of exercise

It has been common knowledge for a long time that being sessile leads to premature hardening of the arteries. In the late 1800s to the early 1900s physical exercise was promoted in various countries around the world.

The latter part of the 20th century saw a renaissance of the fitness movement. It was trendy to go running, cycling, and swimming or working out at a gym. It is not only trendy but healthy: cardiologists support all of these sports to help people stay healthy and keep the arteries free from plaque formation.

Too many refined carbs

Sugar and processed foods, especially those with added sugar to improve flavor, have a direct relationship to heart attacks and strokes. It is known that sugar causes high LDL cholesterol and high triglycerides. In addition sugar also causes inflammation of the arterial walls, which causes plugged arteries. However, sugar is only part of the problem. Starchy foods like rice, noodles, cakes, cookies and other foods made with flour get broken down into sugar. Both lead to insulin production. And both lead to changes of the lining of the arterial walls.

In the 1980s and 1990s there was a school of thought that a low fat diet would be healthy in terms of heart attack and stroke prevention (the low fat/high carb diet). This turned out to be a nutritional disaster: the high carb content of such a diet was the problem. It led to weight gain, obesity and death.

Red meat is a problem

Several studies have documented that saturated fat from red meat is only part of the problem. The other part is carnitine, which is abundantly present in beef, pork, lamb and venison. But mortality of people eating unprocessed red meat is only marginally elevated. It is when people eat processed red meat that there is a significant rise in mortality from heart attacks and strokes. This study examined this. They found that gut bacteria were stimulated by red meat to produce substances that stimulate bacteria in your gut to secrete TMA and TMAO, which makes your platelets more sticky and contributes to plugging your arteries. This research paper from the Cleveland Clinic explains it in more detail.

What must I do to prevent plugged arteries?

Eat the right food

A Mediterranean diet is anti-inflammatory. It contains lots of vegetables, but little red meat. Fish and chicken that contain much less L-carnitine are more dominant in Mediterranean food. As mentioned above, you want to avoid trans fats. And you also want to avoid sugar and too many starchy foods. This includes sugar-sweetened beverages. Making these changes will keep your insulin levels in the normal range eliminating inflammation in your arteries. Avoid eating processed foods, because they contain food preservatives and lots of sugar that we want to avoid. Eat more unsaturated fats like avocados, walnuts, olives, trout, herring, and salmon. The last three contain marine-derived omega-3 fatty acids that are particularly helpful in preventing heart attacks and strokes by being anti-inflammatory and by elevating the protective HDL cholesterol. Drink lots of green or black tea, rooibos tea, or ginger tea. They contain antioxidants and bioflavonoids that prevent plugged arteries.

Regular exercise

Many publications have shown that regular physical exercise will lower blood pressure, condition your muscles including your heart and lower mortality.

Only 10 minutes of brisk walking every day reduced the death rate by 33% compared to those who did not exercise at all.

Regular physical exercise does not only prevent heart attacks and strokes, it also reduces the risk of getting another 35 chronic diseases, as the link shows.

Here are some common exercises: jogging, cycling, running, brisk walking, swimming, playing tennis and doing aerobics. All of them will strengthen your muscles and condition your heart and lungs.

Other ways to prevent plugged arteries

Smokers must quit smoking, as smoking has been identified as a major risk factor for heart attacks and strokes.

Exposure to prolonged stress is a factor that leads to hardening of arteries. Stress management is possible by counseling, by self-hypnosis, yoga, tai chi and other relaxation methods.

Risk factors associated with plugged arteries

We already have mentioned the risk factors that are associated with clogged arteries. But for clarity I would like to repeat the major risk factors here.

  • Smoking
  • High blood pressure
  • Elevated LDL cholesterol (the bad cholesterol)
  • Reduced HDL cholesterol (HDL is increasing with exercise)
  • Obesity (often associated by ingestion of too many carbs)
  • Insulin resistance and diabetes
  • Lack of exercise (too much sitting in front of the TV or doing computer work)
  • Unhealthy diet (Standard American diet instead of Mediterranean diet)
Prevent Plugged Arteries

Prevent Plugged Arteries

Conclusion

We often think that we have no input whether or not we get a heart attack or a stroke. This is completely wrong. If you adopt the solutions I have listed here, you can change things for the better. You will reduce your risk to get a heart attack or a stroke. Treat high blood pressure. Stop smoking. Cut out sugar and starchy foods to reduce triglycerides and LDL cholesterol. Exercise regularly and your HDL will protect you from heart attacks and strokes. Shed pounds, if you are obese by starting a Mediterranean diet and cutting out sugar. This will also improve your insulin resistance or diabetes. Start daily exercise as this reduces your risk of a heart attack or a stroke. In addition exercise reduces the risk of 35 chronic diseases that have also been mentioned in one of the links.

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Dec
02
2017

Vitamin K For Bones And Arteries

Vitamin K for bones and arteries is gaining a lot of attention as a valuable supplement. Most of all in the blood vessels, but in addition in the heart, lungs and kidneys the matrix GLA protein is a key substance. Vitamin K2 is crucial for removing calcium from these organs, as matrix GLA protein is carboxylated. Carboxylation of the GLA protein functions much as a broom. This removes all superfluous calcium from blood vessels and organ tissues. If there is a lack of vitamin K2 intake, matrix GLA protein is uncarboxylated, which as a result invites vascular calcification. Essentially vitamin K2 has emerged as an important player in the regulation of bone conditions like osteoporosis, but also in the prevention of hardening of arteries. Vitamin K2 removes calcium from blood vessels and deposits calcium in bone preventing osteoporosis. I will review some key publications, which support this.

Arterial stiffness study in postmenopausal women

Aging blood vessels become stiff from calcification. By removing calcium it seems like the arterial wall becomes more flexible again. Dr. Knapen and colleagues from Maastricht University, The Netherlands followed 244 healthy, postmenopausal women for 3 years in this double blind, placebo-controlled 2015 study.

120 women received 180 micrograms of vitamin K2 (as MK-7) once daily. 124 women received placebo pills. Next researchers checked arterial stiffness through two types of tests. First of all, carotid intima-media thickness was evaluated by echo tracking. In addition aortic stiffness was tested by carotid-femoral and carotid-radial pulse wave velocity. After 3 years there was a significant reduction of uncarboxylated matrix GLA by 50%. This was missing in the placebo group. All of the markers for arterial stiffness showed a reversal improving flexibility above the median. This shows that hardening of arteries in postmenopausal women is reversible with the help of vitamin K2.

Bone metabolism study in Japanese men and women

This 2015 Japanese study investigated what the minimum amount of necessary vitamin K2 would be to improve osteocalcin carboxylation.

First of all, study 1 examined the effect of 0, 50, 100, or 200 micrograms of vitamin K2 (=menaquinone-7) daily. A group of 60 postmenopausal women received vitamin K2 for 4 weeks. Only the 200 microgram per day dosage showed an effect of carboxylating osteocalcin.

Second part of study

Furthermore, study 2 consisted of 120 men and women. Measurements involved the ratio between carboxylated and uncarboxylated osteocalcin to demonstrate the effect of vitamin K2. As a result of study 1 only a placebo group, a 100-microgram and a 200-microgram daily vitamin K2 group was part of the investigation. Both, the 100 microgram and the 200 microgram doses, reduced the circulating uncarboxylated osteocalcin fraction. Hence they concluded that vitamin K-2 effectively keeps the calcium in the bones and prevents osteoporosis. The investigators recommended taking more than 100 micrograms of vitamin K-2 per day to improve osteocalcin carboxylation.

You can find more detail regarding the interaction of calcium, vitamin D3 and vitamin K2 in this link.

Trabecular bone structure preserved in postmenopausal women

148 postmenopausal women were participating for 12 months in a randomized, placebo-controlled, double-blinded clinical trial. All these women had osteopenia. All of them received supplements with calcium and vitamin D3. In addition they received 375 micrograms of vitamin K2 or placebo pills. Examination involved tests for bone mineral density with dual X-ray absorptiometry (DXA). Furthermore a high-resolution CAT scanner determined the microarchitecture of the tibia bone.

After 3 months the uncarboxylated osteocalcin decreased by 65.6% rather than the placebo group of only 6.4% decrease. The trabecular number, spacing and thickness in the tibial bone were unchanged in the vitamin K2 group. In contrast to that there was a clear deterioration of the bone structure in the placebo group.

Summary of trabecular bone study

The bone density studies showed no detectable difference between the groups. The deterioration of the trabecular microstructure in the placebo group was consistent with expected age-related changes. On the other hand, the vitamin K2 group clearly demonstrated preservation of the trabecular bone structure in the tibial bone.

Vitamin K2 helps to eliminate toxic effects of calcium

This 2015 publication from Krakow, Poland explains rather well how vitamin K2 is important to reduce calcium from blood vessels.

At the same time the article points out that vitamin K2 is important for depositing calcium into bones to prevent osteoporosis. The removal of calcium from blood vessels occurs by carboxylation of matrix GLA protein. This functions like a shield to protect blood vessels from calcium entering into the arterial wall. This way the arteries are probably safe from calcification, and hardening of the arteries cannot take place. On the other hand calcium is binding to the bone. As explained above the hormone osteocalcin is responsible for this.Vitamin K2 is the main player in the process of carboxylization. As a result vitamin K2 makes it happen that calcium travels into the bone, where it belongs.

Rotterdam Study: reduced heart attack rates from vitamin K2

4807 subjects from the Rotterdam Study in the Netherlands were part of a study for considerable time (about 10 years) with no sign of any heart attack in the beginning.

The investigators were interested to correlate the effects of various doses of vitamin K1 and K2. How would this impact the frequency of heart disease, hardening of the aorta and all-cause mortality? Researchers adjusted the data for smoking, age, gender, body mass index, diabetes, education, and dietary factors. Next they compared the middle and upper tertile groups of vitamin K1 and K2 to the lower tertile of vitamin K1 and K2.

Results of Rotterdam Study

Most noteworthy, the relative risk for coronary heart disease was lower for the middle and upper tertile of the vitamin K2 group. They found that the middle tertile vitamin K2 intake lowered heart attacks by 27%. It was especially relevant that the upper tertile of vitamin K2 intake lowered heart attack rates by 57%.

In addition, all-cause mortality also showed a reduction for the middle tertile of vitamin K2 by 9% and for the upper tertile by 26%. Finally, severe aortic calcification was 29% less for the middle tertile of vitamin K2 and even 52% less for the upper tertile. Intake of vitamin K1 (=phylloquinone had no impact on any of the outcomes. The investigators concluded that adequate intake of vitamin K2 (=menaquinone) was crucial for anybody’s health. First of all, vitamin K2 lowers heart attack rates, in addition it reduces hardening of the arteries including the aorta and finally, it lowers all-cause mortality.

Vitamin K For Bones And Arteries

Vitamin K For Bones And Arteries

Conclusion

This review shows evidence that vitamin K2 supplementation is important for the prevention of osteoporosis and heart disease. It prevents heart attacks and hardening of arteries, including the aorta. The dosage necessary to achieve this is only 200 micrograms of vitamin K2 per day. However, in Japan higher doses like 375 micrograms per day are the common protocol for prevention of osteoporosis.

Effect of vitamin K2 for bones and arteries

How does vitamin K2 work? In the blood vessels vitamin K2 carboxylates the matrix GLA protein. Essentially this keeps calcium out of the arterial wall and prevents hardening of the arteries. This reduces heart attacks and significantly lowers mortality from heart attacks as well. The second effect of vitamin K2 is on bones. Vitamin K2 prevents osteoporosis to a large extent. It does so by binding calcium to the bone. The hormone osteocalcin, which is carboxylated by vitamin K2 effectively moves calcium from the bloodstream into the bone and keeps it in the bone. If you take vitamin K for bones and arteries, you double the benefit from this simple vitamin. Remember to take 200 micrograms of vitamin K2 daily. The benefits are certainly remarkable!

 

Nov
18
2017

You May Want To Cut Down Coffee Consumption

Many people drink too much coffee, so you may want to cut down coffee consumption. With all the good news about the health benefits when drinking coffee, some people went too far. They have overdone what was supposed to be good for them. Recently a study came out that tells you how to cut down coffee consumption.

But first I like to review the issue whether to drink caffeinated or decaf coffee. Next I will tell you how you can switch to decaf coffee.

Caffeinated and decaffeinated coffee have the same health benefits

  1. Recently a large study showed that coffee, caffeinated or not, has a connection with lower overall mortality.
  2. Coffee has long been a subject of heated discussions. Some praise it, and others condemn it. There are multiple past studies; some showed health benefits, some did not. This is why the Department of Nutrition, Harvard School of Public Health in Boston, MA. did a larger study. The purpose was to re-examine the health benefits for both caffeinated and decaffeinated coffee.

Mortality data regarding people who drank decaf coffee or regular coffee

Researchers assessed mortality among 74,890 women in the Nurses’ Health Study (NHS). Another 93,054 women in the NHS 2 study became part of this. And 40,557 men in the Health Professionals Follow-up Study were also part in this large study. The medium follow-up for all of these three groups was 22.5 years. 19,524 women and 12,432 men died during that time period. Ming Ding is a doctoral student at the Harvard School of Public Health department of nutrition. She was the lead author of this study. She pointed out that in the past there were confounding problems. Many studies had shown that both caffeinated and decaffeinated coffee consumption lowered the risk of cardiovascular disease. But the results in many studies were blurred. Studies often did not distinguish between smokers and non-smokers. This meant that the cardiovascular risk from smoking wiped out a beneficial effect from coffee drinking.

Confounding and other factors

Ding’s studies took this into account and also other confounding factors like how much sugary soda pop people were drinking and whether or not they were eating well. In addition they normalized for other factors that could interfere like drinking alcohol and eating red meat. Without normalizing for the factors mentioned above the study results were as follows. Study participants who had less than a cup of coffee and three cups a day had a 5% to 9% lower risk of dying than those who drank no coffee. Those who drank more than three cups a day did not see any benefit.

Dose response curve for regular and decaf coffee

After eliminating all the confounding factors researchers compared the various groups again, and the following linear dose-response curve emerged:

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

Coffee consumption reduces diabetes and heart disease

Ming’s study connected with another research paper that had shown that coffee drinkers have a lower risk of developing type 2 diabetes and also less heart disease. She found that both, caffeinated and decaffeinated coffee, reduced the risk of getting diabetes later in life. When asked about what would be responsible for the reduced death rates with coffee consumption, she explained: “There are at least two known chemicals in coffee, namely lignans and chlorogenic acid that could reduce inflammation and help control blood sugar, both of which could help reduce the risk of heart disease”. You may want to cut down coffee consumption because you know decaf coffee does the same as regular coffee.

Other details about the caffeinated/decaf coffee study

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

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

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

Suicide rates and coffee consumption

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

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

Discussion

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

Clear results after confounding factors were removed

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

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

Revisit the statement: “you may want to cut down coffee consumption”

Now we know that there is no difference in benefits whether the coffee is caffeinated or not. Those of you who consume 3 to 5 cups of decaf coffee already enjoy a 15% reduction in risk of cardiovascular disease.

Those of you who take the same amount of regular coffee may get into a caffeine dependency problem. Because every time the caffeine stimulation wears off, you yearn for yet another cup of coffee. You need your fix, and this becomes a dependency problem. You have conditioned your body to that regular dose of caffeine, even though it is the bioflavonoids that are reducing mortality while caffeine is neutral.

My experience of coffee withdrawal

When I came across Ding’s research findings I was glad that now there was clarification about whether decaf coffee was as good as regular coffee. The next step for me was to cut out regular coffee and replace it by decaf coffee. Formerly I had been drinking 5 mugs of coffee daily (translated into 500 mg of caffeine daily). When I decided to quit this habit, I figured I should do it cold turkey from one day to the next. To my surprise this was a much bigger deal than I had thought.

Withdrawal symptoms

I craved the next cup of coffee, and I drank a decaf coffee. It did not help: Still, there was this craving for regular coffee! Yawning, restlessness and tiredness were symptoms that followed me all day long. Then there was irritability, a mild headache and almost flu-like symptoms. Eventually I went to sleep and woke up one hour later feeling a bit more energetic. But two hours later I had to lay down again. I was feeling that bushed. The following few days went better. There was more energy. But I still liked a noonday nap of about 1 hour.

Benefits of getting off regular coffee

This was not like me! Normally I have lots of energy and I don’t need naps. It took me 1-½ weeks to get over my 5-cup a day coffee withdrawal. But it was 100% worth it! Since then my energy is back to normal. I don’t have to chase coffee houses on a trip or ensure there is always a cup of regular coffee available for me at home (work does not apply, because I am retired). If I want I can replace my beloved coffee with another fluid. I love lemon juice sweetened with stevia instead of my decaf coffee. It is liberating that I no longer depend on the caffeine. But I still like the flavor of decaf coffee, and there is something enjoyable about the fragrance of freshly brewed coffee. And so I drink 3 to 4 cups of decaf coffee a day.

How to cut down coffee consumption

Here is a 2016 study from the Johns Hopkins University where 34 patients on 600 mg of caffeine per day received a 1-hour lecture about coffee withdrawal followed by a 6-week diary of their coffee consumption. They were asked to reduce their caffeine consumption down to 50 mg by week 6 of the coffee elimination program. Tests followed with salivary caffeine levels 6, 12 and 26 weeks after coffee cessation. There was also a 1-year follow-up telephone conversation. The results were that there was good compliance. Saliva caffeine levels verified this. The diaries over the first 6 weeks showed that the participants had gradually eliminated caffeine consumption. Perhaps this was a more humane way than my “cold-turkey” approach.

You May Want To Cut Down Coffee Consumption

You May Want To Cut Down Coffee Consumption

Conclusion

Many people are sensitive to too much caffeine consumption in coffee and other caffeinated beverages. But since the Harvard study that I mentioned above there is no need to overdose coffee or tea consumption. Decaf coffee has the same effect on lowering death rates by 15%, as does regular coffee. It pays to avoid caffeine, as you will avoid caffeine dependency. Drink decaf coffee instead!

I also discussed that withdrawal from regular coffee can be done more gently over a 6 week period. I did it from one day to the next and had a 1-½ week long withdrawal reaction. Do it slower or faster, whatever works best for you. The end result will be the same. Then enjoy it that you no longer depend on caffeine!

More info: http://www.askdrray.com/coffee-could-be-a-lifesaver/

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Oct
21
2017

Bioidentical Hormone Replacement

Recently Medical News Today published an article on bioidentical hormone replacement in the Sept. 19, 2017 edition.

Although it was partially informative, I felt that there was an underlying bias against the use of bioidentical hormone replacement. The article made it sound as if hormone replacement therapy would not be safe. But the opposite is true with bioidentical hormone replacement.

Why are many women afraid of bioidentical hormone replacement?

At the time when there was a lot of confusion about hormone replacement therapy (HRT) the results of the Women’s Health Initiative (WHI) made it even more confusing. After all there was one trial to show once and for all that HRT would be beneficial. The expectation was that HRT prevents osteoporosis, heart attacks and breast cancer. But the results were quite different. Instead the study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease and a doubling in the risk for blood clots.

Missing information about synthetic hormones

What the authors of the study did not explain was the fact that it was the properties of the synthetic hormones, progestin and Premarin were responsible for the negative effects. Had research insisted to perform the study with bioidentical hormones, the results would have been quite the opposite! With bioidentical hormone replacement we see the prevention of heart attacks and clots; cancer rates are lower than controls, and the prevention of osteoporosis is another benefit. The end result is a reduction in mortality rates. But the horrifying results that are due to the use of synthetic hormones and that the WHI warned about linger on in the minds of many women.

The use of bioidentical hormone replacement

Dr. John Lee pointed out in several of his books that the physician should only replace hormone loss with bioidentical hormones. He also pointed out that physicians should only replace those hormones that are at low levels or missing. This means that the woman should have confirmatory blood tests like FSH, LH, blood estrogen and salivary progesterone. If estrogen and progesterone are missing, the physician usually starts the woman on progesterone cream first. After two months, when laboratory tests show a saturation with progesterone , the addition of estrogen can follow, typically as the Bi-Est cream. This is a mix of estriol and estradiol.

Caution to balance against estrogen dominance

Progesterone is started first to balance against the potential cancer-inducing effect of estradiol. With the addition of progesterone a balance is the result, and estrogen will not cause breast cancer. This is also why Bi-Est is used: it is a mix of estriol and estradiol. Estriol is neutral with regard to causing breast cancer. Estradiol is the main natural estrogen in a woman, so some of it is necessary to make the woman feel normal. This is how the body receptors are functioning. But estradiol alone, when not in balance with progesterone, can cause breast cancer and uterine cancer.

The key is that only women who need bioidentical hormones should receive it. There are some women whose blood tests do not show a lack of estrogen, but only a lack of progesterone. These women should receive replacement with bioidentical progesterone to re-establish the hormone balance between estradiol and progesterone.

Safety of bioidentical hormone replacement products

As I have mentioned before, the Women’s Health Initiative in 2002 showed that on Premarin and progestin, two synthetic hormone products women came down with breast cancer, heart attacks, stroke, and thromboembolic events. They were using the synthetic drugs, namely conjugated equine estrogen and medroxyprogesterone acetate. The reason these women had to suffer these side effects was because their physicians insisted in using “pure hormones that a drug company had manufactured”. But these synthetic hormones were not pure hormones; they were adulterated with side chains so that pharmaceutical companies could patent them. These side chains made the synthetic hormones not fit the body’s hormone receptors. And this is the reason why the synthetic hormones created chaos in form of breast cancer, strokes and heart attacks.

Women’s Health Initiative authors whitewashed study results

Instead of admitting their mistakes, the full truth never became public. Instead the authors of the WHI study stated that it would be necessary to limit hormone replacement in menopause to the minimum amount of synthetic hormones to control symptoms, and their use should not exceed more than 5 years. These authors never distinguished between bioidentical hormones that fit the body’s hormone receptors and the synthetic hormones that irritated or blocked the body’s hormone receptors. There are thousands of women in Europe who have been on bioidentical hormones for decades, and they are doing just fine!

Bioidentical hormones in balance have no side effects

The truth is that bioidentical hormones –as long as they are kept in balance-do not have any side effects. Bioidentical hormones are the same that a woman produces in her ovaries before menopause sets in. The production of her bioidentical hormones kept her healthy. But the treating physician needs to carefully watch the balance of the hormones in the woman who is replaced with bioidentical estrogen and progesterone. This means that she needs to get enough progesterone to counterbalance estrogen stimulation. Hormones are constantly changing and if you don’t measure them, you don’t know what you are dealing with.

Dr. Lee said to measure hormone levels

John Lee showed a long time ago that you should measure hormones and identify those women who are truly hormone deficient. These are the ones who need hormone replacement. However, physicians should use only bioidentical hormones to replace what is missing. And they should also replace only as much as necessary to normalize the levels. This is also the level where postmenopausal symptoms disappear. Dr. Lee noted: “A 10-year French study of HRT using a low-dose estradiol patch plus oral progesterone shows no increased risk of breast cancer, strokes or heart attacks”.

How is bioidentical hormone replacement done?

The best method is usually a bioidentical hormone cream applied to the forearms or to the chest wall once per day. This avoids the first-pass metabolism where the hormones, if absorbed from a pill in the gut have to pass through the liver. Part of the hormones can get metabolized and some of the hormone effect may disappear. By applying bioidentical Bi-Est cream and progesterone cream to the skin, the hormones get directly absorbed into the blood stream and can do their job without interference. The treating physician can prescribe different amounts of the bioidentical hormones depending on saliva tests or blood tests. 1 or 2 months later repeat blood or saliva tests can follow to verify that the amounts of the replacement hormones and their absorption are adequate for the patient’s need.

What are the side effects of bioidentical hormone replacement?

Normally, when estrogen and progesterone are in balance, there should be no side effect. However, in the beginning of replacement therapy sometimes one of the hormones gets too high. If this happens with estrogen replacement, the woman becomes estrogen-dominant. She would experience symptoms of bloating, fatigue, weight gain, depression, headaches, loss of sex drive. She can also develop uterine fibroids, endometriosis and hypothyroidism. It was Dr. John Lee who first described this (Ref.1). There can also be mood swings, craving for sweets, irritability, and sluggishness in the morning. The key is to cut back on the estrogen dosage; alternatively, if progesterone is low in saliva tests, this hormone may need an increase, which would rebalance estrogen. At the end of fine-tuning of bioidentical hormone replacement the woman will feel normal and have no negative side effects, but the process of fine-tuning may take several months.

Difficulties to measure progesterone levels

Dr. David Zava, PhD gave a talk on breast cancer risks. This was a presentation at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. Dr. Zava, who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way.

Blood (serum) progesterone levels do not adequately reflect what the hormone tissue level is like in a woman’s breasts. On the other hand saliva hormone levels are giving an accurate account of what breast tissue levels are like.

Progesterone blood levels versus progesterone tissues levels

Dr. Zava gave an example of a woman who received an application of 30 mg of topical progesterone. Next, laboratory tests observed hourly progesterone levels in the serum and in the saliva. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream based on a misleading blood test. This leads to overdosing progesterone. With salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava emphasized that testing blood or urine as progesterone hormone tests will underestimate bio-potency and lead to overdosing the patient.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Conclusion

Bioidentical hormone replacement, properly done, does not cause cancer, does not cause blood clots and prevents heart attacks and strokes. It also prevents osteoporosis and the associated fractures in older women. The key is that the natural hormones fit the body’s own hormone receptors. The reason why menopausal symptoms appear is that natural hormones (estrogen and progesterone) are missing. With the replacement of the missing hormones in a menopausal woman through bioidentical hormone replacement, the menopausal symptoms disappear. Contrary to the Women’s Health Initiative in 2002 when patients received synthetic hormones, there are no breast cancers, no heart attacks and no strokes with bioidentical hormone replacement. What is even better is that these women will live without all the postmenopausal problems, and their life expectancy will be about 10 years longer than without bioidentical hormone replacement.

References

Ref. 1. Dr. John R. Lee: “What your doctor may not tell you about menopause: the breakthrough book on natural hormone balance”. Sept. 2004.

Sep
23
2017

Close Diabetes Control Prolongs Life

 

A 20-year study showed that close diabetes control prolongs life. A study divided 160 people with diabetes into two groups. The one group continued to get standard care. Yet the other group received a multi targeted, aggressive treatment protocol. As a result after 20 years the group with the intensive treatment protocol lived 7.9 years longer than the group with the standard treatment.

Dr. Oluf Pederson was the senior investigator of the physician team that followed the diabetes group. He said that they concentrated on a number of known adverse factors and treated them aggressively. These factors were first of all high blood glucose values and clotting risks, also high blood pressure and high triglycerides and in addition cholesterol values. Behavior modification was the therapeutic method to get people with risk factors to exercise more, adopt a healthy diet and stop smoking. Medication in select cases also played a role.

More details about the study

The intervention of intensive treatment lasted 8 years. After that the patients were still in a follow-up study for 13 years. At the beginning of the study patients were on average 55 years old and were borderline obese.

The investigation team screened for complications of diabetes. This included screening for kidney disease, heart disease and blindness. Dr. Joel Zonszein, the director of the New York Clinical Diabetes Center at Montefiore Medical Center said: ”These results are impressive and most patients do not receive the correct treatment, according to national surveys.”

Other studies about diabetes  

Foreign studies

Study from Croatia
  • Another study from Croatia involved 200 patients. It concentrated on patients who did not respond to metformin. Physicians used alternative treatment modalities, and they observed and measured blood sugars and hemoglobin A1C in the following 6 months. The study concluded that those patients who received aggressive treatment of their condition did better than those who did not receive the same vigorous approach.
Study from Japan
  • This Japanese study documented that female patients with type-2 diabetes developed kidney damage earlier than their male counterparts.  Consequently, the investigators pointed out how important it is to treat diabetes aggressively to avoid kidney damage.
Study from Singapore
  • This 2016 study from Singapore analyzed retroactively the impact of diabetes on the long-term survival after coronary bypass grafting (CABG).  5720 consecutive patients had their isolated first CABG surgery between 1982 and 1999. The mean follow-up was 13 years. 34.6% of the patients had diabetes, 51% had high blood pressure and 46.6% had elevated blood lipids. The initial mortality after the CABG surgery was 2.4% in the diabetic group and 1.8% in the non-diabetic group. 20-year survival rates following CABG surgery were 30.9% in diabetics and 49.2% in the non-diabetics, an 18.3% difference. The 20-year freedom from cardiac mortality rates was 56% in diabetics and 68.4% in non-diabetics. Other risk factors that led to cardiac mortality were the following: female gender (1.43-fold risk), diabetes (1.51-fold risk), previous heart attack (1.54-fold risk) and a low left ventricular ejection fraction of less than 35% (2.6-fold risk). The conclusion from this study was that long-term survival in diabetics following CABG surgery was much lower than that of non-diabetic controls. Hence the key to improving long-term survival for diabetics is to treat comorbidities like high blood pressure and elevated lipids aggressively as well as getting blood sugars and hemoglobin A1C values under control.

US studies

  • In this US study 558 youth (age less than 21) between February 2012 to July 2015 received follow-up. Between 40% and 50% of these diabetics needed insulin to improve their diabetes. Unfortunately their diabetes showed poor control, as their high hemoglobin A1C values indicated. Median HbA1C was 6.7%, 8.5%, 9.6%, and 9.7% in those with disease duration less than 1 year, 1-2 years, 2-3 years and less than 4  In other words, the longer the young patients had diabetes, the less seriously they took their treatment. Only 33% treated their high blood pressure and only 11% their elevated blood lipids. Microalbuminuria, an indicator of diabetic kidney disease, and non-alcoholic fatty liver disease were present in 5% to 6% of these young diabetic patients. The authors came to the conclusion that there were serious gaps in treating these young diabetics. Further follow-up data of the same group of patients in the coming years will provide further data. In conclusion, the new hemoglobin A1C ranges of 3.8% to 4.9% as the new normal range explains why these youths who do not treat their diabetes properly are at high risk to develop complications from their poorly controlled diabetes.
Heart attacks and erectile dysfunction
  • Heart attacks are more common among patients with uncontrolled diabetes. This US study classified diabetics according to the tightness of their diabetes control. Researchers found examining 606 men and 606 women with diabetes that they could reduce their risk of a heart attack, if they controlled smoking, glycated hemoglobin (hemoglobin A1C), systolic blood pressure, and total and high-density lipoprotein cholesterol. The control of all these risk factors could contribute to the prevention of heart attacks. 35% of men and 45% of women could prevent having a heart attack. A laxer control still would prevent 36% of heart attacks in men and 38% in women. A very aggressive diabetes control could prevent 51% of heart attacks in men and 61% in women. Most noteworthy: close diabetes control prolongs life.
  • Erectile dysfunction (ED) is a big problem among diabetic men. This study from Seattle shows the investigation of 136, 306 men with erectile dysfunction. 19, 236 of these men had diabetes prior to their ED problem. Over a two-year observation period diabetic men had much worse ED problems. As a result they needed to receive secondary line treatments  like penile suppositories or injectables. Others needed tertiary treatments like penile prostheses. In those whose diabetes control was good, oral agents as first-line therapies were usually sufficient.
More studies about risks and benefits of lifestyle
  • Middle-aged women with diabetes have a 4- to 5-fold higher risk for developing heart attacks while men do not show such a higher risk. It is probably particularly important for women to control diabetes when they are diagnosed with it to reduce the risk of coming down with a heart attack.
  • In 2011 Taylor from Newcastle University showed in a group of diabetes patients that he could cure diabetes permanently with an extremely low calorie diet. The trial was simple: he took overweight or obese patients with diabetes and put them on a starvation diet of 600-700 calories per day for 8 weeks. Consequently 43% of diabetic patients received a permanent cure of their diabetes. More info: http://nethealthbook.com/news/cure-diabetes-permanently/

 

Close Diabetes Control Prolongs Life

Close Diabetes Control Prolongs Life

Conclusion

The new hemoglobin A1C ranges that are desirable are between 3.8% to 4.9%. When diabetics bring their hemoglobin A1C level into this range, they do not get complications from their previously poorly controlled diabetes. Close diabetes control prolongs life. But as can be seen from a brief review of the literature physicians tend to be lax, patients are lax, and diabetes is often not well controlled. This leads to erectile dysfunction in males, to heart attacks and kidney failure in both sexes. Blindness and painful diabetic neuropathy are also common complications of poorly controlled diabetes. Amputations from clogged arteries are also among the complications. “Close diabetes control prolongs life” is the new mantra that everybody with diabetes needs to follow.

Lifestyle changes control diabetes and prolong life

As stated above Dr. Taylor from Great Britain has shown that a brief 600 to 700 calorie diet can cure 43% of diabetic patients permanently. Quit smoking, bring the glycated hemoglobin (hemoglobin A1C) into the normal range, control your systolic blood pressure as well as your total and high-density lipoprotein cholesterol. Do all these things, exercise regularly, and your diabetes will be well controlled. Remember: close diabetes control prolongs life!