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!

Sep
02
2017

Resveratrol Effective In Humans

Resveratrol has been labeled a powerful antioxidant; but is resveratrol effective in humans?

  1. Quack watch says: don’t buy into the hype that resveratrol is effective in humans.
  2. WebMD claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive benefits.

Despite these recommendations the following evidence supports that resveratrol is indeed effective in humans.

Resveratrol effective in humans: high blood pressure patients

A 2017 study of high blood pressure patients examined resveratrol supplementation with two groups, 46 stage 1 hypertension patients and 51 stage 2 hypertension patients. Stage I hypertension had a systolic blood pressure of 140–159 mmHg and a diastolic blood pressure of 90–99 mmHg. Stage 2 hypertension was defined as a systolic blood pressure of 160–179 mmHg and a diastolic blood pressure of 100–109 mmHg. Each subgroup was divided into two groups, one receiving regular antihypertensive medication, and the other group receiving regular antihypertensive medication plus Evelor. Evelor is a micronized formulation of resveratrol. The trial lasted two years. The purpose of the trial was to determine the effect of resveratrol, which was added to the regular antihypertensive medication (or not) to see whether it had blood pressure lowering effects. The interesting result showed that the resveratrol addition was sufficient to bring the blood pressure down to normal levels with only one antihypertensive drug. The control group without resveratrol needed two or three drugs to get the blood pressure under control. In addition, liver function tests showed that resveratrol normalized negative side effects of the antihypertensive drug on the liver. Both liver enzymes, glutamate-pyruvate transaminase (SGPT) and gamma-glutamyl transferase (Gamma-GT) were normal in the group where resveratrol had been added.

Resveratrol effective in humans: diabetes patients

Resveratrol helps diabetes patients. Resveratrol, the bioflavonoid from red  wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. This group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol was 1000 to 5000 mg.

Resveratrol effective in humans: improves bone density

Resveratrol improves bone density in men: 66 middle-aged obese men with an average age of 49.3 years and a mean body mass index of 33.7 were recruited for this randomized, double blind, placebo-controlled trial. The purpose was to study whether there would be changes in bone turnover markers (LDH, an enzyme involved in bone turnover), but also whether bone mineral density (BMD) would increase. Resveratrol was given to a high group (1000 mg per day), a low group (150 mg) and a placebo (fake pills) were given to the third group. The end point was an elevation of the bone alkaline phosphatase (BAP). This was measured in the beginning of the study and at 4, 8 and 16 weeks. The high group of resveratrol had a 16% increase of the BAP throughout the study and a 2.6% in lumbar spine bone density (measured by a trabecular volumetric method). The low resveratrol group showed no bone restoring effect. MJ Ornstrup, MD, the lead investigator said that this was the first time that a clinical team has proven that resveratrol can potentially be used as an anti-osteoporosis drug in humans. She added that resveratrol appears to stimulate bone-forming cells within the body.

Resveratrol effective in humans: anti-aging effects

The Nurses’ Health Study showed that both a Mediterranean diet and resveratrol can elongate telomeres.

The fact that you can have a longer life with a Mediterranean diet is known for some time. But now a study has shown that the reason for a longer life is the fact that telomeres get elongated from the Mediterranean diet. Telomeres are the caps at the end of chromosomes, and they get shorter with each cell division. This is the normal aging process.

The finding of elongated telomeres comes from the ongoing Nurses’ Health Study that started enrolling subjects in 1976. At that time 121 700 nurses from 11states enrolled in the study. In 1980 diet sheets were used to determine who was adhering to a Mediterranean diet. 4676 middle-aged participants were identified to qualify for this study. This diet consists of a combination of vegetables, legumes, fruits, nuts, grains and olive oil. Fish and lean meats were also consumed. The control group followed a regular diet. Between 1989 and 1990 blood tests were obtained to measure telomere length in white blood cells. It is known that smoking, stress and inflammation shortens telomeres. The lead author Marta Crous-Bou stated that overall healthy eating was associated with longer telomeres compared to the control group. But the strongest association was found in women who adhered to the Mediterranean diet when compared to the controls. For the best diet adherence score there was a 4.5 year longer life expectancy due to slowed telomere shortening.

Longer telomeres have been found to be associated with the lowest risk to develop chronic diseases and the highest probability of an increased life span. I have reviewed the importance of lifestyle factors in this blog where I pointed out that Dr. Chang found a whole host of factors that can elongate telomeres by stimulating telomerase. It has been shown in humans that increased physical activity elongated telomeres. So did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet and marine omega-3 fatty acid supplementation. In addition higher fiber intake, bioidentical estrogen and progesterone replacement in aging women and testosterone in aging men, as well as relaxation techniques like yoga and meditation are also elongating telomeres.

Aging is due to shortening of telomeres. Elongation of telomeres by resveratrol leads to prolonged life (or anti-aging).

Resveratrol effective in humans: resveratrol and cancer

As this overview shows, it seems that several mechanisms of action give resveratrol the power to be an anticancer agent. Resveratrol is anti-proliferative and has anti-angiogenesis mechanisms. In addition resveratrol stimulates apoptosis, which is programmed cell death. All these actions together help resveratrol to have anticancer properties. Resveratrol can also be used in combination with other cancer treatments, which improves survival figures. As the link above explains, more cancer clinical trials with a variety of cancers and larger patient numbers are required, but many smaller clinical trials have already been very successful showing efficacy of resveratrol as a chemotherapeutic agent.

In this 2015 publication about malignancies and resveratrol an overview is given about the use of resveratrol and cancer treatment. It summarizes that the development of cancer is a multifactorial process that involves the 3 stages of initiation, promotion and progression. One of the cancer promoting factors is chronic inflammation. Resveratrol has been shown to be anti-inflammatory. At this point it is not clear how the animal experiments will translate into the human situation. More clinical observations are necessary.

Resveratrol effective in humans: cardiovascular disease

Resveratrol has beneficial effects on preventing hardening of the arteries, diabetes, various cancers and inflammatory conditions like Crohn’s disease and arthritis. As this link explains resveratrol also stimulates the antiaging gene SIRT1 by 13-fold. This confirms the anti-aging effect of resveratrol. This 2012 study has also confirmed that resveratrol from red wine is what is responsible for the “French paradox” (longer life expectancy despite high saturated fat intake).

Resveratrol effective in humans: polycystic ovarian syndrome 

Polycystic ovarian syndrome could be significantly healed with resveratrol in a randomized, double blind, placebo-controlled trial. It involved 30 subjects who completed the trial. 1500 mg of resveratrol or placebo were administered daily for 3 months. Serum total testosterone was decreased by 23.1% at the end of 3 months in the experimental group versus the placebo group. There was also a decrease of dehydroepiandrosterone sulfate of 22.2%. Fasting insulin level was reduced by 31.8%. At the same time insulin sensitivity was increased by 66.3%. The authors concluded that resveratrol had significantly reduced ovarian and adrenal gland male hormones (androgens). This may be in part from the drop in insulin levels and the increase of insulin sensitivity.

Resveratrol effective in humans: anti-arteriosclerotic effects in diabetics

A double blind, randomized, placebo-controlled study was done on 50 diabetics. The cardio-ankle vascular index (CAVI) was used to determine arterial stiffness. The purpose of this study was to determine the effect of resveratrol on the stiffness of arteries in a group of diabetics and compare this to a placebo. Diabetics are known to have premature hardening of the arteries (arteriosclerotic changes). After 12 weeks of taking 100 mg of resveratrol per day there was a significant reduction in arterial stiffness in the experimental group, but not in the placebo group. Blood pressure also decreased by 5 mm mercury (systolic) in the experimental group.

Resveratrol effective in humans: ulcerative colitis patients

56 patients with mild to moderate ulcerative colitis received 500 mg of resveratrol or placebo and were observed for 6 weeks. This was a randomized, double blind, placebo-controlled pilot study. Bowel disease questionnaires were used to assess the bowel disease activity before and after the treatment. The resveratrol group decreased the disease activity significantly, but it also increased their quality of life. Blood tests showed that this improvement occurred as a result of reducing oxidative stress by resveratrol.

Resveratrol effective in humans: Alzheimer’s disease prevention

Here is a study where 52 Alzheimer’s patients were divided into two groups; one group was given 200 mg of resveratrol for a number of weeks, the other group placebo pills. There was a significant improvement in memory tests in the resveratrol group and functional MRI scans showed better functional connectivity in the hippocampi of the subjects. It is known that the hippocampus is the seat for short-term memory, which is lost in Alzheimer’s patients.

Resveratrol Effective In Humans

Resveratrol Effective In Humans

Conclusion

Resveratrol has a long history of showing evidence of improving health. It does so by countering oxidation of LDL cholesterol, which lessens hardening of arteries. This prevents heart attacks and strokes. Resveratrol is also a powerful anti-inflammatory, which helps patients with diabetes, with Crohn’s disease and arthritis. There is even a cancer preventing effect of resveratrol because of anti-proliferative and anti-angiogenesis effects as well as stimulating apoptosis. Because of these combined anticancer properties resveratrol is a chemotherapeutic agent that can be combined with conventional anticancer drugs.

There are enough randomized, double blind, placebo-controlled trials in humans to show that resveratrol is effective in preventing and treating several disease conditions. The medical establishment claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive health benefits. After my review outlined above I come to the opposite conclusion. It is quite clear that resveratrol has several important healing properties. It can improve diabetes; prevent hardening of arteries, lower blood pressure, attack osteoporosis and prevent Alzheimer’s disease. I have been taking 500 mg of resveratrol daily for years. It has not harmed me.

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Jun
25
2016

Prevent Unhealthy Aging

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

Studies showing how to prevent unhealthy aging

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

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

Preserving health and vitality to prevent unhealthy aging

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

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

Prevent Unhealthy Aging

Prevent Unhealthy Aging

Conclusion

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

Jan
23
2016

Life Extended By Several Decades

Have you ever thought about the possibility to prolong your “Freshness Date”? At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. Dr. Hertoghe explained that it is possible to extend life by paying attention to the factors that prolong life and combining them as an anti-aging type lifestyle. He made a distinction between

  1. normal aging: up to age 82
  2. healthy aging: up to age 100
  3. anti-aging medicine: up to age 122
  4. reversing aging medicine: much more than 122, perhaps to age 150 or more.

Normal aging (up to age 82)

When you live without any interventions your life expectancy on average is about 82 years. From the age of 50 to 60 onwards you may encounter problems with increased cholesterol, high blood pressure leading to heart attacks and strokes. Coronary artery by-pass surgery may extend an individual’s life by 10 to 15 years. But hardening of the arteries in the general circulation will eventually cut down the blood supply to vital organs leading to premature death that could have been avoided.

Around the mid 60’s to mid 70’s 12.4% of African Americans or 2.9% Caucasians get Alzheimer’s disease. These figures worsen rapidly with further aging: in their mid 70’s to mid 80’s 32.5 % of African Americans and 9.8% of Caucasians suffer from Alzheimer’s disease. At the age of 85+ years 54% of African Americans and 27% of Caucasians have Alzheimer’s disease. Particularly with normal aging Alzheimer’s has already increased, and this trend is likely going to continue.

Memory loss also leads to a shortened survival curve; people with memory loss live two years less on average than compared to a group with no memory loss.

Add to this loss of life because of depression, which is common in older age. Compared to a non-depressed group of older people the depressed group lived 30% shorter over a period of two years.

Musculoskeletal pain is reported in younger age (18-44) to be 38%; the next demographic group aged 45-64 reported 61% of musculoskeletal pains; seniors between 65 and 74 had 68% of musculoskeletal pain, and in the demographic group of 75 and up 71% of persons suffered of musculoskeletal pain. As we will learn later there may be hormone deficiencies behind these neck and back pains that, if left alone. lead to falls, fractured hips and premature loss of life. Those who survive accidents will often become wheel chair bound and get admitted to nursing homes.

One specific subgroup of patients with musculoskeletal pain are rheumatoid arthritis sufferers. After 10 years of having rheumatoid arthritis patients will have a survival of only about 50%; if more than 30 joints are involved (more severe form of the disease) only about 40% will survive. In other words, rheumatoid arthritis is an important factor for lowering people’s life expectancy.

At an age of 65 to 74 men have 23% of disabilities, while woman have 27.5% disabilities. This increases between the ages of 75 or older to 40% for men and 44.5% for women. At the age of 65 disabled men have a 3.5% higher death rate than the average population; disabled women’s death rate is 2.5% higher than the normal population. In other words, disability kills.

Urinary urgency and incontinence leads to a 3.13-fold higher mortality rate than a control group of men who do not have these symptoms.

65% of men and 85% of women above the age of 50 have abdominal obesity. This is not just a harmless condition. It is associated with increased triglyceride levels and increased mortality due to cardiovascular disease and diabetes.

By the age of 65-74 heart disease has a frequency of 32% in men and 23% in women. At the age of 75 years and older this jumps to 44% in men and 32% in women. Once heart disease is established, it causes a lot of premature deaths: on average persons with heart disease live 10 years shorter than those who do not have heart disease!

Healthy aging (up to age 100)

If we look at normal aging, we realize that all these diseases and disabilities we discussed are eventually killing us. In order to live longer we have to take steps that are known to interfere with some of these factors. For instance, quitting smoking will prevent heart disease, several cancers and chronic obstructive lung disease (emphysema). Positive thinking, social support and transcendental meditation will increase survival by preventing mental illness and depression, which in turn will prevent suicides. A healthy diet such as the Mediterranean diet or the Pegan diet will avoid cardiovascular disease and cut down cancer rates. One dietary change called the “polymeal” would contain fish, fruit, vegetables, garlic, almonds, a moderate amount of wine and dark chocolate. Compared to the Standard American diet this type of diet would add 9 years for men and 8.1 years for women regarding their life expectancy. For instance, prostate cancer showed a 7-fold increase in a group of men who ate a lot of pickled vegetables, fermented soy products, salted fish and preserved meats, when compared to a control group who did not include these foods. In a group of women who had their meat well done and ate three servings of beef per week, breast cancer risk was 4.62-fold higher that the risk of women who had their meat done rare or medium rare.

Overall cancer and cardiovascular mortality dropped by 35% in a study where 5 or more servings of fruit and vegetables were eaten per day.

A regular exercise program will strengthen the heart and lungs, keep your weight stable, reduce heart attacks and strokes and reduce the probability to develop cancer. A group of men between 61 and 81 were observed over 12 years and divided into those who did not exercise versus those who walked more than 2 miles per day. The exercising men had 19% less mortality compared to the sessile men. Vitamin C from fruit and vegetables or from taking supplements reduces global mortality from all causes by 46% compared to controls that did not. Similarly taking omega-3 fatty acid supplements (fish oil) daily reduced all cause mortality by 20%.

Dr. Hertoghe calls this “healthy aging” and this would allow you to be able to reach an age of about 100 years.

Anti-aging medicine (up to age 122)

Dr. Hertoghe told the audience that further attention to anti-aging factors could reduce mortality even further. In particular, he found over the years that paying attention to correcting hormonal weaknesses would have profound effects on how old a person becomes. Thyroid hormone replacement has been one of the steps that have helped people to experience more energy and less musculoskeletal problems (less muscle pain, less falls, less fractures and complications). This translates into more energy and longer lives.

One slide showed that a low free T3 level (low thyroid) was associated with a 3.6-fold higher death rate. A low free T3 level predicts of cumulative death rate in cardiac patients most accurately.

T3 is also important for the maintenance of the immune system, which shows in patients with tuberculosis: the one-year mortality rate in thyroid deficient patients with low T3 levels was 75%, while patients with a normal thyroid had a mortality from tuberculosis of only 7%.

Secondly, replacing missing sex hormones can add more life because cardiovascular disease is postponed (less heart attacks, less strokes), there is less cancer and better cancer survival, if a person comes down with cancer. Many statistics were quoted.

One interesting slide showed the longitudinal survival follow-up of congenital dwarfs in comparison with their normal brothers or sisters. Untreated male dwarfs turned only 56 years on average, while their unaffected normal brothers turned 75 years on average (19 years longer). With female dwarfs the difference is even more striking: untreated females dwarfs turned 46 years on average, while their normal sisters turned 80 years on average (a difference of 34 years).

Another publication showed that the heart attack risk was 3.8-fold higher in a group of patients with hypopituitarism (under function of the pituitary gland), but the treatment group (treated with GH) had a normal rate of heart attacks.

11606 men aged 40 to 79 years were followed for between 6 and 10 years. The group who had the top 25% range of testosterone had a 19% lower mortality rated from heart attacks or cancer.

Older women, particularly aged 100 in Okinawa had 2.3-fold higher testosterone levels than women in the US at age 70. On the other hand 70-year old Okinawan women had 2.7-fold higher estrogen levels than US women.

Bioidentical hormone replacement therapy (BHRT) prior to developing breast cancer showed a 27% longer survival among 984 breast cancer patients in Sweden compared to those without prior hormone treatment.

In another group of breast cancer patients (2755 patients) aged 35 to 74 who were treated with bioidentical hormone replacement after their breast cancer diagnosis, 50% had a lower recurrence rate (compared to no-BHRT treatment) and there was a reduction of 66% of mortality from breast cancer compared to controls without BHRT treatment. Another study showed that breast cancer patients would have a mortality rate of 33.3% without hormone treatment, 12.5% mortality rate after non-estrogen hormone use and 6% after estrogen/progesterone use.

This shows the healing results of the various natural hormones.

A group of 280 men and women around the age of 50 were treated with anti-aging hormone replacement for 2 or more years. In the beginning there were 34% of women and 15% of men with coronary artery disease. There were also 36.4% of women and 34.1% of men with high blood pressure. After replacing all of the missing hormones with bioidentical hormones for more than 2 years, coronary artery disease had dropped to 1.6% of the women and 1.08% of the men; high blood pressure had dropped to 2% of the women and 3% of the men. No drugs, just hormones! Of course, initially there were drugs used to stabilize their condition, but they could gradually be dropped safely, because the underlying hormone deficiency, which was the cause of cardiovascular disease, had been treated (treating the cause rather than the symptoms).

Dr. Hertoghe presented data of 6.38-year follow-up of 286 consecutive patients using anti-aging medicine (replacement of missing hormones with bioidentical hormones). These patients had an overall cancer rate of 2.1%, which compared very favorably to the 3.2% cancer rate among US women, 3.1% French women and 3.1% Belgium women on no hormones. This is the type of information that is needed following the Women’s Health Initiative (WHI) that scared women into the false belief that hormones would be “poisonous”. In the WHI synthetic hormones were used causing cancer and heart attacks; the reason for this was that synthetic hormones are not the identical shape as the natural hormones. But hormones and hormone receptors have to fit like a key into a lock; otherwise they are not effective or even block the natural life prolonging action of the natural hormone. This is why in the WHI study the outcomes were poor. Using bioidentical hormones heart attacks and strokes are prevented and they are also cancer-protective.

Reversing aging medicine (much more than 122, perhaps to age 150 or more)

General medicine has the goal to make patients as healthy as possible. With reversing aging medicine the goal is to make patients as young as possible so that they are at their healthiest and feel younger again.

With anti-aging medicine using a healthy diet, exercise and bioidentical hormone replacement therapy the patients can add 15 years of good life. Add to these organ transplants, if necessary, telomerase activators and stem cell therapy and you can add another 25 years of life expectancy to a total of 40 years.

Growth hormone deficiency is the one factor that has been underestimated. We have seen in the discussion of dwarfs in comparison to their healthy brothers and sisters that normal growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many are deficient with regard to GH production. These were patients who already had their thyroid hormones replaced, if abnormal and had their sex hormones replaced when they were found to be low. But they lost hair, developed old looking faces with wrinkles, loss of subcutaneous fatty tissue giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands. He replaced their missing GH using daily GH self-injection with a tiny needle (similar to diabetes injections) and within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of GH daily. This is not inexpensive, but some health care plans pay for this, as a lack of GH is a true hormone deficiency.

Often it is a single limiting organ that determines when we die, typically the heart, lungs, brain, liver, kidneys, small bowel, pancreas or bone marrow. Organ transplants can add years of life, but it can be cumbersome to find a suitable donor. Another limitation is, as one study showed, that only 40% to 60% of organ transplants are surviving 8 years after doing the transplant surgery.

Stem cell therapies are other ways to prolong life. More research is needed to perfect this, but essentially 220 different cell types could be derived from stem cells in the future to replace malfunctioning organs.

Life Extended By Several Decades

Life Extended By Several Decades

Conclusion

The dream of staying younger for longer can be a reality today, if you are willing to discipline yourself to watch what you are eating (Mediterranean type diet), exercise regularly and have a positive psychological attitude. If the outdoor air is poor where you live, you may want to consider moving to a place with good air quality. Sleep well for 7 ½ hours every night and retire not later than 10 to 11PM. You need to be asleep between midnight and 3AM as the growth hormone peak occurs at that time. Take supplements that contain longevity micronutrients (magnesium, vitamins A, C, D, E, B6, B12, Co-Q-10, selenium, zinc, iron in premenopausal women etc.). Replace all missing hormones with bioidentical ones, like thyroid hormones (T3 and T4), sex hormones, DHEA and GH. Stem cell therapy and telomerase activators for cell rejuvenation will also have more of a place in the future.

Even, if you do only part of this reversing aging program you will slow down aging.

May
30
2015

Be Creative, Prevent Dementia

Here is a recent research finding from the Mayo Clinic that caught the media’s attention: be creative, and this will prevent dementia. The study found that when people engage in creative things they could delay the onset of Alzheimer’s and dementia. Dementia can be caused by a number of various causes. But the end result is that there is an inflammatory condition within the brain that leads to a loss of nerve cells and nerve cell connections. When brain cells and nerve cell connections are lost, memory fades, particularly in the frontal brain and in the hippocampus area.

The study

In an April 8, 2015 publication from the Mayo Clinic in Rochester, MN and Scottsdale , AZ 256 participants aged 85 years and older (median age 87.3 years, 62% women and 38% men) were followed for 4.1 years. Mild cognitive impairment (MCI) was measured using psychological tests. At the time of recruitment into the study all of the tests for MCI were normal. As the study progressed it became apparent that there were various risk factors that caused the onset of MCI, which is the immediate precursor of dementia/Alzheimer’s disease. The finding was that the genetic marker APOE ε4 allele was associated with a risk of 1.89-fold to develop MCI and later Alzheimer’s disease. If there were current depressed symptoms present at the time of being enrolled into the study the risk of MCI development was 1.78-fold. Midlife onset of high blood pressure led to a 2.43-fold increase and a history of vascular diseases was associated with 1.13-fold higher MCI development. The good news was that four activities were associated with a lower risk to develop MCI with aging. When the person engaged in artistic activities in midlife or later in life the risk for MCI development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

What we can learn from the study

When you get older it is important that you prepare yourself for an active retirement. You may want to enroll in dance classes, as this combines physical activity with brain activity where you have to remember learnt responses (from old moves you know) and also learn new dance moves (therefore creating new nerve cell connections). You could start a hobby where you create something (arts and crafts, painting etc.). Grandma Moses did this, and she not only became famous with her artwork, but she aged gracefully; she turned 101 years old).

The brain is an organ that needs to be treated with respect. We need to give it proper nutrition and avoid cardiovascular disease as it is known that whatever is good for the heart is good for the brain.

Eat a Mediterranean diet and avoid junk foods including processed foods. If at all possible eat organic foods. Take your fish oil supplements (omega-3 and DHA), as the DHA will provide the material necessary to build up new brain cells. The omega-3 fatty acids are necessary for a healthy heart and healthy blood vessels.

Regular exercise will improve your brain circulation, even in old age. If you take the steps mentioned you will at the same time prevent arthritis from developing and by cutting out sugar and starchy foods your brain will stay sharper for longer. Nurses in care homes for Alzheimer’s patients have known for a long time that Alzheimer’s patients crave sugar and sweets. This leads to hyperinsulinism and Alzheimer’s disease. So let’s take the consequences and cut out sugar and sweets to prevent Alzheimer’s.

Apart from these physical factors that have been published in many medical journals we have now an additional tool in getting the aging persons involved in crafts: social activities like journal clubs, discussion groups, walking groups, bridge groups or religious gatherings that will stimulate the brain to form new circuits and buildup new memories. Artistic activities and learning the use of the computer are additional things that will reduce the risk of developing MCI and later dementia or Alzheimer’s disease.

Be Creative, Prevent Dementia

Be Creative, Prevent Dementia

Conclusion

As the baby boomers age and enter into the old age category these observations are very important. We should think about doing some of these things now, so we do not have to overcome inertness later. The worst you can do is to become a couch potato and watch TV all of the time. Watching other people doing sports activities does nothing for you unless you walk on a treadmill while you watch TV. I do not intend to be hard on you; I am just passing on these new research findings and practicing them myself. The final choice is up to you.

 

Reference:

http://www.cnn.com/2015/04/09/health/creativity-socializing-delay-dementia/index.html

 

Apr
11
2015

Fish Oil, Your Best Supplement

There was a story in CNN last year describing the dramatic recovery of a youngster who was involved in a hit and run brain injury. The physicians involved in his care strongly recommended “to let him go”. His family did not give up on him and tried bioidentical progesterone cream first and finally fish oil in high doses, which lead to a successful recovery from this young man’s brain injury. Nine weeks after the accident the patient was transferred to the rehabilitation hospital, still unconscious. At that time the family increased the fish oil dosage to 20 grams (=20,000 mg) per day. Within two days the young man woke up from his coma and called his mother on a cell phone.

The benefits of fish oil

Fish oil is sold under various brand names. The high potency ones contain about 1400mg of fish oil in one soft gel. Each soft gel has 647mg EPA (Eicosapentaenoic acid, commonly known as omega-3 fatty acid) and 253 mg DHA (Docosahexaenoic acid) and other fatty acids. Any of these more potent fish oil preparations are molecularly distilled meaning that mercury, cadmium and PBA impurities have been removed from the product before it is passed on to consumers.

Fish oil boosts your memory, it helps brain cells to function better. EPA is more beneficial for the lining of arteries and prevents heart attacks and strokes. The DHA component of fish oil is the building block of brain cells, and likely it was DHA that brought the young man with the hit and run accident back to consciousness.

Fish oil also has anti-inflammatory properties, which is important for arthritis and prevention of heart attacks.

Everyday supplementation with fish oil

For persons with no arthritis and health risks a good fish oil supplement dose would be 1 or 2 of the higher potency fish oil capsules per day. This will help to prevent inflammation. The American Heart Association recommends to consume salmon two times per week, which will also give you a good dose of fish oil.

People with arthritis need more fish oil

As this link shows people with arthritis need more omega-3 fatty acids (EPA), namely 2.7 grams or more (=2700 mg or more) per day.

This would mean 5 capsules of the high potency supplement I described above to bring the total EPA to just above 3000 mg per day. People who have arthritis have so much more inflammation in their body that they need this higher amount of fish oil to get the condition under control. When you start fish oil supplements for arthritis it takes about 2 to 3 months for the fish oil to work before the inflammation is under control. So be patient.

Fat metabolism

When it comes to the metabolism of fatty acids, it is important to know the ratio of omega-6 to omega-3 fatty acids that we take in. For instance, there are a lot of omega-3 fatty acids in fish and seafood. On the other hand there is more omega-6 fatty aid in chicken and processed meat. Omega-6 fatty acid gets metabolized into arachidonic acid that causes inflammation. Most processed foods have too much omega-6 fatty acids in them. Here is a hint: when we consume more omega-3 fatty acids by increasing our fish oil supplementation, we counterbalance the omega-6 to omega-3 ratio. This will slow down aging, will control inflammation in the body and will prevent disabilities.

Side effects of fish oil

  1. Be aware that there is a difference between “fish oil” and “cod liver oil” or “halibut liver oil”. Cod liver and halibut liver oil has vitamin A in it; so avoid these formulations as this could lead to toxic levels of vitamin A.
  2. Fish oil is generally safe; there may be a mildly upset stomach at higher dosages, which is harmless and the dosage can be reduced until the stomach accepts it.
  3. Fish oil tends to thin the blood and theoretically there may be a problem when a person takes aspirin or blood thinners. Discuss this with the doctor. Patients with atrial fibrillation on blood thinners should discuss with their doctor whether it is safe for them to take fish oil supplements.
  4. Patients on platelet inhibitors (ASA and others) should first clear with their physician whether it is safe. The FDA did a review on this and stated that theoretically there could be interference in these situations, but practically no case was found that would have substantiated this.
  5. The cytochrome P450 pathway in the liver, which is used to eliminate antidepressants, erythromycin and many acid suppressing drugs (cimetidine, ranitidine) etc. is not interfering with the elimination of fish oil. The FDA confirmed this. This means that you will not have to fear that you overdose with fish oil because of drug interactions in the liver.

Fish oil supplementation in diabetes and heart disease

Many studies have shown that fish oil improves the control of diabetes, improves heart disease based on narrowing of coronary arteries and lowers blood pressure. It does so because of the anti-inflammatory effect of fish oil; this improves endothelial functioning, which leads to more nitric oxide production and lowering of high blood pressure. Patients find that they do not need as much insulin some time after starting fish oil supplementation, and their blood sugar is better controlled. They also get more energy, which may help to motivate them to engage in regular exercise, which in turn helps improve diabetes, prevents cardiovascular disease and Alzheimer’s disease.

Fish oil to prevent Alzheimer’s disease

Apart from other factors mentioned in this link the regular consumption of fish and fish oil will help improve memory and Alzheimer’s in general. It is the DHA contained in fish oil that is needed by the brain and the omega-3 fatty acids in fish oil help keep the cardiovascular system healthy.

A study in the medical journal Alzheimer’s and Dementia from June 14, 2014 followed 193 older men and women with Alzheimer’s patients for 5 years. Every half-year they had a magnetic resonance imaging study (MRI scan) of the brain and neuropsychological testing. 117 subjects used fish oil supplements throughout the study. They were the ones who maintained their brain volume and in particular the hippocampus area, which is important for memory. They also preserved their brain function compared to those subjects who did not consume fish oil. They showed shrinkage of the brain and a decrease in size of the hippocampus as well as poor brain function in neuropsychological testing. Patients who were carriers of the apolipoprotein E4 gene did not show the protective effect with fish oil.

Fish Oil, Your Best Supplement

Fish Oil, Your Best Supplement

Conclusion

Consumption of fish and supplementation with fish oil capsules is a valuable adjunct to all of the other health measures you can take to preserve brain and heart function like regular exercise and consumption of a Mediterranean diet. Take a supplement, which is higher dosed and is molecularly distilled (also called pharmaceutically pure). This way you will get all the health benefits, and you will avoid exposure to toxins from the ocean, which are not eliminated in the less potent, non-purified and cheaper fish oils.

Dec
06
2014

Regrets Following Holiday Foods

Countless blogs have been written about gaining pounds with holiday food. This is not my topic in this blog. I am looking at the medical evidence of what is happening to our bodies, some of which is permanent. I like to focus on the gallbladder, blood pressure, heart function and gout. I will provide little clinical vignettes that make my points clear.

Gallbladder disease

Many patients are unaware that their gallbladder has developed stones that accumulate over several years, perhaps even several decades. But, if infection sets in there is an acute flare-up of gallbladder pain, which can be excruciating. Also, when one of the stones is transported into the gallbladder duct, there is a sudden colicky pain similar to labor pains. In cases where the migrating stone blocks the common bile duct, the patient can get jaundiced and the pancreatic juice can get backed up leading to an acute pancreatitis.

What does that have to do with overindulging during a Thanksgiving meal? Fatty sauces, ham, and gravy can all lead to more cholesterol deposits in the gallbladder and make stones larger. Add to this a rich dessert with ice cream and a dollop of whipped cream and you’ve got yourself a fairly fatty feast. So, this one fatty meal can make a difference by bringing on symptoms of a previously undiagnosed condition, and you spend hours in an emergency room of a hospital.

The scenario could look like this case:

Fred is a 40-year-old teacher, somewhat overweight who enjoyed a holiday meal at his parent’s place for Thanksgiving. His health has been good with no surgeries. Following the turkey dinner, which he enjoyed he noticed right upper abdominal pain, and he started to vomit. As the pain did not improve, his parents called an ambulance that brought him to a hospital. The emergency physician said that he was concerned about Fred’s gallbladder. He ordered a CT scan and this showed multiple stones with one of the stones being stuck in the cystic duct. Despite pain medication and bed rest the situation did not resolve (the stone did not pass). A surgeon was called in and a laparoscopic cholecystectomy was performed. Fred recovered within only 3 days and could return to teaching. The fatty food of the Thanksgiving dinner was only the tip of the iceberg in this case. The fact that there have been many pre-existing gallbladder stones tells us that this patient had the chronic habit to eat foods with too much fat and cholesterol. Here is a blog that I found containing sensible eating suggestions.

High blood pressure

Extra salt intake leads to an elevation of blood pressure. If a person has borderline high blood pressure, the extra salt intake from holiday meals can get the blood pressure out of control and this in turn can cause a stroke (typically a hemorrhagic stroke) or is a strain to the heart leading to a heart attack or to congestive heart failure.

Janice is a 50-year-old janitor who has had problems with borderline high blood pressure readings. Normally her blood pressure was 140 over 90, and when she watched her salt intake it would go down to 125 over 80. She bought a blood pressure monitoring device, just so she could measure her own blood pressure at home. Following the Thanksgiving turkey dinner she noticed that she developed fullness in her head and a headache and her face looked flushed. She took her blood pressure with a reading of 160 over 100. It had never been that high. When she saw her doctor he asked her what she had for Thanksgiving dinner: they sat together with friends and had potato chips with dip and drank some red wine with it. Next for the meal she enjoyed the roasted, brined turkey and ham. Yes, she did add some more salt to the mashed potatoes too.

The doctor found her blood pressure to be 165 over 100. He explained to her that she needs to go on a DASH diet, which is low in salt. He also started her on blood pressure pills. Here is another link for a low salt diet.

Heart attack following turkey dinner

When working as an intern in teaching hospitals of McMaster University of Hamilton/Ont. during my training in 1975 to 1978 I noticed a strange correlation between holidays like Thanksgiving and Christmas and intensive care unit admissions with acute heart attacks. Later a formal study was published that there is indeed such a correlation between consuming a big meal with fat, salt and refined carbohydrates and the development of a heart attack.

This likely does not develop without prior silent conditions of high triglycerides, high cholesterol and insulin resistance leading to inflammatory substances circulating in the blood. The C-reactive protein is one of the substances that has emerged as a useful monitoring device and a fasting insulin level. Both should be low or the person is at a higher risk of developing a heart attack.

Add to this a festive, large meal and you got troubles at your hand like in the next case:

Joan is a 62-year-old high school principal who developed chest pain within 2 hours of having enjoyed her Christmas dinner. She was known to have high cholesterol levels for about 5 years and she had been taking statins for 4 years as diet alone could not control it. But she loved food in general and was about 20 pounds overweight. The doctor had discussed exercise with her, but she felt too busy doing other things. Now all of this came back to her as she was recovering in a hospital bed from an emergency stent procedure. They had to insert two stents to overcome narrowing of the coronary arteries. She was now pain free and felt that she needed to do something about her lifestyle. She would see a dietician and record her weights daily. She wanted to loose 20 pounds and yes, she wanted to start mild exercise when her doctor allowed it and gradually build it up to a maintenance program.

Regrets Following Holiday Foods (Gout Patient)

Regrets Following Holiday Foods (Gout Patient)

Gout attack following rich meal

It is known since the Middle Ages that feasting on a large meal of beef combined with lots of beer or wine can cause a gout attack. Gout at this time was known as a disease of the affluent. The poor obviously could not afford big feasts. Today we know that purines are the end product of meats and this gets excreted in the kidneys. However, alcohol prevents the purines to be excreted in the urine so that uric acid levels exceed a certain limit beyond which uric acid crystals are precipitated in soft tissues like around joints, which is very painful.

The following case will illustrate this:

Carl, a 45-year-old sales person suddenly developed excruciating pain and swelling in his left big toe. He went to the emergency room of the closest hospital. After some tests he was told that he had come down with acute gout. His blood tests showed a high uric acid level and biopsy samples from the left toes also revealed uric acid crystals. With the help of colchicine and allopurinol things turned back to normal within 3 days.

The gout episode occurred just 4 hours after his holiday meal consisting of a few beers and copious amounts of turkey meat. He also seems to be addicted to soft drinks which are sweetened with high fructose corn syrup which he consumes freely all day long.

It is known that sugar from soft drinks make a person 85% more prone to develop gout than a person who uses diet drinks or water.

Here is a diet sheet for Carl to prevent his next gout attack.

Conclusion

Who would have thought in the past that food could be a dangerous substance with the potential of making us sick? But this is exactly what I wanted to point out in this blog. Of course, it does not stop at holidays where we tend to eat more of what we normally eat. It pays dividends watching what we consume even in the days between feasts. For instance a DASH diet is a good idea for those of us who may have developed borderline high blood pressure. Avoiding excessive red meat is a good idea for prevention of heart attacks and strokes, as your cholesterol stays lower. Avoiding soft drinks with sugar and fructose is good prevention for avoiding obesity, cancer, heart attacks and strokes. Get the greens going (vegetables, salads etc.) to live longer without disabilities.

Last edited Dec. 6, 2014

Sep
13
2014

What To Watch Out For In Restaurant Foods

Recently I saw a flyer of a fast food chain restaurant entitled “Food Fact”. Interestingly you get the contents of a list of bakery items, warm breakfast items, burgers, sandwiches and wraps for lunch as well as yogurt parfaits and fruit cups.

I have to commend the restaurant chain to attempt to educate their customers by itemizing each item.  They have listed the serving size broken down into calories, total fat, saturated fat, trans fat, cholesterol, sugar, protein, dietary fiber, vitamin C, A, calcium and iron.

Based on my dietary habits I need to check this list.

No trans fat

Years ago I have given up on trans fats because trans fat contain free radicals that accelerate hardening of the arteritis. Granted , the percentage is low, but 20% come from natural meats and 80% from processed foods. It is the 80% from processed foods that I avoid. Here is another review that explain trans fats in more detail. This eliminates the baked sweet pieces like croissants, cookies, raisin bran muffins, oat fudge bars and even spinach feta wraps.

What To Watch Out For In Restaurant Foods

What To Watch Out For In Restaurant Foods

Total fat

Now we come to total fat. The content list shows me that calories in total and fat content in total are closely related. But you reach the peak when you swallowed a sausage, egg and cheddar breakfast sandwich. This alone accounts for 500 calories. This is also high in cholesterol and high in sodium, so not really on my list of desirable foods.

Sodium content

I am now getting concerned about my blood pressure as I follow the sodium content. Who would have thought that a spinach feta wrap has more than 800mg of sodium? And ham and a Swiss Panini have more than 1500 mg of sodium? Literally 50% of the food list would not be on my menu, if I want to limit my sodium intake to 400mg or less per helping. Especially the sandwiches are out!

Hidden sugar

So, now I am looking at a yoghurt for a light snack,  but suddenly the sugar column has sprung up from 1-2 mg of sugar content in simple sandwiches to 37 to 55 mg of sugar for honey creek yoghurt parfait to strawberry blueberry parfait. It is not the yoghurt, it’s not the fruit, it is extra sugar, honey or high-fructose corn syrup mixed in here. This is definitely not what I am going to choose.

Refined carbs

Although the carbs by weight do not appear too high on the list, it is the total of sugar and carbs and the fat that has been added, which add up very quickly to hefty calorie sums in all of the foods. I am shaking my head and I absolutely cannot find anything that is healthy and would merit being eaten by me.

Missing greens

I am missing vegetables and salads.  The only thing I see that I can eat is their classic oatmeal, which has 160 calories with a nut medley topping. I may add a decaf-coffee sweetened with my own stevia that I brought along and some cream (because that’s how I still like it having been raised in Germany).

Homemade food

Then I rush to the health food store and to the grocery store and load up on organic foods, meat, lettuce, broccoli, peppers, spinach, organic olive oil and balsamic vinegar. And, yes, a tub of plain goat yoghurt. Organic walnut halves are also on the list (quite expensive, I must say).

I suddenly realize that now I have all of the ingredients to never enter a restaurant again. I can prepare my own food and I can do it the way I want it, not how the food industry wants me to eat it.

If I ate the food industry’s way, the salt content would send my blood pressure through the roof and I would get hardening of the arteries within the shortest time (from refined sugar, starchy foods and trans fats).

I find the taste of home cooked meals superb. All of the flavors are there. Of course, I do not mind spending the extra money on the organic food, because the tastes are the way my grandmother’s food used to taste. I rarely add salt and my blood pressure is 105/65, so something must be going right.

I am thinking what would happen, if more people would do what I do: avoid restaurants, especially fast food places, pack your own lunch box with an organic salad and enjoy dinner at home. It can be simple, tasty, healthy, and economical. Nobody needs to be an accomplished chef to do that. Would there be pressure on the food industry to open up organic restaurants and offer alternatives to those who want to enjoy healthy, tasty foods ?  Or are the fast food places here to stay forever and ever?

Conclusion

I thought I go with you today to one of those fast food places that actually list their food content. Listing it does not really help when the whole list consists almost exclusively of foods that are having serious drawbacks, be it in the addition of too much sodium, fats, sugar or refined carbohydrates.

You do not want to get accelerated hardening of your arteries from too much fat, trans fat, sugar and starchy foods. You don’t want to get high blood pressure from too much salt day after day. You may want to rethink that processed foods are really lacking the nutrition that your body needs to function well and healthy. A lot of them are best to be thrown out. You need fresh, organic vegetables and lettuce, spinach, Swiss chard etc. Maybe you want a vegetable omelet for breakfast with egg white, spinach, peppers and Swiss chard? Take charge of your own life. Look after your own affairs. This includes what you do in your kitchen and what foods you consume.

More information on:

1. High blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

2. Cardiovascular disease: http://nethealthbook.com/cardiovascular-disease/

Last edited Nov. 8, 2014

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

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

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

1. Cancer:

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

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

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

2. Heart disease:

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

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

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

4. Stroke:

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

5. Unintentional accidents/injuries:

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

Conclusion:

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

More information on:

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

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

Last edited Nov. 8, 2014

Apr
30
2014

Overuse Of Supplements Can Create Health Risks

The Dietary Supplement Health And Education Act of 1994 made it easier for people to acquire supplements and vitamins from health food stores. But since then there has been a proliferation of various products that are sold as supplements and not as drugs. It may give you the impression that all supplements are harmless, but this is not so. There are some supplements like vitamin A where you need to watch that you are not inadvertently overdosing, as toxicity is a problem; calcium supplements are also potentially toxic, if overdone. And amino acid supplements (protein supplements) can lead to an overdose of brain hormones. Here is a sample of some of the supplements that I would want you to watch.

1.Vitamin A toxicity:

Vitamin A is essential for normal night vision, for red blood cell production in the bone marrow and for the immune system. Here is a brief review about its metabolism. But while small amounts are beneficial for the body, high doses are toxic. In the 19th century the Arctic explorer Elisha Kane reported that consumption of polar bear liver caused severe headaches, drowsiness, irritability and vomiting within a few hours of ingesting it.

It is now known to be due to “pseudotumor cerebri”, a condition that mimics a brain tumor, but is caused by an acute overdose of vitamin A contained in liver (Ref. 1).

In the US where people eat enough meat, fish and dairy products, there is no overt vitamin A deficiency. Read this link to avoid overdosing with vitamin A in multiple supplements.

Overuse Of Supplements Can Create Health Risks

Overuse Of Supplements Can Create Health Risks

2. Vitamin C:

Vitamin C is an important antioxidant vitamin and is needed as a co-factor for many metabolic reactions. It is participating in the production of collagen and connective tissues, helps with fatty acid transport and is necessary for the synthesis of neurotransmitters in the brain (Ref.2). The lack of vitamin C is known as scurvy; symptoms include bleeding gums from fragile capillaries, delay in wound healing and impaired bone metabolism. Although in the earlier research it was hoped that vitamin C would prevent colds and cure cancer, more recent reevaluations found that it does not prevent you from getting colds, but it accelerates the recovery from colds by cutting down the recovery time by as much as 25 to 30% and it also does have some cancer protective effects (Ref.2). Higher doses seem to be more beneficial, but 1500 mg per day seems to now be the consensus of a reasonable upper dose limit per day.

What about kidney stones? Several studies in the past have warned about vitamin C being broken down in some people into calcium oxalate kidney stones. Here is a brief review of the literature with regard to kidney stone formation. A study regarding the DASH diet, which is used for people with high blood pressure, showed that the incidence of kidney stones is almost half for both men and women compared to controls on a normal North American diet.

There has been a concern among the medical community that vitamin C as a supplement would increase kidney stones (oxalate stones). However a 2014 study showed that when both vitamin C and vitamin E are taken as supplements, the kidney stone formation goes down.

Many inhabitants of industrialized countries including the population in the US and other countries are magnesium deficient and this can be a major factor for forming calcium oxalate stones. But it has been known for decades that those who develop kidney stones excrete more oxalates in their urine (so-called “oxalate excreters”). Here is a 1996 study that measured this in detail.

If you are taking in a lot of green smoothies from green leaf vegetables (spinach, kale, Swiss chard) that are high in water-soluble vitamins, you may not require any vitamin C supplements. In other words, think about what else you do and eat and add it up, so you do not exceed a total of 1500 mg to 2000 mg of vitamin C per day.

If you are taking in a lot of green smoothies from green leaf vegetables (spinach, kale, Swiss chard) that are high in water-soluble vitamins, you may not require any vitamin C supplements. In other words, think about what else you do and eat and add it up, so you do not exceed a total of 1500 mg of vitamin C per day.

3. Calcium supplements:

Calcium is a key mineral in the body, important not only for healthy bone structure, but also to balance the electrolytes within the blood, in the extra cellular fluid space and within our cells. If calcium is low, the brain is more prone to seizures and the heart can produce dangerously irregular heart beats. We definitely need a balance of calcium! Because calcium is so central to our wellbeing, several factors work together to keep our calcium levels stable: the kidneys, the thyroid, the parathyroid glands, the adrenal glands, the bone as a reservoir of calcium, the gastrointestinal tract for absorption and a good, balanced nutrition. The chapter on “Vitamins and Minerals” of Ref.3 points out that 4000 mg of calcium per day definitely causes toxicity (hypercalcemia and milk-alkali syndrome).

Absorption is dose dependent meaning that only 500mg of calcium carbonate is absorbed at a time. Vitamin D3 deficiency leads to reduced calcium absorption. But with high doses of vitamin D3, which is now often recommended, more calcium is absorbed, so it is important not to take too many calcium supplements. They can also interfere with iron and zinc absorption and when more than 2600 mg of calcium is taken magnesium absorption is inhibited as well. Calcium can interfere with thyroid hormone supplements (take 4 hours apart) and may reduce the effect of calcium channel blockers, drugs used for angina or high blood pressure.  There is a balance between calcium stored in bone (99% of total body calcium) and the circulating portion of 1% of calcium in the blood. The parathyroid hormone and calcitonin are also involved in this balance. Hypercalcemia is the condition when calcium is too high. Common causes are the improper use of diuretics (thiazide diuretics), overuse of calcium carbonate supplementation (often for osteoporosis) and overuse of vitamin D3, which increases the absorption of calcium (Ref.3). See your family doctor for blood tests and advice what to do in your case.

4. High protein diets and protein (amino acid) supplements:

Many protein supplements are available through health food stores and vitamin stores. The advertisers often state that our food would be substandard and these supplements would help “to regain strength”.  Athletes hope to get stronger muscles from amino acid supplements because they are the building block for protein that builds up muscles. Fact is that no supplements are needed when you eat balanced meals containing meat and fish and you exercise regularly. The protein in your food will be broken down into amino acids and your body metabolizes this into your own protein. Here is a website that reviews the subject of supplementation with amino acids.

It is clear from this that this is a rather complex problem. Vegetarians may require these supplements to replace protein for the missing meat intake. But the rest of us have to guard ourselves against overdosing with too much meat, amino acids supplements or protein supplements.

High protein diets (Atkins diet and others) have been glorified as being helpful for weight loss. But the long-term effect of such diets lead to chronic kidney damage in those with diabetes and high blood pressure as evidenced by protein leakage in the urine (called ”microalbuminuria”, Ref.4).

According to this reference the average protein requirement is 0.6 g of protein/kg body weight/day. This text comments that this would be compatible with the World Health Organization (WHO) recommendation for protein intake. For a person weighing 140 lbs. this translates into about 50 grams of protein per day. Here is a website that explains the upper limit of meat intake with the example of an 8-ounce portion of top sirloin steak.

Protein supplements have become very popular, but you need to be careful when you supplement with this that you do not get an overdose of amino acids. Amino acid profiling has been useful for physicians and naturopaths to examine deficiencies in children or adults checking for essential amino acids in the blood.  However, in the industrialized countries such as the US, Canada and others the larger concern is now the overuse of meat in our food (e.g. Atkins-like diets) and protein supplements. The same amino acid screening tests will find several of the ingredients (amino acids) in these protein supplements to be too high. In this case it is imperative to stop the protein supplements to prevent amino acid toxicity.

This study warns that not enough is known how performance-enhancing supplements affect the metabolism of the body. There are discussions that perhaps upper limits for amino acid supplements need to be established:

5. Creatine supplementation:

Other supplements of concern are creatine supplementation in the sports-minded and in athletes who want to build up muscle mass. Creatine is synthesized by the liver form amino acids derived from fish and meat that is broken down into the amino acids arginine, glycine and methionine. So, there is no shortage, but athletes and sports minded people want to push the envelope and take in additional creatine that helps their energy metabolism (ATP production) in the muscles to increase their performance (Ref. 5) Creatine is vital for the brain, the heart, the kidneys and the eyes (retina). It is a buffer for lactic acid during anaerobic exercise. Some of the side effects are muscle cramps, diarrhea, fluid retention and kidney failure when exposed to high heat and dehydration. There are no long-term studies of the use of creatine supplements, yet some athletes are taking them long-term.

Conclusion:

We are tempted by various merchants and infomercials to take in more and more vitamins and supplements including protein and amino acid supplements. But when you eat well-balanced meals, preferably organic food, you already have enough protein, nutrients, calcium, vitamin C and vitamin A contained in food. So you may be inadvertently putting a strain on your kidneys that have to eliminate whatever it is that is too much for your body to take. Your liver may also be quietly working overtime as well. Your brain gets overactive by the surplus of amino acids that are utilized by the brain to make brain hormones. Your system can only take so much; at one point a surplus of supplements will make you sick! So, be vigilant and think about what your regular food intake already provides. Do you really need that supplement or do you already get enough from your food intake? Are you falling for some marketing scheme? Remember, you are the steward of your own health!

References:

1.Shannon: Chapter 69: The Vitamins. Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed.© 2007 Saunders

2. Mandell: “Water-Soluble Vitamins”. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed. © 2009 Churchill Livingstone

3. Rakel: Chapter “Disturbances in Calcium and Phosphate” and chapter entitled “Vitamins and Minerals”. Textbook of Family Medicine, 8th ed. © 2011 Saunders

4. “High Dietary Protein Intake” in “Taal: Brenner and Rector’s The Kidney”, 9th ed. © 2011 Saunders

5. DeLee: DeLee and Drez’s Orthopaedic Sports Medicine, 3rd ed. © 2009 Saunders

Last edited April 30, 2014

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