Flax Seed A Source Of Omega 3

Prevention has been gaining more momentum for public health as well as for the health conscious individual. Instead of looking at salvation from a slew of diseases like arteriosclerosis, high blood pressure, osteoporosis, Alzheimer’s, and the complications from diabetes in the form of super pills, prevention looks a lot more promising.
Flax seed has been around for several thousand years, but it has been making a name for itself as part of healthy eating.

Its most important components are its fiber content, the alpha-linoleic acid, and the lignans. Eating flax seed helps to mop up cholesterol in the bowel, and studies have shown a drop in the “bad” LDL cholesterol levels. Duke University is publishing results that show flax seed to be helpful in blocking prostate cancer. A publication going back to August 2001 in the Archives of Ophthalmology point out the fact, that the omega-3 fatty acids, which are contained in flax seed, reduce the risk of macular degeneration. The same omega-3 fatty acids also have a favorable influence in the glucose response after a meal, a fact that is important for the prevention of diabetes.

It has to be mentioned at this point, that flax seed oil does not have all the benefits, as the fiber has been removed, and some of the benefits get lost as a result of the temperature used with processing. Also, just eating a spoon full of flax seeds will not be the answer, as flax seed is not fully used during digestion (the seeds are simply excreted in a bowel movement). To unlock the benefits it is best, to grind the seed.

Flax Seed A Source Of Omega 3

Flax Seed A Source Of Omega 3

A coffee mill does the job well enough, and freshly ground seeds are better than the pre-ground variety that has been sitting around in the bin of a store for some time. Two teaspoons of ground flax seed mixed with some yogurt and fruit makes for a good starter in the morning or an easy evening snack. A slice of flax seed bread does not give you the benefits; remember that heat during cooking or baking destroys the key components.
The nice part about flax seed is the fact, that it is inexpensive, plentiful, has no adverse side effects*, and it is the ounce of prevention which is readily available to you.

More info on Omega-3:

Reference: The Medical Post, October 12, 2004, page 13

* Comments (added Aug.28, 2005): Despite the Duke University study cited above there are disturbing news from a 14 year follow-up prospective study that has been confirmed by other studies showing that there are side-effects. This study showed that in males there is a 2-fold risk of developing invasive prostate cancer when flax seed was the supplement used. As flax seed contains alpha-linolenic acid (=ALA) and fish oil contains eicosapentaenoic acid (=EPA), there are striking differences of action that have not yet been defined in more detail. The same study showed that over 14 years EPA (when mixed with DHA) lowered the risk of getting invasive prostate cancer by 26%. Until it is known more how flax seed works, it likely is wiser to to take a molecularly distilled EPA/DHA supplement daily as this also reduces the cardiovascular risk, but at the same time prevents cancer.

Last edited October 27, 2014


Stop That Heart Attack

There is a window of opportunity for the patient who is rushed to hospital with a heart attack.

To be precise: if the patient is brought to hospital without delay, and there are changes in the ECG, which traces the heartbeat, and there are changes that point to the possibility of a heart attack, there is a chance to administer medication that prevents blood clots. If these “clot busters” are administered within one hour, as many as 25 % of heart attacks in the making can be aborted. This procedure is called “fibrinolysis”.

Dr. Paul Armstrong, professor of medicine at the University of Alberta, explains, that the aborted heart attack (or “aborted MI”) is a new term in cardiology. If treatment is received early, the patient will avoid heart muscle damage. Even if the treatment with the anti-clotting medication is given after only two hours, the patients still have a more favorable outcome. Patients with aborted heart attacks also have smaller infarcts than those who go on to have a full-blown MI (or heart attack). Dr. Armstrong points out that it is important to not only watch out for known high-risk factors (previous coronary artery bypass surgery, hypertension and diabetes), but also to pay close attention to treating the patient early.

Stop That Heart Attack

Stop That Heart Attack

More info on heart attacks:

Reference: The Medical Post, July 27,2004, Vol.40, No. 29,pg.8

Last edited October 26, 2014


Too Much Fat Fuels Metabolic Syndrome

In a review article for physicians from the St. Michael’s Hospital of the University of Toronto (see reference below) Dr. Monge outlined some of the newer human research where links were found between the lining of the blood vessels and the hormones produced by fat cells that lead to the complications of the metabolic syndrome. In obese people there is a cluster of conditions such as high blood pressure, high blood sugar, high cholesterol, lipid abnormalities and high insulin levels, which is known as “metabolic syndrome”. Another name that was used for this condition in the 1990’s was “syndrome of insulin resistance”.

Dr. Monge pointed out that blood vessel health depends on the fine balance between two opposing forces. On the one hand there is a system that leads to blood vessel spasm, blood clotting, growth promoting, inflammation causing and oxidizing. On the other hand there is a system that is responsible for blood vessel relaxation, growth inhibition, blood clot dissolving, inhibiting inflammation and antioxidant activity. Complex changes occur in our metabolism when we put on pounds and accumulate too much fat. It is important to realize that fat is not just sitting there, but is composed of highly active fat cells that respond to insulin and growth factors and in turn produce a number of hormones and factors that affect the cells that are lining the blood vessels. Inflammatory cytokines are produced by fat cells that attack the blood vessels by producing atheromatous plaques, causing them to accumulate fat again and help in the processes that lead to rupture of the plaques.

Too Much Fat Fuels Metabolic Syndrome

Too Much Fat Fuels Metabolic Syndrome

The end result is that the deadly interplay between the fat cells and the endothelial cells lining the blood vessels tips the balance between the two systems mentioned above to the point where heart attacks and strokes suddenly occur.

There are two complex pathways that are involved in this process and that are linked to what was stated above. One crucial aspect of this involves nitric oxide, a small molecule that is normally produced by the endothelial lining cells and that is needed for normal circulation of the heart muscle, skeletal muscles and internal organs. This protective system is where much of the derangement of normal metabolism occurs with regard to the metabolic syndrome.

Dr. Monge pointed out that with these newer insights into the complex metabolic changes associated with the metabolic syndrome in obese people, there will be very practical results in the near future. Anti-inflammatory medications are already being utilized and some of the anti-diabetic medications have been shown to reduce the risk of heart attacks. It is hoped that sensitive tests will be developed to measure the hidden endothelial dysfunction at a time when preventative steps are still effective or early intervention can be done.

More info on the metabolic syndrome:

Reference: Metabolic Syndrome Rounds (April 2004): J.C. Monge “Endothelial Dysfunction and the metabolic syndrome”

Last edited Oct. 26, 2014


Ankle Blood Pressure Reveals Diabetic Problems

One of the complications of diabetes is that ity leads to clogged arteries from peripheral artery disease and this can lead to heart attacks, strokes and circulation problems in the legs.

Recommendations were recently given to physicians in the December edition of the medical journal Diabetes Care that circulation problems in diabetics need to be monitored more stringently to avoid needless amputations.

Medically these circulation problems that affect mainly lower legs and feet are known as “peripheral vascular disease” (or PVD for short). PVD can be detected by the physician checking for ankle pulses. Another valuable and very simple test is to measure the blood pressure in the arm and at each ankle (using the stethoscope just under the inside (medial) ankle bone. If there is a major discrepancy between the arm and ankle blood pressure or if the ankle pulse is missing, this would be a sign of possible PVD. With a diabetic patient it would still be important to get the hemoglobin A1C under control through exercise, a low glycemic diet and possibly anti-diabetic medication. But the patient likely would have to be referred to a cardiovascular surgeon for further testing in order to find out whether there would be hardening of the arteries with circulation problems in the lower leg, the ankle or foot.

Ankle Blood Pressure Reveals Diabetic Problems

Ankle Blood Pressure Reveals Diabetic Problems

Dr. Peter Sheehan, the director of the Diabetes Foot & Ankle Center at the New York University school of medicine, stated that many patients and doctors overlook how frequent this condition is. About 33% of diabetic patients who are older than 50 years have PVD, but only a fraction know about it until it is too late. Once a patient has PVD in one of the legs there is a 4-fold risk of getting a heart attack or a stroke, because the hardening of the arteries is happening simultaneously in all of the body’s arteries. If the blood pressure is normal at the ankle, Dr. Sheehan recommends to check it again in 5 years.

Who should have the blood pressure check at the ankle? Here is a table that summarizes Dr. Sheehan’s recommendations.

Which diabetic needs the ankle blood pressure check?
High risk group: Remarks or more detail:
Anyone with leg PVD* symptoms legs tired or hurting when walking
Young diabetics
with other risks
smoking, high blood pressure, high cholesterol, diabetes present for more than 10 years are such risk factors
diabetics 50 years of age and over particularly when the hemoblobin A1C is high and other risk factors are present
*PVD peripheral vascular disease

Why is it so important to screen for circulation problems in the lower legs? Because this is the area where diabetics tend to get problems that often result in amputations of a foot or lower leg below the knee. With early detection of these problems and intervention by a cardiovascular surgeon often disastrous outcomes can be avoided.

More info is available at:


High blood pressure:

Last edited October 26, 2014


Fat Cells Secrete Hormones That Raise Blood Pressure

Fat cells are known to secrete a number of substances that affect the lining of the arteries and that are also known to be associated with the metabolic syndrome. One of the observations that physicians were aware of for some time is that aldosterone, a hormone from the adrenal glands, is often elevated in patients with high blood pressure and obesity or people who are overweight.

Dr. Ehrhart-Bornstein and her group from the University Medical Center, Heinrich Heine University of Düsseldorf in Germany investigated this interaction between fat cell metabolites and the cells of the adrenal cortex in more detail. They used a tissue culture model with human adrenocortical cells (NCI-H295R). To their surprise they found two separate hormone factors that were produced by fat cells and that showed in the tissue culture system a 7-fold increase in aldosterone hormone release. As aldosterone is a mineralocorticoid hormone they called these new releasing hormones mineralocorticoid-releasing factors. Further characterization of these factors demonstrated that one was of a higher molecular structure and was heat-sensitive, the other one was smaller in size and was more heat resistant. Each factor alone lost much of the aldosterone releasing activity, but when recombined they had 93% of the original action. Synthesis of messenger RNA inside the adrenocortical cells was stimulated by a factor of 10-fold from the action of the mineralocorticoid-releasing factors. Other hormones were also somewhat stimulated such as release of cortisol by a 3-fold increase and DHEA by a 1.5-fold increase. Other known substances from fat cells were entirely ineffective in this testing system.

Fat Cells Secrete Hormones That Raise Blood Pressure

Adipose cells secreting aldosterone releasing factor

When asked how this new research might fit in with the observation that loss of fat through calorie restriction has a beneficial effect on high blood pressure, the authors commented that with less fat storage in fat cells during weight loss the production of mineralocorticoid-releasing factors would go down significantly and aldosterone would be released at a much lower rate thus decreasing blood pressure through the aldosterone/angiotensin/renin mechanism.

Nov. 12, 2003 paper on which this write-up is based:

Last edited October 26, 2014


Obesity And Metabolic Syndrome

In the June 10, 2003 edition, following page24, of The Medical Post there was a minisymposium on obesity and the metabolic syndrome (also known as the “syndrome of hyperinsulinism”).

Four specialists had a discussion about this topic: Dr. Ehud Ur (endocrinologist, Dalhousie University, Halifax, N.S., Canada), Dr. Robert Dent (Director of the Weight Management Clinic, Ottawa Hospital, Ont.), Dr. Dominique Garrel (Director of Department of Nutrition and endocrinologist, University of Montreal, Quebec), and Dr. Arya Sharma (Prof. of Medicine, McMaster University, Hamilton, Ont.).


Obesity is now a health threat that about 25% of the North American population is suffering from. There is still a lot of discussion what the exact criteria should be, but the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) has simplified the detection of the metabolic syndrome.

Obesity And Metabolic Syndrome

Obesity And Metabolic Syndrome

The experts agree that when three or more of the criteria mentioned in this table are positive the person would be considered to have metabolic syndrome.

There is a wide age-related variety: in one study only 7% had metabolic syndrome in the age group of 20 to 29. The same study found 40% of study participants had the metabolic syndrome in the age group of 70 years and older. It is thought that too many calories coupled with too little activity over a longer period of time, perhaps coupled in some people with a genetic tendency to develop metabolic syndrome, leads to an accumulation of abdominal (so-called”visceral”) fat.

Because fat cells have their own hormone systems (leptins etc.) there is a change of metabolism including an elevation of the insulin level with associated loss of “insulin sensitivity”. So, the more obese a person becomes, the less effective insulin becomes in transporting blood sugar through cell walls. At the same time the liver metabolism is changing with the good cholesterol (HDL) being less produced and the bad cholesterol (LDL) being overproduced. The liver will produce a different mix of coagulation factors, which leads to a tendency to form clots in the veins of the legs and in the lungs. As the pancreatic capacity for insulin production gets exhausted over a period of time, the patient eventually develops type 2 diabetes mellitus. Due to the risk of the coronary arteries clogging up with the cholesterol changes and the accelerated hardening of arteries from diabetes, the risk for getting severe heart attacks in obese people with the metabolic syndrome when compared to a normal weight population is about 4-fold.

Elements leading to the diagnosis of “metabolic syndrome”
Finding: Comments:
abdominal obesity waist circumference more than 102 cm in men or more than 88 cm in women
elevated triglyceride level level of 150 mg/dl or higher
low HDL cholesterol level under 40 mg/dl in men or under 50 mg/dl in women
elevated blood pressure systolic or diastolic blood pressure exceeding 130/85 mm Hg
high fasting blood glucose level fasting glucose higher than 110 mg/dl

Treatment of metabolic syndrome:

The experts agreed that a reduction of only 5% to 10% of the body weight through a sensible combination of a mild exercise program (e.g. walking 30 to 45 minutes every day) and a calorie reduced food intake will make a significant difference in terms of normalization of the body chemistry. It is my estimate that perhaps 70% to 90% of all cases of obesity and metabolic syndrome can be treated this way.

However, the remaining cases should continue to see their physician and be followed like the doctor would follow someone who has high blood pressure. There are two types of medications available and they have nothing to do with the Phen-Fen diet pills from not too long ago that were found to cause pulmonary hypertension. These new diet pills are fairly safe and show weight loss results provided the patient co-operates with regard to a modified to low fat diet and some degree of regular exercise.

1. Sibutramine (brand name: Meridia) is a specific brain hormone inhibitor in the area where the appetite zone is located (serotonine and norepinephrine reuptake inhibitor). This medication helps the patient by experiencing satiety sooner so that the patient does not feel deprived despite less calorie consumption.

It is the medication of choice for those who tend to eat a lot. Like with other anti-depressants side-effects are a dry mouth, heart rate increases and sleep loss (insomnia).

2. Orlistat (brand name: Xenical) inhibits fat uptake at the level of the gastrointestinal wall (gastrointestinal lipase inhibitor). This leads to an inhibition of fat absorption by about 30%. The patient needs to keep the fat intake down to about 2 oz. (=60 gm) per day. If the patient consumes more fat, the side-effect of orlistat will be flatulence, abdominal cramps and diarrhea. If the patient is on a strict low fat diet, there would not be enough fat in the gut for the medication to be effective.

At this point it is not known how long the patient should be on such weight loss medication, if this was the chosen route. The experts felt that 1 year would be reasonable, but that the patient should be observed by the treating physician and it may be necessary after some intermission to go for another year of therapy all the way attempting to permanently change eating and exercise habits as an ongoing maintenance program.

Here is a link to another reference about the metabolic syndrome (syndrome of insulin resistance).

Last edited December 9, 2012



High Blood Pressure On The Increase In The US

High blood pressure on the rise

Dr. Hajjar, of the University of South Carolina in Columbia and Dr. Kotchen, of the Medical College of Wisconsin in Milwaukee have compared a large group of people in the US in the years 1999-2000 with prior studies in 1988-1991and 1991-1994 where peoples’ blood pressures were measured.

The latest study involved more than 5000 people, the prior studies more than 9000 people each. Almost 29% of the population has a blood pressure of 140/90 or higher in the latest study.

Compared to the 1988-1991study this is a significant increase of 3.7%. More than half of this was explained on the basis that the population’s weight (measured by body mass index calculation) had increased. The sub groups who had the largest increase in blood pressure were as follows:

1. diabetics with high blood pressure. In this high risk group only about 25% had a blood pressure readings of less than 130/85, which is the target value.

2. Mexican Americans had a significantly poorer awareness and control of their elevated blood pressures than the non-Hispanic whites and non-Hispanic blacks.

3. Women as a group were poorer in blood pressure controlling than men.

4. People above the age of 60 had a much higher rate of uncontrolled blood pressure as well.

The study concluded that by concentrating campaigns and efforts on these four target groups significant gains could be made in terms of control of blood pressure, reduction of strokes, heart attacks and kidney damage.

Here are some links regarding high blood pressure, prevention of strokes and heart attacks to various chapters of my

High blood pressure link

Heart attack link

Stroke link

Last edited October 26, 2014


Do Diet Drinks Make You More Hungry?

There were some articles recently that stated that diet drinks would make you hungry. However, they lacked proper controls. For this reason the gastroenterologist, Dr. Khursheed Jeejeebhoy, from the University of Toronto/Ontario designed a well controlled 10 week trial where several parameters were measured while patients were either snacking on diet drinks or on sugar containing soft drinks on top of their regular food intake, which was also closely monitored. The only requirement in the beginning of the study was that the subjects had to be overweight (body mass index of 27 to 28). Participants of the study were then divided randomly into subjects drinking soft drinks with either sugar or sugar substitutes. The drinks were blindly given, but meticulous records were kept of what was consumed. In addition the subjects were allowed to eat as many snacks as they liked with either sugar in it or sugar substitutes. Below  is a tabular summary of the findings.

The surprising findings were that the sugar group had an increased appetite and wanted to eat more and more. Sugar also raised the blood pressure significantly.

Do Diet Drinks Make You More Hungry...

Diet Drinks Make You More Hungry

The result was a significant weight gain during the 10 weeks of the trial while the other group (AS) had lost a significant amount of weight without any hunger pangs. The researchers also measured body fat versus muscle mass and found that the sugar group (SG) had gained fat mass without changing the muscle mass. On the other hand the atrtificail sweetener group (AG) had lost only fat mass, not muscle mass.

Dr. Jeejeebhoy concluded according to the article in The Medical Post (Jan.14, 2003 edition, page 27) that sugar in snacks and drinks should be kept to a minimum to prevent obesity from developing or getting worse. Patients with high blood pressure should avoid sugar as much as possible and stick to a low glycemic-index diet. Drinks should be diet drinks or fluids without sugar content. Do diet drinks make you more hungry? The answer is: “NO!”

Artificial Sweeteners And Weight Loss(10-Week Study)
Findings: Comments:
Additional Calories
from drinks per day:
AS: 250 Cal.       SG: 870 Cal.
total caloric intake over the 10 weeks: AS:decreasing steadily
appetite sensation: AS:no appetite
SG:sugar stimulated
weight gain or loss: AS:significant weight loss SG:significant weight gain
activity level(exercise) no change in either groups (AS or SG)
blood pressure
AS:no change
SG:sugar increased
blood pressure significantly
AS=Artificial sweetener group SG=Sugar group

Comment: Not every diet drink is medically safe. Aspartame and Sodium cyclamate are brain excitotoxins. One of the safest alternatives to sugar is Stevia. Read this review about  sugar alternatives.

Last edited December 10, 2012


What Goes Around Comes Around With Blood Pressure Medications

A large clinical study with 42,418 men and women 55 years and older has been published in the American Medical Association Journal recently(JAMA 2002:288:2981-2997,3039). The thiazide type water pill chlorthalidone(12.5 mg to 25 mg/day) is the clear winner in this trial, called the ALLHAT trial. It stands for “Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial” and is the largest hypertension trial that was ever performed going over a period of 5 years.

In this trial a calcium channel blocker(amlodipine) and an ACE (=angiotensin converting enzyme)inhibitor(lisinopril) were tested as the initial medication and compared to chlorthalidone.There was a 15% higher risk to develop a stroke with lisinopril and a
38% increased risk with amlodipine to develop congestive heart failure when compared to the chlorthalidone group. The interesting conclusion from this study is that the least expensive therapy for high blood pressure turns out to be the safest. Another ineresting finding was that black patients responded much better to water pills than to ACE inhibitors, which had been noted before by other authors. When more than one medication is required to control high blood pressure, the dosage of the second medication can often be kept lower with a combined therapy thus reducing the likelihood of side-effects and complications.

What Goes Around Comes Around With Blood Pressure Medications

What Goes Around Comes Around With Blood Pressure Medications

Comments: Several decades ago the teaching was that the doctor would start a new high blood pressure patient with a water pill first, and combine this with a second or even third pill of a different medication class, if the water pill would not be effective enough on its own (it was called the “step care therapy”). For decades the side effects of the water pill consisting of low potassium blood levels brought the water pill treatment in disrepute. The original trials,however, were done with chlorthalidone doses of 50 and 100 mg per day, much higher than would now be recommended. It appears that with this study medicine has gone a full circle back to the old stand-by water pill, but at a much safer, lower dosage.

Here is a useful link (regarding hypertension):

Last edited December 10, 2012