Mar
07
2015

Drink Your Coffee, But…

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

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

1. Calcification of coronary arteries and osteoporosis

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

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

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

2. Whether or not you put sugar into your coffee

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

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

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

4. Micronutrient components of coffee

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

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

This link explains more details about the micronutrients in coffee.

5. Clinical conditions that are partially prevented by coffee consumption

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

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

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

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

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

6. What are the risks of drinking coffee?

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

7. What is the process of decaffeinating coffee?

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

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

Drink Your Coffee, But…

Drink Your Coffee, But…

Conclusion

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

References:

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

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

Nov
25
2014

Gluten Intolerance Or Food Sensitivities?

A report about gluten free food is circulating in the media based on this publication. It points out that gluten-free food is not as healthy as the companies want you to believe it to be.

Wheat is the source of gluten, so rice, potato, corn and sugar are used to replace wheat. Corn is deficient in niacin leading to B3 deficiency; and the amino acids lysine and tryptophan (missing in corn) are needed for production of serotonin in the brain, which prevents you from getting depressed.

The reference cited above points out that rice can be contaminated with arsenic, which is a toxin.

Gluten-free food is a special form of processed food. Any processed food is not as good as natural food that you buy from the periphery of the grocery store.

So, what do we know about gluten sensitivity?

Causes of increased diagnosis of gluten sensitivity

Only 1% of people are gluten sensitive at this point. Just 30 years ago this number was 0.025%. 10 years ago 0.04% of people were thought to have gluten sensitivity. The difference may be due to improved sensitivity of the testing methods. But another factor is the new wheat, called Clearfield wheat, which was obtained through chemically forced hybridization of wheat resulting in significant genetic modifications from the original wheat. This type of wheat is now grown all over the world. As I explain in this blog Clearfield wheat has a significantly higher percentage of gluten, which likely contributes to the increased gluten sensitivity in the population at large and particularly among patients with irritable bowel syndrome (IBS).

Irritable bowel syndrome and other food sensitivities

According to Ref. 1 among patients with irritable bowel syndrome (IBS) 4 to 5% have true gluten intolerance (celiac disease). In the general population (without IBS) the gluten sensitivity percentage is less than ¼ of that. On the other hand lactose intolerance in the US is found in 25% of all adults and in 35% to 45% of IBS patients. Another common food sensitivity is fructose and sorbitol intolerance, which occurs in about 40% of patients with IBS and about the same percentage in non-IBS controls. This means that if you leave out sorbitol and fructose, about 40% of people will find relief from abdominal cramps or bloating. A common item that people chew on, according to Ref.1 is sorbitol-containing chewing gum. If this type of chewing gum is eliminated, 40% of people will feel better in their gut. So, keep in mind that the majority of people with food sensitivities do not have gluten sensitivity, but lactose intolerance and allergies to fructose and sorbitol.

Other manifestations of celiac disease

Celiac disease is not only a disease that manifests itself in a skin rash (as originally described in celiac patients). It is responsible for a significant amount of ADHD (attention deficit hyperactivity syndrome) or ADD (attention deficit syndrome) and can even cause Parkinson’s disease. It stands to reason that these conditions can be improved with an appropriate diet.

 

Gluten Intolerance Or Food Sensitivities?

Gluten Intolerance Or Food Sensitivities?

Gluten-free foods often contain problematic replacements

When you go to a grocery store or health food store and look at their gluten free shelves, they offer you an array of products like gluten-free bread and bakery items, cereals, cookies, pastas and many other processed foods. As explained above wheat is the main source of gluten and when you replace it, the substitutes are rice, tapioca starch, quinoa, potato, corn and sugar. We already pointed out some deficiencies of corn. There are also concerns of toxicities as in rice, particularly if it comes from imported material (arsenic). As the majority of people with food sensitivities are allergic to milk sugar (lactose), fructose and sorbitol, these items have to be screened carefully by reading all of the details on the food labels of the products. If you suspect other food allergies, see your primary care physician doctor for testing to these allergens and also have several of the gluten sensitivity tests done. If the gluten sensitivity tests are all negative, you only need to pay attention to milk sugar, fructose and sorbitol, particularly, if you have been diagnosed with IBS.

Hidden sugar and starch content of gluten-free food

What has not been mentioned so far is the sugar and starch content, which eventually leads to higher calories. Sugar is easy to spot on the food label as this is usually listed clearly. I stopped buying dark chocolate, even the 85% variety as they are selling me 10 grams of sugar in a 40 gram helping (25% of sugar). All the health benefits are no longer applicable when you consume that much sugar with a supposedly healthy food item. So add up the sugar you are getting and add up the calories you are seeing listed. Usually, if the sugar content is high, the calories are high.

As an example, when you research on Google regarding gluten-free corn chips, the food content of a typical product is listed as follows: 12 chips (28 g) contain 0 g glucose, 7 g fat, 14 g carbohydrate, 4 g protein, 100 mg sodium and 250 mg of potassium. It also lists that the total calories are 140, of which fat contributed to it 60 calories. 78% of the 80 calories left (namely 62.4 calories) came from the carbohydrate (starch in corn) and 22% of the remaining calories were protein derived (this I had to calculate). As the stomach digests the corn chips within half an hour into sugar, you really have eaten 62.4 calories from sugar. The Internet tells you that 2.3 g of sugar from a sugar cube are the equivalent of 9 calories. Our “sugar math” can be completed by doing this: 62.4 / 9 x 2.3 g = 15.94 or 16 grams of sugar. So, the food industry actually lied to you by saying that there was 0 g sugar in the 12 corn chips. What happened is that your body digested the 14 grams of carbohydrates and converted it into sugar, which was absorbed into your blood stream. Your pancreas could tell you a story, because it had to produce insulin to keep your blood sugar level in balance!

You may wonder how I solved the dark chocolate problem, which by the way would double as a gluten-free food: You buy 100 % unsweetened Baker’s chocolate (0 g sugar on the label) and liquefy it in a little bowl in a pot with hot water. Add a tiny bit of stevia sweetener and add a tiny bit of vanilla extract into the well-stirred chocolate liquid. Prepare a form out of aluminum foil with a rim. Pour the content carefully into this (watch it, hot!) and let it sit to cool down. When it is at room temperature, cut into smaller pieces, which you keep in a glass jar. This is 100% gluten-free chocolate, 100% chocolate and 100% healthy.

Conclusion

Not all is well in the gluten grocery row of your friendly super market. There are problems in that 20 to 25% of people believe they may have gluten sensitivity when in reality only 1% have it. But the majority of people have not done a gluten-screening test, which would confirm that they have indeed celiac disease. As pointed out above, it is much more likely that a food sensitivity may be caused by another offending agent rather than gluten (milk sugar, fructose and sorbitol). Avoiding the offending food components is the treatment protocol.

Those who take in gluten-free food will expose themselves to unnecessary toxins, to extra sugar leading to obesity and metabolic syndrome that leads to premature heart attacks and strokes. For those who do need to be on a strict gluten-free diet, they can safely do so by following a strict gluten free diet at home (preparing your own meals from healthy ingredients), preferably with organic foods. There are many websites that you can find online that have meal suggestions.

More information about celiac disease.

References:

1. Rakel: Integrative Medicine, 3rd ed. Patrick J. Hanaway, MD: “Chapter40: Irritable Bowel Syndrome. Integrative Therapy”. Copyright 2012 Saunders, An Imprint of Elsevier

Last edited Nov. 25, 2014

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Nov
16
2014

Smoking E-Cigarettes Of No Benefit

Electronic cigarettes (e-cigarettes) were invented to help people get away from the carcinogenic content of real cigarettes and they were thought to help people in the process to quit smoking as well.

In the October 2014 issue of the BC Medical Journal a review article is entitled: “Electronic cigarettes: Do we know the benefits vs. the risks?” In it Dr. Roy Purssell, the Chair of the Emergency Medical Services Committee in BC, Canada reviewed the literature about e-cigarettes (Ref.1). He pointed out that several studies have shown that the number of cigarettes used may have declined with the use of e-cigarettes, but the quitting rate on e-cigarettes is not higher than when quitting conventional cigarettes.

Why were e-cigarettes developed?

Originally they were marketed as an alternative to cigarette smoking with the thought that they would only contain the nicotine, but not the myriad of cancer producing chemicals. However, studies now show that this is not the case. As explained earlier people use e-cigarettes, but they often still smoke real cigarettes on the side, in effect just reducing the number of cigarettes smoked per day. Says Dr. Purssell: “Reducing the number of cigarettes smoked per day is much less effective than quitting entirely for avoiding the risks of premature death from all smoking-related causes of death” (also based on Ref. 2).

Chemical composition of e-cigarettes

E-cigarettes are battery-operated vaporizers that give you the feel of smoking a tobacco cigarette. The container inside the e-cigarette can be refilled with “e-juice” that can be bought through the Internet. The liquid contains highly concentrated nicotine, propylene glycol, glycerin, and flavorings (you can choose from cinnamon to cherry flavor and more). The liquid is vaporized by a heating element and the vapor is inhaled. No long-term experiments are available at this time with regard to the safety of these inhaled chemicals in humans. Only short-term experiments are behind the FDA’s declaration that propylene glycol would be “generally recognized as safe” (GRAS) as a food additive. But there is still a difference between inhaling and ingesting propylene glycol, and the same is true for glycerin.

The manufacturers of e-liquid (or e-juice) always put this disclaimer on their products: “Warning: Always keep e-cigarette liquid in a safe place and out of reach from children and pets. Nicotine in its pure form is a poison, and can cause harm if ingested by a child.”

Smoking E-Cigarettes Of No Benefit

Smoking E-Cigarettes Of No Benefit

Toxic effects of e-juice (e-liquid)

From September 2010 to February 2014 there were 2405 reports to the poison control centers in the US about e-cigarette exposures. In the month of February 2013 there were 70 calls, in February of 2014 there were 215 calls, a 300% increase.  More than 50% of these cases involved young children.

In BC, according to Dr. Purssell the Drug and Poison Information Centre received 70 calls between July 1, 2013 and June 30, 2014. 50% of these involved children who were younger than 4 years old. There was no case of serious toxicity. If, however, enough fluid is swallowed, there can be deaths from nicotine overdose, particularly in children and in pets. Seizures can be caused by nicotine overdoses and poisoning of the breathing center in the brain stem.

Nicotine is highly addictive. In children and in adolescents nicotine has a negative effect on brain development. Here is a report from the Minnesota Poison Control Center, which reports poisoning incidences with e-juice that was swallowed by young children and it reports also about adolescents who overdosed on e-cigarettes.

It appears that the nervous system is more sensitive for toxic effects of nicotine at a younger age.

Regulations of e-cigarettes

At this point e-cigarettes are illegal because the FDA is still examining the pros and the cons. The situation in Canada is similar: Under the Canadian Food and Drugs Act regulations it is currently illegal to sell e-cigarettes containing nicotine. The international Union against Tuberculosis and Lung Disease has issued a position statement saying that its preferred opinion is to regulate e-cigarettes as tobacco products. The UK will be following this advice.

Dr. Purssell commented: ”This is a reasonable course of action for a product that delivers a highly addictive substance with negative effects on brain development and can cause serious poisoning.“

While the Internet merchants are busy marketing these products, it is important that the legislators around the globe take swift action to draft policies and regulations now to protect children and adolescents.

Conclusion

In conclusion it can be stated that smoking e-cigarettes (=vaping) does not have any benefits whatsoever. Smokers still smoke, as the addictive substance (nicotine) in e-cigarettes undermines their efforts to quit. It may be true that they are not exposing themselves to lung cancers as much as those who puff away on regular cigarettes, but instead their cardiovascular system is exposed to the nicotine that causes heart attacks and strokes. It sounds very sobering that they just traded one cause of  unnecessary death (lung cancer) for another one (cardiovascular disease leading to strokes and heart attacks).

More information on:

1. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

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

3. Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/stroke-prevention/

4. Here is a useful information about health risk from vaping.

References

1.BC Medical Journal Vol. 56, no.8, October 2014 (www.bcmj.org)

2.US Department of Health and Human Services. The health consequences of smoking – 50 years of progress: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention and Health Promotion, Office on Smoking and Health, 2014.

Last edited Nov. 16, 2014

Oct
24
2014

TACT Study Proves Effectiveness of Chelation

Even though the Trial to Assess Chelation Therapy (TACT Study) has been published in March 2013 (Ref. 1), it still needs to make its way into the common public knowledge. The National Institute of Health was noticing an “alarming 68% increase” of chelation therapy between 2002 and 2007. These patients had problems with previous heart attacks and others had angina due to coronary artery disease, so they sought relief through intravenous chelation treatments. The purpose of the TACT study was to see whether chelation treatments with EDTA were safe and whether they would show any benefits when compared to a placebo group.

TACT study design

A total of 1708 patients were randomized into two groups, 869 treated with EDTA chelation therapy and 869 in treated with placebo infusions of normal saline/dextrose. Treatments were blinded (nobody knew what was given in the intravenous). 134 research sites in Canada and the US were involved in this trial including the Mayo Clinic. Patients had to be at least 50 years old, but the average age was 65 years. They had all a prior heart attack, but not less than 6 weeks before enrolment; on average they did have their heart attack 4.6 years before enrolment. Participants had to quit smoking at least 3 months before entering into the study and if they had revascularization procedures (bypass surgeries or stents), this had to be done more than 6 months in the past.

31% of the study population had diabetes. 83% had revascularization procedures done in the past. The majority of patients were taking heart medications (72% beta blockers, 73% statins to lower cholesterol and 84% aspirin to thin the blood).

65% completed 40 infusions, 76% completed at least 30 infusions.

The chelation infusion was the standard infusion usually used in chelation clinics, namely containing EDTA (the chelating agent), salts and vitamins as indicated in this Mayo clinic summary report. The follow-up period was for 4 years. There was a drop-out of 30% for various reasons and 17% refused their consent to carry on in the study.

TACT Study Proves Effectiveness Of Chelation

TACT Study Proves Effectiveness Of Chelation

Results of the TACT study

Overall mortality in the chelation group was down 2.8% versus the placebo group. Heart attacks in the chelation group were down 19.5%; strokes down 20% and hospitalization rates were down 28.6% when compared to the values of the placebo group.

Diabetic patients (the subgroup of 31%) appear to have greater benefits from chelation treatments than the non-diabetic ones. The diabetic group benefitted by 39% with regard to risk reduction (strokes, heart attacks, mortality) versus the non-diabetic chelation group (only a 4% reduction).

Perhaps as important as the results of the effect of the chelation study versus the placebo group was the fact that the side-effect profile was indistinguishable between the two groups. This establishes for the first time that chelation therapy is safe and that it also has beneficial effects.

It is interesting that when the results of the TACT Study were announced at the 2012 American Heart Association meeting in Los Angeles, the majority of cardiologists did not believe the results (that chelation was effective); instead they were looking for alternative explanations to explain the effect and suggested that this study needed to be repeated again.

What are the benefits of chelation therapy?

Originally EDTA was used to treat children with lead poisoning in Germany. However, workers who were exposed to lead containing paints in various industries also were described to have improve significantly with EDTA chelation (see this chelation history link).

In the 1990’s environmental concerns about heavy metal poisoning of the earth atmosphere came more into the forefront. This 2007 paper reports about heavy metal poisoning in detail.

A new concern for those who like organic food is the use of copper sulfate by organic food growers to spray against fungal and bacterial growth on crop as copper sulfate is one of the 5 chemicals used in organic agriculture approved by the USDA.

Those who consume organic foods may inadvertently expose themselves to copper in their system. This will reduce zinc levels as zinc naturally counterbalances the effects of elevated copper levels. But normal zinc levels are needed for normal body function, particularly in males.

As I have explained in this blog before, chelation therapy and several other methods can detoxify the body. Pollution continues to play havoc with our system and we need to consider taking steps to counteract that. In this blog I explained that we live in a toxic world and I mentioned several steps we can take to counteract this including chelation therapy. Particularly heavy metals like lead, mercury, cadmium and copper will be reduced in the blood by intravenous EDTA chelation treatments.

Conclusion

I felt that I should take some time explaining the carefully conducted TACT Study that was a randomized double blind, government sponsored study examining the effects of chelation treatments. It showed that there were significant improvements in terms of cardiovascular recovery, but it also showed that it was entirely non-toxic. Chelation should be done by an American College for Advancement in Medicine (ACAM) certified practitioner to ensure that you get the same chelation treatment as described in the TACT Study. People with heart conditions will need 30 to 40 treatments (usually 1 week apart) to improve. However, a person with a normal heart who considers detoxification will only need 10 treatments initially (twice per week or weekly), then one every three months for maintenance. We all reside on the same planet and are exposed to ongoing pollution and food toxicity. Due to this reality the topic of chelation and detoxification is worth some serious consideration not only for patients with heart health issues.

More information about vitamins and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

Reference: 1. J. American Medical Association (March 27, 2013, Vol. 309, No. 12)

Last edited Nov. 8, 2014

Oct
14
2014

New Material To Fill Bone Defects

Disfiguring head injuries from car accidents, work injuries or personal injuries left plastic and cranial surgeons with the problem of how to fill the gaps. This problem may soon be medical history as a new polymer foam material has been invented that serves as a scaffold. With its interconnected pores it allows bone to fill the gaps and subsequently gets absorbed leaving new bone in the place where the scaffolding foam had been placed by the surgeon. Texas A&M and Rensselaer Polytechnic Institute researcher Melissa Grunlan who is an associate professor in the university’s Department of Biomedical Engineering develop this material together with her co-workers.

It has interesting properties. The shape of memory polymer foam (SMP foam) is malleable when treated with warm saline water and can be fitted into the bone gaps from the injury. After a short time it hardens in place and provides the scaffolding needed for new bone growth.

This new material lends itself to fill gaps from birth defects (like cleft palates), from facial injuries or from the removal of bone tumors in the head, jaw or face.

Traditionally, bone grafts were used to fill gaps. They had to be taken from an area like the hip, but there were problems attaching these grafts to the underlying bone to which the graft would hopefully attach to in the future. Many complications could occur like graft absorption leaving the original defect or infection of the grafted material.

With the new polymer foam material there is instant attachment, instant shaping of the surface of the material and very quick population of the foam with bone cells from the surrounding bone. In addition, the polymer foam has all its surfaces coated with a bioactive substance that attracts bone-forming cells, called osteoblasts. Experiments have shown that after only three days the coated sponge channels attracted five fold more osteoblasts than that of uncoated control foam material.

New Material To Fill Bone Defects

New Material To Fill Bone Defects

Traditional bone grafting

Traditionally, bone grafts are used to help with complicated fractures in the healing process. In spinal surgery bone grafts may be required to over bridge facet joints with end stage arthritis, as following successful healing after fusion surgery the back pain will improve significantly. Bone grafts have also been used when bone defects were present from severe infection, injury or congenital defects. In these cases the bone graft is used to fill in the defect. Finally, bone grafts are sometimes necessary to fill in bone following surgical hip joint replacements or after repairs of fractures with plates and screws. More about these traditional bone graft techniques can be found through this link.

Complications of traditional bone grafting

Complications depend very much on the location of the surgery and what type of procedure is being used. For instance when it comes to fusion surgery in the lower neck or lower back region, the traditional success rate of fusion surgery is about 70%, which means that in 30% of cases the procedure did not work. On the one hand the combination of mechanical stabilization through instrumentation with bone grafting has increased the success rate of fusion surgery above 70%. But smoking, older age, osteoporosis, obesity, diabetes, and prior spinal surgery have decreased the success rate as indicated in this review.

This overview about autografts (bone graft in the same patient), allografts (bone grafts with bone from a bone donor center), xenografts (bone from an animal) as well as synthetic bone grafting explains more details about these topics.

Another website also contains useful information about this topic.

Other applications for memory polymer foam

In the same facility Duncan Maitland, associate professor in the university’s Department of Biomedical Engineering, is researching the use of SMP foam for the treatment of brain aneurysms in humans. A flat piece of SMP foam is introduced into the aneurysm, a sac-like pouch of a brain blood vessel and activated through heat from a laser beam. This actives the foam to become round and fill the pouch of the aneurysm, closing off the area that could have ruptured and led to bleeding. This application has to be proven in clinical trials as well as does the use of the SMP foam for bone defects.

Conclusion

Often in medicine new ideas were necessary to lead to progress in treatments. For instance when hemoglobin A1C was detected by an Iranian team of doctors, all of a sudden a powerful  tool to monitor treatment of diabetes had become available. Prostate specific antigen (the PSA test) is another example of a test that allows for a much earlier diagnosis of prostate cancer. Earlier detection of prostate cancer leads to a more successful treatment of this cancer.

With memory polymer foam (SMP foam) physicians will soon be given a new tool of closing big bone gaps to help their patients overcome unsightly appearances or unstable situations in the spine or in other body locations. The brain aneurysm application will help prevent brain hemorrhages. More research is needed for these clinical applications, but the initial research shows a lot of promise.

More information on bone cancer where following surgery large bone defects can remain: http://nethealthbook.com/cancer-overview/bone-cancer/

Last edited Nov. 8, 2014

Oct
04
2014

The Problem Are Sugar And Starchy Foods

Fareed Zacharia interviewed Chief Medical Correspondent Sanjay Gupta on CNN on Sept. 10, 2014 regarding why sugar is worse than fat.

I like to explain why it is important to rethink the issues of fat, cholesterol, sugar, starchy foods, longevity, prevention of cardiovascular diseases (strokes, heart attacks) and cancer.

I have blogged about this many times before, but perhaps an overview regarding these issues would be in order.

The Framingham Heart Study indicated first that too much cholesterol in our system was a problem leading to heart attacks and strokes (Ref. 3). As more research was done, the reasons for this have become clearer.

1.Liver metabolism

The liver plays a major role in the metabolism of glucose. Digestion of refined starchy foods starts in the mouth where amylase from the saliva digests the surface of the pasta or white bread you eat. The stomach carries on with this process and the job is finished in the small intestine with the help of pancreatic enzymes (Ref.1). This digestive process is so efficient that within 20 to 30 minutes all of the refined carbs from pasta, donuts and bread appear as sugar in the blood stream. The portal vein system that collects the nutrients from the gut delivers all sugar straight to the liver where it is reassembled into glucagon as the storage form in the liver and skeletal muscles. This would all be good, would we have periods of fasting in between our sugar consumption. Periods of famine are no longer part of modern civilization, but consumerism is. Most of the processed food contains sugar and this leads to excess sugar uptake, which has to be processed by our liver. The end result is production of LDL cholesterol, oxidization of LDL cholesterol by sugar and in the process the production of VLDL (=very low-density lipoproteins) that leads directly to deposits in the arterial walls and clogging of arteries. Triglycerides are also produced, which leads to fat deposits (the cause of the obesity wave all around us).

2. Where does the fat that we see around us come from?

In the past we thought that it was from too much saturated fat and cholesterol in the food that would have caused the accumulation of fat and cholesterol in the body. Now we know that this was an over-simplification. In fact more cholesterol and fat comes from metabolized sugar and with a slight time delay also from starchy foods.

Sugar and starchy foods (like pasta, white rice, white bread, potatoes, grapes, honey etc.) get metabolized by your liver into LDL cholesterol, triglycerides, and fat. This does not mean that you should not pay attention to the total fat content and the quality of fats you eat.

3. The finer points about subfractions of cholesterol

You have heard many times about the good (HDL) and the bad (LDL) cholesterol. Sugar and refined starches do not only lead to the production of LDL cholesterol, but also to oxidized LDL cholesterol, which is very aggressive (VLDL=very low-density lipoproteins) leading directly to deposits in the arterial walls and to clogging of arteries. Your doctor can order a detailed lipid profile test, if you belong into a higher risk group to determine your VLDL level.

It may surprise you to read that many of the foods that were demonized in the past 2 to 3 decades like whole eggs; unprocessed grass-fed red meat, coconut oil etc. are now seen to be good for you.

But there are provisos: supplement with molecularly distilled omega-3 fatty acids, have enough vitamin D3, vitamin K2 and calcium in your diet or supplement with these. This will make sure that calcium will leave the blood stream (not lead to arteriosclerosis) and enter into the bones where it is needed for healthy bone structure. The anti-inflammatory effect of vitamin D3 and of the omega-3 fatty acids will prevent arthritis, strokes, heart attacks and cancer.

The Problem Are Sugar And Starchy Foods

The Problem Are Sugar And Starchy Foods

4. Four major conditions causing heart attacks and strokes

According to Ref. 2 only 4 conditions have been proven over the years to lead to serious hardening of arteries causing strokes and heart attacks: dyslipidemia (high triglycerides, high LDL cholesterol and VLDL), hypertension, cigarette smoking, and/or diabetes (Ref. 3). What has not been appreciated until recently is the fact that sugar and refined starchy foods metabolized by the liver are the culprits in causing plaque in arteries as the oxidized LDL cholesterol is aggressively invading the arterial wall and is inflammatory. A total cholesterol level greater than 5.2 mmol/L (200 mg/dL) has been shown to be associated with increased heart attacks and strokes. Ref. 2 also points out that dietary changes; days of fasting and weight loss have all been shown to stabilize and reduce plaque lesions and reduce heart attacks and strokes. It is the rupture of unstable plaques that lead to attraction of platelets and thrombus formation. It is this localized thrombosis that leads to the closure of coronary arteries or brain vessels causing heart attacks and strokes. According to Ref. 2 there are 9 factors that determine whether we get a stroke or heart attack, the four factors mentioned above (dyslipidemia, hypertension, cigarette smoking, diabetes) and abdominal obesity, lack of physical activity, low daily fruit and vegetable consumption, alcohol overconsumption, and a psychosocial risk. This latter factor includes any kind of chronic stress like interpersonal stress at work or home, depression, financial stress, major life events like marriage, death, divorce, and lack of control. Counseling is useful for support regarding psychosocial risk factors. It is significant to note that according to Ref. 2 several studies have shown that 90% of heart attacks and strokes can be prevented by paying attention to these 9 risk factors. Managing stress effectively and seeking professional help for psychosocial difficulties as well as avoiding the  physical health risks will contribute to good allover health.

Conclusion

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats including omega-3 fatty acids. By taking care of the 4 major causes of heart attacks and strokes and also attending to the additional minor contributors mentioned above you will be able to eliminate 90% of the cardiovascular events. As you change these things you will also prevent many cancers as you changed the body metabolism and chronic inflammation has been taken care of as well as I pointed out in several blogs before. Finally, pay attention to stress management. The body and mind work together.

I have discussed all of these items in detail in my book as well (Ref. 3).

More information on high density and low density carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

References:

1.Townsend: Sabiston Textbook of Surgery, 19th ed.,Copyright 2012 Saunders.

2.Melmed: Williams Textbook of Endocrinology, 12th ed.,Copyright 2011 Saunders.

3. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Sep
24
2014

Two Approaches To Heart Disease

Over the years I noticed that there are two approaches to heart disease that people and physicians seems to subscribe to.

1.The conventional approach to heart disease

The patient essentially ignores health advice, may smoke cigarettes and eat in a lot of fast food restaurants. People who do not care about their heart drink sodas, eat lots of sugar, starch and processed foods. They may think that they are invincible. Famous politicians have subscribed to this type of approach including former vice president, Dick Cheney.

But the big surprise comes when acute chest pain hits and an ambulance has to be called. We are lucky in the industrial countries where a 911 service is available. You call that number when in distress and an ambulance with all the modern equipment will rush to you. The problem though is that you have neglected your arteries for all those years and it is likely that one or two of the three coronary heart vessels are severely narrowed so much that your heart reported chest pain. This pain signals that one area of the heart muscle was not getting enough oxygen and nutrients.

On arrival at the hospital the emergency physician sees you. Nurses put monitors up, attach electrodes to you, and IV-lines are put into your veins, just in case things get worse and they would need to give you quick life-saving medicine intravenously. They have also given you an oxygen mask, and after 30 minutes or so you feel much better. A cardiologist has been called in by the emergency physician and will assess you.

This will very likely be the verdict: “We have to do a coronary arteriogram where I advance a thin catheter through your femoral artery backwards to where the coronary arteries originate from. We can then study each coronary artery separately and determine whether an angioplasty needs to be done.” Upon your questioning he explains that an angioplasty is a procedure where a catheter is advanced through a new clot that often forms during a heart attack and a stent is left behind that will keep the previously blocked off coronary artery open.

Within an hour the procedure will be completed. The cardiologist will explain that he found significant narrowing, such a san 85% narrowing in the anterior descending coronary artery and a second lesion in the right coronary artery with maybe 55% narrowing. He has stented both of these arteries successfully. But he warns you that the stents may close off, if you are unable (or rather unwilling) to change your lifestyle. He also will be very specific with what he meant: Quit smoking immediately, get into a regular exercise program and adopt a strict heart healthy diet like the Mediterranean diet. They would keep you overnight just to observe your heart rhythm and blood pressure. In the morning, if everything is OK he will likely discharge you.

Comment: Unfortunately this scenario is all too familiar to me having worked as a family physician doing my rotations as an emergency physician in a community hospital for 16 years. I found that people tended to NOT think preventatively unless they were forced to. When an acute event like a heart attack happens, a higher percentage of people is committed to prevention, but medical people call this “secondary prevention” as this prevention was only started after a close call. Our sample patient above could have developed a serious arrhythmia (irregular heart beats after a heart attack) and suddenly slipped into a coma and died before the interventional cardiologist could have placed the stents.

Primary prevention is much more powerful and this is what I like to cover next.

Two Approaches To Heart Disease

Two Approaches To Heart Disease (Placement Of Stent Shown)

2. The preventative approach to heart disease

Most people never have to be rushed to the hospital with chest pain. They engage in various ways of “primary prevention”.  So, what exactly is this?

They keep very active, like walking or jogging, dancing, working out in a gym, biking or swimming etc.

They also like a healthier than normal lifestyle: eat at home as much as possible, and many adopt to buy only organic food. Why, you may ask? Organic food does not contain insecticide residues that resemble estrogenic substances (so-called “xenoestrogens” which accelerate hardening of the arteries). But organic food also does not contain GMO (genetically modified food). We know enough about GMO now to indicate to us that autoimmune diseases with inflammation of the arteries and the gut can occur. But the full impact on people’s health will not be known for several more decades. So why experiment with yourself? Buy organic instead. It is known to be safe.

Vitamins and minerals can be very useful supplements that also prevent premature aging of our blood vessels.

Anti-aging research has shown that with aging come various hormone defects. Melatonin is one of the first to go (in your twenties). But melatonin tables that are widely available in drug stores and health food stores can come to your rescue:  3mg of melatonin at bedtime will give you a good night sleep and provide powerful anti-oxidant effects. DHEA is an adrenal gland hormone that can be measured in your blood (or in saliva). In case it is low, it can be easily replaced with supplements. In the 50’s or 60’s women and to a lesser degree men will start to show thyroid under-functions. We call this hypothyroidism. Have your TSH and T4 levels checked and talk to you doctor about whether you need thyroid replacement, if the values are off.

It is somewhat more difficult to explain the rest of the hormones. But you know that women get into menopause and men about 10 to 15 years later will hit andropause, which is the male equivalent of menopause in women.  An easy way to check this out is by doing a hormone panel from just one tube of spit. Yes, it is a saliva hormone panel I am talking about. For women it is estrogen, progesterone, cortisol, DHEA and testosterone that should be analyzed. For men it is testosterone, DHEA, cortisol, estrogen and progesterone. I am aware that these are the same 5 hormones, but I listed them in the order of importance for women and men. In this blog you find more details about bio-identical hormone replacement.

I have followed a primary heart attack prevention program since 2001 and it seems to suit me well.  Just to check things out I had a carotid intima test, which showed no hardening of the arteries. Just two weeks ago my optician took images of the retinal vessels and found hardly any hardening of my retinal arteries. I scored high on a Bruce treadmill protocol in March of 2013 and my lipid VAT values were excellent indicating a low risk for a heart attack.

I have delved into this subject in more detail in my book entitled “A Survivor’s Guide to Successful Aging” (Ref. 1).

Conclusion

Prevention of a disease is always better than curing a disease, this applies to heart attacks as well. While you do something good for your heart, you are at the same time preventing strokes and many degenerative conditions like Parkinson’s disease, Alzheimer’s disease. In addition you also prevent cancer. It really is a good deal!

More information on prevention of heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/prevention-heart-attack/

Reference:

1. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Sep
03
2014

Probiotics Are Important For Your Health

We need to be aware that probiotics are important for your health. Growing up in Germany after World War II I remember that occasionally there were interesting newspaper headings. It  showed an older person in the nineties when the average life expectancy was in the late 60’s. The reporter asked, “What did you do to turn that old?” The answer was that the person always ate a lot of yogurt.

This did not sink into mainstream medicine at that time and people did not really believe this statement. How could eating yogurt make a person live longer?

Fast forward to 2014. You read about probiotics in magazines, on the Internet, and even TV commercials expose you to it.

In the Wikipedia it is accepted that yogurt can help seniors who have a lower bifidus bacteria population in their colon to rebalance their gut flora, which will prevent colon cancer. It also describes that yogurt can help yeast infections in women.

In the meantime probiotics have been developed and concentrations like 20 to 80 billion bacteria per capsule with a mix of Lactobacillus and Bifidobacterium species are available in the health food store for prevention.

The medical profession has studied the effects of higher potency probiotics and came to the conclusion that probiotics have indeed effects on the body far beyond the gut.

Here are a few highlights.

Bowel disease improves

In cases of bacterial or viral diarrhea the frequency of bowel movements and the intensity of bowel cramps gets helped within a few days, and recovery from the diarrhea is much faster with probiotic than without. Patient with irritable bowel syndrome and ulcerative colitis are helped with probiotics. Probiotics help both constipation and diarrhea in otherwise healthy people as well.

Immune system booster

The small bowel contains clusters of immune cells within the bowel wall. Together they are a formidable immune organ in the gut, which connects to the blood and the rest of the immune system throughout the body (lymph glands, spleen, bone marrow). Specifically it has been proven in humans that macrophages, natural killer (NK) cells and cytotoxic T-lymphocytes, which are the working horses of the immune system, are all stimulated by probiotics.

Less respiratory infections

School children who were given 1 capsule of probiotics twice per day for 3 months and flu symptoms and absenteeism were observed due to colds and flus. When they did get a viral infection, the illness had a shorter course, resulting in much less school absenteeism over the course of the trial when compared to a placebo group. It seems that a healthy gut flora stimulates the immune system to work at its best.

Cancer prevention

To a certain degree cancer can be prevented by probiotics and other nutritional factors. Breast cancer is one of the cancers where probiotics have been shown to be effective in reducing disease.

Apparently the probiotic bacteria bind to the cancer causing factors (carcinogens) that some of the bad gut bacteria produce. Probiotics also suppress other bacteria that convert pro-carcinogens into carcinogens. This is not all: the probiotics also interfere with enzymes involved in the production of carcinogens in the gut. This stimulates the gut immune cells to produce cytokines that are needed in the battle against early cancer. Probiotics play a role in multiple processes that help the body to fight cancer, not only in the gut, but also in the rest of the body!

Helps diabetes get better

How can gut bacteria help diabetes, which is an endocrinological disease? Both human and animal studies have shown that insulin resistance is improved by probiotics. In a 6-week study both blood sugar levels and hemoglobin A1C values (that measure long-term control of diabetes) dropped significantly by eating 300 grams of yoghurt per day when compared to a control group who did not.

Obesity

Probiotics given to mothers at least one month prior to birth and at least up to 6 months after birth prevented excessive weight gain in both the mothers and their children. In addition, probiotics can suppress a lot of the inflammatory substances in obesity.

Probiotics reduce cardiovascular risk

Several studies have shown that probiotics lower LDL cholesterol, total cholesterol and inflammatory markers in the blood stream resulting in lower risk for hardening of the arteries.

One should not look at probiotics as a single factor for prevention of heart attacks and strokes. Combine probiotics with exercise and a low refined carbohydrate diet. High sugar and starch diets lead to absorption of sugar in the stomach and small intestine. This results in a lack of nutrients to support the gut flora. Combine probiotics with vegetables and lettuce. Then you have the proper mix of fiber, minerals and other nutrients to sustain balanced bacteria in the bowels. This prevents heart attacks and strokes and keeps inflammatory markers down. I have blogged about this before and stated that the combination of organic food (to avoid antibiotic residues in our diet), fruit and vegetables combined with probiotics will protect you from heart attacks and strokes.

Probiotics Important For Your Health

Probiotics Are Important For Your Health

Conclusion

Maybe the newspaper articles in Germany after the Second World War were right. There is something in yogurt (Lactobacillus and Bifidobacterium species) that can make you live longer. The explanation seems simple: add probiotics to your diet.  You will have a better immune system and get less respiratory infections. But you also prevent heart attacks, strokes and prevent obesity and cancer. All of this in combination will lead to healthier lives, and more people will live to tell about it.

Last edited Sept. 3, 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

May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014

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