Medical Articles by Dr. Ray

Feb

2024

Ashwagandha’s Benefits

By Ray Schilling | immune system, sexual arousal, sleep, stress, testosterone

Medical news today had an article in October 2023 that reviewed ashwagandha’s benefits. I thought it would be useful to discuss this topic in an abridged version. Often things get distorted on the Internet and a reality check helps to separate facts from fiction. Ashwagandha (botanical name: Withania somnifera) is a small shrub that grows in Southeast Asia, Africa and some areas of India. An alternative name is Indian ginseng. Ashwagandha has been part of Ayurvedic medicine for more than 3000 years.

About ashwagandha’s effectiveness

Ashwagandha is part of natural medicines that go under the name of adaptogens. The effective substances of ashwagandha were isolated. Researchers named them withanolides. They are alkaloids and consist of polyoxygenated steroidal lactones with 28-carbon ergostane skeletons.

People are taking ashwagandha supplements to counter stress and fatigue. But it also increases testosterone, which increases muscle mass. In addition, there is an increase of libido in men as well as in women.

People with insomnia benefit from the relaxing and sleep-inducing effect of ashwagandha supplements. Ashwagandha stimulates the immune system. It also significantly counters the stress response, as it lowers cortisol levels.

The active chemical components of ashwagandha

Various researchers pinpointed the diverse actions of ashwagandha extracts to withanolides, which are the pharmacologically active ingredients. There are at least 25 different chemical structures of withanolides, which are depicted in this reference: This explains the diverse effects of ashwagandha extracts on the immune system, the stress hormone axis, the libido brain centers and testosterone production. One human study showed that within 96 hours of ashwagandha extract administration the immune system was activated; T cells and natural killer cells were measured and were significantly elevated in number in comparison to controls:

Specific clinical trials showing effects of ashwagandha

Effects on the brain

In a small clinical study oral intake of ashwagandha improved performance on cognitive tasks, executive function, attention, and reaction time.

Dr. Amala Soumyanath is a professor of neurology in the School of Medicine at Oregon Health & Science University. She stated: “These laboratory studies show that ashwagandha extracts can act on neurotransmitter pathways including those involving serotonin and Gamma-aminobutyric acid (GABA), and also affect systems like the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) axis.”

What does this mean? It means that ashwagandha contains a mix of withanolides that calm down the brain, particularly when it is stressed. At the same time, it increases serotonin and GABA, which has antidepressant and calming effects. Clinical trials have measured cortisol levels in volunteers and found that cortisol is lowered within a few weeks. This is the strongest evidence that ashwagandha in fact counteracts stress.

Libido and muscle strength

A small human study found that muscle strength was higher after exposure to oral ashwagandha in comparison to controls.

Ashwagandha showed a significant increase of maximum oxygen consumption (VO_2max) in healthy adults and athletes, which is a direct measurement of exercise fitness. A clinical trial with 50 overweight males aged 40-70 years, showed that 16 weeks of oral ashwagandha increased their testosterone level by 14.7%. In addition, there were improvements in fatigue, vigor, and sexual and psychological well-being. There was also an increase of 18% of DHEA-S a precursor of testosterone. The authors felt that a larger study with a longer observation time would be beneficial to confirm this study. Overall, the objective effects of ashwagandha are in the mild to moderate category. The mild increase in testosterone affects libido only marginally. Some articles in social media are vastly exaggerating the objective findings.

Health risk of ashwagandha

There are downsides as well. Ashwagandha stimulates the immune system and in doing so may exacerbate autoimmune diseases. It also can increase thyroid hormones, which is important to know for people with hyperthyroidism or hypothyroidism. Men who have hormone sensitive prostate cancer should avoid ashwagandha, because it elevates testosterone.

Researchers pointed out that gastrointestinal upsets, such as diarrhea, nausea, and vomiting due to ashwagandha are common side effects. The higher the dosage and the longer the exposure is, the more likely it is that the patient experiences side effects. Researchers reported a few cases of reversible liver toxicity cases due to ashwagandha. At this point the effects of concomitant medications taken at the same time as ashwagandha is not known.

Ashwagandha’s Benefits

Conclusion

Lately social media is full of ashwagandha’s benefits. Rosy reports of increased libido, extra energy and boosts of confidence circulate on the Internet. Men are told that in order to build up muscle bulk with exercise they must take ashwagandha. This review checked the facts. There is a 14.7% rise in testosterone from taking ashwagandha and this may contribute to an increase of muscle mass with exercise, but this is not a huge effect. Also, the mild increase of libido due to the increase of testosterone is not as significant as reported in the social media. The active ingredients of ashwagandha are the withanolides, which researchers isolated. They do help to deal with stress-related problems like lack of energy and insomnia. In addition, they stimulate the immune system to give a stronger response.

Side effects of ashwagandha

But ashwagandha also has some side effects. It can make auto immune reactions worse. It can interfere with both hyperthyroidism and hypothyroidism. Men who have hormone sensitive prostate cancer must avoid ashwagandha because of the testosterone increase. Gastrointestinal upsets, such as diarrhea, nausea, and vomiting from ashwagandha supplementation are common side effects. So far scientific evidence is based on relatively small clinical trials. Scientists must conduct much bigger trials that are going on for several years to provide more in-depth information on the effects of ashwagandha.

Feb

2024

Beef and Dairy May Cause Cancer and MS

By Ray Schilling | autoimmune disease, Cancer, colorectal cancer, immune system, Multiple sclerosis, red meat

New cancer research suggests that chronic virus particles in beef and dairy may cause cancer and MS (multiple sclerosis). The Medical journal Medscape.com had a review article that summarized this line of research.

Papillomaviruses and cervical cancer

Harald zur Hausen, M.D., D.Sc., a German virologist, detected that papillomavirus causes cervical cancer. He was given the Nobel prize in Medicine in 2008 for “his discovery of human papillomaviruses causing cervical cancer”. In the meantime, we know that there are two strains, namely HPV-16 and HPV-18 that are carcinogenic. We also learnt that papillomavirus causes oropharyngeal cancer, anal cancer, penile cancer and vulvar cancer. Since then, HPV vaccines are commonly in use for cancer prevention.

Evidence for causation of colorectal cancer

Professor Harald zur Hausen and his wife, Professor Ethel-Michele de Villiers, continued work on looking for viral particles in many other cancers. This led them to state that colorectal cancer was due to a latent viral infection. He determined that, when women were breastfeeding their infants for prolonged periods of time (about 1 year), they transmitted oligosaccharides with the breast milk to their offspring, which gave lifelong prevention against colorectal cancer to their children. He also showed that colon cancer patients had round particles in their intestinal mucous membranes, which consisted of single-stranded DNA rings.

Persistent viruses

The researchers said that they came from viruses and they named them bovine meat and milk factors (BMMF). In the same areas in the intestine, they detected acid radicals from oxidative stress typical for chronic inflammation. They postulated that infants who are weaned from breast milk prematurely, and started on cow milk formulas ingest BMMF. This infects the lining of the gut where a chronic subclinical BMMF infection gets established. Decades later the patient comes down with colorectal cancer. They established that children who are breast fed for 1 year do not get BMMF particles in the lining of their guts or colorectal cancer. They also don’t get MS in adult life.

Criticism of two regulatory agencies in Germany

The above results of professor zur Hausen and his wife were published in February of 2019. This led to a lot of press releases questioning these results. In Germany the consumption of beef and milk products is popular. The DKFZ (Deutsches Krebsforschungszentrum) felt that an “all-clear signal” was necessary. The Bundesinstitut für Risikobewertung (BfR) stands for the German Federal Institute for Risk Assessment, situated in Berlin. It is a substructure of the German government responsible for food safety. The second agency is the Max Rubner Institute (MRI) in Karlsruhe, also known as Federal Research Institute of Nutrition and Food. Both agencies started to investigate the facts of Prof. zur Hausen’s research. At the end of November 2022 the BfR and MRI made a joint statement. They stated the following:

BMMF were not new viral agents, but variations of already known DNA sequences.
BMMF commonly occurred in a variety of animal- and plant-based foods.
BMMF were not capable of infecting human cells.
It was true that consumption of red and processed meat correlates with the incidence of intestinal tumors.
However, consumption of dairy products are linked to a reduced risk of intestinal tumors.
There is no evidence that breast cancer would be associated with the consumption of beef or dairy.
They stated that milk products and beef are valuable supplementary diet components for infants due to their micronutrients. They further stated that dairy and beef products are safe for people of all ages.

Evidence for causation of multiple sclerosis

Professor zur Hausen and his wife, Professor Ethel-Michele de Villiers both worked at the German Cancer Research Center in Heidelberg. They pursued research about MS. MS is usually attributed to IgG1 and IgG3 autoantibodies that destroy Schwann cells. The Hausen research team found the following perplexing facts:

MS was associated with the consumption of dairy products and beef products.
They isolated ring-shaped DNA molecules (BMMF) from dairy and cattle blood.
Epstein Barr virus (EBV) also plays a role in initiating MS. MS patients have higher antibody titers against EBV.
One research paper noticed that MS patients in Antarctica secreted EBV in their saliva in the winter month. However, vitamin D3 stopped the viral excretion. This is very interesting as vitamin D is an important immune response stimulator.

More evidence:

They isolated BMMF particles from lesions of MS patients.
They noticed the old fact that MS is more common further away from the equator. Vitamin D production from sun exposure reduced cases of MS.
Prolonged breast feeding up to one year prevents life threatening rotaviruses and noroviruses in the newborn. The reason is exposure to oligosaccharides in breast milk. The mother starts producing breast milk in the middle of her pregnancy. It protects mother from tumors (including breast cancer), from MS later in life as well as type 2 diabetes.
The researchers formulated the hypothesis that both EBV and BMMF are responsible in patients to form MS lesions in the brain when vitamin D levels are low. A good dose of vitamin D3 every day may be helping to keep EBV and BMMF in a dormant phase.

Discussion

At this point there is no consensus why an increased consumption of beef and processed meat causes more colorectal cancer. The question is whether BMMF particles cause colorectal cancer or whether meat consumption experiences metabolization into carcinogenic substances? Either way it would be desirable to cut down on your red meat consumption.

With respect to MS, we know that autoantibodies are destroying the Schwann cells. But the question is why the immune system produces autoantibodies. Could it be that persistent EBV viruses switch the immune system from a normal to an autoantibody mode? Would BMMF be an additional factor?

Beef and Dairy May Cause Cancer and MS

Conclusion

Professor zur Hausen, a virologist from Germany and his wife Professor Ethel-Michele de Villiers researched persistent viruses. Professor zur Hausen detected the connection of papilloma viruses to cervical cancer. He received the Nobel prize in medicine 2008. They proposed the theory that newborns in their first year of life have an immature immune system. If they are fed cow’s milk and/or beef during the first year they accumulate bovine meat and milk factors (BMMF), which can subsequently lead to colon cancer or to MS as an adult. Two top German institutes banded together to criticize Prof. zur Hausen’s research.

Criticism of Professor zur Hausen’s research

The Bundesinstitut für Risikobewertung (BfR) stands for the German Federal Institute for Risk Assessment, situated in Berlin. It is a substructure of the German government responsible for food safety. The second agency is the Max Rubner Institute (MRI) in Karlsruhe, also known as Federal Research Institute of Nutrition and Food. These research institutes concluded that not all of the findings of Professor zur Hausen were valid. I listed 7 of their concerns. On the other hand, they agreed that it was true that consumption of red and processed meat correlated with the incidence of intestinal tumors. Time will tell which parts of the research ultimately will be valid and which are not.

Jan

2024

Fasting-Mimicking Diet Is Benefitting Cardiovascular Health

By Ray Schilling | diet, fasting mimicking diet, food, Heart Disease, Nutrition, Weight loss

A crossover study showed that a fasting-mimicking diet is benefitting cardiovascular health. This new study was done by Dr. Valter Longo et al. from the University of Southern California. It compared the effect of two diets. They were the fasting-mimicking diet versus an unrestricted diet. In other studies Dr. Longo compared the fasting-mimicking diet (FMD) with a Mediterranean diet. He said: “The significance is that fasting-mimicking diet cycles were able to decrease fat mass without reducing muscle mass and without requiring changes in the subjects’ preferred diet for 25 days a month. In contrast, the everyday Mediterranean diet required a change in everyday dietary habits and was associated with a 5 pounds loss of muscle.”

Findings of the effects of 5 days of the fasting mimicking diet per month

3 cycles of 5-day FMD per month showed the following effect. Fasting-mimicking diet patients experienced a remarkable decrease in trunk fat mass. Dr. Longo also showed in a previous study that the FMD reduces the circulating insulin-like growth factor 1. In addition, blood sugar, triglycerides, LDL and total cholesterol were reduced. In short, cardiovascular markers showed a protective effect in the FMD group.

Comments of a cardiologist to fasting mimicking diet

Dr. Rigved Tadwalkar is a cardiologist at Providence Saint John’s Health Center in Santa Monica, CA. He was not involved in the study by Dr. Valter Longo. He said: “When we look at different sorts of diets, we really want to get down to what sort of health benefit they actually provide. It was nice to see that both the fasting-mimicking diet and Mediterranean diet – which is almost like the mainstay of recommended diets right now – both led to weight loss and improvements in blood pressure, cholesterol, and blood sugar. These are all very important cardiometabolic parameters that lead to cardiovascular disease, so it’s nice to see that both are able to do so.”

Fasting-mimicking diet reduces abdominal fat

He went on to say: “What was interesting about the fasting-mimicking diet is that it had the added benefit of reducing abdominal fat, which was really important because that is a big reason why a lot of people diet. Not to mention it’s still important even from a medical standpoint because abdominal fat is a risk factor for cardiovascular disease.” He continued to point out that it will be important to show the long-term effect of the FMD. He suggested to have observations over several month and years. Also, he stressed the importance of showing the direct effect of the FMD on the reduction of cardiovascular disease. This would be in comparison to controls. All this requires much larger clinical trials with longer follow-ups.

Advantage of fasting-mimicking diet

The FMD is easy to follow. You only have to reduce your daily calorie intake for 5 days out of a month. The remaining 25 days they eat their normal diet. People are often unwilling to change their diet. With the FMD they only have to reduce their calorie intake to 500 to 600 calories per day. And this is only for 5 days in a row once per month. They will lose 0.5 to 0.7 units of body mass index (BMI) once a month. Compare the first day of your 5 day FMD with the day after your last FMD.

My experience with the fasting mimicking diet

I have done this for 6 years. In December of 2017 I listened to a lecture by Dr. Valter Longo at a conference in Las Vegas. Immediately after I started dong monthly FMD for 5 days. This kept my BMI within 21.0 to 22.0, because I use the FMD to correct any weight gains. Whether you want to adopt a DASH diet or a Mediterranean diet is another issue. This is eventually desirable to solve. But in the meantime stay in a healthy range with your BMI with the help of the FMD.

Fasting-Mimicking Diet Is Benefitting Cardiovascular Health

Conclusion

The fasting-mimicking diet (FMD) is a tool to reduce your abdominal fat. At the same time you improve your blood pressure, cholesterol, and blood sugar. You can achieve that by reducing your daily calorie intake. With the FMD you aim for between 500 and 600 calories for 5 consecutive days every month. With body composition scales you can see how your weight, fat percentage and body mass index reduce from before. These are all very important cardiometabolic parameters. If you allow them to get out of control they lead to cardiovascular disease. Start adopting the FMD to keep your weight the same or reduce it slightly. Worry about a possible diet change to a Mediterranean diet at a later point and introduce the beneficial changes. This makes dieting easier.

Jan

2024

Backup your New Year’s Resolutions by looking at short-term Consequences

By Ray Schilling | alcohol, Anxiety, Cancer, Cardiovascular disease, Diabetes, exercise, fasting mimicking diet, Health, heart attack, Insomnia, Smoking, sugar

In the New Year it pays to backup your New Year’s resolutions by looking at short-term consequences. An article in “the conversation” explains how you can keep yourself motivated to stick to healthy habits. The alternative would be to fall back into unhealthy habits, which lead to various disease conditions. Traditional thinking centered around keeping long-term outlooks in front of your mind when tempted by the smell of doughnuts. In these cases, you think that the long-term consequences of eating doughnuts or consuming sugary drinks result in diabetes and obesity. But the smell or taste of unhealthy foods can be so overpowering that the long-term consequences of potential diseases is forgotten. This is the point when your New Years resolution may fade away in favor of falling back to unhealthy eating habits.

Think short-term to resist temptation

The new approach is to replace the thinking of long-term outlooks by short-term outlooks. The authors cited an example of 4000 participants in 7 separate studies. When the short-term consequences of anxiety and a sugar and caffeine crash were explained for caffeine containing sugary drinks, 25% of participants were able to abstain from the energy drinks in comparison to those who were informed about long-term consequences.

Another experiment

A similar experiment involved the consumption of sugar in the form of cookies. One group of participants read about the short-term effects of eating sugar. A second group read about the long-term effects of eating sugar. A third group did not get any information about the effect of sugar. There was also a “reward system” for all the participants: they had to decide between receiving a tote bag or eating cookies. Those who had read about the short-term effects of sugar were 30% less likely to choose cookies than the ones who read about the long-term effects. The ones who read the short-term effects were 45% less likely to choose the cookies than the ones who read nothing about the effects of sugar.

Verbalizing short-term consequences

Here are some thoughts that help to verbalize short-term consequences:

For alcohol: excessive drinking can lead to poor sleep and hangovers.
Fast food can make you feel bloated or give you indigestion.
Sugar and starchy meals: make you bloated and give you an acidy stomach, also will lead to rapid weight gain.
Focus on the good taste of apples and carrots. People will eat more of it and get the health benefits without mentioning it.

You can keep your goals easier when you combine them with small rewards here and there. When you have achieved one thing, you could watch your favorite TV show. Another reward could be a brief visit to the gym that makes you feel more fit. Or go and buy yourself a new pair of shorts for the gym. The authors of this article provide evidence from studies that showed that several mini rewards distributed throughout the day are more effective than big rewards at the end of the day.

Measurements of weight fluctuations

I found that body composition scales are very useful to monitor your diet intake. Here is an example how I use this device. My weights, fat% and body mass index for a number of days is listed below. The first line shows the baseline measured in the morning. On Saturday lunchtime I was invited to a Christmas family dinner. I ate more than I should have had. You can see the results on the Sunday readings: weight up, fat up and BMI up. I watched my calorie intake throughout Sunday.

Weekday Weight (KG) Fat % Body mass index

Saturday: 63.6 13.2 21.7

Sunday: 64.0 14.2 21.9

Monday: 63.4 14.3 21.7

It took another two days (Wednesday) before the fat percentage was down to 12.9.

There is another powerful tool, Dr. Valter Longo’s fasting mimicking diet. I reported about this under this link. Briefly, once a month I eat only 500 to 600 calories daily for 5 days. This helps me to lose my body mass index from 21.8 down to 21.1 or 21.2. After that I can eat a normal diet until the next month when I do the fasting mimicking diet again. It is an easy way to keep my body mass index in the 21.0 to 22.0 range. My wife and I prepare our own 500 to 600 calorie diet with natural food.(No, you do not get much, but it can taste good!) We do not buy Dr. Longo’s expensive diet boxes.

Backup your New Year’s Resolutions by looking at short-term Consequences

Conclusion

Focusing on short-term goals and consequences increases the percentage of success for those who have New Year’s resolutions. You can use this for many different approaches: eating less sugar, losing weight, getting regular exercise, reducing your alcohol intake, cutting out fast food and increasing your healthy vegetable and fruit intake. I also added a description of what I do with the help of body composition scales to control my weight and body mass index. I also use Dr. Longo’s fasting mimicking diet once per month for 5-days. Since December 2017 (for 6 years) I practiced this. I find it extremely useful to maintain my body mass index in the 21.0 to 22.0 range. Medicine knows that it is important to keep your body mass index below 25.0. This will prevent heart disease, type 2 diabetes and cancer. It also helps to look forward to a healthy New Year.

Dec

2023

Any Form of Exercise is good

By Ray Schilling | Cancer, Cardiovascular disease, diet, exercise, Fitness, Health, heart attack, Mortality

Here are a few items that can prolong life; among them any form of exercise is good. This article concentrates on the exercise part in relation to longevity. A recent publication described how regular exercise prolongs your long-term survival. According to a study released on occasion of the American Heart Association’s Scientific Session 2023 there are 8 major factors that prolong life: healthy diet, physical activity, nicotine exposure, sleep health, BMI, cholesterol, blood sugar, and blood pressure. Among this group of factors regular physical activity plays a major role to prolong your life. Researcher who studied various people found that those who neglected their physical health had a chronological age of 53, but their average biological age was 57. On the other hand, a group of fit people who engaged in regular physical exercise had a chronological age of 41 years, but a biological age of 36.

Clinical trials showing that any form of exercise is good

JAMA Internal Medicine study by Dr. del Pozo Cruz

This study examined what the optimal amount of physical activity per week is to reduce mortality compared to an inactive population. 500,705 eligible US adults were observed for about 10 years. The abbreviations that the authors used in the study were as follows:

MPA: moderate aerobic physical activity

VPA: vigorous aerobic physical activity

MSA: muscle-strengthening activity

Results of mortality reduction with various amounts of physical activity

The best group engaged in more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week. Their mortality rate was 50% lower than an inactive comparison group.
The optimal combination for reduction of cardiovascular disease (CVD) and cancer mortality risk was as follows: more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week. This reduced combined mortality of CVD and cancer by 70%.
The researchers stated that the adjusted mortality rates represented 50% lower mortality rate for all-cause and cancer mortality. The mortality rate for CVD mortality was 3-fold lower than for inactive controls.

Smallest amount of exercise that reduces mortality

In a study published in the European Heart Journal the authors asked how little exercise per week was enough to reduce mortality from heart disease. They found that it takes at least 15–20 min/week of vigorous physical activity (VPA) to reduce mortality from heart attacks by 16–40%. If you increased the exercise level by 50–57 min/week the mortality rates reduced even further.

Are physically active jobs healthy?

Recent research showed that people who work in physically demanding jobs are more likely to develop early cognitive impairment. This is the pre-stage of Alzheimer’s disease. 15.5 % of people who worked in high levels of occupational physical activity developed dementia. This compared to 9% risk for people whose work involved a low level of physical activity, not too much and not too little. The finding confirms the notion that there is a need for balance of physical exercise. Several publications stressed what is optimal in terms of exercise: vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week). People who expose themselves to these amounts of exercise live the longest and stay healthy.

Discussion

The studies discussed here showed that the right amount of exercise can reduce mortality from heart disease and cancer. However, exercise is not the only factor that can do this. It is important to combine regular exercise with a healthy diet. Your diet should consist of fruits and vegetables, whole grains, low-fat dairy products, lean proteins and limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight, manage your stress, and don’t smoke.

Any Form of Exercise is good

Conclusion

In this review I touched on the importance of regular exercise to reduce mortality from heart disease and cancer. Vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week) reduce mortality from heart attacks by 16% to 40%. But physical exercise is only one factor of mortality reduction. If you want the full benefit from other factors, you must quit smoking, eat a Mediterranean type diet with fruits and vegetables, whole grains, low-fat dairy products and lean proteins. Also you should limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight and manage your stress. Once you adopted this lifestyle, you live longer and you will get less diseases.

Dec

2023

Too much Ultraprocessed Food Makes you sick

By Ray Schilling | Cancer, Cardiovascular disease, colorectal cancer, Diabetes, diet, Mortality, Nutrition

A Lancet study published on Nov. 13, 2023 found that too much ultraprocessed food makes you sick. Researchers noted that ultraprocessed animal products and sweetened beverages were linked to an increased cancer risk as well as other diseases such as strokes or diabetes.

In Europe more than half of the food intake consists of ultraprocessed food. In the US a 2019 study found that 71% of the food supply is ultraprocessed.

Details of the study

The details of the study were summarized in a CNN report. Researchers of the study collected nutritional data from 266,666 men and women (60% were women) from 7 European countries between 1992 and 2000. The researchers followed the participants for 11 years. During that time they observed the participants for the development of chronic diseases and cancer. During the observation time 21,917 primary cancers, 10,939 cardiovascular events, and 11,322 type 2 diabetes cases developed. On entry into the study participants were questioned about their food intake in the past 12 months. This was matched with the NOVA classification system. It became clear that not all ultraprocessed foods were detrimental to the health of the participants. Animal products and sugar-sweetened drinks and foods caused chronic diseases in the participants of the study. However, ultra-processed breads, cereals or alternative plant-based products were neutral in terms of health risks.

Main findings of the study: too much ultraprocessed food makes you sick

The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. However, when you reduce your intake of ultraprocessed food your risk of developing these diseases reduces. The key is to eat more fruit and vegetables and concentrate on eating minimally processed food.

Other studies with similar findings

In 2022 the British Medical Journal published two studies that documented a higher colorectal cancer rate and cardiovascular disease rate when subjects were eating larger amounts of ultraprocessed foods (UPF). Specifically, when men had exposure to a high percentage of UPF in their diet they developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet.

French study 2019

A French study in 2019 followed 44, 551 French adults 45 years or older for 7.1 years. A 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. The authors stated that 80% of all premature deaths from noncommunicable disease are due to cardiovascular disease (CVD), respiratory disease, cancer, and diabetes. The authors discussed in detail the problems with overconsumption of ultraprocessed food.

Some of the contents of ultraprocessed food

Ultraprocessed food contains:

High salt content, and high sodium intake has been associated with cardiovascular deaths and increased stomach cancer risk.
Excessive amounts of added sugar. There is an association between added sugar consumption and an increased risk of mortality from cardiovascular disease.
Ultraprocessed foods contain very little fiber. More dietary fiber in one’s diet has an association with lower death rates.
Studies have estimated that reducing saturated and trans fats, salt, and added sugar in the diet prevent cardiovascular deaths.
High temperature food processing produces acrylamide. Acrylamide is a known carcinogen.
Consumption of processed meat products causes a higher risk of colorectal cancer and stomach cancer.

More ingredients of ultraprocessed food

Artificial sweeteners can alter microbiota and can cause the onset of type 2 diabetes and metabolic diseases.
With bisphenol A coating in food packaging endocrine disruptors enter the food. Bisphenol A causes endocrine cancers and metabolic diseases, such as diabetes and obesity.
The food industry uses additives frequently in their formulations. Some studies raised concerns about the health consequences of food additives. For instance, the food industry uses titanium dioxide widely. There is an association of titanium dioxide and increased risk of chronic intestinal inflammation and carcinogenesis.

It is easy to see that when we expose our bodies to a mix of these ingredients this can cause cardiovascular diseases, cancers and diabetes. The final outcome is that this leads to premature deaths.

Too much Ultraprocessed Food Makes you sick

Conclusion

Too much ultraprocessed food (UPF) makes you sick. This is the conclusion of a large study, which the Lancet published on Nov. 13, 2023. Researchers followed 266,666 men and women (60% women) for 11 years. The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. Other studies going back to 2019 and 2022 showed very similar findings.

Other studies

A French study from 2019 noted that a 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. Several studies in 2022 showed that men who had an exposure to a high percentage of UPF in their diet developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet. It follows from this data that a simple diet consisting of vegetables, fruit, nuts and lean meat (chicken turkey, fish) with minimal amounts of UPF protects you from premature death.

Nov

2023

Help to Walk for Parkinson’s Disease Patients

By Ray Schilling | neurological disease, Parkinson’s disease

A new study describes how a spinal cord implant provides help to walk for Parkinson’s disease patients. The original study was published in Nature: . CNN published a simplified article that describes how a Parkinson’s patient with gait problems could walk again, when a spinal cord implant was inserted. This patient’s name is Marc Gauthier from a town near Bordeaux, France. He was 36 years old when he was diagnosed with Parkinson’s disease. For many years he could control his Parkinson’s disease symptoms with Dopamine replacement therapy.

Insertion of deep brain stimulator

But by 2004 the medication did not control his gait anymore. His doctors inserted a deep brain stimulator, which helped with tremors and muscle stiffness. But as the disease progressed, he developed a severe walking disorder. The drugs and the deep brain stimulator no longer helped his walking problem. His muscles stiffened up, and often he fell 4-times per day. He had to give up his work as an architect. Finally, in 2021 his doctors inserted a nerve stimulator with electrodes connecting to the lower spinal cord.

Spinal cord stimulation

Researchers from France, Switzerland and other parts of the world determined which part of the spinal cord were in need of electrical stimulation to improve his gait and balance problems. Dr. Eduardo Moraud is an author of the study and researcher at Lausanne University Hospital. He said: “The stimulation here is focused on the spinal cord. We target the region of the spinal cord that will control all the leg movements.” The team managed to develop an electric stimulator for implantation under the skin over the abdomen with electrodes going to the lower spinal cord. This way his physicians stimulated muscle groups and also relaxed them in sequence so that his gait improved and steadied. His balance stabilized as well and he could walk stairs again.

Future routine surgery to implant spinal stimulator

Marc Gauthier’s case is a first in approaching Parkinson’s disease with a spinal stimulator. The researchers stressed that they will improve the technology and learn from other patients how to individualize this technique. But eventually the spinal cord stimulator could become a routine approach for end stage Parkinson’s disease. Dr. Moraud said: “Addressing deficits of gait and balance in Parkinson’s disease is extremely challenging. These deficits can be very heterogenous. They can be variable across patients. They can affect walking but also symmetry, balance, posture. The neuroprosthetic approach that we have developed here allows for the first time to target and address these problems individually in a highly specific manner for each patient. It operates in real time, and importantly, it is complementary to other existing therapies.”

Marc Gauthier’s progress since his spinal cord stimulator

The researchers identified hotspots in the lower spinal cord with connection to the gait and balance problem of the patient. The surgeon connected the neuroprosthesis to these hotspots to stabilize gait, balance and muscle strength. Following the surgical procedure Mr. Gauthier had to undergo a few months of rehabilitation with the neurostimulator to practice walking, develop strength and coordination between the right and left leg. His body was no longer stiffening or freezing in place. He could now take a 3-mile lakeside stroll without stopping. He can now manage stairs going up or coming down smoothly. In the past his gait would suddenly freeze or he lost hist balance. None of this

Is happening now. He simply is walking normally.

The final word of Dr. Moraud

“The stimulation here is focused on the spinal cord. We target the region of the spinal cord that will control all the leg movements.” Inserting a neurostimulator is not a cure, simply a procedure to help the patient lead a normal life.

Help to Walk for Parkinson’s Disease Patients

Conclusion

A new surgical procedure, namely inserting a neurostimulator under the abdominal wall, is the latest approach to treat Parkinson’s disease. This is help to walk for Parkinson’s disease patients. The case, which I described here is the first case where doctors performed this new procedure. They identified hot spots in the lower spinal cord and connected them to the neurostimulator with electrodes. After a lengthy rehabilitation period the patient learned how to use the stimulator for optimal walking, balancing, and going stairs up and down. There are no more falls or gait problems and no freezing. At the end the patient can walk normally and even manage a walk of 3 miles. Researchers anticipate that this method will become an accepted treatment modality for gait problems of Parkinson’s disease patients.

Nov

2023

New Treatment against Advanced Bladder Cancer

By Ray Schilling | Cancer, laser therapy, Mortality

At a Cancer congress in Madrid, Spain a new treatment against advanced bladder cancer was discussed at this year’s European Society for Medical Oncology Congress. The standard treatment for advanced bladder cancer is gemcitabine in combination with cisplatin or carboplatin. According to CNN the median survival with the standard chemotherapy is 16.1 months. In contrast, treatment with the new intravenous antibody drug enfortumab vedotin in combination with intravenous pembrolizumab resulted in longer survival. The combination yielded a survival of 31.5 months for advanced bladder cancer patients. This new immunotherapy method resulted in a 96% longer survival. The safety profile of the two approaches were similar. 55.9% of patients taking the combination immune therapy developed skin rashes or hyperglycemia, while 69.5% of those taking platinum chemotherapy developed this.

Other new findings about advanced bladder cancer treatment

Dr. Thomas Powles is a professor of urology cancer at the University of London and director of the Barts Cancer Centre in the United Kingdom. He said:” The problem with chemotherapy is although it works quite well initially, resistance occurs quickly, and the median survival for metastatic bladder cancer has been about a year. What this study showed is, we did a big, randomized Phase 3 study where we compared a new treatment — two new drugs — with standard chemotherapy,” Powles said. “And in this randomized trial, when you gave those two drugs together, you reduced the risk of death for this cancer by over 50%. So, you’ve doubled survival, with patients living twice as long, and we’ve got long-term durable remission.”

Erdafitinib study

A second study from the New England Journal of Medicine used erdafitinib in comparison to standard chemotherapy. Erdafitinib is a small molecule inhibitor of fibroblast growth factor receptor and is effective in the treatment of cancer. This study compared 136 patients on erdafitinib with 130 patients on chemotherapy. Patients treated with standard chemotherapy had a median overall survival of 7.8 months. This compares to 12.1 median survival for the erdafitinib group. Erdafitinib, a kinase inhibitor drug, is slowing the spread of cancer cells.

Side effects that led to death were less common with erdafitinib than with chemotherapy. Only 0.7% of erdafitinib patients had serious side effects versus 5.4% of chemotherapy patients.

Nivolumab study

Another clinical trial was recently published in the New England Journal of Medicine.

Nivolumab is an immune checkpoint inhibitor that was originally developed for treatment of intractable melanoma. However, subsequently it was found to be active also against lung cancer, kidney cancer and bladder cancer. In the clinical study mentioned above 304 patients with intractable bladder cancer were treated with standard chemotherapy alone. They were compared to 304 patients on standard chemotherapy plus nivolumab.

The median complete response with the nivolumab-combination therapy was 37.1 months. In contrast, with gemcitabine–cisplatin alone it was only 13.2 months. Side effects of the two treatments were about similar. The authors concluded that treatment with the immune checkpoint inhibitor, nivolumab plus standard chemotherapy with gemcitabine–cisplatin resulted in better survivals than treatment with gemcitabine–cisplatin alone.

Discussion

Immunomodulation is one of the newest approaches to cancer treatment. But at the Hope 4 Cancer Clinic immunomodulation is only one aspect of a comprehensive approach to cancer treatment.They mention that they restore the microbiome in the gut. Great detail is spent to a full spectrum nutrition. Detoxification and non-toxic cancer therapies are employed. Oxygenation helps to restore the acid/base balance. Immunomodulation with the newer agents mentioned above helps as well to combat cancer. Low-dose laser photodynamic therapy with various light frequencies helps to destroy cancer cells as well. These lasers activate a variety of sensitizers, which are taken up by cancer cells and lead to their destruction. Finally, the cancer patients are taught how to achieve spiritual and emotional well-being. The Hope 4 Cancer Clinic demonstrates that treatment with immunomodulation is best combined with other treatment modalities to improve patient survival.

New Treatment against Advanced Bladder Cancer

Conclusion

Physicians used three different immune therapies to treat advanced bladder cancer. Erdafitinib vedotin, a kinase inhibitor drug, in combination with intravenous pembrolizumab resulted in a survival of 31.5 months for advanced bladder cancer patients versus 16.1 months with standard chemotherapy. Another clinical trial showed that patients on standard chemotherapy had a median overall survival of only 7.8 months for advanced bladder cancer. This compares to 12.1 months median survival for the erdafitinib group. Finally, nivolumab, an immune checkpoint inhibitor was combined with standard chemotherapy. When end stage bladder cancer patients were treated with this combination, they survived 37.1 months. In comparison, the control group with chemotherapy alone (gemcitabine–cisplatin) survived only 13.2 months. There is definitely better survival of patients when immunomodulation is used. The hope is that future immunomodulators will have a stronger effect against cancer with less side effects.

Oct

2023

News from the Blue Zones Regarding Longevity

By Ray Schilling | alcohol, andropause, Cancer, Cardiovascular disease, diet, exercise, heart attack, Hormones, lifestyle, Menopause, testosterone

This article is about news from the Blue Zones regarding longevity. Blue Zones are areas where many centenarians live. Medical News Today ran a review article about Blue Zones on Sept. 23, 2023. These Blue Zones are located in Sardinia, Italy; Ikaria, Greece; Nicoya, Costa Rica; Loma Linda, California and Okinawa, Japan. Many studies looked at centenarians in these areas and analyzed what lifestyles led to their longevity. Dan Buettner summarized at a conference that only 20% of deaths in the world are due to genetic conditions. 80% of people can postpone their death date by adopting healthy lifestyles.

Factors associated with longevity

Dan Buettner called the factors that lead to prolonged life “Power 9”. The following factors must be adopted simultaneously, if you want to reach 100 years of age and more:

Moving naturally and regularly
People in Blue Zones have a purpose in life
Reduce stress in your life
Practice the 80% diet rule, which is to stop eating when 80% full
Adopt a plant-based diet.
Consume alcohol in moderation
Be part of a community
Put family first
keep a social circle that supports healthy behaviors

A diet for longevity

Dan Buettner analyzed the dietary habits of centenarians. He found that 90% of the diet they consumed consisted of whole food, plant-based sources and about 65% of their diet were complex carbs. Buettner noted: “The pillars of every longevity diet in the world are whole grains, nuts, greens, and other garden vegetables, tubers and beans.” For years the benefits of a Mediterranean diet were investigated and found to be life prolonging. It also emphasizes vegetables, whole foods, greens, grains, nuts and beans. The review article in Medical News Today that I mentioned above contains recommendations of how to change your diet to a healthier one.

Regular exercise

We are built in a way that requires regular exercise. When you exercise regularly, your body produces healthy HDL cholesterol that balances the unhealthy LDL cholesterol. Overall, this counteracts clogging of arteries and prevents heart attacks and strokes.

When you prevent strokes and heart attacks, you live longer.

Have a purpose in life

When you have a purpose in life, your mind is focused on what excites you. Achieving what is your dream satisfies you. Your brain releases feel-good brain hormones (dopamine, serotonin, endorphins, and oxytocin). When these hormones are released, you relax and cope with stress better. Your blood pressure normalizes, hardening of the arteries is postponed. At the same time, you prevent heart attacks and strokes. This contributes to longevity.

Reduce stress in your life

When under stress, your adrenal glands release adrenaline and cortisol. In the short term these stress hormones help you to cope better with stress. But when stress gets chronic, it weakens your immune system and increases your risk for a heart attack or stroke. It ages you faster. You can counter stress in your life by adopting stress management techniques. Regular exercise stabilizes your emotional life. You can listen to relaxation recordings or to relaxing music to calm your nerves. Developing friendships is another method of coping with stress. Here is more information on how to reduce stress in your life.

Limit alcohol consumption

In the past it was thought that small amounts of alcohol would prevent cardiovascular disease. But these studies overlooked the fact that even small amounts of alcohol can cause various cancers. So, by limiting the amount of alcohol consumption you also limit your probability of getting cancer.

Be part of a community

Many psychological studies showed that social isolation leads to health problems. It follows from this that being part of a community stabilizes your health and prevents disease. When you socialize with other people you counter stress and prevent loneliness.

Putting family first

When you care about your family, family members will care about you. Studies showed that this is an important factor in preventing disease. It even reduces mortality. Lower mortality leads to longevity.

Keep a social circle that supports healthy behaviors

Strangely enough here is another psychological factor that leads to longevity: getting support from a social circle. Being part of a social circle can create positive energy that prevents health problems.

Discussion of factors that lead to longevity

It is interesting to see that a lot of the longevity factors are psychological in nature. But physical factors are also important, like a Mediterranean diet and regular exercise. One factor that was not mentioned by Dan Buettner is the importance of preservation of hormone stability. I attended many yearly conferences of the American Academy of Anti-Aging Medicine (also known as A4M). They take place in the middle of December in Las Vegas every year. Over the years many lectures centered around hormone deficiencies. They collectively lead to premature aging and deaths. However, speakers also stressed that when you replace the missing hormones, you can reach a balance point where life gets prolonged.

Hormone replacement

One of the speakers, Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular HGH injections can add 26.5 years to your life expectancy. But other hormones like thyroid hormones, testosterone in males, and progesterone and estrogen in females can prolong life when replaced after menopause or andropause (the male version of menopause).

News from the Blue Zones Regarding Longevity

Conclusion

Many factors contribute to longevity in centenarians. A lot of the factors are psychological in nature, like having a purpose in life or reducing stress in your life. Others are: be part of a community, put family first and keep a social circle that supports healthy behaviors. Physical factors causing longevity are moving naturally and regularly; adopt a plant-based diet; and consume alcohol in moderation. There is one important factor of longevity that Dan Buettner overlooked: your hormone balance. When we approach age 60 and beyond many people stop producing adequate amounts of hormones.

Replacing missing hormones

Anti-aging doctors have done studies showing that replacing missing hormones in proper doses will prolong life. Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular injections can add 26.5 years to your life expectancy.

Oct

2023

Sudden Cardiac Death in Athletes

By Ray Schilling | heart attack, Mortality

This article is about sudden cardiac death in athletes. Dr. Robert A. Harrington and Dr. Manesh Patel reported from the European Society of Cardiology 2023 Congress in Amsterdam. Notably, this congress took place from August 25-28, 2023 with 30,000 participants. Another key point is that one of the important topics was sudden cardiac death in athletes. In general, you normally assume that athletes are healthy, and their hearts would support their peak athletic activities. It is important to realize as Drs. Harrington and Patel reported that under certain circumstances athletes can suddenly die.

Bronny James, a high school basketball player was rescued from a cardiac arrest as this article shows. Apparently, he has a congenital heart condition, which makes him more vulnerable to get an irregular heartbeat. It must be remembered that his can cause his heart to stop beating. Fortunately, he was revived at the Mount Sinai Hospital in New York. To clarify, there are a number of non-invasive procedures that interventional cardiologists use to correct abnormalities in a heart. Specifically, following such procedures the person’s heart is more stable.

Ventricular fibrillation

To explain, irregular heartbeats leading to ventricular fibrillation is one cause of death in athletes. Another key point, often there can be other underlying conditions that lead to this. Examples are a long QT interval on an ECG, a big thick heart (medical term: hypertrophic cardiomyopathy), and dilated aortas in tall people.

Success stories of reviving people and athletes with sudden cardiac death

In other words, over the years two methods showed success in rescuing athletes with sudden cardiac deaths. The first is CPR (cardiopulmonary resuscitation). This keeps the blood flowing and delivers oxygen to the lung capillaries. Next the emergency medical team is called in who provide an automated external defibrillator to the chest. This can revive up to 100% cases of athletes with sudden cardiac deaths. The key is to do CPR right away and to have the emergency medical team use the automated external defibrillator (AED) right away.

Screening methods to prevent sudden cardiac death in athletes

With this in mind, the medical profession has started to do preventative tests of athletes. First, Italy is one of the countries that has persistently done standard screening. Physicians order ECG’s and echocardiograms. They can readily diagnose hypertrophic cardiomyopathy with these tests. Second, a new stethoscope can get sounds and some ECG signals at the same time. This helps to diagnose several abnormal cardiac conditions.

Third, another point is that there have to be enough people around a sports event who have experience in performing CPR (cardiopulmonary resuscitation). Certainly, the sooner you start CPR, the more successful is the outcome with respect to a full recovery. Next medical personnel with the AED equipment are necessary to bring the heart rhythm back to a sinus rhythm. When the patient’s heart beats normally again, the patient needs transportation to the nearest hospital for further monitoring and stabilization.

Commotio cordis

When there is a lower chest impact from a hockey puck, baseball or lacrosse ball the heart can suddenly come to a standstill. Physicians call this commotio cordis. These athletes need immediate CPR to keep them alive followed by timely administration of an automated external defibrillator. Often the heart beats normally after this. If immediate medical help is not available, these young athletes die and it becomes an upsetting newspaper story.

Sudden Cardiac Death in Athletes

Conclusion

Dr. Harrington interviewed Dr. Manesh Patel, a cardiologist from Duke University regarding sudden cardiac death in athletes. A thump to the chest from a hockey puck or a baseball can cause the heart to stop beating. In order to save this athlete from dying bystanders have to start CPR right away. This helps to continue blood circulation and brings oxygen into the tissues. Next medical personnel apply electrode pads from an automated external defibrillator (AED) to the chest wall. One or two electric shocks are administered. This often revives the heart or converts irregular heart contractions to the normal sinus beats, and the athlete recovers. The emergency medical team transports the patient to the nearest hospital for observation and further treatments. CPR and AED in combination can save up to 100% of cases that would otherwise turn into sudden cardiac deaths.

About ashwagandha’s effectiveness

The active chemical components of ashwagandha

Specific clinical trials showing effects of ashwagandha

Effects on the brain

Libido and muscle strength

Health risk of ashwagandha

Conclusion

Side effects of ashwagandha

Papillomaviruses and cervical cancer

Evidence for causation of colorectal cancer

Persistent viruses

Criticism of two regulatory agencies in Germany

Evidence for causation of multiple sclerosis

More evidence:

Discussion

Conclusion

Criticism of Professor zur Hausen’s research

Findings of the effects of 5 days of the fasting mimicking diet per month

Comments of a cardiologist to fasting mimicking diet

Fasting-mimicking diet reduces abdominal fat

Advantage of fasting-mimicking diet

My experience with the fasting mimicking diet

Conclusion

Think short-term to resist temptation

Another experiment

Verbalizing short-term consequences

Measurements of weight fluctuations

Conclusion

Clinical trials showing that any form of exercise is good

JAMA Internal Medicine study by Dr. del Pozo Cruz

Results of mortality reduction with various amounts of physical activity

Smallest amount of exercise that reduces mortality

Are physically active jobs healthy?

Discussion

Conclusion

Details of the study

Main findings of the study: too much ultraprocessed food makes you sick

Other studies with similar findings

French study 2019

Some of the contents of ultraprocessed food

More ingredients of ultraprocessed food

Conclusion

Other studies

Insertion of deep brain stimulator

Spinal cord stimulation

Future routine surgery to implant spinal stimulator

Marc Gauthier’s progress since his spinal cord stimulator

The final word of Dr. Moraud

Conclusion

Other new findings about advanced bladder cancer treatment

Erdafitinib study

Nivolumab study

Discussion

Conclusion

Factors associated with longevity

A diet for longevity

Regular exercise

Have a purpose in life

Reduce stress in your life

Limit alcohol consumption

Be part of a community

Keep a social circle that supports healthy behaviors

Discussion of factors that lead to longevity

Hormone replacement

Conclusion

Replacing missing hormones

Ventricular fibrillation

Success stories of reviving people and athletes with sudden cardiac death

Screening methods to prevent sudden cardiac death in athletes

Commotio cordis

Conclusion

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Navigation Menu

Tags