Medical Articles by Dr. Ray

Mar

2024

New Blood Test for Alzheimer’s Disease

By Ray Schilling | Alzheimer’s disease, blood test, Dementia

A recent study explained that a new blood test for Alzheimer’s disease is very reliable. Specifically, it determined with 96% accuracy elevated levels of beta amyloid. It also accurately identified tau protein, another Alzheimer’s marker, with 97%. The original research study was published at JAMA Neurology.

Significance of tau protein and beta amyloid for Alzheimer’s diagnosis

Both beta amyloid and tau protein play an important role in the functioning of nerve cells in the central nervous system. But people who develop Alzheimer’s disease experience a lot of beta amyloid deposits in their brains. In addition, there is an overproduction of tau protein as well with insoluble filaments that accumulate as neurofibrillary tangles.

Conventional ways to diagnose Alzheimer’s disease

Alzheimer’s disease conventionally is diagnosed by a PET scan. However, this involves some radiation exposure and costs over $5,000. Next a spinal tap allows the physician to send a sample of cerebrospinal fluid to the lab for analysis. This test gives detailed information, but people are often reluctant to get this invasive test. These tests are expensive and not covered by insurance.

The preventive neurologist Dr. Richard Isaacson is the director of research at the Institute for Neurodegenerative Diseases in Florida. He was not involved in the study. Dr. Isaacson said: “Having a blood test like this can also help democratize access for people and just make it easier for our health care system to more proactively manage the tsunami of dementia risk that our society is facing. This is the key to unlock the door into the field of Alzheimer’s prevention and preventive neurology.”

Home test

The Alzheimer’s disease test was introduced in the US in May of 2022 under the name “AD-Detect™ Test” by Quest. Again, this test is not covered by insurance. The cost is about 399.00 USD plus a 13.00 USD physician service fee.

Research background of the home test

Researchers performed a clinical trial that correlated the blood test, phosphorylated tau (p-tau), with PET scanning of the brain. The blood test was also correlated with lumbar punctures and analysis of cerebrospinal fluid tests. A total of 786 participants (504 females and 282 males) were tested 3 times over 5.22 years. The researchers found that phosphorylated tau (p-tau) was a specific blood biomarker to detect Alzheimer’s disease. It was very sensitive and accurate in terms of correlation with PET scans and cerebrospinal fluid tests. The investigators concluded that the Alzheimer blood test is a practical solution for diagnosing dementia and Alzheimer’s disease early. It will also be a good tool to monitor, whether any future Alzheimer’s drug is effective in controlling the disease process.

Discussion regarding the new blood test for Alzheimer’s disease

For years there was no easy way for physicians to diagnose Alzheimer’s disease. The alternatives were to order the expensive PET scan or the invasive lumbar puncture for a cerebrospinal fluid test. Now with the new blood test for Alzheimer’s disease the physician can screen for Alzheimer’s based on clinical suspicion. The blood test can also tell whether any lifestyle changes have slowed down the clinical course or not. Another important aspect is that this test allows an earlier diagnosis of dementia.

Difficult to interpret tests and test results in other forms of dementia

About 20% of the study participants had blood test results, which were not clear. In a case like this the doctor would order further testing with imaging or a spinal tap to diagnose the condition accurately. Other forms of dementia like vascular dementia or Lewy body dementia were negative with this Alzheimer’s test, which added to the specificity of the test. Also, this test picks up Alzheimer’s about 10 years before symptom onset, so it is an early diagnostic test.

New Blood Test for Alzheimer’s Disease

Conclusion

One of the clinical tests for Alzheimer’s disease is to test for recent memory loss. But with the new phosphorylated tau (p-tau) blood test physicians can now objectively diagnose Alzheimer’s much earlier, even when the person has no symptoms yet. Researchers validated the test in 786 participants (504 females and 282 males). They were tested 3 times over 5.22 years. Researchers also did PET scans and spinal tabs for analysis of cerebrospinal fluid in the same participants to validate the blood test. There was a 96% accuracy for elevated levels of beta amyloid. It also accurately identified tau protein, another Alzheimer’s marker with 97%. There is now a reliable Alzheimer’s blood test, which helps the physician in the management of patients with Alzheimer’s disease.

Mar

2024

Living with the Aging Process

By Ray Schilling | Alzheimer’s disease, andropause, Arthritis, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, erectile dysfunction, exercise, heart attack, Hormones, lifestyle, Menopause, osteoarthritis, telomeres

The following article describes living with the aging process. Older adults undergo the process of aging between the ages of 50 and 80. This is a complex process affecting various systems parallel. There are hormone factors that are particularly prominent in women during menopause. Joints are affected by degenerative changes, which can lead to total knee and hip replacements. The aging process was described in an article by Monica Jimenez at Tufts University.

What is aging?

Aging is the loss of function over time. The body is much more complex than a car, so there are more possible points of failure. Christopher Wiley is a scientist on the Basic Biology of Aging Team who studies the role of nutrition and metabolism in aging at a cellular level at Tufts University. He said:” The fact that life works is amazing”. He went on to say: “The body tries to maintain itself and restore homeostasis(self-healing) even in the face of all this stress and all this damage. We have these really sophisticated programs for dealing with these points of failure.”

Aging goes on relentlessly

He explains the aging process this way: “It can start with something as simple as a broken molecule, one little thing that goes wrong in one cell, and then it’s like the butterfly effect,” Wiley said. “The tissue starts struggling, and then the organ, and then your entire body.”

Dr. Wiley warns about those who say physicians could make people “immortal”. “There’s definitely a misconception out there that we’re trying to make people immortal. But there is never going to be an immortality vaccine,” Wiley said. “There’s never going to be one thing that defeats all of aging. There’s always going to be another point of failure.”

Slowing down biological aging

The emphasis of research about aging is not to add chronological years. It is on biological aging and on how well our cells and tissues are functioning. Dr. Sarah Booth is the director of the Human Nutrition Research Center on Aging (HNRCA) at Tufts. She said: “Lengthening the time in which we can continue to move around, care for ourselves, and participate in social life and activities, is a worthier goal than extending years of suffering.” Many people become disabled in their last years of life, then they die. “Healthspan” is a new term for our years of freedom from disability, Booth noted.

Factors that prolong healthy aging

Telomere length: One of the factors of longevity is our telomere length. Telomeres are the protective caps at the end of each chromosome. When they wear down, it leads to mistakes in the DNA copies of genetic information. There are supplements and herbs that can elongate telomeres. Exercise and the fasting mimicking diet also make telomeres longer. Older adults in good shape have longer telomeres, which stabilizes the DNA in their cells.
Healthy diet: Researchers have determined that several diets are healthier than others. The Mediterranean diet is anti-inflammatory, so is the DASH diet, which was developed for people with high blood pressure. The HNRCA of Tufts is one of six organizations that got research grants recently to investigate life-prolonging diets. The amount was for $8.5 million.

Exercise and lifestyle factors

Regular exercise: Over the years a lot of research accumulated data that shows regular exercise makes people biologically younger. Heart vessels have less atheromatous deposits and the brain stays younger as well. One study reported that 30 minutes of exercise daily prevents dementia.
Other lifestyle factors: other factors are whether or not you are smoking (it goes without saying that you must quit). In addition, genetics (longevity gene), the environment (polluted or not), stress levels and socioeconomic class all play a factor in how fast we age. These latter points are difficult to tease apart, but they influence us globally. Target organs for aging are: the brain, heart, eyes, and bones, along with cancer, obesity, and more.

Hormone replacement

Bioidentical hormone replacement: One factor about delaying aging significantly was not mentioned in the review article by Monica Jimenez. But I am including it, because bioidentical hormone replacement is important for women who undergo menopause in their 50’s. I also mention it because men enter andropause in their 60’s. BiEst estrogen and progesterone cream make a big difference for the symptoms of menopausal women. Similarly, men experience a lot of relief with testosterone injections twice a week, when blood testosterone levels are low. If they have a lack of erections (erectile dysfunction) they may in addition need to take the “happy pill”. Sildenafil or tadalafil can treat erectile dysfunction by giving a good erection to a menopausal male. Hormone replacement can add as much as 10 healthy years to your life.

Discussion

Dr. Booth said: “We’re looking at the same question through different lenses with different tools, technologies, and perspectives. Progress in aging research is only going to be achieved by bringing together different disciplines addressing the same problem.”

Christopher Wiley added: “The biggest change I’ve seen in the past ten years is that we really are finding new, different ways of actually intervening somewhere that could potentially extend the healthy years of life, and prevent people from getting age-related diseases.” He mentioned that scientists are gradually reducing the suffering associated with aging: “What aging research is really trying to do is compress the morbidity and make it as small as possible – to alleviate suffering,” Wiley said. “I think that’s a much more humanitarian goal, and I think we’re having a lot of success with those efforts.”

Living with the Aging Process

Conclusion

Aging is a slow process that starts the moment we are born. But between the age of 50 and 80 we age faster. I mentioned 5 specific areas that can slow down the aging process. If somebody smokes, he/she must stop smoking. Cigarette and tobacco smoking the biggest aging factor. The protective caps at the end of each chromosome go by the name of telomeres. When they shorten prematurely, mistakes occur in the DNA copies of genetic information. This leads to premature aging.

What keeps you younger for longer

The good news is that exercise, the fasting mimicking diet and several supplements can elongate telomeres. A healthy diet like the Mediterranean diet and regular exercise keeps the arteries open preventing heart attacks and strokes. Bioidentical hormone replacement helps to rebalance your hormones, which is important for normal cell function. In anti-aging circles they talk about life prolongation of about 10 years for hormone replacement alone. It comes down to not simply extend your lifespan, but to extend your years of healthy living without disability.

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.

Significance of tau protein and beta amyloid for Alzheimer’s diagnosis

Conventional ways to diagnose Alzheimer’s disease

Home test

Research background of the home test

Discussion regarding the new blood test for Alzheimer’s disease

Difficult to interpret tests and test results in other forms of dementia

Conclusion

What is aging?

Aging goes on relentlessly

Slowing down biological aging

Factors that prolong healthy aging

Exercise and lifestyle factors

Hormone replacement

Discussion

Conclusion

What keeps you younger for longer

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

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