March 27, 2004 Caller: My son what had surgery for colon cancer, is on all bunch of supplements and his doctor also advised him to follow the South Beach diet, and could you please elaborate on this diet and where could he get more information?
DrH: I'm not sure why the South beach diet per se, because the South beach diet is a great diet for dealing with the problems of insulin resistance. And insulin resistance is certainly a factor in heart disease, and certainly a factor in diabetes, and it's a factor in some cancers. We know that insulin resistance may increase the risk of certain cancers, breast cancer in women, perhaps even colon cancer.
But I have problems with a diet that views apples and fruit as a taboo. If you look at the South Beach diet, apples are prohibited in the first phase of the South Beach diet. And I don't think that's necessarily beneficial for many types of cancer and, in particular, colon cancer, where there's evidence that phytonutrients from fruit are actually helpful for cancer prevention and for treatment.
So I wouldn't say that that diet necessarily encapsulates all the benefits for cancer -- you know, cancer is a diverse set of diseases. And different people with different problems have cancer. And I don't think there's a one-size-fits-all approach that's helpful for cancer. I think many different diets have that, can have that potential benefit. But you have to customize diets for different types of cancer.
Caller: I'm a healthy male. I'm 57 and I play a lot of racquetball and other sports and my knees are just hurting me. I saw a specialist and had an MRI done on one of my knees months ago and he said I was not a candidate for surgery and I'm reluctant to have that done anyway.
DrH. That's actually good. It's like not being a candidate for a whack in the head. That's good.
I came across an ad in a magazine that makes a claim. There's a clinic in Florida that makes the claim that by using cold lasers of some sort and injecting growth hormone or other chemicals, and in the process of two to six injections, I'm back renewed. And it sounds like a magic potion here and I'm very skeptical but I'm also very hopeful. And that's why I'm speaking to you here.
Well, I don't know about the clinic in question but I don't think that injecting growth hormones into the knee has been shown in a systematically reviewed scientific way to help knee problems. I think that that may be the future for knee problems, is that various custom-developed growth agents may help to regenerate cartilage in the knee and in other parts of the body. I just don't think we're there yet. I think that they're on the cutting edge and maybe a little bit over the edge in terms of their claims.
Cold laser is also a technique for dealing with pain. There's one particularly well done study looking at assembly line workers suffering from repetitive stress injury. They had carpal tunnel syndrome. And cold laser, which is used quite a lot in Europe, was helpful for alleviating pain. Cold laser won't burn you. You have no sensation from it but it enhances circulation just below the surface of the skin. It can bring about healing and it can bring about regeneration and pain relief.
But I just don't know. I'm skeptical of these claims. Presumably, you've tried all the nutrients, MSM, glucosamine, all those things are helpful but I don't think that growth hormone is the magic bullet for knee problems.
April 1, 2004
Filmmaker to challenge fast food perceptions
Richard Morrison, 202 331-2273
Effects of frequent ultrasound during pregnancy: A randomized controlled trial
(1993). The Lancet, 324(Oct.9), 887-891
Case-controlled study of prenatal ultrasound exposure in children with delayed speech
(1993) Canadian Medical Association Journal, 149(10), 1435-1440
Safety of ultrasound
http://www.bmus.org/safety_of_ultrasoundNF.htm
FDA warns prenatal portrait studios
Associated Press. March 31, 2004
Why the French are slim
Research from France's CNRS scientific research institute
April 3, 2004
Monologue-Aspirin vs. Tylenol
Acetaminophen use linked to asthma in women
American Journal of Respiratory and Critical Care Medicine, April 1, 2004
Aspirin improves blood flow to heart
Heart, April 2004
This week, score one for aspirin, but Tylenol took a hit in health studies. First, let's take a look at aspirin. Headline: Aspirin Improves Blood Flow to the Heart. You say, "I already heard about that, aspirin is good for the heart." But what we tend to believe about aspirin is that aspirin prevents blood clots and prevents big events like strokes and heart attacks. But short of preventing a calamitous problem, can aspirin actually help circulation? And the answer to that question came in a study in an American journal called, Heart. A regular-strength aspirin taken every day reduces the number of episodes of restricted blood flow to the heart experienced by people with cardiovascular disease; this, according to a Greek study.
These people had chronic stable angina. In other words, they had not rip-roaring symptoms but they had symptoms of chest pain on exertion, but it was stable. It wasn't getting worse -- a galloping rate. But when they were given 300 milligrams of aspirin -- that's a standard aspirin pill, not a baby aspirin, versus a placebo -- for three weeks, their episodes of pain fell from 339. That's for a group of people. Boy, it would be lousy to be one person and have 339 episodes of chest pain in three weeks. That would be too much. 339 episodes were recorded among the participants during placebo treatment and 251 got the pain during aspirin treatment. That's pretty good, a reduction from 339 to 251. And the duration of the episodes fell approximately 50 percent. So the suggestion is that aspirin keeps the blood flowing and doesn't just reduce horrendous blood clots that can cause heart attacks or strokes, but it also helps to reduce episodes of mild pain.
Now, so some people say, "I better start taking aspirin because it's good for the heart." No, no. That's not what the study shows. The study shows that if you have heart problems or angina specifically, then aspirin is a good thing to take. That's what I recommend to my patients. I don't recommend that every man and woman over the age of 40 start immediately taking aspirin the day after their 40th birthday as a way of preventing cardiovascular disease. I think that that's still a shaky proposition.
So now, let's take a look at Tylenol. Tylenol took a hit. American Journal of Respiratory and Critical Care Medicine this week -- use of acetaminophen has been linked to asthma in several studies. This is part of the nurse's health study -- over 120,000 women so it's a big authoritative study.
Among the women in the study with asthma, those who use Tylenol frequently -- what does frequently consist of? You always have to ask that question. In this case, the definition of taking it frequently was taking it more than 14 days per month. I'd say that's a lot of use. That's not taking an occasional Tylenol. That's people pretty much relying on it for pain relief. But if you took it more than 14 days per month, these women were 63 percent more likely to develop asthma. So if you've got asthma, don't gobble Tylenol like it was M&M's or Jujubes because you could make your asthma worse.
Mild iron deficiency may drain endurance:study
American Journal of Clinical Nutrition, March 2004
There's a study that looks at whether iron supplements could help women in terms of exercise performance. You know, many women are iron deficient because of menstruation, because of pregnancy or poor diets. It's probably the single biggest nutritional problem in the world. There are hundreds of millions of women worldwide who are iron deficient and tens of millions in the United States.
So they looked at whether giving iron supplements to exercising women improved exercise performance and what they found was yes and no. Only in the women who had iron deficiency did iron supplementation improve exercise performance on a stationary bike, five days a week. In the women who had adequate iron, it made no difference at all. So it's important to check with your doctor, especially if you're feeling run down, if you don't feel up to snuff in terms of exercise performance. Particularly if you're a woman find out if your iron is depleted and begin taking iron supplements in your diet.
Good food sources of iron include red meat, lentils and other legumes, and spinach. Iron fortified cereals and grains, all those are not as good a source as animal protein.
On the other hand, iron can be bad for you. Too much iron, in a recent study, was found to be a risk factor for cardiovascular disease. And there are a lot of folks out there who are iron overloaded, more men than women, but check with your doctor. Get a blood test called ferritin to find out about your iron status.
CT scans can find cancer but they could give you the disease, too
Health(magazine) By Eric Steinmehl. April, 2004. p. 35
Is it reasonable to use superaccurate diagnostic tests like the spiral CT scan to get in there early and diagnose lung cancer? Well, we get some clues to the answer from an article in this month's edition of Health magazine, April 2004.
The article is entitled, Caution, This Test May Be Harmful. CT scans can find cancer but they can give you the disease too. Eric Steinmel, in this article, records a statistic that CT scans zap you with up to 250 times the amount of radiation that's present in a simple x-ray. And a lot of doctors aren't even aware of that. They order the test pell-mell, left and right often in response to patient concerns.
But I guess there's a medical/legal thing going on because God forbid you miss a patient with a cancer. You would rather do the test even if there˘s hardly a scintilla of evidence that the patient is at risk.
Well, the U.S. food and drug administration says the chance of developing a fatal cancer from one CT Scan is 1 in 2,000. That's not much but hey, if that were the risk associated with getting in a plane and flying from one part of the country to the other, I'd take a Greyhound. And get this, the risk of simply getting a cancer, not necessarily a fatal cancer, but a cancer from a CT Scan may be closer to 1 in 100. That's not a very good aviation safety record. That would shut down commercial aviation in this country if that were the case.
And if a patient undergoes a handful of CT˘s -- and a lot of people who get CT Scans, they get repeat CT Scans -- the estimate is that a person who gets three CT Scans sequentially may absorb the same amount of radiation seen in some atomic bomb survivors who got cancer. So the tests should be done appropriately.
But there is a risk that may outweigh the benefits. This is especially applicable to those worried-well types who take whole body scans, which do expose you to a fair amount of radiation, in attempt to find something if you're well. While the radiation threat of a single whole body screen is small, patients need to be fully aware of the risks. And I do advocate the ultra fast CT Scan of the coronary arteries because it is just that. It's an ultra fast CT Scan involving lower levels of radiation, especially when you use something called an EBT scan. That's a lower radiation scan, and it gives us valuable information about your heart.
And so I do order that just prohibitively. I don't have big problems with that. Some other types of CT Scans, body scans -- also when kids get them, you bop your head in the playground. Hey, I was a baby boomer fell off the jungle gym, bopped my head. And they took me to the school nurse and if I could see straight, things were okay. But these days, with all the risk of liability, the kid goes in an ambulance to the hospital, gets a CT Scan of the head, exposing the developing tender cells of the brain to high doses of radiation several times during the child's development.
You know if the kid is an adventuresome tree climber or a jungle gym acrobat, and maybe that's not good. Some studies have shown changes in mental development, cognitive ability in kids who have had multiple CT Scans, that is a concern.
Effort pays off when diabetics try to lose weight
Diabetes Care, March 2004
Diabetics are always encouraged to lose weight. One of the ways to reduce dependency on medication and get completely off it is to lose weight. So there's a big push for diabetics to optimize their weight.
So what if you tried a diet and you just can't seem to lose the weight? Well, that's also the case with diabetics. They're very resistant to weight loss. They have a condition called insulin resistance. Insulin resistance promotes weight retention and for some of my diabetic patients, it's a big struggle. They follow the diet, they try to exercise and the scale doesn't budge or changes just a couple of pounds. Is all their striving for naught? That question is answered in an article in last month's edition of Diabetes Care. What they say here is interesting. It is that even if you don't lose weight, if you try, you will dramatically reduce your risk of death.
Most diabetics in this study who said that they merely tried to lose weight during the past year were 23 percent less likely to die over the next nine years than those who reported no weight loss effort. So even if the pounds don't melt off dramatically, using healthy lifestyle changes including exercise, cutting calories and accessing healthier foods -- lower glycemic index foods -- some degree of carbohydrate restriction, and improved diet, can make a difference in your long term health and your longevity if you're diabetic.
Despite warning, CDC won't urge mercury-free shot
By Myron Levin. The Los Angeles Times. April 2, 2004
Here comes the medical outrage of the week and it is outrageous. The headline from the Los Angeles Times: Despite Warning CDC Won't Urge Mercury-free Shot. The problem with most flu shots is that they're laced with a preservative called Thimerosal, which is mercury. And it's been eliminated from virtually all other pediatric vaccines due to health concerns. But the Centers for Disease Control recently has confirmed that they won't advise parents and doctors to choose a mercury-free version of the flu vaccine. That's kind of a double standard. They say that mercury is bad for you. They've taken it out of other vaccines but they leave it in the flu vaccine and they say it's okay for you.
I actually had a patient who wanted to get a flu shot, asked for the mercury-free vaccine, was told that the vaccine contained mercury, but don't worry because it's the same mercury you find in fish.
China's cosmetic surgery craze
By Jonathan Watts. The Lancet. Vol 363. March 20, 2004. p.958
The Height Gap
By Burkhard Bilger. The New Yorker. April 5, 2004.p. 38
A story that was in the New Yorker this week, I found it very interesting, it's called, The Height Gap: Why Europeans Are Getting Taller and Taller, and Americans Aren't. A guy by the name of Burkard Bilger said he was just in Holland and he said as he walked down the streets of Amsterdam, he had an odd sensation of drowning because he couldn't lift his head above the crowds.
He's normal size for an American. He's 5'10 1/2" -- that's exactly my height. He is an inch taller than the average in the United States but over there in Holland, he was a shrimp. In a century's time, the Dutch have gone from being the smallest people in Europe to the largest in the world. The men now average 6'1", 7 inches taller than in Van Gogh's day, and the women, 5'8".
And I guess one index of that phenomenon is that we're starting to see NBA basketball players from Germany, from Yugoslavia, Serbia and now Yao Ming from China -- a country that were formerly thought of altitudinally challenged people.
So what's going on with this? Well, there's a large speculation in this article but, bottom line, the author of this article says that height is the kind of biological shorthand for a society's well-being. He's saying that there are problems in America with nutrition, that initially better nutrition allowed Americans to grow from a Civil War height of about 5'7" on the average to America's present height. But the Europeans have gotten better and better in their nutrition. And societal well-being in many European countries is superior to that overall in the United States.
One thing that some people might point out is they might say that we have a lot of immigrants in the United States. We're seeing an influx of Asians, and Latin Americans and they're bringing the height down because they tend to be shorter. But these statistics include only native born Americans and have been carefully culled to screen out people of Asian and Hispanic descent. So it's not about immigrants in the population.
The Dutch, for example, have the world's best prenatal and postpartum clinics, free for every citizen. And an interesting fact is that among the tallest Americans in history were the men of the northern Cheyenne, Native Americans. They were the tallest people in the world in the late 19th century. They were well nourished on a diet of plentiful bison and berries. They were hunter gatherers and they were free of disease on the high plains. They averaged nearly 5'10". They were the giants of their day and of course, the American Indians were decimated by disease and starvation and their health has suffered. Those Native Americans surviving into the current era beset with degenerative diseases because of thrifty genes and poor diet.
But Americans are no longer the tallest in the world and Asians are rapidly catching up because of prosperity in China. What are they doing in China?
Interesting article in the Lancet Medical Journal, China is becoming a prosperous country. One of the reasons why our gas prices are high is because the Chinese and the Indians are consuming more and more gas. Chinese and Indian people are starting to own cars and drive and as a result, China is becoming a prosperous country. And prosperous countries can afford to indulge in plastic surgery.
So this article talks about the kind of plastic surgery that's popular in newly prosperous China. Of course, there's a 25 percent increase in women seeking nips and tucks. The most popular operation puts an extra fold in the eyelids, permitting a more western appearance.
But there's a new cosmetic surgery craze in China and that is a height enhancement operation. Usually reserved for only people who have dwarfism, really impaired in height, that surgery can help you a bit, but just for cosmetic purposes. The Chinese are undergoing a $4,000 operation. Doctors are offering to make people up to ten centimeters taller -- that's about 3-inches plus. It's a leg lengthening procedure. First the legs are broken and steel pins are pushed through the bones. They're fixed to an external frame by eight or so screws. Then comes stretching. Sounds like the rack, it's primitive. It's a little like, they did foot binding in China about 150 years ago.
So now they're going on the rack to conform to western ideas of beauty. The stretching is done over several months depending on how much the customer wants to grow. This is done by turning the screws each day and lengthening the bone at the point it was broken. When the stretching is complete, the external frame is removed, steel pins are left in place for about a year as a support for the newly regenerated bone. Once the bone is hardened, the pins are removed.
So this is a nasty procedure but they're starting to do more and more of these in China. And it doesn't always work. Some patients who undergo this procedure are left crippled, with pain in the legs, akimbo, difficulty walking and squatting, but they're doing it. They're doing it in droves because it's fashionable because they want to keep up with the west.
Caller: I've had atrial fibrillation. I was in the hospital for almost four days and I was put on Coumadin, 5 milligrams, and I've had six nosebleeds since then and it seems to have stopped now and I'm having it monitored. Will I have to be on this forever because you know, I have to stop taking the green vegetables which are necessary for, I have macular degeneration --
DrH: You're on the wrong track here. I think one of the most common misconceptions in the field of medicine and nutrition is when you start taking Coumadin you have to stop eating green vegetables. That would mean that the Coumadin is going to work fine and protect you from a stroke but ultimately, you're going to be deprived of the benefits of green leafy vegetables which could protect you from diseases like cancer and other degenerative problems.
So the suggestion is that you work with your nutritionist, hopefully a knowledgeable nutritionist. But the new thinking on green leafy vegetables and cabbage family vegetables is that you can use some but get your Protime monitored. It's a test now that can be done through home monitoring.
The good news too is, you say, "Will I be taking Coumadin forever?" Invariably, no. Because within, I would say, probably two to five years, Coumadin is gradually going to be replaced by a newer medication which does not require extensive monitoring and which will not require that you alter your diet significantly to avoid foods like green-leafy vegetables that contain vitamin K, which could neutralize the effect of Coumadin.
The nosebleeds, well, you go to an ENT and make sure you don't have an area of chronic inflammation in your nasal passages. The nosebleeds may be a sign that you have a tiny crack or cut in your nose. It might also be a sign that you're overdosing on the Coumadin. So they're going to need to get some monitoring from your doctor. I often find that nosebleeds occur in people who take excessive amounts of fish oil or vitamin E, so be careful that you don't take too much of those because they may thin your blood excessively too.
Caller: Quick question, I'm 52 years old and yesterday I had a blood test result that said I had an elevated C-Reactive protein, it was 3.6 --
Dr Hoffman: Right, that is elevated.
Caller And I'm wondering what causes that and what nutritionally could I do about it?
Dr Hoffman: C-Reactive protein is a marker for inflammation and right now there's a big controversy about whether C-Reactive protein is significant in predicting cardiovascular disease. Some studies say it is significant. Some studies suggest it is the most significant thing, more important than cholesterol and HDL and homocysteine and all the other things we mention on this program.
But this is an opportune time to mention that just this week -- you know this so often happens, scientific controversy, we come up with a new idea and another study appears that questions the validity of the whole concept. That happened just this week when a large European study raised the whole question of whether C-Reactive protein is important in determining the likelihood of coronary heart disease.
This is in the April 1st issue of the New England Journal of Medicine. This issue showed that a high C-Reactive protein was associated with a slightly higher risk. Yeah, the risk was higher, one and a half times higher of cardiovascular risk but there was not a doubling or tripling of risk as reported in other studies. So they're saying C-Reactive protein is a moderate risk factor for heart disease.
But you ask, how can you get it down. Let's assume it's a problem, and I think it is. Couple ways. One is if you consume -- this very important, just came out in the American Journal of Clinical Nutrition this month -- if you consume -- and I have to ask you if this is the case -- do you consume a lot of hydrogenated fat? Do you consume baked goods and do you use margarine and shortening and things like that?
Well, I don't use margarine and shortening but I certainly have a sweet tooth for cookies.
Okay the cookies, you have to read the labels. They are often made with a lot of hydrogenated fat. Potato chips and corn chips are often made with this and these days people, I think, are getting away from trans-saturated margarines. And there's actually an initiative in the fast food business to reduce the amount of hydrogenated fat in things like chips. And I go to the market and I'm surprised even Lay's potato chips has a no trans-fat alternative that -- it used to be only the gourmet health food chips offered.
So there's a trend to get away from these things. But this definitely raises C-Reactive protein in women according to a big study in American Journal of Clinical Nutrition this month. That's number one.
Number two: If you are on a high-glycemic index diet. What are we talking about there? We're talking about every diet book from Atkins to Barry Sears to the Eades Protein Power. They're all talking about the glycemic index, the potential for foods to send your blood sugar through the roof and then cascading downward toward hypoglycemia. Foods that pack a wallop in terms of carbohydrates can worsen C-Reactive protein, that's actually been shown.
So bad fats excessive, refined -- not necessarily beans and whole grains, they will actually offer you a gentle carbohydrate nudge as opposed to a major carbohydrate wallop that you might get from guzzling fruit juice or eating candy or soft drinks and the like. So that's another strategy.
Another thing is a study has shown that merely taking a broad spectrum multivitamin will lower your C-Reactive protein. We don't know which component of that multivitamin is most important, but I believe it is the antioxidants. I think that things like CE, zinc, selenium have an anti-inflammatory effect. Fish oil has an anti-inflammatory effect so, you have to make sure you have adequate omega-3s in your diet or take a supplement.
Another thing that is helpful is if you have a high C-Reactive protein, you might be a candidate for taking an aspirin. Statin drugs lower C-Reactive protein, that may be why they work. That may be as important or more important than their effect in lowering cholesterol. That may be why some people that have good cholesterol get additional benefit in terms of reducing cardiovascular risk by taking a statin. It's not so much working like a cholesterol lowerer but it's working like a superaspirin to reduce inflammation.
But the other thing about C-Reactive protein, you have a problem in your body, anywhere in your body -- if you have an inflammation, say you have a bad tooth. You don't know about it or if you have a chronic sinusitis or if you have a chronic infectious problem anywhere in your body, perhaps in your gut, maybe you have chronic diverticulitis. That problem will raise your C-Reactive protein.
Also gingivitis, periodontal disease. This will raise your C-Reactive protein and there's an association with higher risk of cardiovascular disease. So find the focus of infection or inflammation, take antioxidants, improve your diet, exercise will help too and you'll get that C-Reactive protein down. I see it again and again in my patients where patients have high C-Reactive proteins and we correct them.
Caller: I have angina and a lot of other things, osteoporosis, and I don't like medication. I take vitamins, the whole spectrum. I couldn't get my cholesterol down, so I've finally been taking, for the last month, Zocor 20. And I wanted --
Dr Hoffman This is not a sign of a character flaw or cowardice on your part. It's actually prudent that if you have angina and high cholesterol, you've got to bite the bullet; you've got to take a statin drug. Actually, the statin drugs are proven to be helpful in reducing your risks.
Caller: I gave in. For a year I was taking Twinlab success at your suggestion and policosanol and that got me down about ten points. Could I take both now?
DrH: Actually, you can take these in conjunction with your Zocor. There's no evidence that they harmfully interact with Zocor and in fact, I have some patients on that very combination. The Twinlab Success Cholesterol Success is the name of the product, contains what are called phytosterols, which are plant cholesterols actually. But they block cholesterol. They tend to displace its absorption from the gastrointestinal tract. And that will lower your cholesterol somewhat. It may not be enough and it may not have Zocor's anti-inflammatory effect blood vessels. It's known to do that.
In addition, policosanol is often all it takes to get cholesterol down. You may want to ask your doctor if in conjunction with Zocor you could take a little bit of niacin. Niacin in conjunction with statin drugs has been shown to be more effective than either taken separately. They seem to have a synergistic effect, reducing cardiovascular disease risk, risk of heart attack or stroke by approximately 70 percent, whereas the statin alone may reduce it only 40 or 50 percent.
So it's appropriate to take combinations. But doctors who administer these combos have to be familiar with how these things interact. And if you take too much Zocor and niacin, for example, together, you can run into liver problems. So you need to get your liver checked. I think you're on the right track and I think you'll do well.
Caller: My question is about my blood pressure. I was recently diagnosed with hypertension and I was in the hospital. I was in the hospital for a short while with arrhythmia and I think I acquired or got the high blood pressure and arrhythmia from a back injury and all the medication I was on.
DrH: Tell me what kind of medication you're on?
Caller: Metropac, all kinds of pain killers and things like that. This happened back in November. I was a runner for 30 years --
DrH: A couple of things, what you say is actually plausible because number one, you're a big runner and exerciser and then you injured your back. So you probably reduced your physical activity or curtailed it altogether. So if you don't drastically modify your diet, you're going to possibly gain some weight, get a little out of condition, your blood pressure will go up.
You know your exercising may be a hedge against the development of high blood pressure. That's number one.
Number two, you make Medrol. Medrol is a steroid and steroids tend to make you gain weight. They can actually make you diabetic. So yeah, that's possible.
The other thing is nonsteroidal anti-inflammatory drugs. That's everything from Motrin to some of the prescription drugs like Naproxen. These drugs have been associated with kidney problems, retention of fluid in the body and in some cases -- you use a lot of these things -- your blood pressure can go up. You may be on the right track with this.
Caller: I started back in my exercising. I can't run anymore so I started cycling again and swimming, and I feel better. I dropped a few pounds. But I try to tell my doctor this and they kind of pooh pooh the whole idea that it's not possible that this all came from -- I said to him, for 30 years I have been running, cycling, doing all sorts of physical fitness, triathlons and I've been really good. And all of a sudden, for two or three months I'm laid up and everything goes haywire.
DrH I have one question for you. You're a big exerciser and, are you a training table regimen, you know, maybe do a little carboloading?
Caller No I actually eat pretty good. I have a shake in the morning. It consists of berries, bananas, yogurt peanut butter, skim milk, I might have a couple of eggs. And lunch is generally tuna, or turkey and peanut butter and jelly sandwich. And in the evening, it's pasta, fish, vegetables and that sort of thing.
DrH I think you're on a good diet in the sense that you're not eating unadulterated junk. But you are on a pretty massive calorie diet between the peanut butter, which is generally healthy, and the pasta. I worry a little bit about that.
You may have to, now that you're entering a new era full-tilt with triathlons and running. I mean I see this in people that are big exercisers and it's tough to do. You have to adjust your food intake downward to compensate for your reduction in exercise otherwise things like high blood pressure, higher cholesterol and weight gain are going to start to catch up with you.
I know you use exercise as a way to mitigate this but the high-end exercise that you did, you no longer can do. Even though you're doing other stuff, you swim, cycle, adapt to an injury, work around it.
Caller: You mentioned earlier about the flu vaccine. I started looking at my oldest two children, they got the full complement of vaccines. And I started just kind of by chance getting into the whole vaccine issue and I saw that there was a lot of literature about adverse reactions. And without getting into a whole controversy, what I'm looking at, is there a way by any types of supplements or something I can do to protect my children prior and after they get the vaccines to kind of maybe diminish any possible side effects that they may get from them?
DrH: I think that the question is legit but the answer is, we don't know. We do know that in adults, vaccines don't take sometimes. They don't work properly when there's inadequate nutrition. There's a big problem in our older population because how many times have you heard, especially from an older individual, you know I got the flu shot but then I got the flu. So what does that mean? Maybe the vaccine was wrong for that year's type of flu or maybe the vaccine just didn't take. And folks who have poor nutritional intake for flu vaccine and other vaccines just don't work. And studies have shown that vitamin E, C selenium, zinc, various vitamins have been tried but those were the main ones. They seem to help support immune function.
I like to use a product called Transfer Factor. I think Transfer Factor is helpful in reestablishing normal immunity both in adults and kids. But I wouldn't go so far as to say just use Transfer Factor and you can avert any possible vaccine reaction. All I ask is that the government and Centers for Disease Control, FDA, whichever of these agencies are going to be responsible for vaccine safety, that they undertake a thorough and impartial evaluation of whether your current system of vaccination is safe and correct.
Right now, everything is lost in this fervor between the vaccine advocates and the vaccine Luddites. Luddites were people in the 19th century who smashed all the machinery during the Industrial Revolution because they didn't believe in the new, modern advancements. I think that we need a vaccination program in this country. We should also study, are there certain kids who shouldn't get vaccines early on? Should we be doing multiple vaccines? Certainly we should be taking the mercury out of the vaccines because we know that's a problem. But we need less of a headlong pell-mell emotional approach to the vaccine issue.
Caller: I suffer from, I've been diagnosed with Behcet's disease, which is a rare auto-immune disorder that attacks my blood vessels in my body.
DrH It's like a vasculitis and inflammatory condition. Caller: Yes and it has affected my retina, the right eye, the retina has been damaged so I'm permanently or legally blind in my right eye --
DrH: I want to give you as much information as we can. Behcet's, not a very common condition but the principles that apply to treatment of conditions like Lupus and rheumatoid arthritis apply here. You need to look at food sensitivities. You need to be tested for the presence of gluten sensitivity, that's a big factor, potentially, here. You need to be checked for vitamin D levels because very low levels of vitamin D are permissive of auto-immune problems like multiple sclerosis and rheumatoid arthritis. You need to take lots of fish oil and antioxidants, in particular vitamin E. And check your levels of DHEA, it's an adrenal steroid which is often very low in patients with auto-immune disease. Your condition could be helped with nutritional support.
April 7, 2004
Study: Wheat-free foods may contain wheat
Annual Meeting of the American Academy of Allergy, Asthma & Immunology
Most low-carb dieters eat too many carbs-study
Market research from NPD Group
Herbal preparation reduces colds in children
Arch Pediatr Adolesc Med 2004 Mar; 158:217-21
Aged garlic extract may help manage diabetes
Wakunaga of America Co., Inc. www.kyolic.com
April 10, 2004
Monologue: Chocolate During Pregnancy
Here is some news that I think will be greeted with great pleasure by a lot of women that are pregnant. The news is that chocolate during pregnancy has a good impact on the baby. A lot of concerns about -- you tell them not to drink, not to eat, not to have coffee and this is a story, it's an actual study done in the New Scientist, a prestigious scientific journal. The headline is from Reuters, London, England. Pregnant Women Rejoice, Eating Chocolate is Good for the Baby, this according to Finnish researchers.
Scientists at the University of Helsinki who asked 300 pregnant women to record their chocolate consumption and stress levels found that daily treats had a positive impact not so much on mom, but on the baby's behavior, measured six months after the infants were born. Mothers who had eaten chocolate reported more reactions such as smiling and laughter in their offspring and the babies of stressed women who had regularly consumed chocolate showed less fear of new situations than babies of stressed women who had abstained, this according to the New Scientist magazine.
Researchers admitted they can't be certain that chocolate consumption and baby's behavior are not linked with other factors. Maybe mothers who eat chocolate are happier mothers to begin with and maybe they give rise to happier babies for genetic reasons. But they speculate that the effects they observed could result from happy chemicals in chocolate associated with a positive mood being passed on to the baby from the womb. This is from the latest edition of New Scientist magazine and I think that that is good news.
Also, while we're talking about candy and condiments and I guess a favorite for a lot of people, Oreo cookies. And here's good news for consumers of Oreo cookies -- look, I don't encourage people to consume Oreo cookies, they're the absolute antithesis to what people need if they're following a low-carb diet. But you know all that hoopla of lawsuits directed at food manufacturers, a lot of people are saying is what we need less of in this country is aggressive lawyers and lawsuits because you can get sued for practically anything in this country.
A recent lawsuit against the manufacturers of Oreo cookies, Kraft International food conglomerate has produced a desirable result. Oreo cookies have been reformulated; they now contain no transaturated fat, none of that artificial hydrogenated fat and 30 percent less fat than regular Oreos. Also, an added bonus is reduced calories.
The change was triggered by a lawsuit brought against Kraft under the leadership of Professor John Banzhaf III; he was actually one of the guys who led the charge against the tobacco industry. And he's saying some of the tactics that were used against the tobacco industry can be used against food manufacturers who behave irresponsibly and manufacturer unhealthy junk. The lawsuit alleged that in violation of California law there is no disclosure that Oreo cookies contain dangerous transfatty acids nor was there any discussion of the risk they created. So rather than fighting the lawsuit -- because how can you fight a lawsuit like this, it's indefensible to put potentially harmful junk in cookies so it would be a publicity nightmare -- Kraft took the high road.
Instead, they agreed to remove transfats entirely from its famous Oreo cookies and in return, the lawsuit, which actually never sought monetary damages -- you may say, "Well these lawyers are all about money, they want to make money and the public rarely benefits." Well, in this case, this was really a public interest effort. It was just a lawsuit that was undertaken for the principle of it, but the lawsuit was dropped because Oreo manufacturers, Kraft, complied.
Kraft has now come through. They just announced an aggressive plan in place to reduce or eliminate transfat levels in their cookie and cracker products by 2004, 2005. And haven't we been talking about this for over a couple of decades on Health Talk -- the problems associated with hidden hydrogenated fats, transfats in our food supply. It's a big problem and a lot of manufacturers are responding positively.
I went to get Lay's potato chips, and certain Lay's potato chips no longer contain hydrogenated fats. It's expeller pressed canola oil. And that's the trend now -- Fritos as well -- getting rid of those bad hydrogenated fats.
Fat law suit successful-Oreo cookies reformulated
http://banzhaf.net/obesitylinks
Chocolate during pregnancy has good impact on baby
Pfizer makes $800 million bid to reshape heart-care market
By Scott Hensley and Ron Winslow. The Wall Street Journal. April 8, 2004
Big study this week in the New England Journal of Medicine -- Statin Drugs Work. Not only do they work, but higher doses of statin drugs, specifically the drug Lipitor, produce even more dramatic results than a little dab'll do you. Now that kind of goes against what I generally believe, which is that if you have a choice between using a lot of a drug and a little bit of a drug, use the least possible to achieve your effect.
So if you can lower cholesterol moderately with 10 milligrams of Lipitor, why take 80 mg and run the risk, a bigger risk, of side effects. But in the studies, there were striking improvements. Not just in the cholesterol levels but in the risk of subsequent heart attacks and death in people using higher doses of Lipitor, as high as 80 milligrams and the goal was to get LDL, that's the bad cholesterol, not just to 100, that's an ambitious goal for a lot of people but they were getting these people's LDL below 80 and down into the 60s. And the ones who got their LDL lower -- this is like LDL limbo, how low can you go -- the lower it went, the better.
Well an article in the Wall Street Journal this week comments that Pfizer, who makes Lipitor, is embarking on an ambitious strategy to corner the market on preventive drugs for cardiovascular disease. They got some new drugs, and one of these is an interesting drug that raises HDL. So far, not much will raise HDL. We get a lot of questions, "What's going to raise HDL?" Well, a good diet and exercise raises HDL. If you got the right genes, you've got a high HDL, pick the right parents -- that's important. Niacin will raise your HDL but some people can't tolerate it, it causes flushing, it can cause liver problems.
So now they got a drug that they're betting big time on. 800 million dollars will be invested on R&D on a new drug that is almost impossible to pronounce -- it's called Torcetrapid. You can be sure that they're going to come up with some really cool name for it before it's released in a few years as a medication. But 800 million dollars of tests later, we may have a medication that can increase HDL by 50, 60, 70, 80 percent and that's coming down the pike as well.
Here's a study in a little village in Italy where everybody seems to be free of cardiovascular disease in spite of the fact they smoke and eat a lot of fat. Based on studies of populations that have high levels of protective HDL, they're going to develop HDL infusions. They'll give you a series of six or eight IVs. They'll probably cost a fortune, but these IVs have already been shown not just to prevent cardiovascular disease, but make some of the plaque melt away from the arteries. Pfizer, again, is trying to corner the market on that particular form of therapy. They acquired a little company called Esperion Therapeutics just recently for 1.3 billion dollars.
Esperion makes an intravenous drug that can be used to melt plaque in patients having heart attacks. So with this combination of strategies, pushing statins, pushing new drugs like Torcetrapid and intravenous infusions of cocktails that contain beneficial fragments of HDL to melt plaque, you're going to see a real wave of medical treatments to prevent people from having to undergo bypasses and stents. And it's kind of a war between the cardiologists and the heart surgeons -- and advantage to the cardiologists because they're going to have more and more tools to prevent people from ending up on the operating table.
So it's going to be very interesting in the next few years. And they'll also want to see how natural therapies interact with some of these conventional therapies. And we're also going to see if we can afford these therapies because some of them are going to cost a lot of bucks -- putting tens of millions of Americans on statin drugs. That may be one of the reasons why Medicare and Social Security will go belly-up in the next decade or two. We simply run up against the wall in terms of outrageous expense in using all these aggressive therapies to treat cardiovascular disease. Lifestyle and diet and inexpensive supplements, exercise, natural measures may ultimately save the day and our economy.
The big story this week, medical story, an article in the New England Journal as well as articles in such newspapers as the Wall Street Journal, has to do with a new thrust in high-tech treatments for cardiovascular disease.
Now, we're not talking about natural therapies. And I think that's, to some extent, a pity because natural therapies are ignored. For years, the potential benefits of a low-carb diet as espoused by Dr. Atkins were ridiculed by the scientific establishment. The results of such measures -- nutritional supplements, chelation therapy, is controversial but is actually under study right now by the national institutes of health. A 30-million-dollar study will reveal by the end of this decade whether chelation is beneficial. I think it is for cardiovascular disease. It's an inexpensive treatment that can be used to reduce plaque in blood vessels -- blood vessels in the heart, blood vessels leading to the brain and the leg but the high-tech hunt for preventive treatments for cardiovascular disease is underway. And there really is something to this. And I think perhaps in 5, 10, 15 years, we'll see a combination of strategies being employed to deal with heart disease.
First, let's talk about new studies on statin drugs. Now, a lot of people take the position that statins are part of the armamentarium of the pharmaceutical industry, hence, they are bad -- drugs are bad, they're synthetic, they're chemicals, we don't want to put chemicals in our body and hence, let's avoid statins.
I take the position -- I call it Intelligent Medicine -- that if these things are proven to work, that they can be part of a program to prevent or, more importantly, to reverse cardiovascular disease in people we've identified as being high risk. Diabetics, people who've had angina, people who've had heart surgery, who've had stents; these are people who might be real candidates for the use of statin drugs.
I think that the debate between conventional medicine and alternative medicine is a little bit like the political debate this year. There are some people that look at Kerry on TV, and they go, "I can't stand that guy." And then people look at Bush and they say, "That guy's a clown, we have to get rid of that guy." So there's no intelligent debate going on, it's all emotional. In the world of medicine, you have to make intelligent, strategic choices.
Japanese people warned to curb unhealthy lifestyles
The Lancet. Vol 363. April 3, 2004. p. 1126
A lot of you saw the movie, Lost in Translation. Well, according to this article, the translation of western lifestyle to Japan may be all too good. This is from the Lancet, the world's leading medical journal, Japanese People Warned to Curb Unhealthy Lifestyles.
The article states that Japanese have enjoyed the longest life expectancy in the world for three decades now. Japanese men can expect to live, on the average, until they're 78; women, until they're 85. But there's a new and growing problem in Japan and for the first time, obesity is regarded as a disease of childhood as well as adulthood.
What's happening is that traditional fare has been replaced with western foods. So the Japanese have a diet that's pretty high in salt, but it's low in fat. And the older generation still swears by the life-giving quality of a simple meal of grilled omega-3 rich fish, plain boiled rice, pickles, miso soup and something called "natto", which is a pungent fermented soybean extract that may actually have blood thinning and cancer preventive effects.
But younger families are as likely to begin their day with toast and coffee and end it with a steak, which costs God knows how much in Japan, it's very expensive -- beef costs a fortune over there -- or deep-fried pork cutlet.
What they're finding is that now one in six adults, that's more than 16 million Japanese, now either have diabetes or at a high risk of developing the disease. And that's a new trend in this country. Childhood obesity is a sign that diet is beginning to rend the fabric of Japanese society as much as it has here in the United States. It's a pervasive problem, now world-wide.
Men, having friends is good for the heart
European Heart Journal. January 2004
We just talked about the prospect for drugs to reduce cardiovascular disease. The problem with drugs is they're going to cost thousands of dollars per capita just to prevent cardiovascular disease. And for some people, they might completely reduce the impetus to do healthy things. People say, "I'm taking medication for my cholesterol, I don't need to exercise. Bring on the spaghetti and meatballs -- I'll have three portions tonight."
Here's a solution that's as simple as arranging a weekly poker night for men: That Wednesday night poker game might be healthy for your heart, just skip the stogies and the fattening snacks; this according to the European Heart Journal. Having friends is good for the heart.
A group of Swedish investigators found that men with the most social support were about half as likely to develop heart disease as men who had the least social support. The researchers say these results likely apply to women but the study was done in men. Men tend to be a more easy population to discover heart disease in, not that women don't get heart disease, but men get heart disease earlier and it's more clearly identified.
The researchers found that men with the highest level of social integration -- that was defined as having many quality friends whom they saw on a regular basis -- were only 45 percent as likely as men with the least social integration to have heart disease. Men who had the most friends to lean on when needed, a factor known as emotional attachment, the odds of developing heart disease were only 58 percent as high as for men with the least amount of emotional attachment. This, of course, is very problematic for men; men sometimes lonely, stoical, isolated, not likely to ask for help or assistance or support.
But those men who can call upon a social support system can do a whole lot of good for their hearts. Conversely, men who are angry, hostile, impatient, or isolated, they're at a higher risk for cardiovascular disease. The interesting thing about this study, you got a benefit from social support regardless of your smoking, exercise habits body weight, blood pressure; these things made a difference. But there was still a benefit of social support throughout all types of men.
Nominal Benefits Seen Drugs for Alzheimer's Disease
By Denise Grady. The New York Times. April 7, 2004
Is Alzheimer's Field Blocking Research Into Other Causes?
By Sharon Begley. The Wall Street Journal. April 9, 2004
A couple of articles this week take a look at progress or the lack thereof on the Alzheimer's front. There's been a tremendous amount of research lately trying to seek a cure to Alzheimer's disease. They're rushing to keep up with the aging population. As baby boomers age, we're going to see an explosion of this disease, which is a devastating disease, but also a tremendous drain on resources because if any caregiver for an Alzheimer's patient can tell you, it's extremely difficult, challenging and stressful and the disease can last for years -- witness former president Reagan.
A couple of articles, one in The Times, suggests that the progress that is claimed in this field may be exaggerated. Some researchers say, according to the article by Denise Grady in The Times last week: It may be decades before real progress is made in reducing the toll of the disease.
One expert said that there is just one chance in ten that the drugs currently used will have an effect; that patients can try them for six to eight weeks but should quit if there's no improvement. Another expert gave the drugs somewhat better odds of helping but most of the medications that are out there don't seem to do that much good. And they're expensive. They each cost about $120 a month. A million Americans take them. This costs our insurance system, and Medicare 1.2 billion dollars a year.
A doctor interviewed for this article says we don't want to raise expectations to the effects of these drugs at large. The drugs are Aricept, Exelon, Reminyl, by the way which is derived from the daisy plant and Tacrine. One critic of these drugs writes: In my opinion, in ten years we'll be embarrassed by how much of this stuff we once prescribed.
He adds that hundreds of millions of dollars have been wasted on the drugs, but it's understandable that the families and patients want them fast tracked -- it's just that they don't seem to work that well.
Other people are critical of a study published last July in the Journal of American Geriatric Society claiming that one drug, Aricept, could delay a patient's need for nursing home care by nearly two years and that would clearly matter to patients and families. But Pfizer, which makes Aricept, paid for the study and it's cited as one of the article's authors, critics are crying conflict of interest. They're saying the study was flawed and this data does not support this rather ambitious claim.
Another article in the Wall Street Journal points out that researchers in the Alzheimer's field have blinders on when it comes to looking for a solution. There's currently something called amyloid hypothesis, which is the idea that some gummy stuff called amyloid gunks up the brain causing Alzheimer's disease and researchers who do not subscribe to this theory tend to get ignored. It's kind of like a scientific cabal where either you're a member of the club or you're not in the club. It's the scientific orthodoxy that may be inhibiting this valid research into other avenues of treatment or cure, and there are natural things that can be employed.
There's no cure for Alzheimer's disease but the condition can be ameliorated with various nutrients; with injections of vitamin B12, essential fatty acids like DHA, with avoidance of heavy metal contamination. High levels of phospholipid support for the brain can be beneficial either given by mouth or intravenously. There are a variety of approaches that really deserve exploration. The only problem is, they're natural approaches and they don't make big money for drug companies like Pfizer.
Diet of worms can cure bowel disease
By Frank van Kolfschooten. New NewScientist.com. April 6, 2004
This is an incredible story. It's turning out to really be a potential solution for people with inflammatory bowel diseases. These include Crohn's Disease and ulcerative colitis. And the headline is: Diet of Worms Can Cure Bowel Disease. This is not from The Enquirer, this is not from The Star, this is from a respectable scientific journal called New Scientist. You can read about it at NewScientist.com.
Regular doses of worms really do rid people of inflammatory bowel disease, according to this article. The first trials of this treatment had been a success and a drinkable concoction containing thousands of pig whipworm eggs could soon be approved and launched in Europe.
Well, the concept is that humans evolved in unclean environments where parasites affected our gastrointestinal tracts. In fact, the vast majority of people in this world harbor parasites. Enter the hygienic culture of Europe and the United States. Everything is cleansed, sterilized, and we're seeing diseases develop that seem to be diseases of over exuberance of the immune system. These diseases include allergies and autoimmune diseases. And they have -- the hygiene hypothesis is that kids should play in the dirt with farm animals and get exposed to germs because that will keep their overactive immune systems battling appropriate outside invaders rather than attacking our own bodies, and that's the theory.
And suddenly we are seeing an increase in autoimmune diseases and allergies as we solve the terrible infectious diseases that once afflicted our society. We give kids vaccines, we keep them away from dirt, they're raised in hermetically-sealed environments, and the result is, well, maybe there are some health problems that are the consequence of that.
The guy who is mostly responsible for this is a gastroenterologist named Joel Weinstock at the University of Iowa. He devised this treatment. He did a pilot study in 1999. He came up with the idea of using worms to treat Crohn's Disease and ulcerative colitis after noting that the sharp rise in disease over the past 50 years in western countries coincided with a fall in infections by parasites such as round worms and human whipworms.
Crohn's Disease and ulcerative colitis are still rare in developing countries where parasitic infections remain common. So what he decided to do is come up with a -- it's hard to say a good parasite. He researched and came up with a type of parasite called the pig whipworm. The pig whipworm doesn't seriously invade the bodies of humans. And so he turned to a new German company called BioCure who has a subsidiary that sells leeches and maggots for treating wounds. And they said, "Come up with something." They came up with a product called TSO, which is the medical name for pig whip worm, eggs. This is a worm that doesn't survive very long in people. Patients would have to take TSO around twice a month and the result is amazing. Preliminary studies showed that the remission rate was 50 percent for ulcerative colitis, 70 percent for Crohn's.
Please don't check my website to see if we sell this stuff yet or go to the health food store and ask them for pig whipworm eggs. This isn't available yet, but it's under research. And it's going to have to go through a lot of research to make sure it's safe as well as effective. But new trials are underway in Europe and soon to be made available to European patients with inflammatory bowel diseases -- very exciting development for these serious and hard-to-treat diseases.
Eye Jewelry
Here's another story and that has been in the news this week and it is amazing. There's a new form of body jewelry, body adornment, and it has to do with your eyes. The story has circulated -- it's true, because I checked out the website -- that people in the Netherlands are beginning to get eye jewelry, hearts, stars, like little sequins implanted on the white part of their eyes.
Yes, indeed folks. And this is actually being offered by a fairly reputable company that manufacturers devices for ophthalmologists doing regular eye surgery. The company is the Netherlands Institute for Innovative Ocular Surgery and they say here, it says, it's not a good translation to English: It is of all times for people to wear jewelry.
Earrings, makeup, and, more recently, tattoos are accepted forms of body cosmetics. Surprisingly, no jewelry is available for the organ that is most important to social interactions, the eye. As if we needed, in some way, to schmutz the eye with an extraneous thing. And what they're saying is, the product is called JewelEye, and it is available in Europe, probably soon to be available in the United States.
It says the implant does not interfere with the ocular functions, i.e. visual performance and movement. The implant is made of especially designed material that can be molded in all kinds of desired shapes and sizes. And they have a little picture here of probably a young 20-something with a fetching piece of eye jewelry. It's a little, diamond sequined heart located just lateral to the colored part of the eye, on the white of the eye. And they come in all shapes and sizes.
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