Tuesday, July 31, 2007

CoQ10 study backs heart health claims

Supplementation with the coenzyme Q10 (CoQ10) may boost naturally occurring antioxidant enzymes and endothelial function in patients with coronary artery disease (CAD).

The randomized, double-blind, placebo controlled trial, published in the European Heart Journal, divided 38 CAD patients into two groups, with one receiving 100 mg/d of CoQ10 and the other a placebo for one month.

CAD reduces extracellular superoxide dismutase (ecSOD), a major antioxidant enzyme system of blood vessel walls. However, the CoQ10-supplemented group had more ecSOD at the end of the trail than the placebo group. The coenzyme also boosted endothelial function.

"The results of the present investigation indicate that the oral CoQ10 supplementation in CAD patients has beneficial effects, which can be ascribed either to the bioenergetic role of the quinone or to its antioxidant properties," the researchers wrote. "Moreover, recent data from our group demonstrated that the CoQ10 administration improves cardiac contractility in ischaemic heart disease patients, measured by low dobutamine stress echocardiography," they added.

Bonnie - while a small study, it adds to the ever-mounting evidence showing how beneficial CoQ10 is to cardiac function. However, one must always be cognizant that not all CoQ10 is created equal. There are wide variants in quality.

Monday, July 30, 2007

CDC launches youth sports concussion website

Parents, coaches, and athletes can benefit from the information on this website.

A resource like this is important because head injuries in youth sports are hardly discussed and preventative measures are rarely taken.

Here's a novel idea: no cure, no charge

Here's an interesting idea that is being tested in the UK. A drug company has agreed to charge the country’s National Health Service for its multiple myeloma drug Velcade (bortezomib) only if it cures the patient. It will refund the full cost of the drug to every patient who doesn't respond to the drug, provided it is prescribed according to the company’s specifications. British Medical Journal, 2007; 335: 122-3

Sunshine 'protective' against MS

People who spend more time in the sun as children subsequently have a lower risk of developing multiple sclerosis (MS), a US study shows. The University of Southern California team suggest UV rays offer protection by altering the cell immune responses or by boosting vitamin D levels. An earlier study found women who took vitamin D supplements were 40% less likely to develop MS. The latest research is published in the journal Neurology.

For the study, researchers surveyed 79 pairs of identical twins who had the same genetic risk of MS. In each pair, one of the twins had MS.
The researchers found the twin with MS spent less time in the sun as a child than the twin who did not have MS. Depending on the activity, the twin who spent more hours outdoors had up to a 57% reduced risk of developing MS.

Steve - yet another reason why those living in Northern latitudes, or anyone who does not get adequate sun exposure, should supplement with vitamin D. Of course, Cod Liver Oil is our preferred source.

Raw foodists show B12 deficiencies in studies.

No exact definition exists, but raw food diets are often described as "uncooked vegan diets" -- which exclude all animal products and byproducts -- or more loosely as "uncooked vegetable diets" or "living foods" diets. Adherents consume from half to virtually all of their foods raw. Aside from fruits and vegetables, the diets include raw nuts and seeds and are rounded out with sprouted grains and beans.

Those who aim to consume "living foods" do their best to eat foods as quickly as possible after harvest. Devotees say that beneficial components in plants -- variously referred to as enzymes, energy or even a life force -- are destroyed when foods are heated above a temperature of about 118 degrees.

The number of raw foodists in the U.S. is unknown, and very little research exists documenting their eating habits. They cited health as the primary driver in adopting the diet as well as a number of perceived advantages, including disease prevention, faster healing, weight control, better digestion, more energy and a greater connection with nature.

Research has yet to prove whether raw food can provide all of these benefits, but the diets have some potential shortcomings.

A raw vegan food plan may lack adequate protein and calcium and is likely to be deficient in vitamin B12. A compound found naturally only in animal foods, vitamin B12 protects nerve fibers and genetic material. In a recent study of 201 raw foodists in the Netherlands, published in the Journal of Nutrition, 38% were vitamin B12 deficient, and more than half had elevated blood levels of homocysteine, an amino acid that requires vitamin B12 for processing and that, when elevated, increases heart disease risk.

A diet rich in raw plant matter is bulky, filling and low in calories, so it is not surprising that the adoption of a living foods diet is associated with a substantial loss of weight. In one of the largest studies of long-term raw foodists in Germany, published in the Annals of Nutrition & Metabolism in 1999, 25% of women and nearly 15% of men were underweight. Among women of childbearing age, 30% had disruptions or cessation of their menstrual cycles -- likely related to loss of weight and body fat.

It should be noted that the plant enzymes that raw foodists attempt to preserve are no match for the highly acidic environment of the stomach. There, they're rendered inactive before digestion is complete. And some phytonutrients, such as the brightly colored carotenoids found in tomatoes, spinach and carrots, are not as readily absorbed from raw foods as they are from cooked foods. Similarly, the magnesium, calcium, iron and zinc naturally present in whole grains are released more thoroughly during cooking.

Anthropologists Richard Wrangham and Nancy Lou Conklin-Brittain of Harvard University say humans were meant to consume cooked foods. Heating foods renders them more digestible -- allowing better absorption of much-needed calories.

They point out that humans have cooked foods for more than 250,000 years, a time period long enough to produce biological adaptations -- smaller teeth, longer small intestines and smaller colons than our ancestors -- in response to eating a cooked-food diet.

Courtesy of LA Times

Bonnie - it is refreshing to see someone besides myself bring this information to light. I have said for a long time that humans, especially with certain genetic variations, do not thrive on raw/vegan diets for the reasons mentioned above. I have seen clients who have followed these diets, had major downturns in their health, and took several years to build it back. Going back to my core philosophy, balance is key. Make sure your food is real, minimally processed, and preferably organic, creates the best of both worlds!

Friday, July 27, 2007

Are Statins a problem for the brain?

Cognitive problems do not appear as side effects in any of the Physician's Desk Reference's Statin drug entries.

However, there have been hundreds of cases of statin-induced memory loss reported to MedWatch, the FDA's system for filing adverse drug events.

Dr. Beatrice A. Golomb, a researcher at University of California at San Diego, is leading a study funded by the National Institutes of Health looking at the effects of statins on the central nervous system. The 1,000-patient trial is studying patients receiving Merck's Zocor, Bristol-Myers Squibb's (BMY ) Pravachol, Golomb says she has been in touch with many patients and families outside the study (over 4,000) reporting problems with statins ranging from memory lapses to changes in personality. New data is to be published shortly. Here is what she has to say on the study's website:

"Memory, Thinking and Concentration. Some people report changes in memory, attention, or concentration on statins. They may have trouble finding the right word; may forget tasks they started to do; and may have trouble following conversations. Some people describe "holes in their memory." Some people worry that they are developing Alzheimer's. Of course, since people on statin drugs are often older, and may be experiencing age-related loss of memory, it makes it difficult to know whether the drugs are responsible. Many people report improvement in memory and thinking when they stop the drug; or improvement if they go on a lower dose."

Bonnie - I anticipate we will be hearing MUCH more about this in the near future. In the meantime, if you are taking a statin, it is mandatory that you take CoQ10. If you have any symptoms commonly associated with the drug, you need to take high does of CoQ10.

Antioxidants linked to better bone health for osteoarthritis

Increased intake of fruit and the antioxidants they contain, like vitamins C and E, may improve bone health and may reduce the risk of osteoarthritis.

"Our study suggests a beneficial effect of vitamin C intake on the reduction in bone size and the number of bone marrow lesions, both which are important in the pathogenesis of knee osteoarthritis," wrote lead author Yuanyuan Wang from Monash University.

The new study, published in the Arthritis Research & Therapy, recruited 293 healthy adults (average age 58) without knee pain or injury, and asked them to complete a 121-item food frequency questionnaire (FFQ) to assess antioxidant intake.

Ten years after the start of the study the researchers measured cartilage volume, bone area, cartilage defects and bone marrow lesions using magnetic resonance imaging (MRI).

Increased intake of vitamin C was associated with a 50 per cent reduced risk of bone marrow lesions, and a smaller bone area. Fruit intake was also linked to a smaller tibial plateau bone area and a 28 per cent reduction in the risk of bone marrow lesions.

Increased intake of the carotenoids lutein and zeaxanthin was associated with a 29 per cent reduction in the risk of cartilage defects, while beta-cryptoxanthin intake was linked to smaller tibial plateau bone area.

Indeed, Wang and co-workers suggested that since vitamin C is a cofactor in the hydroxylation of lysine and proline, it could be considered a required nutrient in the cross-linking of collagen fibrils in bone.

Steve - this was a well-structured study that studied healthy subjects, not sick ones. Cross-sectional studies from food frequency questionnaires always need to be interpreted with caution. However, these researchers were looking only for antioxidants' effect on bones, nothing else. Other studies structured similarly begin with a different purpose and change directions to suit their discoveries.

Aquafina labels to spell out source - tap water

PepsiCo Inc. will spell out that its Aquafina bottled water is made with tap water, a concession to the growing environmental and political opposition to the bottled water industry. According to Corporate Accountability International, a U.S. watchdog group, the world's No. 2 beverage company will include the words "Public Water Source" on Aquafina labels.

Pepsi's Aquafina and Coca-Cola Co's Dasani are both made from purified water sourced from public reservoirs, as opposed to Danone's Evian or Nestle's Poland Spring, so-called "spring waters," shipped from specific locations the companies say have notably clean water.

Steve - while we have know this for a while, much of the public does not. For those thinking they were getting better quality can now save a lot of money on water by simply buying a home filter.

Thursday, July 26, 2007

Cases of Jaw Bone Death Caused by Fosamax Underreported

According to the American Association of Oral and Maxillofacial Surgeons (the surgical sector of dentistry), there may be "serious underreporting" of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) from Merck, the manufacturer of Fosamax.

About 10 million men and women are prescribed Fosamax with top annual sales of $3 billion. A class action lawsuit filed in April, 2006 claimed that Merck knew about the risk and hid it from the public.

Fosamax is supposed to help increase bone density and it is mostly prescribed to menopausal women suffering from osteoporosis. But in the jawbone, this drug does the reverse and actually destroys bone.

The American Association of Oral and Maxillofacial Surgeons (AAMOS) considers patients to be at risk of BRONJ if they have used a bisphosphanate (bis FOS fo nayt) such as Fosamax, if they have bone death (a condition that results from poor blood supply to an area and in this case, the jaw) and there has been no history of radiation therapy to the jaw.

In 2003, oral surgeons recognized and reported cases of jaw bone death in patients treated with IV bisphosphonates. Since these reports, several cases have been reported. Novartis, another manufacturer of the IV bisphosphonates, notified healthcare professionals of additions to the labelling of these products, including a risk of developing osteonecrosis of the jaws. In 2005, a broader drug warning of this serious side effect was issued for all bisphosphonates, including the oral preparations. Fosamax is included in this group of medicines.

Although jaw bone death is uncommon, it is a terrifying side effect and difficult to treat. Many patients taking Fosmax have no idea that problems with their jaw could be linked to this drug.

Epigenetics' Providing a New View of Diet and Cancer

A new study concludes that one of the ways diet may help prevent or treat cancer is through its impact on gene expression – influencing which genes are turned "on" or "off." This "epigenetic" view of cancer is quite new, researchers say in the report, and may help explain not only how some cancers form and progress, but also provide new approaches to their treatment and prevention, either through drugs or diet.

The findings are being published by researchers from the Linus Pauling Institute at Oregon State University, in Seminars in Cancer Biology, a professional journal. “The traditional view of cancer is that genetic damage and DNA mutations occur, in ways that can turn off key genes and our natural defense mechanisms against cancer,” said Rod Dashwood, a professor of environmental and molecular toxicology and head of LPI’s Cancer Chemoprotection Program. “That clearly is one cause of cancer. But we’re finding out that epigenetic mechanisms can also produce this same effect within cells containing normal, non-mutated DNA.”

In this view of cancer, genetic damage to a cell is less relevant than other forces – which can be the result of toxins, stresses or diet – that have the power to change gene expression in cells that are otherwise undamaged. It has been known for some time that broccoli, for instance, contains anti-carcinogens and can help protect against cancer. In several recent studies, OSU researchers are finding out one reason why. They have been able to trace – first in the cell, then in mouse experiments and finally in human tests – the effects that sulforaphane, one of the key compounds in broccoli and other cruciferous vegetables, has on gene expression. In particular, they showed that sulforaphane may inhibit the activity of histone deacetylases, or HDACs, in human colon and prostate cancer lines. HDACs are a family of enzymes that, among other things, affect access to DNA and play a role in whether certain genes are expressed or not, such as tumor suppressor genes. "Our experiments suggest that HDAC inhibitors can turn on these silenced genes, restore normal cellular function and suppress tumor growth,” says researchers.

They first demonstrated this effect in human colon cancer cells treated with sulforaphane, and then LPI collaborator Emily Ho found the same HDAC inhibition in prostate cancer cells. In studies done with mouse models, tumors were suppressed 50 percent by a diet containing sulforaphane. And then in human experiments, the OSU researchers were able to show a dramatic level of HDAC inhibition immediately following a single serving of broccoli sprouts, rich in sulforaphane. Some cancer drugs have already been developed that take advantage of this HDAC inhibition process, and OSU researchers believe that options are available for cancer prevention or even therapy with certain diets or supplements. Appropriate dietary programs might also serve as a synergistic complement to conventional treatments for cancer.

Other dietary HDAC inhibitors studied by researchers include garlic organosulfur compounds and butyrate – a compound produced in the intestine when dietary fiber is fermented, and providing one possible explanation for why higher intake of dietary fiber might help prevent cancer.

“The health implications of epigenetics are really enormous. The root of many disease processes is aberrant gene or protein expression. To the extent we can learn new ways to affect or change gene expression in desirable ways, through diet or drugs, we may be able to better address not just cancer but many other chronic diseases or health problems as well.” That could include heart disease, stroke, neurodegeneration, Huntington’s disease, epilepsy, bipolar disorder, and aging, the researchers speculated in their report. At least in theory, a single dietary component – whether it’s sulforaphane in broccoli or resveratrol in red wine – might affect a number of disease issues, scientists say.

This field of research is sufficiently new that the first-ever summer conference on HDACs was just held last month. Another such meeting is planned in September, 2007, at the National Institute of Health, with Dashwood as an invited speaker. Studies by Dashwood and Ho are currently supported by the National Cancer Institute, the National Institute of Environmental Health Sciences and the Oregon Agricultural Experiment Station.

Bonnie - does this not sound familiar? We have been talking Epigenetics at Nutritional Concepts since last year. In fact, we recommend dietary and supplemental substances to harmonize our epigentic pathways (i.e. kinases) whenever needed. It is very exciting that the research is beginning to mount!

State of the Nutritionist Speech
Epigenetics Part I: Preventing Chronic Disease.
Epigenetics Part II: First Priority in Preventing Chronic Disease

Wednesday, July 25, 2007

NOHA News reports on Proton Pump Inhibitors

According to a column written by Dr. Mayer Eisenstein in the Nutrition for Optimal Health Association (NOHA) Summer Newsletter, people over age 50 who take proton pump inhibitors (PPIs) for more than one year have a 44% increased risk of breaking a hip. PPIs inhibit the body from producing stomach acid. However, some stomach acid is needed to absorb calcium, which of course, is needed for healthy bones.

Bonnie - it is nice to see another health professional acknowledge this.

Soy isoflavones may halve prostate cancer risk

Increased intake of soy isoflavones may cut the risk of prostate cancer by 58 per cent, suggests a new study from Japan.

The research, published in the Journal of Nutrition, adds to an earlier study that claimed to be the first prospective study to report an inverse association between isoflavone and prostate cancer in Japanese men (Cancer Epidemiology Biomarkers & Prevention, Vol. 16, pp. 538-545).

The new case-control study recruited 200 Japanese men with different stages of prostate cancer - one case of Stage 1, 131 cases of Stage 2, 44 cases of Stage 3, and 24 cases of Stage 4 - and compared their dietary intakes with 200 healthy male controls.

The intake of 12 food items was measured: tofu (soybean curd), natto (fermented soybeans), miso soup (soybean paste soup), bean curd refuse, fried bean curd, fried bean curd with vegetables, soy flour, dried bean curd, soybean milk, soy sauce, green soybeans, and bean sprouts.

The researchers report that an increased intake of the soy isoflavones genistein and daidzein and their aglycones was significantly associated with a decreased risk of prostate cancer. The highest average isoflavone intake was associated with a 58 per cent reduction in risk compared with the lowest average isoflavone intake.

The researchers indicated that the results may not be generalized to other populations since the traditional Japanese is a rich source of dietary isoflavones.

"Serum phytoestrogen concentrations are higher among Japanese men and women than among those in Western countries," they said.

The earlier study linking isoflavones to potential protection from prostate cancer stated that the benefits could be due to the weak oestrogenic activity of soy isoflavones, which may act to reduce testosterone levels and inhibit 5 alpha-reductase - an enzyme involved in the metabolism of testosterone.

Bonnie - this is not a surprise. Fermented soy foods have shown to be a prostate cancer preventive in several research studies. While I do not suggest taking high dose isoflavone supplements, eating fermented soy products, preferably organic, a few times weekly, is a good idea for men. Tofu, tempeh, natto, miso soup (MSG-free), and edamame are the most available for consumption in the US. Soy milk, soy protein, and are not recommended.

Low vitamin D levels linked to higher blood pressure

People with low blood levels of vitamin D may be at an increased risk of higher blood pressure.

"This finding may have public health significance, as vitamin D levels can easily, and cheaply, be increased by a modest increase in sun exposure or vitamin D supplementation," wrote lead author Robert Scragg in the American Journal of Hypertension.

The researchers used data from Third US National Health and Nutrition Examination Survey (NHANES III). The analysis was confined to 12,644 people (aged 20 or over, 6547 women) and those on hypertensive medication were excluded.

Vitamin D status was measured using blood levels of 25- hydroxyvitamin D (25(OH)D). Non-Hispanic whites had the highest blood levels, followed by Mexican Americans, while non-Hispanic blacks had the lowest vitamin D levels.

When the subjects were split up into five groups depending on blood levels, the researchers calculated that people with the highest average vitamin D levels had better blood pressure than people with the lowest vitamin D levels.

After adjusting the results to account for Body Mass Index, the associations remained statistically significant for systolic blood pressure.

Tuesday, July 24, 2007

Diet sodas linked with health risks

Sodas -- even diet ones -- may be linked with increased risk factors for heart disease and diabetes. U.S. researchers found adults who drink one or more sodas a day had about a 50 percent higher risk of metabolic syndrome -- a cluster of risk factors such as excessive fat around the waist, low levels of "good" cholesterol, high blood pressure and other symptoms.

The study
that appears in the journal Circulation included about 6,000 middle-aged men and women who were observed over four years. Those who drank one or more soft drinks a day had a 31 percent greater risk of becoming obese. They had a 30 percent increased risk of developing increased waist circumference. They also had a 25 percent increased risk of developing high blood triglycerides as well as high blood sugar, and a 32 percent higher risk of having low high-density lipoprotein or "good" cholesterol levels.

The researchers then analyzed a smaller sample of participants on whom data on regular and diet soft drink consumption was available. Those who drank one or more diet or regular sodas per day had a 50 to 60 percent increased risk for developing metabolic syndrome.

Researchers postulate that people who drink soda, whether diet or sugar-sweetened, tend to have similar dietary patterns: eat more calories, consume more saturated fat and trans fat, eat less fiber, exercise less and be more sedentary. The researchers adjusted for those factors and still observed a significant link between soft drink consumption and the risk of developing metabolic syndrome.

Theories discussed about how diet sodas could increase a person's metabolic risk. "One possibility is that diet soda is sweet. Maybe drinking something sweet conditions you in such a way that you develop a preference for sweet things," they said. "Also, diet soda is a liquid. When you take liquids at a meal, they don't satiate you as much (as solids)," they said. The caramel coloring of some sodas also may play a role. He said caramel coloring in animal experiments was associated with tissue inflammation.

The American Heart Association, which publishes Circulation, said people should understand that the study did not demonstrate that diet sodas cause heart disease.

Bonnie - while we must keep in mind that this was an observational study, it was well-structured, simple, focused only on sodas, and followed subjects participating in the prestigious Framingham Heart study.

Did anyone notice the 800 pound gorilla in the room that was ignored? Artificial Sweeteners. The toxicity generated by these substances create an chronic inflammatory state that is as much to blame for the aforementioned health issues as anything the researchers alluded to.

Monday, July 23, 2007

More support for sterols for cholesterol cuts

Writing in the journal Nutrition, researchers report that encapsulation of phytosterols reduced total and LDL-cholesterol levels by 3.5 and five per cent, respectively.

Numerous clinical trials in controlled settings have reported that daily consumption of 1.5 to 3 grams of phytosterols/-stanols from foods can reduce total cholesterol levels by eight to 17 per cent, representing a significant reduction in the risk of cardiovascular disease, but whether such benefits could be repeated if the delivery system was changed from food to capsules has not been extensively studied.

"Our findings indicate that encapsulated phytosterol ester ingestion at 2.6 g/d does modulate some plasma lipid parameters, but it is possible that higher doses of phytosterols, when administered in this form, would be more effective," they added.

Steve - plant sterols/stanols have been and continue to be a very effective tool for maintaining optimal cholesterol.

Caffeine, calories for kids concern nutritionists

With Starbucks and Dunkin' Donuts seemingly around every corner, educators and nutritionists say more and more teens are consuming coffee drinks, from caramel lattes to Coffee Coolattas. But is all that caffeine - not to mention sugar and calories - a good idea for kids whose bodies are still developing? No definitive studies on the effects of caffeine on children have been done. But while caffeine doesn't stunt one's growth, as one well-known myth suggests, it is an addictive drug that can have lasting effects - and coffee contains as much as five times the amount of caffeine as soda. Some nutritionists worry that adolescents are substituting coffee for meals, while others fret that some popular drinks - certain Frappucinos, for instance - feature as many calories as a Big Mac. And with sodas still a frequent choice and so-called "energy drinks" becoming more and more commonplace, the number of caffeinated beverages that teens consume seems almost limitless.

While market analysis firms do not track coffee consumption for youths younger than 18, the percentage of 18- to 24-year-olds who drink coffee every day has doubled since 2003, from 16 percent to 31 percent, according to the National Coffee Association. By itself, caffeine is not particularly harmful. It can cause anxiety, insomnia and a handful of stomach and cardiovascular problems in some. But the main downside to caffeine is its addictive properties and the effects on the body when one stops ingesting it - effects that may be magnified in the smaller bodies of children.

What is most forgotten is that many of the coffee drinks that appeal to children - those with plenty of sugar, flavoring and cream - contain a lot of calories and fat. A 12-ounce can of Coke has 140 calories. By contrast, a 16-ounce Mocha Frappuccino with whipped cream from Starbucks has 380 calories, while a 16-ounce Coffee Coolatta from Dunkin' Donuts has 210.

Steve - as we have learned in this profession, when you think you have achieved victories in some areas (i.e. the rise of organic foods, removing junk food from schools), there are always more battles to fight. This is an especially tough battle because you are fighting two biochemically addictive substances: sugar and caffeine. When you add fat to the equation, it is a potent triumvirate. Parents are not in an enviable position because their children have been watching them consume these products for years. What to do? One client seemed to have a pretty sensible solution. They do not purchase any coffee products for their children or allow it in the house. If their children choose to use their own money to buy them, and are not consumed in the house, that is their

Thursday, July 19, 2007

75 percent could be overweight in U.S. by 2015

If people keep gaining weight at the current rate, fat will be the norm by 2015, with 75 percent of U.S. adults overweight and 41 percent obese, U.S. researchers predicted in a study published in the journal Epidemiologic Reviews. Studies show that 66 percent of U.S. adults were overweight or obese in 2003 and 2004. Sixteen percent of U.S. children and adolescents are overweight and 34 percent are at risk of becoming overweight, according to federal government figures.

Calls get louder to raise vitamin D levels

Recommended daily intakes of vitamin D should be quadrupled to 800 International Units, says a leading US expert from Boston University School of Medicine.

The review, published in the prestigious New England Journal of Medicine, increases the need for policy makers to review current guidelines for the vitamin, and could open opportunities for food fortification and supplements.

Dr. Michael Holick states that current recommendations of 200 IU per day for children and adults up to 50 years of age for vitamin D need to be increased to 800 - 1000 IU vitamin D3.

"However, one can not obtain these amounts from most dietary sources unless one is eating oily fish frequently," said Holick. "Thus, sensible sun exposure (or UVB irradiation) and/or supplements are required to satisfy the body's vitamin D requirement."

No Cancer Shield Found in Fruit and Vegetable Diet

A seven-year government experiment in more than 3,000 women found no benefit from a diet that included far more than the recommended servings of five fruits and vegetables a day. The study appears in Wednesday’s Journal of the American Medical Association. For now, the message for the 2.4 million breast cancer survivors in the United States is that they do not need to go overboard on vegetables, researchers said. In this experiment, all the women had been successfully treated for early stage breast cancer. Their average age was 53 when the study began. A group of 1,537 women were randomly assigned to a daily diet that included five vegetable servings, three fruit servings, 16 ounces of vegetable juice and 30 grams of fiber. In most cases, a serving equaled a half cup. French fries and iceberg lettuce could not be counted as vegetables. The women were allowed to eat meat, but were told to get no more than 15 percent to 20 percent of their calories from fat. As a comparison, an additional 1,551 women were assigned to get educational materials about the importance of eating five servings of fruits and vegetables a day. During the next seven years, the cancer returned in about the same proportion of women in both groups. About 10 percent of both groups died during that time, most of them from breast cancer.

Bonnie - this is disgusting. If you are talking about cancer prevention, you cannot look at people who have already had it because their immune system is already compromised.

Update 7/26/2007 -
isn't it interesting that a study to appear in the August issue of Journal of the National Cancer Institute says men who often eat broccoli and cauliflower may be less likely to develop aggressive prostate cancer than men who skimp on those vegetables. The finding comes from a study of more than 29,000 U.S. men aged 55-74 who were followed for an average of four years. When the study started, the men didn't have prostate cancer. They completed surveys about the foods they typically ate. During the study, the men were regularly screened for prostate cancer. A total of 1,338 men were diagnosed with prostate cancer, including 520 men with aggressive prostate cancer. The men who reported frequently eating cruciferous vegetables -- which include broccoli, cauliflower, cabbage, Brussels sprouts, mustard greens, and turnip greens -- were 40% less likely to be diagnosed with aggressive prostate cancer during the study than men who rarely ate those vegetables.

This study was geared towards prevention!

New research on belly fat/diabetes connection

Abdominal fat, the spare tire that many of us carry, has long been implicated as a primary suspect in causing the metabolic syndrome, a cluster of conditions that includes the most dangerous heart attack risk factors: prediabetes, diabetes, high blood pressure, and changes in cholesterol. But with the help of powerful new imaging technologies, a team of Howard Hughes Medical Institute (HHMI) researchers at Yale University School of Medicine has found that insulin resistance in skeletal muscle leads to alterations in energy storage that set the stage for the metabolic syndrome.

The new study, published July 16, 2007, in the Proceedings of the National Academy of Sciences (PNAS), demonstrates that insulin resistance in skeletal muscle -- caused by decreased ability of muscle to make glycogen, the stored form of carbohydrate from food energy -- can promote an elevated pattern of lipids or fats in the bloodstream that underpins the metabolic syndrome. Coauthors of the paper were from Yale and Harvard Medical School.

The subjects for the study were all young, lean, non-smoking, healthy individuals who were sedentary and matched for physical activity. Aside from insulin resistance in one cohort, these volunteers had none of the other confounding factors typically associated with obesity and type 2 diabetes, which have been thought to play a key role in the pathogenesis of the metabolic syndrome. After providing the study's subjects with two meals high in carbohydrates, magnetic resonance spectroscopy measured the production of liver and muscle triglyceride, the storage form of fat, and of glycogen, the storage form of carbohydrate. "What we found is that (insulin) sensitive individuals took the energy from carbohydrate in the meals and stored it away as glycogen in both liver and muscle," said rersearchers. In the insulin resistant subjects, the energy obtained from their carbohydrate rich meals was rerouted to liver triglyceride production, elevating triglycerides in the blood by as much as 60 percent and lowering HDL cholesterol (the “good cholesterol”) by 20 percent. "What we see," they noted, "is alterations in patterns of energy storage. An additional key point is that the insulin resistance, in these young, lean, insulin resistant individuals, was independent of abdominal obesity and circulating plasma adipocytokines, suggesting that these abnormalities develop later in the development of the metabolic syndrome."

Another key observation was that skeletal muscle insulin resistance precedes the development of insulin resistance in liver cells, and that fat production in the liver is increased. “These findings also have important implications for understanding the pathogenesis of nonalcoholic fatty liver disease, one of the most prevalent liver diseases in both adults and children” The good news, according to Shulman, is that insulin resistance in skeletal muscle can be countered through a simple intervention: diet exercise.

Bonnie - I see this pattern routinely with people who have large amounts of belly fat. These people should always be on a low glycemic load diet (meaning most of their carbs should come from fruits and vegetables). Also, because cow's milk affects insulin (skim more than 2%), they should also avoid milk (but not necessarily, plain yogurt or lowfat cheese).

Tuesday, July 17, 2007

Colitis cases on the rise

According to researcher that appears in the Archives of Surgery, the bacteria Clostridium difficile, which is one of the causes of Colitis, a particular bowel inflammation, may have become more common, stronger or more resistant to antibiotics. A look at discharge data from U.S. hospitals from 1992 through 2003 found that the rate of such infections increased from 261 cases per 100,000 patients to 546 cases per 100,000 discharged patients, a 109 percent increase.

Clostridium difficile is found in the intestines of 1 percent to 3 percent of healthy adults and about 20 percent of those taking antibiotics, the study said. When the bacteria grow they can cause severe or complicated diarrhea that may eventually lead to death, it added. "Three million new cases of C. difficile colitis occur in the United States each year," the research team wrote, and anecdotal evidence and some studies suggest it "has become more common and potentially more pathogenic."

While the study shows the changing nature of this kind of colitis, it does do not offer explanations for the change, the researchers said. The shift could be caused by new strains of the bacteria, its increasing resistance to antibiotics or the increasing severity of illness and therefore susceptibility to infection among hospitalized patients, they concluded.

Steve - the hypothesis for the increase in cases is right on. Weaker hosts and more resistant pathogens make for larger numbers affected by C. Dificile. This pathogen can be extremely virulent. This first step in reducing its effect is to go off of antibiotics. Then, one must repopulate the gut with high-dose healthy flora (probiotics). A large influx of omega 3 fatty acids and an exemplary diet will accelerate healing and calm the inflammation.

High glycemic carbs linked to AMD

According to a study in the American Journal of Clinical Nutrition, heavy consumption of high glycemic foods, those which break down faster into glucose, increase the risk of age-related macular degeneration by as much as 40% (in those consuming the highest amount).

High glycemic foods are considered simple carbohydrates, such as cakes and cookies, cheese pizza, white bread, and foods sweetened with sugar and corn syrup.

Steve - for an extensive explanation of glycemic foods, access our Blood Sugar Balance Action Plan.

Monday, July 16, 2007

HRT 'no benefit' to older hearts

More evidence that hormone replacement therapy could be harming, not protecting the hearts of older women has been published. Research into 5,000 women from the UK, Australia and New Zealand suggests women over 60 are more at risk of heart and blood problems. The British Medical Journal study backs major US research which revealed risks for millions of women worldwide.

The WISDOM study began in 1999, and involved doctors at the University of Adelaide in Australia, Wellington School of Medicine and Health Sciences in New Zealand, and the Medical Research Council in the UK. It identified 5,692 healthy women registered at GP practices with an average age of 63, and randomly gave them either combined oestrogen and progestogen HRT pills, or "dummy" placebo pills. When the US Women's Health Institute (WHI) study was halted in 2002 after finding significant evidence of HRT endangering the health of some of its patients, the WISDOM study, which was almost identical in its method, was also stopped. However, researchers were able to analyse the results in the first few years of the trial. They found, like the WHI study, a significant increase in the number of "major cardiovascular events", such as angina, heart attack or even sudden heart death, and potentially dangerous blood clots in the group given HRT, compared with those given no hormone treatment.

Dr Madge Vickers, former head of the MRC General Practice Research Framework, who led the study, added: "Importantly, the WISDOM study showed that there is no overall disease prevention benefit from HRT and some potential risk for women who start hormone replacement therapy many years after menopause.

Bonnie - as a Certified Menopause Educator, I have counseled many women over age 60 still on HRT. There are ways to safely wean off; and, if necessary, use natural substances to ameliorate menopausal symptoms.

Canada's folic acid success to encourage others?

If anyone needed further support for benefits of folic acid fortification, a new study shows that the incidence of neural tube defects in Canada has dropped by 46 per cent since the advent of folic acid addition to flours.

The study, published in the New England Journal of Medicine, has implications for countries debating the effectiveness of fortification. Currently, only Canada, the United States, and Chile require that folic acid be added to flour. The signs are indicating that it will be introduced in the UK soon. An announcement is expected within the next month or so concerning fortification in Ireland, and similar measure under scrutiny in Australia.

"We found that food fortification with folic acid was associated with a significant reduction in neural-tube defects in Canada," wrote lead author Philippe De Wals of Université Laval. "Furthermore, the risk reduction appeared greatest in regions in which the rates were highest before the fortification program was implemented.

Steve - the UK is predicted to go a step further by introducing an activated form of folate, L-5 methyl tetrahydrofolate, as the main fortifying ingredient, so it can be absorbed by a large part of the population who cannot break down folic acid into absorbable folate.

High levels vitamin B-6 may boost conception and miscarriage rates

High levels of vitamin B6 prior to falling pregnant may boost conception rates and reduce the odds of losing the baby during early pregnancy, suggests new research published in the American Journal of Epidemiology.

If the results are repeated in more studies in other populations around the world, it may see vitamin B6 force an extension of the current cogs of pregnancy nutrition: folic acid, calcium with vitamin D, and omega-3 fatty acids.

"We found that poor preconception vitamin B6 status was associated with increased risk of early pregnancy loss and reduced probabilities of conception and clinical pregnancy in a prospective cohort of young Chinese women," wrote lead author Alayne Ronnenberg from the University of Massachusetts Amherst.

"This study underscores the potential importance of micronutrient status at the time of conception on pregnancy outcome."

The researchers, from U of M Amherst, University of Illinois, Harvard Medical School, Anhui Medical University (China), Northwestern University, and Children's Memorial Hospital and Children's Memorial Research Center, looked at the B vitamin status (folate, B6 and B12) of 364 women (average age 24.9, average BMI 19.8 kg per sq. m) working in the textile industry in Anqing, China.

The women were included if they conceived at least once during prospective observation (1996-1998) and provided daily urine samples over a 12-month period. The urine was tested for human chorionic gonadatropin (hCG) to detect conception and early pregnancy loss.

Ronnenberg and co-workers report that women with sufficient vitamin B6 levels increased the odds of conception by 120 per cent, and halved the odds for early pregnancy loss.

They also report that sufficient levels of B6 improved the odds of conception by 40 per cent and lowered the odds for early pregnancy loss by 30 per cent, compared to women with B6 deficiency.

Bonnie - well, well, well! For those of you who have seen me over the years for prenatal and pregnancy counseling, you know that B-6, in particular the co-enzymatic form Pyridoxyl-5-Phosphate, is a staple of my nutrient regimen. I cannot tell you how elated I am with this study.

Wednesday, July 11, 2007

Epigenetics Receives Green Light as Major Initiative in NIH Roadmap

The National Institutes of Health (NIH) has concluded their selection process for a new cohort of Roadmap initiatives, approving four topics as Major Roadmap Initiatives. Two programs, epigenetics and microbiomes, were approved for immediate implementation as five year programs.

Epigenetics is the study of stable genetic modifications that result in changes in gene expression and function without a corresponding alteration in DNA sequence. The epigenome is a catalog of the epigenetic modifications that occur in the genome. Epigenetic changes have been associated with disease, but further progress requires the development of better methods to detect the modifications and a clearer understanding of factors that drive these changes.

Steve - if you have followed our newsletters and blog for the last year, you know that we have discussed epigenetics many times in reference to nutrition's positive and adverse effect depending on diet and lifestyle. The NIH roadmap is very good news for the public.

Selenium supplements raise risk of type 2 diabetes

Bonnie - It is astounding that studies like this get published, much less get splattered all over the media landscape.

In a nutshell, researchers took data from a study looking at the preventive benefits of selenium supplementation on certain forms of cancer and then linked selenium with an increased risk of diabetes (the cancer outcome was positive and the researchers note this).

First of all, nutrition professionals do not prescribe supplemental selenium for diabetes prevention, they do for cancer prevention. In fact, any selenium I prescribe beyond what is in a multivitamin/mineral I do very cautiously because it can be toxic in large amounts.

The researchers admit that the study must be interpreted cautiously because the aim of the study had nothing to do with diabetes!

The researchers admit that diagnosis of type 2 diabetes was self-reported by the subjects, not medically diagnosed.

Unmeasured diabetes risk factors such as family history, body fat distribution, physical activity, and DIET were non existent.

The subject samples were elderly (average age 63.2 years).

Chance cannot be ruled out in the findings because out of the 1200 subjects, 58 got diabetes in the selenium group while 39 got diabetes in the non-selenium group. This has no clinical significance!

Annals of Internal Medicine study

Vitamin C may boost folate supplement response

Supplementation with vitamin C may increase the uptake of a folic acid derivative, suggests new research from Belgium.

"Administration of a physiological dose of [6S]-5-methyltetrahydrofolate with L-ascorbic acid significantly improved the measured serum folate response in folate saturated healthy men," wrote the researchers, led by Professor Ann Van Loey, in the European Journal of Clinical Nutrition.

Scientists at the University of Bonn in Germany reported last year that the folic acid derivative, [6S]-5-methyltetrahydrofolate ([6S]-5-MTHF), is even more bioavailable when given as supplements than folic acid, and could be an alternative for the primary prevention of neural tube defects (American Journal of Clinical Nutrition, Vol. 84, pp. 156-161).

Steve - we have said for many years that at least a quarter of the human population cannot genetically break down folic acid into 5-methyl tetrahydrofolate and 5-formyl tetrahydrofolate to be absorbed. It is nice that researchers are finally recognizing this. To cover yourself, make sure you take a complete folate with all three of the above (Metagenics makes one called Actifolate).

Antibiotics Won't Prevent Urinary Tract Infections in Kids: Study

Giving antibiotics to prevent recurrent urinary tract infections in small children won't help and may even hurt, a new study finds. Reporting in the July 11 issue of the Journal of the American Medical Association, researchers say the use of antibiotics as prevention boosts risks for drug resistance while doing nothing to shield kids from future urinary tract infections (UTIs).

The authors looked at 611 children under the age of 6 who had had a first urinary tract infection and 83 children who had suffered from recurrent UTIs. Preventive antimicrobial therapy did not lower a child's risk of recurrent UTI, the researchers found. However, prior use of antibiotics to prevent infection did boost the likelihood of developing a drug-resistant infection by nearly 7.5 times. Indeed, 61 percent of recurrent urinary tract infections were caused by a pathogen with antibiotic resistance, the researchers pointed out.

Bonnie - this is welcome news. I have been incessant on this issue. Antibiotics do more harm than good for UTI's in kids as well as adults. Probiotics, consumption of low acid foods, and cranberry/cherry extract are natural therapies that have helped my clients.

Tuesday, July 10, 2007

Kids in northern climates at risk of low vitamin D

Babette Zemel, director of the Nutrition and Growth Laboratory, The Children's Hospital of Philadelphia said: "The recommended levels of dietary and supplemental vitamin D from the Institute of Medicine (Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC: National Academy Press; 1997) are probably too low to maintain healthy levels of vitamin D. Fortification of foods other than liquid milk should be explored," she said.

The new research measured blood levels of vitamin D in 382 healthy children between six years and 21 years of age living in the northeastern U.S. After measuring the intake of vitamin D from dietary and supplemental sources and evaluating blood levels of vitamin D, the researchers found that 55 per cent of the children had inadequate vitamin D blood levels (levels of 25(OH)D below 30 nanomoles per litre of serum), with the proportion increasing to 68 per cent in winter.

Steve - this should not come as a surprise. There was a reason Cod Liver Oil used to be a staple in children's diets way back when!

Monday, July 09, 2007

ADA spokesperson makes startling statement.

In a Chicago Tribune piece that appeared over the weekend entitled, "Think before you drink diet. Although better than regular, no-calorie cola still has problems," Dietitian and American Dietetic spokesperson David Grotto was quoted as saying,

"Diet drinks, however, are still a better choice over the full-calorie versions. Grotto said he has a patient who has lost 40 pounds simply by switching from regular to diet pop."

But he recommends capping consumption.

"I advise my patients to limit their soda consumption to two or three servings a day," Grotto said. "And keep in mind that a serving is considered 8 ounces."

Bonnie - it is amazing that a Dietitian could advocate drinking any soda. Diet drinks are no better that regular, and in some cases worse, because of reactions to the artificial sweeteners. We've known for years about the neurotoxic effects of aspartame. But, in light of the latest aspartame rat study linked to cancer, his comments are even more shocking. A recent study also showed that those drinking diet soft drinks gained more weight than those who drank sugar soft drinks. I hope he was misquoted.

Thursday, July 05, 2007

Nutrition education ineffective

The federal government will spend more than $1 billion this year on nutrition education — fresh carrot and celery snacks, videos of dancing fruit, hundreds of hours of lively lessons about how great you will feel if you eat well. But an Associated Press review of scientific studies examining 57 such programs found mostly failure. Just four showed any real success in changing the way kids eat — or any promise as weapons against the growing epidemic of childhood obesity. "Any person looking at the published literature about these programs would have to conclude that they are generally not working," said Dr. Tom Baranowski, a pediatrics professor at Houston's Baylor College of Medicine who studies behavioral nutrition.

The results have been disappointing, to say the least:
• Last year a major federal pilot program offering free fruits and vegetables to school children showed fifth graders became less willing to eat them than they had at the start. Apparently they didn't like the taste.

• In Pennsylvania, researchers went so far as to give prizes to school children who ate fruits and vegetables. That worked while the prizes were offered, but when the researchers came back seven months later the kids had reverted to their original eating habits: soda and chips.

• In studies where children tell researchers they are eating better or exercising more, there is usually no change in blood pressure, body size or cholesterol measures; they want to eat better, they might even think they are, but they're not.

Nationally, obesity rates have nearly quintupled among 6- to 11-year-olds and tripled among teens and children ages 2 to 5 since the 1970s, according to the Centers for Disease Control. The medical consequences of obesity in the U.S. — diabetes, high blood pressure, even orthopedic problems — cost an estimated $100 billion a year. Kentucky cardiologist Dr. James W. Holsinger Jr., nominated as the next surgeon general, says fighting childhood obesity is his top priority. The challenges to changing the way children eat are as numerous as the factors that have prompted the obesity epidemic in the first place:

Experts agree that although most funding targets schools, parents have the greatest influence, even a biological influence, over what their children will eat. When children slim down, it's because "their families get religion about this and figure out what needs to happen. If the mother is eating Cheetos and white bread, the fetus will be born with those taste buds. If the mother is eating carrots and oatmeal the child will be born with those taste buds," said Dr. Robert Trevino, at the Social and Health Research Center in San Antonio, Texas. Most kids learn what tastes good and what tastes nasty by their 10th birthdays."If we don't reach a child before they get to puberty, it's going to be very tough, very difficult, to change their eating behavior," said Trevino.

Poorer kids are especially at risk, because unhealthy food is cheaper and more easily available than healthy food. Parents are often working, leaving children unsupervised to get their own snacks. Low-income neighborhoods have fewer good supermarkets with fresh produce. Parks often aren't safe and sports teams cost money.

Children between 8 and 12 see an average of 21 television ads each day for candy, snacks, cereal and fast food — more than 7,600 a year, according to a recent Kaiser Family Foundation study. Not one of the 8,854 ads reviewed promoted fruits or vegetables. There was one ad for healthy foods for every 50 for other foods. Children may be the best sources to explain why lessons about nutrition don't sink in.

The USDA doesn't have the resources to undertake "long term, controlled, medical modeled studies" necessary to determine the impact of its programs. Doctors like Tom Robinson, who directs the Center for Healthy Weight at Lucile Packard Children's Hospital at Stanford University, said those studies aren't needed. The research has already shown they don't work. "I think the money could be better spent on programs that are more behaviorally oriented, as opposed to those that are educationally oriented, or studies that just describe the problem over and over again," he said. There may be pieces of solutions found in limited studies currently being tested around the country. In some situations, obese and overweight children can lose weight and get healthy through rigorous hospital and clinic-based interventions that involve regular check-ins, family involvement, scheduled exercise and nutrition education. School programs that increase physical activity are also more likely to have an impact than nutrition education.

Courtesy of AP

Steve - this is a sobering, yet refreshing study. It shows that what exists is not working.

We were so happy they addressed parental responsibility for being the overriding factor in nutrition education. We could throw billions of dollars per year for school nutrition education, but it will not make an ounce of difference without parental change. Schools have to involve parents in their nutrition education programs, because many need it more than the children!

Organic food 'better' for heart

A ten-year study comparing organic tomatoes with standard produce found almost double the level of flavonoids - a type of antioxidant. Writing in the Journal of Agricultural and Food Chemistry, the team said nitrogen in the soil may be the key. Dr Alyson Mitchell, a food chemist at the University of California, and colleagues measured the amount of two flavonoids - quercetin and kaempferol - in dried tomato samples that had been collected as part of a long-term study on agricultural methods.

They found that on average they were 79% and 97% higher respectively in the organic tomatoes than in the conventionally grown fruit. New Scientist magazine reported that the different levels of flavonoids in tomatoes are probably due to the absence of fertilizers in organic farming. Flavonoids are produced as a defense mechanism that can be triggered by nutrient deficiency, such as a lack of nitrogen in the soil. The inorganic nitrogen in conventional fertilizer is easily available to plants and so, the researchers suggests, the lower levels of flavonoids are probably caused by over-fertilization.

Soil Association policy director said: "We welcome the now rapidly growing body of evidence which shows significant differences between the nutritional composition of organic and non-organic food. "This is the second recent American study to find significant differences between organic and non-organic fruit. "These findings also confirm recent European research, which showed that organic tomatoes, peaches and processed apples all have higher nutritional quality than non-organic."

Steve - a compelling and well-structured study adds to the mounting data on organic versus conventional.

Monday, July 02, 2007

Obesity dramatically increases risk of Alzheimer's

In 50 years time, up to 2.5m people in the United Kingdom could have dementia unless steps are taken to stem the obesity epidemic, the Alzheimer's Society warned. Better diet, more exercise and lower blood pressure would all help to reduce people's risk of the condition. Around 700,000 people currently suffer from dementia in the UK. The biggest risk factor for all types of dementia, of which Alzheimer's disease is the most common, is age. But experts are also starting to realize that lifestyle factors also have a big impact on a person's risk. Obesity, smoking, high blood pressure and cholesterol all increase the risk of dementia because they can lead to damage of the blood vessels in the brain, which in turn leads to the death of brain cells. According to the Alzheimer's Society: "People who are obese at 60 are twice as likely to develop dementia by the time they are 75. They added that research had shown that regular exercise and a healthy diet could substantially reduce the risk.

Bonnie - sobering number for the UK. I shutter to think what these numbers will be in the US!

Adopting a healthy lifestyle in middle age can lower risk of premature death

It is never too late to change your lifestyle habits! According to a study that appeared in the American Journal of Medicine, 16,000 middle-aged adults who began eating five or more fruits and vegetables every day, exercising at least two hours a week, keeping weight down and not smoking decreased their risk of heart disease by 35 percent and risk of death by 40 percent in the four years after they started.

Five percent of US adults report food allergy

According to a FDA survey, a 5.3% of US adults said a doctor diagnosed them with food allergy. Most were allergic to one or more of the eight most common food allergens.

Bonnie - this is a very significant number (approximately 15 million Americans) given the fact that these were doctor-diagnosed food allergies. Allergists, much less doctors, ever take food allergies into account for health-related symptoms. My estimation would be closer 15-20% of the population if you take into account those with food allergies who are undiagnosed. Add to that the number of Americans with food intolerances, I would say that somewhere between 50-60% of the population have a food issue.