Monday, August 31, 2009

Ragweed Foods: Remove and Replace

Ragweed season is here again for an estimated 36 million Americans. Ragweed is the number one cause of fall allergies, according to the American Academy of Allergy, Asthma & Immunology.

Ragweed is common in most regions of the United States from mid-August through the first frost. Each plant produces 1 billion pollen grains in an average season, and the grains can travel up to 400 miles with the help of the wind.

Many individuals with ragweed allergy also experience symptoms while eating certain cross-reacting foods.

- Keep your windows closed at night. If possible, use air conditioning, which cleans, cools and dries the air.

- Try to stay indoors when the pollen or mold counts are reported to be high. Wear a pollen mask if long periods of exposure are unavoidable.

- Check your area's pollen and mold levels from the National Allergy Bureau.

- Avoid mowing the lawn or raking leaves because it stirs up pollen and molds. Also avoid hanging sheets or clothes outside to dry.

- Take a shower before bed to wash pollen from your hair and face, which prevents it from ending up on your pillow.

-Use a saline nasal rinse or neti pot to keep sinuses clear of pollen.

- Avoid cross-reacting foods.

Bonnie - we have come up with a perfect one-sheet called Ragweed Foods: Remove and Replace.

Sixty percent of adults can't digest milk

By Elizabeth Weise, USA TODAY

Got milk? If you do, take a moment to ponder the true oddness of being able to drink milk after you're a baby. No other species but humans can. And most humans can't either. The long lists of food allergies some people claim to have can make it seem as if they're just finicky eaters trying to rationalize likes and dislikes. Not so. Eggs, peanuts, tree nuts, fish, shellfish soy and gluten all can wreak havoc on the immune system of allergic individuals, even causing a deadly reaction called anaphylaxis. But those allergic reactions are relatively rare, affecting an estimated 4% of adults.

Milk's different. First off, it's not actually an allergy in that there's not an immune response. People who are lactose intolerant can't digest the main sugar —lactose— found in milk. In normal humans, the enzyme that does so —lactase— stops being produced when the person is between two and five years old. The undigested sugars end up in the colon, where they begin to ferment, producing gas that can cause cramping, bloating, nausea, flatulence and diarrhea.

If you're American or European it's hard to realize this, but being able to digest milk as an adult is one weird genetic adaptation. It's not normal. Somewhat less than 40% of people in the world retain the ability to digest lactose after childhood. The numbers are often given as close to 0% of Native Americans, 5% of Asians, 25% of African and Caribbean peoples, 50% of Mediterranean peoples and 90% of northern Europeans. Sweden has one of the world's highest percentages of lactase tolerant people.

Being able to digest milk is so strange that scientists say we shouldn't really call lactose intolerance a disease, because that presumes it's abnormal. Instead, they call it lactase persistence, indicating what's really weird is the ability to continue to drink milk. There's been a lot of research over the past decade looking at the genetic mutation that allows this subset of humanity to stay milk drinkers into adulthood. A long-held theory was that the mutation showed up first in Northern Europe, where people got less vitamin D from the sun and therefore did better if they could also get the crucial hormone (it's not really a vitamin at all) from milk. But now a group at University College London has shown that the mutation actually appeared about 7,500 years ago in dairy farmers who lived in a region between the central Balkans and central Europe, in what was known as the Funnel Beaker culture. The paper was published this week in PLoS Computational Biology.

The researchers used a computer to model the spread of lactase persistence, dairy farming, other food gathering practices and genes in Europe. Today, the highest proportion of people with lactase persistence live in Northwest Europe, especially the Netherlands, Ireland and Scandinavia. But the computer model suggests that dairy farmers carrying this gene variant probably originated in central Europe and then spread more widely and rapidly than non-dairying groups.

Author Mark Thomas of University College London's dept of Genetics, Evolution and Environment says: "In Europe, a single genetic strongly associated with lactase persistence and appears to have given people with it a big survival advantage." The European mutation is different from several lactase persistence genes associated with small populations of African peoples who historically have been cattle herders. Researchers at the University of Maryland identified one such mutation among Nilo-Saharan-speaking peoples in Kenya and Tanzania. That mutation seems to have arisen between 2,700 to 6,800 years ago. Two other mutations have been found among the Beja people of northeastern Sudan and tribes of the same language family in northern Kenya.

Use of Low-Dose Aspirin in Primary Prevention of Cardiovascular Events Not Recommended

The use of low-dose aspirin in the primary prevention of cardiovascular events in healthy individuals with asymptomatic atherosclerosis is currently not warranted, according to the lead researcher of a large "real-world" study presented at the European Society of Cardiology (ESC) 2009 Congress.

In the randomized trial of 3350 subjects deemed at high risk for cardiovascular and cerebrovascular events because of a low ankle-brachial index (ABI) (<0.95), aspirin had absolutely no effect on reducing events compared with placebo, Dr Gerry Fowkes (University of Edinburgh, Scotland) reported on behalf of the Aspirin for Asymptomatic Atherosclerosis (AAA) trialists. However, aspirin did increase the risk of major hemorrhage. The bleeding effect "is a real obstacle," Fowkes told heartwire . "I don't think the evidence is convincing enough as yet that aspirin should be used routinely in the general population."

At the same conference, German researchers stated that routine use of low-dose aspirin in primary prevention of cardiovascular events with type 2 diabetes should be revised and may be harmful. Their comments came from results from two trials (Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes and Prevention of Progression of Arterial Disease and Diabetes). Both failed to find any efficacy from aspirin use.

Steve - the evidence continues to mount against the use aspirin for CVD prevention in healthy and diabetic individuals.

Antibiotic prescriptions going down

Antibiotic prescriptions are being written less frequently for patients with respiratory tract infections, which include ear infections, sinus infections and bronchitis, as well as colds and flu.

Antibiotics must be used judiciously or they'll start to lose their effectiveness. Bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae are a growing problem as they've become resistant to entire classes of antibiotic drugs. This means many bacterial illnesses are harder to treat. Further, antibiotics that are developed to combat resistant bacteria are generally more expensive and often more toxic.

The most egregious misuse of antibiotics is when they're used to treat a viral illness such as the common cold. Antibiotics are effective against bacteria, not viruses. However, ear infections, sinus infections and bronchitis may be viral, bacterial or both, so sometimes antibiotics are prescribed just in case there's a bacterial component.

The Journal of the American Medical Association study showed inn children younger than 5, rates of antibiotic prescription decreased by 27% overall, and by 36% in patients with respiratory tract infections. In children 5 and older and adults, overall rates of antibiotic prescription didn't change over the study period, but an 18% decrease was found for people with respiratory tract infections.

For ear infections -- the most frequent reason for prescribing antibiotics to young children -- researchers found antibiotic use didn't change during the study period. Antibiotics were prescribed about 80% of the time an ear infection was diagnosed in kids less than 5 years old.

Bonnie - while encouraging, there still needs to a major reduction in children with ear infections. More often than not, watchful waiting will be effective and will lower the amount of recurrences.

Friday, August 28, 2009

September Locavore Tidbit

What's in season in the Midwest and other colder climates: Apples, Beans, Beets, Bell Peppers, Blueberries, Broccoli, Cabbage, Cantaloupes, Carrots, Cauliflower, Cucumbers, Eggplant, Fennel, Garlic, Grapes, Horseradish, Lettuce, Melons, Mushrooms, Nectarines, Okra, Onions, Peaches, Pears, Plums, Potatoes, Pumpkins, Radishes, Raspberries, Rhubarb, Shallots, Spinach, Summer Squash, Sweet Corn, Sweet Potatoes, Tomatoes, Turnips, Watermelons, Winter Squash.

Locally grown produce provides a fresh, less toxic product, supports your local economy, and reduces your carbon load.

Wheat consumption may contribute to diabetes

An abnormal immune response to wheat proteins may contribute to type 1 diabetes, according to a study appears in the August issue of Diabetes..

Nearly half of the subjects with type 1 diabetes had immune system T-cells that overreacted to wheat. The researchers also identified genes associated with this abnormal immune response.

"The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or overreacting to the environment, and this can be particularly challenging in the gut, where there is an abundance of food and bacteria," study author Dr. Fraser Scott, a senior scientist at the Ottawa Hospital Research Institute and professor of medicine at the University of Ottawa, said in a hospital news release.

"Our research suggests that people with certain genes may be more likely to develop an overreaction to wheat and possibly other foods in the gut, and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes," he explained.

Bonnie - can you say gluten? Wheat has more gluten than any other grain. American wheat, in particular, has the highest gluten content of any wheat in the world, which is why we have the most gluten intolerance in the world.

Wednesday, August 26, 2009

Recipe du Jour - Gluten-Free Banana Bread

Banana Bread (Gluten-free)

1 package Namaste muffin mix (made with rice flour)
2 eggs
1/4 cup organic canola oil
1 tsp. baking powder (corn-free Featherweight brand)
2 mashed bananas
1/4 cup organic agave syrup
1/4 c. dark chocolate chips, optional
1/4 c. walnut or pecan pieces, optional

Preheat oven to 350 degrees. Combine wet ingredients in a large bowl. Add muffin mix and baking powder into wet ingredients. Mix well. Add dark chocolate chips and nuts, if desired. Pour mixture into large loaf pan or 3 small loaf pans. Bake for 50-60 minutes.

More of our recipes can be found in Recipes to Live By or eNewsletter Archives.

Acupunture brings relief from PCOS

Polycystic ovary syndrome, a common condition among women, can be relieved by the use of acupuncture and exercise.

Nearly 10% of women of reproductive age have polycystic ovary syndrome (PCOS). The syndrome expresses itself as a large number of small immature cysts on the ovaries that cause a disturbance in the production of hormones and an increase in the secretion of the male sex hormone. This means that many women with the condition do not ovulate normally, and the syndrome may lead to infertility. The women run an increased risk of becoming obese, developing type 2 diabetes, or developing cardio-vascular disease.

During the Swedish study, one group of women with polycystic ovary syndrome received acupuncture regularly for four months. They received a type of acupuncture known as 'electro‑acupuncture', in which the needles are stimulated with a weak low‑frequency electric current, similar to that developed during muscular work. A second group of women were provided with heart rate monitors and instructed to exercise at least three times a week. A control group was informed about the importance of exercise and a healthy diet, but was given no other specific instructions.

The American Journal of Physiology - Regulatory, Integrative and Comparative Physiology study showed that activity in the sympathetic nervous system was lower in the women who received acupuncture and in those who took regular exercise than it was in the control group. The acupuncture treatment brought further benefits.

“Those who received acupuncture found that their menstruation became more normal. We could also see that their levels of testosterone became significantly lower, and this is an important observation, since elevated testosterone levels are closely connected with the increased activity in the sympathetic nervous system of women,” says Elisabet Stener‑Victorin.

Bonnie - this has been effective for some of my clients with PCOS. It is nice to see the research data to back it up.

Tuesday, August 25, 2009

Understanding metabolic detoxification

A few tips from a detoxification conference we attended confirms why our Smart Detox Action Plan is such a valuable tool to incorporate into your lifestyle twice a year. It is extremely safe, gentle on the organs, and offers three different protocols based upon individual need.
  • What impairs detoxification?? Diet, Lifestyle, Exposure to Toxins, Nutrient Deficiencies, Genetic Polymorphisms, Medications.

  • Fasts devoid of protein and liquid only detox protocols are not optimal. You need energy from macro and micro nutrients to see a positive outcome and reduce stress on your organs.

  • Many of us have detectable levels of chemicals similar to that of Vietnam Vets with Agent Orange issues. For example, a study in the August issue of Therapeutic Drug Monitoring found that childhood leukemia patients had highly elevated levels of household pesticides in their urine compared to children without leukemia.

  • The toxins nestle into fat cells as the bodies way of protecting them from the rest of the body.

  • Phase 1, 2, and 3 of detoxification requires taking a fat soluble toxin and turning it into a water soluble toxin so it can be excreted through kidney/urine/g.i. tract. Balancing the three phases is crucial or you can end up recirculating an even more potent toxin back into your body if it is unable to be excreted.

  • Many of the nutrient suggestions we make in Smart Detox mirror the experts views: magnesium glycinate is great for phase 1 & 2 support; glycine in particular for phase 2; Tea, Advaclear, Ultraclear, and Phytoganix provide phenomenal macro and micronutrients to support all three detox phases.

The Claim: Some Foods Can Ease Arthritis Pain

Courtesy of The New York Times

The Claim: Some Foods Can Ease Arthritis Pain


Patients with arthritis are often encouraged to steer clear of all sorts of foods. But few of these diets are supported by any evidence. In one of the largest analyses of diet and various types of arthritis, researchers looked at data on more than 800 patients from 15 studies. They examined several diets popular among arthritis patients and found that the one that had the greatest effect was a Mediterranean-type diet emphasizing foods like fruits, vegetables, grains, fish and olive oil, while limiting red meat. In 12 weeks, people on the diet reported about 15 percent less pain, but no improvement in physical function or morning stiffness. A vegetarian diet that allowed eggs and dairy products had a similar effect. In other studies, patients who were given daily capsules of fish oil to take along with their antirheumatic medications saw greater benefits for swollen and tender joints than patients given a placebo, apparently because of the oil’s anti-inflammatory properties.

Meanwhile, vegetables in the nightshade family, like potatoes and tomatoes, have long been said to contribute to arthritis pain. Some researchers have speculated that a group of compounds in the vegetables called alkaloids might worsen inflammation in sensitive people. But so far no solid studies have demonstrated this. Experts say a diet in which suspect foods are gradually removed should help patients identify any problematic foods.

THE BOTTOM LINE There is some evidence that certain diets may help with arthritis symptoms.

Bonnie - does this not sound like something we created several years ago...The Pain Relief Diet? It is a two-week diet geared to encourage anti-inflammatory foods, remove inflammatory foods, and then gradually add back potential reactors. While it does not work for everyone, it is certainly worth trying.

Issues affecting our children: ADHD, Antidepressants, Child Obesity, and Vaccines.

These four issues are paramount when addressing issues affecting the current generation of American children. Our perspective concerning the latest data:

Attention Deficit Hyperactive Disorder (ADHD)

A National Institutes of Health panel in 2000 was quoted as saying "we have no strategies for prevention of ADHD." Fast forward to July 2009: according to the National Institute of Mental Health, in youth with ADHD, the brain matures in a normal pattern but is delayed three years in some regions compared those those without ADHD. The NIMH went further by saying, "Finding a normal pattern, albeit delayed, should be reassuring to families and could help explain why many youth eventually grow out of the disorder."
Bonnie - based upon these comments, as well as the recent dangers with ADHD drugs (see below), is it crucial to medicate so many of our young people this way?

Pharmacy-benefits manager Medco's May 2009 annual report on drug spending by its clients exhibited one item that caught our attention: Kids aged 19 and below were the ones who had the greatest increase in spending, at about 4.5%. Medco pointed to the increased use of drugs for diabetes and attention deficit hyperactivity disorder among youngsters as drivers of the increase among that group.

Not surprisingly, calls to
poison control centers about teens abusing attention-deficit drugs has soared 76 percent over the last eight years, sobering evidence about the dangerous consequences of prescription misuse of this class of stimulants.

ADHD standard treated is with behavioral therapy, pharmacotherapy, or a combination of both. However, there are many parents who resist giving their children ADHD medication. Instead, they opt for behavioral and alternative therapies. We have compiled the most recent data revealing the common triggers and alternative therapies for Attention Deficit Hyperactive Disorder:
  • Environment (especially in prenatal women, fetuses, and infancy)
  • Diet
  • Food Additives
  • Heavy Metal Toxicity
  • Vitamin and Mineral Deficiencies: Iron (low serum Ferritin level), Magnesium, Zinc, Vitamins B-6, B-12, and D
  • Food Allergies/Intolerances
  • Excessive television viewing
  • Sleep Disturbances
Here is a list of the most effective alternatives therapies for ADHD:
  • Behavioral Therapy
  • Yoga
  • Balanced diet
  • Remove preservatives, chemicals, artificial colors, flavors, and sweeteners.
  • Remove foods high in salicylic acid.
  • Acupuncture
  • Chiropractic
  • EPA/DHA supplementation for an omega 3:omega 6 imbalance. According to research published in the August Alternative Therapies in Health and Medicine, daily supplements of omega-3 and vitamin E were associated with improvements in speech, imitation, eye contact, and behavior. Claudia Morris from the Children’s Hospital and Research Center Oakland (CHRCO) and Marilyn Agin from the Saint Vincent Medical Center in New York recruited families with experiences of omega-3 fatty acid and vitamin E supplementation. The majority of families used doses of 800 IU of vitamin E, while the average omega-3 consumption was 280 to 840 mg DHA and 695 to 2,085mg EPA. Bonnie - we like liquid Cod Liver Oil best for ADHD.
  • Melatonin (helps with sleep disturbances related to ADHD). However, because it is a hormone, a deficiency needs to be diagnosed first and okayed by a pediatrician or side effects such as a gonad abnormality are possible.
  • Supplemental Iron, L-carnitine, Magnesium (for over 300 enzymatic functions), Pyridoxine (Vitamin B6) or Pyridoxyl-5-Phosphate (Activated Vitamin B6), Vitamin B-12, and Zinc for deficiencies.
The following details the mounting safety issues with ADHD meds:
ADHD Drugs Raise Heart Rate and BP
ADHD Drugs Under Fire for Unexplained Deaths
ADHD Drugs Only Work for the First Few Months
ADHD Drugs Can Cause Hallucinations
Stimulants Used in Children With ADHD Raises Cardiac Risk
Study Links Medication With Better Test Scores
Food Additives Raise Hyperactivity
Ritalin the Next Brain Booster?


In a welcome public health about-face, use of antidepressants by children continued to drop sharply this year (25%) in the wake of warning labels linking the prescription drugs to suicidal behavior. The decrease signals that doctors and parents are taking a more careful look at benefits and risks of treatments for depression, says child psychiatrist David Fassler of Burlington, Vt. "Not all depressed kids need medication. There are effective therapies, especially for milder forms of depression."

The Food and Drug Administration ordered "black boxes," the most severe safety warning, for antidepressants in October 2004, and these stronger labels were on the medicines by March. The FDA said two out of 100 children were more likely to think about or try suicide because they were taking the pills. They made an official statement this week saying that after careful review of all recent data, people under age 25 who take antidepressants categorically have a higher risk of suicide.

There are many non-pharmacological options that can address childhood depression. Our Improve Your Mood Action Plan delves into this.

Child Obesity

The latest astonishing statistic: 1 in 5 American 4 year-olds is obese according to an April study in
Archives of Pediatric and Adolescent Medicine: 13% Asian, 16% white, 21% black, 22% Hispanic, 31% American Indian. The numbers have tripled in the last 25 years. Keep in mind, this is obese, not overweight. Given the fact that dealing with obesity-related illness accounts for 10% of our overall health care costs, imagine where we'll be when these kids reach adulthood if we do not take drastic action right now?

In another indictment of poor diet, the CDC states that more than half of children 5 to 9 have had at least one cavity or filling, and 78% of 17 year-olds have experienced tooth decay. Of course, 90% of all tooth decay is preventable with good nutrition and hygiene.

Beyond the host of health complications that accompany childhood obesity, a recent study in Journal Obesity showed that overweight students had lower reading comprehensions scores, half a grade point lower, lower physical fitness scores, less inclined to participate on athletic teams, and five times more likely to have six or more detentions than normal-weight kids.

Too little sleep or not spending enough time in rapid eye movement (REM) sleep may double the chance that a child will gain weight, according to an Archives of General Psychiatry study.

The CDC has "thrown down the gauntlet" with new community strategies and measurements to prevent obesity. But does it go far enough?

One intriguing
Pediatrics study shows that a community-wide approach can be effective for promotion and provision of drinking water in schools. The intervention consisted of the following: installation of a new water fountain in the school (2 if the school was big enough); provision of a plastic water bottle to each child; instruction to teachers to facilitate having the children fill water bottles each morning (at school); and delivery by teachers of 4 standardized lessons over the course of the academic year (45 minutes each lesson) on water needs. At the end of the trial, the intervention group increased water consumption by 1.1 glasses per day over the control group and the intervention was effective in preventing overweight.

There are numerous public health steps that can be taken to address this issue. To be effective, they must be drastic and would unpopular to special interests. So the chances of being implemented are remote. What can parents control? First, control your home environment from a dietary and physical activity standpoint. Outside the home, allocate your dollars to healthful, positive lifestyle choices. If accomplished, the powers-that-be, as they always do, will follow the money.

A few new studies that will definitely not make national news, but are important to note:
  • The CDC's Immunization Safety Office earlier this year stated that children who get the combined MMR+Varicella (Chicken pox) are slightly more likely to have seizures compared to those getting two separate shots for the same diseases.
  • During an outbreak of varicella (Chicken pox) in an elementary school in Arkansas, students who were vaccinated once or twice still came down with the illness, though their symptoms were mild. Furthermore, vaccine effectiveness was no better among those who received two inoculations prior to the outbreak than those who received only one, researchers report in the Pediatric Infectious Disease Journal for August. There were 84 cases of varicella. Twenty-five cases had received two doses, 53 had received one dose, and 6 were unvaccinated.
  • A Pediatrics study found that there is increased risk, albeit small (one in 40,000), of getting the blood disorder immune, thrombocytopenic purpura (ITP), where the immune system destroys its own blood platelets from the MMR vaccine.

  • The inactivated flu vaccine does not appear to be effective in preventing influenza-related hospitalizations in children, especially the ones with asthma. In fact, children who get the flu vaccine are more at risk for hospitalization than their peers who do not get the vaccine, according to new research that will be presented by Mayo Clinic researchers on May 19, at the 105th International Conference of the American Thoracic Society in San Diego.

The following is a summary of the April 2009 NVAC Vaccine Safety Working Group Report. The NVAC is a government appointed, broad-based committee of vaccine stakeholders, including researchers, vaccine manufacturers, advocacy groups, and parents whose children have been injured from vaccines. It is the NVAC's responsibility to make recommendations to the Institute of Medicine to prioritize and pinpoint specific measures to answer questions about the National Immunization Program's safety.

Note that the NVAC requested broad public engagement before coming to a consensus on their questions/recommendations:
  • There is a strong need for a federal vaccine safety research agenda that encompasses research undertaken by non-governmental agencies.
  • There is a strong need to have increased collaboration with all governmental agencies involved with vaccine safety.
  • Are influenza and meningitis vaccines associated with increased risk for Guillain-Barre Syndrome?
  • Is exposure to thimerosal (ethylmercury) associated with increased risk for clinically important tics, Tourette syndrome, and/or speech language delays?
  • Are varicella (chicken pox, shingles) vaccines associated with increased risk for clinically important events related to virus reactivation?
  • Do multiple vaccinations increase risk of immune system disorders?
  • Immunization Safety Office should evaluate cumulative levels of non-antigen (added ingredients besides the actual organism) component exposure possible through the schedule of recommended vaccinations. They specifically mention that many of these chemicals have no safety data from administration via injection.
  • There is little attention paid to performing studies to prevent the risk of adverse events before the exposure to the vaccine. A fundamental principle in vaccine safety research should be to prevent vaccine adverse reactions whenever possible, and if not possible, to ameliorate the effects of the adverse reaction.
  • Create a feasibility study to see the value of a study of vaccinated versus unvaccinated children to determine if there are differences in health outcomes.
  • Identify and evaluate ways to increase the number of severe events that are reported to VAERS (Vaccine Adverse Event Reporting System) and to improve the completeness and quality of reports received.
  • Create an expert advisory group on genomics and vaccine safety to assist with developing a focused genomics research agenda and product development protocol.
  • Create a single written guide dedicated to comprehensive clinical guidance for identifying, reporting, and treating vaccine adverse events.
  • Include vaccination of children with mitochondrial disease, mitochondrial dysfunction, and other metabolic diseases as a priority scientific area for clinical guidance.
  • There needs to be more study with regards to vaccine and drug interactions.
Bonnie - the only comment we could add to clarify the committee's suggestions would be: why weren't these questions answered a long time ago, before we mandated over 25 vaccines for children under the age of six?

Monday, August 24, 2009

AHA on sugar: where have you been?

I bet you must be shocked with The American Heart Association's revelation...cut back on the added sugars!

In a statement issued Monday, the organization says most women should limit their sugar intake to 100 calories, or about six teaspoons, a day; for men, the recommendation is 150 calories, or nine teaspoons.

Whoah, go out on limb there guys.

This is the first time the heart association has suggested specific limits. The recommendations apply only to what are known as added sugars—those that are added to foods during manufacturing, or by consumers.

Added sugars "offer no nutritional value other than calories to the diet," the AHA said. "The majority of Americans could reduce their risk of heart disease by achieving healthy weight and the evidence is fairly clear that reducing the amount of sugars can help with that."

While it is going out on a limb for this ultra-conservative organization to make we what we consider very ordinary suggestions, they are way too late to the party. They could have made a real impression twenty or thirty years ago.


FDA's Ongoing Safety Review of Weight Loss Drug Orlistat (Xenical and Alli)

The U.S. Food and Drug Administration announced today that it is reviewing adverse event reports of liver injury in patients taking the weight loss drug orlistat, marketed as the prescription drug Xenical and the over-the-counter medication Alli.

Between 1999 and 2008, the FDA received 32 reports of serious liver injury in patients taking orlistat. Of those cases, 27 reported hospitalization and six resulted in liver failure. Thirty of the adverse events occurred outside the United States. The most commonly reported adverse events included yellowing of the skin or whites of the eyes (jaundice), weakness, and stomach pain.

The FDA is reviewing additional data submitted by orlistat manufacturers on suspected cases of liver injury, and the issue has been discussed at the FDA’s Center for Drug Evaluation and Research Drug Safety Oversight Board.

“The issues here are complex, but FDA has benefited from the input of the Board, including comments from representatives from three FDA Centers and several other Agencies in the Department of Health and Human Services,” said Steven Osborne, M.D., executive director of the Board.

The FDA’s analysis of these data is ongoing, and no definite association between liver injury and orlistat has been established at this time. Consumers taking Xenical should continue to take it as prescribed, and those using over-the-counter Alli should continue to use the product as directed.

Full text of the Early Communication about an Ongoing Safety Review can be found here. The Early Communication is a risk communication tool used by the FDA to inform the public about its ongoing safety reviews of drugs. The FDA will release its findings on orlistat as soon as the review is completed.

Consumers who have used orlistat should consult a health care professional if they experience symptoms possibly associated with development of liver injury, particularly weakness or fatigue, fever, jaundice, or brown urine. Other symptoms may include abdominal pain, nausea, vomiting, light-colored stools, itching, or loss of appetite.

The FDA urges both health care professionals and consumers to report suspected side effects from the use of orlistat to FDA's MedWatch Adverse Event Reporting program either online, or by regular mail, fax, or phone.
-- Online
--Regular Mail: use postage-paid FDA form 3500 and mail to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787
--Fax: 800-FDA-0178
--Phone: 800-FDA-1088

Oxycholesterol: New Cardiac Risk?

Scientists are reporting that another form of cholesterol called oxycholesterol — virtually unknown to the public — may be the most serious cardiovascular health threat of all.

Scientists from China presented one of the first studies on the cholesterol-boosting effects of oxycholesterol at the 238th National Meeting of the American Chemical Society. The researchers hope their findings raise public awareness about oxycholesterol, including foods with the highest levels of the substance and other foods that can combat oxycholesterol's effects.

Fried and processed food, particularly fast-food, contains high amounts of oxycholesterol. Avoiding these foods and eating a diet that is rich in antioxidants, such as fresh fruits and vegetables, may help reduce its levels in the body, the researchers note.

Scientists have known for years that a reaction between fats and oxygen, a process termed oxidation, produces oxycholesterol in the body. Oxidation occurs, for instance, when fat-containing foods are heated, as in frying chicken or grilling burgers or steaks. Food manufacturers produce oxycholesterol intentionally in the form of oxidized oils such as trans-fatty acids and partially-hydrogenated vegetable oils. When added to processed foods, those substances improve texture, taste and stability. Until now, however, much of the research focused on oxycholesterol's effects in damaging cells, DNA, and its biochemical effects in contributing to atherosclerosis. Chen believes this is one of the first studies on oxycholesterol's effects in raising blood cholesterol levels compared to non-oxidized cholesterol.

In the new study, Chen's group measured the effects of a diet high in oxycholesterol on hamsters, often used as surrogates for humans in such research. Blood cholesterol in hamsters fed oxycholesterol rose up to 22 percent more than hamsters eating non-oxidized cholesterol. The oxycholesterol group showed greater deposition of cholesterol in the lining of their arteries and a tendency to develop larger deposits of cholesterol. These fatty deposits, called atherosclerotic plaques, increase the risk for heart attack and stroke.

Most importantly, according to Chen, oxycholesterol had undesirable effects on "artery function." Oxycholesterol reduced the elasticity of arteries, impairing their ability to expand and carry more blood. That expansion can allow more blood to flow through arteries that are partially blocked by plaques, potentially reducing the risk that a clot will form and cause a heart attack or stroke.

But a healthy diet rich in antioxidants can counter these effects, Chen said, noting that these substances may block the oxidation process that forms oxycholesterol. Good sources of antioxidants include fruits, veggies, beans, and certain herbs and spices. Healthy alternatives to fast-food, which also boosts oxycholesterol, include whole grains, fresh fruits and vegetables, seeds, and nuts.

Scientists do not know whether the popular anti-cholesterol drugs called statins lower oxycholesterol, Chen said.

Steve - while the study was done on hamsters, we decided to publish it because it is an intriguing finding which will surely translate to human studies.

Antioxidants reduce Non-Hodgkins Lymphoma risk

Increased intakes of antioxidant-rich fruit and vegetables may reduce the risk of developing non-Hodgkin lymphoma, says a new study from the Mayo Clinic. Intakes of vitamin C, alpha-carotene, and proanthocyanidins were associated with reductions in the risk of non-Hodgkin lymphoma of 22, 29, and 30 percent, respectively, according to findings published in the International Journal of Cancer.

From a food perspective the researchers, led by Dr James Cerhan, report that yellow/orange and cruciferous vegetables, including broccoli, were found to confer the greatest risk reductions.

Mayo Clinic researchers examined data from 35,159 Iowa women aged between 55 and 69 participating in the Iowa women's health study. Diets were analyzed using a validated semi-quantitative food frequency questionnaire. Over 20 years of follow-up, a total of 415 cases of non-Hodgkin lymphoma were documented. Intakes of 204 or more servings per month (about 7 servings per day) of all fruit and vegetables were associated with a 31 percent reduction in NHL risk, compared to intakes of less than 104 servings per month. High intakes of yellow/orange vegetables (14 or more servings of per month) were associated with a risk reduction of 28 percent, as were four or more broccoli servings per month, compared to people who are no broccoli. Considering the nutrients, in addition to the risk reductions associated with increased intakes of vitamin C, alpha-carotene, and proanthocyanidins, increased intakes of manganese from dietary sources was also associated with a risk reduction of about 40 per cent.

Friday, August 21, 2009

Ghostwriting for Big Pharma

Drugmaker GlaxoSmithKline used a sophisticated ghostwriting program to promote its antidepressant Paxil, allowing doctors to take credit for medical journal articles mainly written by company consultants, according to court documents obtained by The Associated Press.

An internal company memo instructs salespeople to approach physicians and offer to help them write and publish articles about their positive experiences prescribing the drug.

Known as the CASPPER program, the paper explains how the company can help physicians with everything from "developing a topic," to "submitting the manuscript for publication."

The document was uncovered by the Baum Hedlund PC law firm of Los Angeles, which is representing hundreds of former Paxil users in personal injury and wrongful death suits against GlaxoSmithKline. The firm alleges the company downplayed several risks connected with its drug, including increased suicidal behavior and birth defects.

Articles from the company's program appeared in five journals between 2000 and 2002, including the American Journal of Psychiatry and the Journal of the American Academy of Child and Adolescent Psychiatry.

Steve - should anybody be surprised by this?

Therapy Beats Drugs for Moms

Courtesy of WSJ

Pregnant women suffering from depression should consider psychotherapy before taking antidepressant medications, according to the first comprehensive treatment recommendations issued on the subject from the American Psychiatric Association and American College of Obstetricians and Gynecologists.

Women with moderate to severe depressive symptoms, including suicidal thoughts, or who have experienced repeated episodes of depression should remain on their medications during pregnancy, the recommendations say. Any pregnant woman already taking an antidepressant should talk with her doctor before deciding to continue or to taper off.

"The black box in this -- what we don't know -- are people with milder depression," said Kimberly Yonkers, a professor in the departments of psychiatry and obstetrics and gynecology at Yale University, and the first author on the report, which is being published Friday in the journal General Hospital Psychiatry. "The story is not established in the literature whether that group of people should be kept on antidepressants in pregnancy."

The biggest concern for unborn babies with a popular class of antidepressants known as selective serotonin reuptake inhibitors is increased risk of pulmonary hypertension, or increased pressure in the lungs that can lead to heart failure. Newborns who were exposed to SSRIs after 20 weeks in the womb have a sixfold increase in the relative risk of developing this condition, though the absolute risk is small at 1 to 2 per 1,000, according to the report.

Popular SSRIs include Eli Lilly & Co.'s Prozac and Pfizer Inc.'s Zoloft, both marketed in generic versions. Another SSRI, paroxetine, sold by GlaxoSmithKline PLC as Paxil, has been associated in rare cases with cardiac abnormalities if used by the mother during the first trimester.

Vitamin D may reduce pre-eclampsia risk

Increased intakes of vitamin D during pregnancy may reduce the development of pre-eclampsia by about 25 per cent, suggests an Epidemiology study with over 20,000 Norwegian women. The risk of pre-eclampsia was 27 per cent lower in women who consumed vitamin D supplements with daily doses of 10 to 15 micrograms, compared to women who did not take supplements, according to researchers from the Norwegian Institute of Public Health.

Bonnie - vitamin D, magnesium, and B-vitamins are all crucial for prevention of pre-eclampsia.

Thursday, August 20, 2009

'Killer Spices' Provide Eco-friendly Pesticides For Organic Fruits And Veggies

Mention rosemary, thyme, clove, and mint and most people think of a delicious meal. Think bigger…acres bigger. These well-known spices are now becoming organic agriculture's key weapons against insect pests as the industry tries to satisfy demands for fruits and veggies among the growing portion of consumers who want food produced in more natural ways.

In a study presented at the American Chemical Society's 238th National Meeting, scientists in Canada are reporting exciting new research on these so-called "essential oil pesticides" or "killer spices." These substances represent a relatively new class of natural insecticides that show promise as an environmentally-friendly alternative to conventional pesticides while also posing less risk to human and animal health, the researcher says.

These new pesticides are generally a mixture of tiny amounts of two to four different spices diluted in water. Some kill insects outright, while others repel them.

The natural pesticides have several advantages. Unlike conventional pesticides, these "killer spices" do not require extensive regulatory approval and are readily available. An additional advantage is that insects are less likely to evolve resistance — the ability to shrug off once-effective toxins — Isman says. They're also safer for farm workers, who are at high risk for pesticide exposure, he notes.

The "killer spices" aren't just limited to agricultural use. Some show promise in the home as eco-friendly toxins and repellents against mosquitoes, flies, and roaches. Unlike conventional bug sprays, which have a harsh odor, these natural pesticides tend to have a pleasant, spicy aroma. Many contain the same oils that are used in aromatherapy products, including cinnamon and peppermint, Isman notes.

Manufacturers have already developed spice-based products that can repel ticks and fleas on dogs and cats without harming the animals. Researchers are now exploring the use of other spice-based products for use on fruits and vegetables to destroy microbes, such as E. coil and Salmonella, which cause food poisoning.

Steve - we have reported in this now for several years. As consumers, we need to really support this. In turn, we can contribute to significantly reducing our toxic load.

Wednesday, August 19, 2009

High dose vitamin outperforms Zetia?

Courtesy of WSJ

Tongues wagged after word came out last month that an independent study comparing Merck and Schering-Plough’s cholesterol drug Zetia with a rival treatment had abruptly ended. There was no explanation why the trial was stopped early. Speculation followed. Several analysts now are saying the study was probably halted because the rival drug, Abbott’s Niaspan, outperformed Zetia. “It is nearly uniform thinking among the industry contacts we know that Niaspan likely beat Zetia,” Sanford Bernstein’s Tim Anderson wrote in a note today.

Zetia, of course, is a component of Merck and Schering-Plough’s cholesterol-fighting medication Vytorin. The definitive word will not come until the researchers speak at the American Heart Association’s meeting in November, according to the analysts. Other possible outcomes are that Zetia performed better than Niaspan, or that the drugs fared equally. A Merck spokesman said Merck and Schering-Plough did not sponsor the study, which the researchers initiated, and the companies don’t know the results from the trial. “At this point, the results are not available to us nor are they in the public domain,” the spokesman said. Spokeswomen for Abbott said the company hadn’t seen the results either and had no comment. Some previous studies have not treated Vytorin and Zetia kindly. Prescriptions have fallen off in the wake of the brouhaha that followed the delayed release of findings from a study called Enhance and the safety concerns surrounding the findings in the so-called Seas study.

Steve - we should not rush to judgment. However, if Niaspan (high dose niacin), which has been an effective and inexpensive option for cholesterol and HDL modification forever, did outperform Zetia, all I can say is for shame, for shame.

Just because you don’t have celiac disease, doesn’t mean you are free of problems with gluten

I find two approaches to be effective in combating the symptoms of IBS:

  • Identification and elimination of food triggers.
  • Correction of any underling imbalance in the ecosystem in the gut.
It is possible that any food can trigger IBS symptoms. In my experience, wheat is the No. 1 offender. Sometimes wheat sensitivity is caused by sensitivity to a protein found in wheat (as well as oats, rye, and barley) known as gluten.

In conventional medicine, gluten sensitivity is a recognized condition that is known as celiac disease. This can be tested for using blood tests and biopsies of the lining of the small intestine. If the tests come back positive, celiac disease is diagnosed. If they come back negative, it is often assumed that not only is there no celiac disease, but also there’s no sensitivity to wheat or gluten. But is this really so?

I have seen over the years many patients who have turned up negative test results for celiac disease, but who nonetheless have IBS symptoms that seem to have a very clear relationship with wheat consumption. Last year, a 4-year-old girl came to my practice whose parents told me she got diarrhea when she ate wheat, but had no diarrhea if she didn’t eat it. The test of celiac disease was negative, and her dietitian (with the support of her gastroenterologist) enthusiastically advocated a diet for this child that was full of grain-based foods, including wheat.

What are we to make of individuals who don’t appear to have celiac disease but nonetheless appear to react adversely to wheat? It’s possible that individuals may react to wheat in a way or through mechanisms that are not necessarily related to full-blown celiac disease.

This concept was put forward recently in a paper that appeared in the American Journal of Gastroenterology. Doctors based at McMaster University in Hamilton, Canada, and the Mayo Clinic, Minnesota, United States, put forward the idea that gluten can induce symptoms similar to FBD “even in the absence of fully developed celiac disease.”

In short, just because someone doesn’t have celiac disease, doesn’t mean the bowel symptoms are not due to gluten.

One simple but often effective way of identifying food sensitivities is to eliminate foods to see if it helps. One problem here is that some individuals are sensitive to a range of foods, and if all of them are not removed, symptoms may persist even though problem foods have been eliminated. To be on the safe side, I tend to recommend that when they take out wheat, they take out other gluten-containing grains and dairy products.

In my experience, the overwhelming majority of IBS sufferers improve dramatically on this regime. Foods can be added back into the diet (about one every two days) to see which foods cause a return of the IBS symptoms.

Bonnie - this annotated piece was written by a London-based doctor in the Epoch Times.

Stomach bugs boosts risk for IBD

A bout of diarrheal disease caused by the stomach bugs Salmonella or Campylobacter increases the odds that a person will develop inflammatory bowel disease, with the risk persisting 15 years or more after infection, researchers report in the latest issue of the journal Gastroenterology.

Nielsen and colleagues compared the risks of IBD between 13,148 patients with documented gastroenteritis caused by Salmonella or Campylobacter and 26,216 uninfected controls.

After accounting for a variety of factors that might influence the risk, stomach bug patients had nearly a threefold increased risk of developing IBD over the entire study period, and nearly a twofold increased risk in the first year after infection.

The increased risk of IBD after the gastroenteritis episode persisted throughout the 15-year observation period and was similar for Salmonella and Campylobacter and for a first-time diagnosis of Crohn's disease and ulcerative colitis.

Steve - this is another reason to supplement with probiotics. You are giving yourself more ammunition to battle pathogens.

Harvard's new aspirin guidelines

Here are several comments from Harvard Medical School clarifying their position on aspirin:
  • Aspirin was once used mainly to relieve pain and ease fever, but now is a mainstay for heart health. But limited evidence on aspirin’s preventive effects has made it difficult for experts to give recommendations about who benefits from daily aspirin and how much to take.

  • For men, the main benefit of aspirin is preventing a heart attack. For women, it’s preventing the kind of stroke caused by a blood clot (ischemic stroke). It’s the most common kind of stroke. For both, the risks of taking aspirin are gastrointestinal bleeding and hemorrhagic stroke.

  • It makes the most sense to take aspirin if your chance of having a heart attack or stroke is greater than the odds of aspirin causing a problem. The simplest way to figure your heart disease or stroke risk is to use an online calculator, such as the Framingham or Reynolds risk scores, which give you a percentage. If yours is 13% it means that for every 1,000 people with risk factors like yours, 130 will have a heart attack or stroke over the next 10 years. Bonnie - they failed to mention that you can take a genetic test to see if you are aspirin-compatible.

Several things boost the chances of getting into trouble with aspirin:

  • Regular use of ibuprofen (Advil, generic) or another nonsteroidal anti-inflammatory drug in addition to aspirin increases the risk of gastrointestinal bleeding fourfold.
  • Men are twice as likely as women to have gastrointestinal bleeding.
  • Having had a gastrointestinal ulcer, gastrointestinal bleeding, or hemorrhagic stroke increases the chances it will recur.
  • Uncontrolled high blood pressure or use of an anticoagulant such as warfarin (Coumadin, Jantoven, generic) also increases the risk for a hemorrhagic stroke or serious bleeding.
  • Bonnie - they fail to mention that if you are salicylate-sensitive, aspirin is poison.
Do you need aspirin for prevention?
  • Trials evaluating the heart benefits of aspirin have tested doses ranging from 500 milligrams (mg) a day to 100 mg every other day. Experts conclude that a dose of 81 mg a day, the amount in a baby aspirin, seems to work just as well as higher doses, with fewer bleeding problems.
Beyond Aspirin
  • Aspirin isn’t a miracle worker. It lowers the chances of having a first heart attack or stroke, which is great, but it means you can’t rely on aspirin alone to protect you. If you’re really serious, there’s a lot more you can do. The combination of not smoking, maintaining a healthy weight, exercising daily, choosing a healthful diet, and drinking alcohol in moderation lowers the risk of having a heart attack or stroke between 50% and 80%.
Bonnie - based upon the newest research, Harvard's position may even be too encouraging (see routine benefits of Aspirin questioned).

Monday, August 17, 2009

Large amounts of caffeine not good for headaches

People who consume high amounts of caffeine each day are more likely to suffer occasional headaches than those with low caffeine consumption, reports a study in the Journal of Headache Pain.

Low caffeine consumption was also associated with a greater likelihood of chronic headaches, defined as headaches for 14 or more days each month.

The results are drawn from a large cross-sectional study of 50,483 people who answered a questionnaire about caffeine consumption and headache prevalence as a part of the Nord-Tr√łndelag Health Survey (HUNT 2).

Low Choline Levels In Pregnant Women Raise Babies' Risk For Brain And Spinal-cord Defects, Study Shows

A newborn’s risk for brain and spinal-cord defects rises if the mother has low blood levels of the nutrient choline during pregnancy, researchers at the Stanford University School of Medicine have discovered.

The scientists used a collection of 180,000 blood samples from pregnant California women to look for risk factors for two neural tube birth defects: anencephaly, a lethal condition in which the brain and skull do not develop, and spina bifida, a spinal-cord malformation that causes paralysis and lifelong disability. Neural tube defects have become less common since the 1996 decision to fortify the U.S. food supply with folic acid, a B-vitamin shown to prevent the defects, but they have not disappeared.

“Families whose infants die or suffer permanent disability from NTDs still feel the burden of these defects,” said Gary Shaw, DrPH, professor of neonatology and primary author of the new research, which will appear Aug. 14 in Epidemiology.

About 500 pregnancies per year are affected by neural tube defects in California alone, noted Shaw. “We’re keen on understanding what risk factors explain the continued disease.”

“As choline levels went up, risk went down,” Shaw said. Risk for neural tube defects was 2.4 times higher in women with the lowest blood choline levels compared to women with average blood choline levels. The highest blood choline levels were associated with the lowest risk. A previous study by Shaw’s group showed that consumption of choline-rich foods was associated with lower risk for neural tube defects, but this is the first study to evaluate blood levels of choline and NTD risk.

Researchers also need to test whether choline supplements given in early pregnancy reduce the rates of neural tube defects. Right now, prenatal multivitamins contain little or no choline. Women of reproductive age should also follow U.S. Public Health Service recommendations to take a multivitamin containing other nutrients previously shown to promote healthy pregnancies, he said.

The study was funded by grants from the U.S. Centers for Disease Control and Prevention, the National Institute of Neurological Disorders and Stroke, and the Foundation to Promote Research into Functional Vitamin B12 Deficiency.

Bonnie - the prenatal I recommend, Metagenics Wellness Essentials for Pregnancy, contains a separate choline softgel.

ADHD Stimulant Raises Heart Rate and BP in Adolescents

In adolescents with attention deficit hyperactivity disorder (ADHD), high-dose extended-release methylphenidate raises heart rate and blood pressure, say researchers from Massachusetts General Hospital in Boston.

"I would emphasize the possible moderators/mediators of cardiovascular outcomes, such as being more aware of pre-drug risk factors, such as high body-mass index (BMI) and borderline blood pressure," lead author Dr. Paul Hammerness told Reuters Health by email.

Dr. Hammerness and colleagues assessed the cardiovascular safety of daily methylphenidate doses of up to 1.5 mg/kg in 114 adolescents with ADHD, ages 12 to 18, followed for up to 6 months.

In the Journal of Pediatrics, they report that at 6 weeks, diastolic blood pressure and heart rate were slightly but significantly increased compared to baseline, whereas the increase in systolic blood pressure did not reach statistical significance.

By 6 months, the increase in systolic blood pressure had become significant, but the change in diastolic blood pressure from baseline was no longer significant.

Heart rate remained elevated at 6 months, but its change from baseline was not statistically significant.

During methylphenidate treatment, 8% of youngsters met the criteria for prehypertension and 6% met the criteria for hypertension. These patients had higher BMI than did the rest of the sample.

There were no significant ECG changes or serious adverse events during the study, the researchers note.

"We are planning additional studies in this area to examine cardiovascular outcomes in more detail," Dr. Hammerness said, adding that "clinicians have to be aware of the need for accurate and consistent blood pressure/heart rate monitoring."

J Pediatr 2009;155:84-89.

The Expense of Eating With Celiac Disease

By LesleyAlderman
New York Times

You would think that after Kelly Oram broke more than 10 bones and experienced chronic stomach problems for most of his life, someone (a nurse? a doctor?) might have wondered if something fundamental was wrong with his health. But it wasn’t until Mr. Oram was in his early 40s that a doctor who was treating him for a neck injury became suspicious and ordered tests, including a bone scan.

It turned out that Mr. Oram, a music teacher who lives in White Plains, had celiac disease, an underdiagnosed immune disorder set off by eating foods containing gluten, a protein found in wheat, rye and barley.

Celiac disease damages the lining of the small intestine, making it difficult for the body to absorb nutrients. Victims may suffer from mild to serious malnutrition and a host of health problems, including anemia, low bone density and infertility. Celiac affects one out of 100 people in the United States, but a majority of those don’t know they have the disease, said Dr. Joseph A. Murray, a gastroenterologist at the Mayo Clinic in Minnesota who has been studying the disease for two decades.

Seven years after receiving his diagnosis, Mr. Oram, who is married and has one daughter, is symptom-free, but the cost of staying that way is high. That’s because the treatment for celiac does not come in the form of a pill that will be reimbursed or subsidized by an insurer. The treatment is to avoid eating products containing gluten. And gluten-free versions of products like bread, pizza and crackers are nearly three times as expensive as regular products, according to a study conducted by the Celiac Disease Center at Columbia University.

Unfortunately for celiac patients, the extra cost of a special diet is not reimbursed by health care plans. Nor do most policies pay for trips to a dietitian to receive nutritional guidance.

In Britain, by contrast, patients found to have celiac disease are prescribed gluten-free products. In Italy, sufferers are given a stipend to spend on gluten-free food.

Some doctors blame drug makers, in part, for the lack of awareness and the lack of support. “The drug makers have not been interested in celiac because, until very recently, there have been no medications to treat it,” said Dr. Peter Green, director of the Celiac Disease Center at Columbia University. “And since drug makers are responsible for so much of the education that doctors receive, the medical community is largely unaware of the disease.”

As awareness grows and the market expands, perhaps the prices of gluten-free products will come down. Meanwhile, if you suffer from the disease, here are some ways to keep your costs down.

When people first learn they have celiac disease, they tend to stock up on gluten-free versions of breads, crackers and pizza made from grains other than wheat, like rice, corn and buckwheat. But that can be expensive and might not even be that healthy, since most gluten-free products are not fortified with vitamins.

“The most important thing to do after being diagnosed is to get a dietary consultation,” Dr. Murray said. With planning, you can learn to base your diet on fruits, vegetables, rice and potatoes. “I have some patients who rarely use those special gluten-free products,” he said.

Get in the habit of reading labels, advises Elaine Monarch, executive director of the Celiac Disease Foundation, a nonprofit organization in Studio City, Calif. Soy sauce, for instance, often has wheat protein as a filler. But Ms. Monarch found a brand of light soy sauce at her local grocery with no wheat that cost much less than one specifically marked as gluten-free. “There are often alternatives to specialty products, but you have to look,” she said.

Gluten-free bread is more expensive than traditional bread and often less palatable. And that holds for many gluten-free items. Some people, including Mr. Oram, end up buying a bread machine and making their own loaves. Nicole Hunn, who cooks gluten-free meals for her family of five and just started the Web site, avoids mixes, which she says are expensive and not that tasty, and instead bakes with an all-purpose gluten-free flour from a company called Bob’s Red Mill, which can be used in place of wheat flour in standard recipes.

If you’re too busy to cook, look for well-priced gluten-free food at large chains like Whole Foods Market and Trader Joe’s. “Trader Joe’s now carries fantastic brown rice pasta that is reasonably priced and brown rice flour tortillas that can sub for bread with a variety of things,” says Kelly Courson, co-founder of the advice site Celiac Chicks. Ms. Courson put out a Twitter message to her followers and learned that many were fans of DeBoles gluten-free pastas, which can be bought in bulk on Amazon, and puffed brown rice cereal by Alf’s Natural Nutrition, just $1 a bag at Wal-Mart.

Finally, it may be worthwhile to join a celiac support group. You can swap cost-cutting tips, share recipes and learn about new products. Many groups invite vendors to bring gluten-free products to meetings for members to sample — members can buy items they like at a discount and skip the shipping charges. Support groups typically have meetings, as well as newsletters and Web sites where you can post questions. Groups to check out include the Celiac Disease FoundationGluten Intolerance Group of North America. and the

Finally, if you itemize your tax return and your total medical expenses for the year exceed 7.5 percent of your adjusted gross income, you can write off certain expenses associated with celiac disease. You can deduct the excess cost of a gluten-free product over a comparable gluten-containing product.

Let’s say you spend $6.50 on a loaf of gluten-free bread, and a regular loaf costs $4; you can deduct $2.50. In addition, you can deduct the cost of products necessary to maintain a gluten-free diet, like xanthan gum for baking. If you mail order gluten-free products, the shipping costs may be deductible, too. If you have to travel extra miles to buy gluten-free goods, the mileage is also deductible. You’ll need a doctor’s letter to confirm your diagnosis and your need for a gluten-free diet, and you should save receipts in case of a tax audit.

Do you have a flexible spending account at work? Ask the plan administrator if you can use those flex spending dollars on the excess cost of gluten-free goods — many plans let you do this. For more on tax deductions, go to the tax section of the Celiac Disease Foundation’s Web site.

Yes, managing the disease is a hassle. But untreated celiac disease can wreak havoc with your health. A study published in the July issue of the journal Gastroenterology found that subjects who had undiagnosed celiac were nearly four times as likely to have died over a 45-year period than subjects who were celiac-free.

“Sometimes I resent how time-consuming it is to cook from scratch,” Ms. Courson of said. “But I remind myself that my restrictions actually help keep me in line, more than the next person with unhealthy foods readily available.”

Cancer deaths on the decline

Cancer death rates are declining, especially among younger people, new research shows.

And while cancer is poised to become the number one killer in the United States, topping heart disease, that is because deaths from heart disease have decreased faster than for cancer.

"Older Americans have only experienced decreased [cancer] mortality very recently, but younger Americans have been seeing benefits for a long time so, as a result, everyone born in the last 60 years has been reaping the benefits of efforts in prevention research and treatment research and early detection research," said Dr. Eric Kort, lead author of a study appearing in the Aug. 15 issue of Cancer Research.

Recent studies have had good news, including an American Cancer Society report from May which found an encouraging 19.2% drop in cancer death rates among men from 1990 to 2005 and an 11.4% drop in women's cancer death rates during the same time period.

These researchers looked at mortality rates since 1955 in specific age groups, finding that U.S. cancer mortality rates have decreased overall, first in children and younger adults then more recently, in older Americans as well.

The youngest age group showed the most improvement, with a 25.9% decline in death rates for each successive decade, while death rates in the older age groups decreased a respectable 6.8% each decade. The difference likely reflects early advances in cancer treatment affecting malignancies, such as childhood leukemia, seen in younger people.

"People quitting smoking has had an enormous impact. We have also made major inroads in cervical cancer death rates," Brooks said.

The authors pointed to successful chemotherapy regimens for childhood leukemias, then in lymphomas and testicular cancers of early adulthood.

Now, screening programs for breast, prostate and colon cancer are also starting to bear fruit.

"The traditional way of presenting this data is only presenting one aspect of the story of cancer mortality," Kort said. "What we're doing is filling in the rest of the picture."

Friday, August 14, 2009

Heart attack survivors: better outcome with chocolate

Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold compared to those who do not, according to the study which appears in the September issue of the Journal of Internal Medicine.

It was specific to chocolate -- we found no benefit to sweets in general. Researchers say that it seems the antioxidants in cocoa are a likely candidate for explaining the live-saving properties.

Bonnie - the best choice for chocolate is milk-free and 70% cocoa content or higher.

Thursday, August 13, 2009

Canada examines vitamin D for swine flu protection

The Public Health Agency of Canada (PHAC) has confirmed that it will be investigating the role of vitamin D in protection against swine flu. The agency started a study last year on the role of vitamin D in severe seasonal influenza, which it said it will now adapt to the H1N1 swine flu virus. “Researchers in PHAC are working with colleagues at McMaster University and with partners at other universities and hospitals to determine whether there is a correlation between severe disease and low vitamin D levels and/or a person's genetic make up. This line of research in seasonal influenza will be adapted to H1N1,” wrote the agency

Part of the researchers’ goal is to understand if vitamin D levels are in any way responsible for the fact that most people with seasonal influenza develop a mild illness but a small minority go on to develop severe symptoms. According to PHAC, results from its study will indicate the extent and nature of the role of vitamin D in severe seasonal influenza. The agency said it would most likely take at least three influenza seasons to be able to recruit a sufficient sample size of individuals with severe disease and controls before the results can be “meaningfully” analyzed.

The PHAC added that early work in the 1940s, in experimental animal models, indicated that mice that receive diets low in vitamin D are more susceptible to experimental swine flu infection than those that receive adequate vitamin D (Young, 1946). In addition, PHAC said that epidemiological evidence suggests a role for vitamin D in seasonal influenza in general. “Influenza infection is correlated geographically and seasonally with levels of solar ultraviolet radiation (Cannell, 2006). Given that vitamin D is synthesized in our skin on exposure to sunlight, low serum levels of 25(OH) vitamin D in winter months appear to correlate with the occurrence of seasonal influenza in the winter. However a direct causal relationship between low vitamin D levels and the risk of influenza remains to be proven. However new research suggests that vitamin D induces the production of antimicrobial substances in the body that possess neutralizing activity against a variety of infectious agents including influenza virus (Doss, 2009).

Wednesday, August 12, 2009

Acupuncture Affects Brain's Ability To Regulate Pain

How acupuncture works at the cellular level is largely unknown. Using brain imaging, a University of Michigan study provides novel evidence that traditional Chinese acupuncture affects the brain's long-term ability to regulate pain. The results appear in the September Journal of NeuroImage.

In the study, researchers at the U-M Chronic Pain and Fatigue Research Center showed acupuncture increased the binding availability of mu-opoid receptors (MOR) in regions of the brain that process and dampen pain signals – specifically the cingulate, insula, caudate, thalamus and amygdala.

Opioid painkillers, such as morphine, codeine and other medications, are thought to work by binding to these opioid receptors in the brain and spinal cord.

One implication of this research is that patients with chronic pain treated with acupuncture might be more responsive to opioid medications since the receptors seem to have more binding availability, Harris says.

Analysis confirms antidepressant suicide risk in young adults

People under age 25 who take antidepressants have a higher risk of suicide, but adults older than that do not, an analysis by U.S. Food and Drug Administration researchers released this week showed.

The report by the FDA scientists confirms earlier studies and supports the agency's age-related warnings on the drugs' labeling.

In February 2005, the FDA added a so-called black box warning -- the agency's strongest warning -- on the use of all antidepressants in young children and teens to draw attention to the possible risks of these medications. In May 2007, it extended the warnings to young adults aged 18 to 24.

Drugs can cause serious digestive upset

Courtesy of People's Pharmacy

Diarrhea is your gut’s way of defending itself against invaders. Sometimes they’re germs like E. coli or salmonella. Other times they’re drugs.

An astonishing number of medications can cause digestive-tract upset and diarrhea. We’re not talking about loosely formed stool, but rather the mad-dash-for-the-bathroom kind. Our readers have shared some extraordinary stories.

One woman wrote: “My partner, a man in his 60s with ED, began taking Cialis daily. This improved his erectile problem, but a little while later he began experiencing diarrhea of an uncontrolled nature; often he didn’t make it to the bathroom in time.

“Needless to say, he was overwhelmed by this issue and started on a medical journey to nowhere. His primary doctor recommended a gastroenterologist, who put him through a maze of tests from colonoscopy to endoscopy (through the mouth), blood tests for parasites and other arcane problems, a scan for ulcers, Crohn’s and countless others.

“Absolutely everything proved negative. He was a seemingly healthy man suffering severe, chronic diarrhea that caused him to lose 30 pounds. He changed his eating habits, trying gluten-free, lactose-free diets, but nothing made a difference.

“The quantity of medications he was taking to stop each of the symptoms was impressive and did not help. His life was changed, and he was severely depressed.

“Finally, he looked up the side effects of Cialis, since it was the only new medication that coincided with the onset of his diarrhea. He noticed that the information mentioned ‘stomach upset.’ That didn’t exactly describe the tsunami that his problems presented!

“He decided to quit taking his beloved Cialis. Lo and behold! His digestive tract improved: No more Questran, no more Reglan, Librax or other drugs.”

Drugs for erectile dysfunction like Cialis, Levitra and Viagra can cause diarrhea as a reported side effect. It’s uncommon, but not unknown.

Hundreds of other medications also can cause diarrhea. In some cases it can be extremely disruptive. In other cases it can be life-threatening.

“My husband took the drug clindamycin for an infection on his leg. He developed nonstop diarrhea as a result of the antibiotic. He was eventually diagnosed with a C. difficile infection in his intestines.

“He spent nine days in critical condition and 41 days total in the hospital and rehabilitation. He lost his large intestine and gallbladder and has an ileostomy now. The clindamycin complications drastically changed his life.”

Clindamycin can be a helpful antibiotic for certain hard-to-treat infections. But it can also disrupt the ecology of the digestive tract. This allows the dangerous bacteria called Clostridium difficile (C. diff) to take over. C. diff has developed resistance to common antibiotics and can be hard to cure.

Diarrhea can have many different causes, from tainted food to irritable bowel syndrome. When diarrhea is caused by a medicine, however, it may be difficult to diagnose. People who suspect that their digestive woes are a side effect of their medication should check with the pharmacist and the physician. There may be an alternative treatment less likely to cause “the runs.”

Dementia: Diet & Exercise Matter

Courtesy of WSJ

Two studies published in this week's Journal of the American Medical Association add to evidence that long-term lifestyle habits may reduce the risk of mental decline in old age.

The first study, a long-term look at 1,880 elderly people in New York City, found that a Mediterranean-type diet and physical activity each were linked to less risk for Alzheimer's disease.

The second study, a shorter-term observation of 1,410 patients in France, found some correlation between a Mediterranean-type diet and slower cognitive damage.

These studies are observational and not definitive, but they hint at what might reduce the chances of Alzheimer's or dementia. In the Columbia research, those who adhered most closely to the diet reduced their risk for Alzheimer's by 40%, while those with the highest physical activity decreased their risk 33%, compared with people who didn't adhere closely to the diet or were not physically active.

The French study found that subjects who adhered to the Mediterranean-type diet experienced a slower rate of mental decline than those who did not eat the diet, but did not prove a link for dementia, which requires a clinical assessment of a variety of mental and social functions.

For now, the French researcher says his studies strongly suggest that a Mediterranean diet and exercise both confer independent and positive health benefits. But together, they are even better.

"The relative risk reduction for Alzheimer's is about 60% when you combine the diet and exercise," he says.

Pesticides in your peaches: Chicago Tribune

Steve - for those who snickered over the media lambasting organic foods for not being more nutritive than conventional in one study, will you snicker about this? This is the main reason most of choose organic.

As we munch into the fragrant core of peach season, shoppers face an array of choices for the same fuzzy fruit but little guidance on which type to pick. Expensive organic? Pricey farmers market? Cheap peaches from the grocery store?

Cost is certainly important. But there are essential numbers that go beyond the price tag of a peach, or any other item from the produce aisle.

Which contain the highest levels of pesticides?

Preliminary 2008 U.S. Department of Agriculture tests obtained by the Chicago Tribune show that more than 50 pesticide compounds showed up on domestic and imported peaches headed for U.S. stores. Five of the compounds exceeded the limits set by the Environmental Protection Agency, and six of the pesticide compounds present are not approved for use on peaches in the United States.

These are the types of findings that have landed peaches on one environmental group's "Dirty Dozen" list -- 12 fruits and vegetables that retain the highest levels of pesticide residues -- and give many consumers pause as they shop grocery aisles. It seems that peaches' delicate constitutions, fuzzy skins and susceptibility to mold and pests cause them to both need and retain pesticides at impressive rates.

Although most pesticides in peaches were found at levels well below EPA tolerances, some scientists and activists remain concerned about even low-level exposure, especially to pregnant women and children. They point to studies, for example, that show cognitive impairment in rats after dietary exposure to chlorpyfiros, a pesticide that showed up in 17 percent of conventional peaches tested by the USDA.

For assurance, some shoppers turn to farmers markets, which don't guarantee reduced pesticide use but do allow shoppers to discuss pesticide practices with the farmer. Organic, meanwhile, does come with the expectation that the fruit will be free of synthetic pesticides. Yet no government agency ever tested that promise until this year -- and so far those tests have been limited to lettuce, with no published results.

To get some hard facts and new insights, the Tribune paid for lab tests on California organic peaches bought here and local farmers market peaches from Illinois and Michigan.

The newspaper sent these samples to the same federal lab where the USDA does its pesticide testing and found promising results. Of the 50 compounds the Tribune had tested for, one showed up on the organic peaches and three or fewer pesticides were detected on the Michigan and Illinois peaches.

"Our growers [in southwest Michigan] pride themselves on being very careful," said William Shane, district fruit educator for Michigan State University, when he learned how Michigan peaches fared in the test. "We also tend to have smaller operations and it's easier to keep track of pesticide use."

The better results in the Tribune's small sample may also be attributable to the fact that the wider 2008 USDA conventional tests included peaches imported from Chile.

Chilean peaches have, in the past, shown a higher incidence of certain pesticides than U.S. peaches. The conventional samples, taken from more than 700 sites, also included peaches from areas like Georgia and South Carolina where a broader range of pesticides are often needed to control pests and fungus.

More surprising, however, was the presence of the unapproved pesticide fludioxonil on the organic peaches from California. According to Shane, the pesticide is often used on conventional peaches postharvest to slow rot and extend shelf life.

University of Illinois entomologist and extension specialist Rick Weinzierl suggested that the unapproved pesticide could have come from drift or cross-contamination at processing facilities. "But there is always the chance that a farmer is not doing what he is saying," he added.

Rayne Pegg of the USDA's agriculture marketing service confirmed that fludioxonil is not an approved compound for organic farming but added, "as long as the concentrations don't exceed 5 percent of EPA tolerances, it can be sold as organic." In fact, the USDA allows such levels of any legal pesticide to be present on organic produce. In the wake of recent allegations about slipping standards in the USDA's National Organic Program, Congress has widened a probe into the NOP and recently USDA announced an independent audit of the program. The organic world was further rocked last month by a controversial British review of nutrient studies that challenged the nutritional benefits of organic produce.

Supporters of organic foods complained that many important studies were left out of the review, and the debate on nutrition ignores the question of pesticide residue.

Although the 1996 Food Quality Protection Act sets pesticide tolerances at levels that offer "a reasonable certainty that no harm will result from aggregate exposure to the chemical residue," some scientists worry about exposure among children and pregnant women.

Alex Lu, who teaches environmental exposure biology at Harvard, has studied a particularly troubling class of pesticide called organophosphates, or OPs, which showed up consistently in the systems of Seattle-area children ages 3 to 11 who ate non-organic diets. When the children switched to an organic diet for five days, these pesticide levels became nearly undetectable, the study found.

The professor acknowledged the importance of fresh produce in a young diet but is concerned that conventional produce consumption translates too easily into the presence of OPs in these developing systems. He advises against giving children conventionally farmed produce from any items on the Environmental Working Group's "Dirty Dozen," which is culled from FDA and USDA test results. Other produce on that list are strawberries, apples, nectarines, cherries, lettuce, bell peppers, celery, pears, kale, imported grapes and carrots.

Lu is even more concerned about the dietary habits of pregnant women.

"Don't eat conventional peaches while you are pregnant," he said. "It's a critical time. Spend a little bit more money to buy organic just to be safe."

Dr. Catherine Karr, who serves on the American Academy of Pediatrics Environmental Health committee, stopped short of advising against conventional peaches for children altogether.

"You want to maximize the healthfulness of children's diets by making sure they get plenty of fruits and vegetables," she said. "But ... you want to minimize their exposure to pesticides, and we know that the best way to do that is by giving them as much organic produce as possible."

According to the USDA, when its Pesticide Data Program discovers the use of unapproved pesticides or pesticide residues that exceed federal tolerances, it reports them to the FDA and EPA. Because of the length of the complicated screening and reporting process, these violation reports are not used for enforcement but rather to highlight potential problem areas.

"Consumers should feel confident that we collect this data and provide it to the proper regulatory agencies for enforcement," said USDA spokesman Justin DeJong.