Wednesday, December 15, 2010

Bonnie's Blog on Hiatus until January 4, 2011.

Have a Happy, Healthy New Year!

Monday, December 13, 2010

Corn Refiners Association study sad

Consuming fructose from added sugars at levels in the average American diet does not lead to weight gain or an increased risk for heart disease when part of a weight-stable diet, according to new data presented today at the American Heart Association's (AHA) Scientific Sessions 2010. "These findings demonstrate that added sugars, whether from table sugar or high fructose corn syrup (corn sugar), do not promote weight gain or increase total cholesterol, triglycerides, or LDL (low-density lipoprotein) cholesterol when coupled with a balanced diet," says James Rippe, M.D., a cardiologist who is director of Lifestyle Medicine Initiative at Orlando Regional Healthcare and the study's chief investigator.

The study followed 64 overweight and obese people who were placed on a weight-stable diet for 10-weeks. The diet incorporated sucrose or high fructose corn syrup-sweetened low-fat milk, at 10% or 20% of calories. After 10 weeks, there was no change in body weight in the entire group. In addition, there were no changes in total cholesterol, triglycerides, LDL(low-density lipoprotein, often referred to as "bad" cholesterol), apolipoprotein B (elevated levels of APOProtein B represent an increased risk for heart disease), or mean LDLparticle size. Group assignment also had no effect on HDL(high-density lipoprotein, often referred to as "good" cholesterol). The research for this study was supported by a grant from the Corn Refiners Association (CRA).

Bonnie - I do give them credit. The CRA does not give up easily. They are a powerful lobby and have deep pockets. I wonder how they got this cardiologist to agree to a study with this few subjects and for such a short period of time. Maybe this doctor has not peered over the hundreds of studies, some of them then times the size of this study and over much longer periods of time showing the negative effects of HFCS.

Which Health Professional is Healthiest?

When it comes to eating a balanced diet, taking vitamins or other dietary supplements, exercising regularly, and engaging in other wellness behaviors, dietitians come out on top among eight healthcare professional populations according to the "Life…supplemented" Healthcare Professionals (HCP) Impact Studies. The 2009 study shows that 96 percent of dietitians report trying to eat a balanced diet; 96 percent of dietitians report using dietary supplements at least seasonally—74 percent say they take them regularly; 83 percent say they exercise regularly; 80 percent say they maintain a healthy weight; 86 percent say they regularly visit their own healthcare professional and 72 percent claim they get a good night's sleep. While dietitians rank highest, other healthcare professional groups are also practicing healthy lifestyle habits. Following are the results, by healthcare professional group (listed alphabetically):

Of the cardiologists surveyed, 80 percent say they try to eat a balanced diet; 57 percent of cardiologists report taking dietary supplements, at least seasonally—37 percent say they take them regularly; and 67 percent say they exercise regularly. Sixty-nine percent say they maintain a healthy weight; and 49 percent say that they regularly get a good night's sleep. Only 34 percent of cardiologists report visiting their own healthcare professional regularly. Sixty-six percent claim that they try to manage their stress levels.

Eighty-one percent of dermatologists surveyed report they try to eat a balanced diet. Seventy-five percent of dermatologists report using dietary supplements at least seasonally—59 percent say they use them regularly. Additionally, 70 percent say that they exercise regularly; 79 percent agree that they maintain a healthy weight; 64 percent report that they regularly get a good night's sleep. Only 56 percent of dermatologists say they visit their own healthcare professional regularly. Seventy-one percent say they try to manage their stress levels.

Eighty-four percent claim that they try to eat a balanced diet. Ninety-five percent of nurse practitioners report taking dietary supplements at least seasonally—71 percent claim doing so regularly. Sixty-four percent claim to exercise regularly. Nurse practitioners try to manage their stress level, as reported by 86 percent of those surveyed; 76 percent say that they regularly visit their own healthcare professional; while 63 percent, claim to get a good night's sleep. Only 59 percent of nurse practitioners say they maintain a healthy weight.

Eighty-one percent say they try to eat a balanced diet; 80 percent of Ob/Gyns report taking supplements, including 56 percent who say they use them regularly. When it comes to engaging in regular exercise, 68 percent claim to do so. Sixty-eight percent of Ob/Gyns also report that they maintain a healthy weight. Only 57 percent report getting a good night's sleep, and slightly more than half (51 percent) say that they visit their own healthcare professional regularly.

Seventy-seven percent claim that they try to eat a balanced diet; 75 percent of orthopedists say they use dietary supplements at least seasonally, with 50 percent saying they use them regularly. Sixty-nine percent say they exercise regularly. Sixty-nine percent also report that they maintain a healthy weight. When it comes to managing their stress levels, eight out of 10 orthopedists (80 percent)report doing so. Orthopedists are less likely to get a good night's sleep (56 percent report that they do) and visit their own healthcare professional regularly (40 percent report doing so).

Of the pharmacists surveyed, 76 percent report that they try to eat a balanced diet. Eighty-six percent of pharmacists use dietary supplements at least seasonally, and 62 percent say they take them regularly. Fifty-six percent claim that they exercise regularly. More than three quarters—77 percent—of pharmacists say they try to manage their stress levels. Seventy-five percent report visiting their own healthcare professional regularly and 67 percent claim they maintain a healthy weight. Sixty-five percent report regularly getting a good night's sleep.

A good majority of primary care physicians say that they try to eat a balanced diet (80 percent); and while only 48 percent of primary care physicians report regular use of supplements, 71 percent say they use them at least seasonally. Seventy-one percent of primary care physicians report that they exercise regularly. Interestingly, only 40 percent of primary care physicians report visiting their own healthcare professional regularly and 68 percent maintain a healthy weight. Sixty-three percent of primary care physicians say that they get a good night's sleep.

Rolaids recall

Johnson & Johnson issued a recall of its Softchews Rolaids antacids after consumers reported finding wood and metal bits in the tablets. Johnson & Johnson, which recalled some Rolaids products in November, said it was voluntarily recalling all lots of its Softchews products after potentially uncovering problems with a third-party manufacturer that left particles in the medicines. The recall is the latest in a string of pulled products for Johnson & Johnson's McNeil consumer unit that has drawn attention from U.S. authorities and Congress. About 130 lots are affected and include Extra Strength Softchews, Extra Strength Plus Gas Softchews and Rolaids Multi-Symptom Plus Anti-Gas Softchews.

Steve - this is a good time to remind you that we do not recommend Rolaids or its equivalents as antacids or calcium supplements. The calcium, in carbonate form, is very poorly absorbed. These products also block the absorption of key nutrients.

Wednesday, December 08, 2010

CoQ10's effect on breast cancer cells

Matrix Metalloproteinases 2 is a key molecule in cellular invasion and metastasis. Mitochondrial ROS has been established as a mediator of MMP activity. Coenzyme Q10 contributes to intracellular ROS regulation. Coenzyme Q10's beneficial effects on cancer are still in controversy but there are indications of Coenzyme Q10 complementing effect on tamoxifen receiving breast cancer patients.

In a Nutrition Journal study, researchers aimed to investigate the correlation of the effects of co-incubation of coenzyme Q10 and N-acetyl-L-cysteine (NAC) on intracellular H2O2 content and Matrix Metalloproteinase 2 (MMP-2) activity in MCF-7 cell line. The results showed that both coenzyme Q10 and N-acetyl-L-cysteine reduce MMP-2 activity along with the pro-oxidant capacity of the MCF-7 cell in a dose proportionate manner. Collectively, the present study highlights the significance of Coenzyme Q10 effect on the cell invasion/metastasis effecter molecules.

Tuesday, December 07, 2010

Weight Watchers New System: Bonnie's Take

In its attempt to reflect the changes of nutrition research over the last 15, Weight Watchers has updated its points system. They also admitted that many members were skipping their fruits and vegetables so as to not waste their points. Here are the highlights:
  • Fresh fruits and vegetables are considered free. However, fruit juice, dried fruit, and starchy vegetables are not free.
  • The importance of protein and fiber for fullness and warding off hunger.
  • The body has to work harder to metabolize protein and healthy fat, thus revving up metabolism.
Bonnie - it is nice to see that Weight Watchers has finally come around to making these changes. Now if they could just do a complete overhaul of their meals!

Comments on Lancet aspirin study

In light of the Lancet study showing that aspirin may reduce cancer risk by 20% over a twenty to thirty year period in healthy individuals, BBC writer Fergus Walsh explains how he is going to start taking aspirin despite aspirin's known risks.

We would warn Mr. Walsh that it does not have to be a black and white issue. While we do not dispute that aspirin can be effective in some individuals for certain chronic diseases, it can be devastating to others. Recent evidence, especially with heart disease and type 2 diabetes, have gone away from recommending aspirin in healthy individuals because its effectiveness does not outweigh the risk of adverse effects.

Mr. Walsh, you do not have to blindly take aspirin for the next 20-30 years without knowing if it is damaging to you (several people shared their horror stories in the comments section of his article). A simple, while expensive, genetic test can discover whether or not you can metabolize aspirin. A good portion of the human population unfortunately does not. So would it not be more responsible to have added this to your article for not just your own safety, but for that of your readers?

P.S. Confirmation of low-dose aspirin's side effects: A recent American Journal of Gastroenterology study found that overall, 42.2% of aspirin-treated subjects developed multiple erosions and/or ulcers. Gastroduodenal ulcers were observed in 17.6% of aspirin-treated subjects. Low-dose aspirin induced a surprisingly high incidence of acute gastroduodenal ulcers, highlighting that aspirin's upper GI risk begins early and may require gastroprotection.

On a positive note, the purpose of this study was to find a substance that could help reduce the ulcers. Researchers found the phospholipid, phospatidylcholine, when added to aspirin, significantly reduced mucosal damage. Only 22% of subjects developed multiple erosions/ulcers and only 5.1% had gastroduodenal ulcers.

Monday, December 06, 2010

Food Dyes: FDA to hold hearing

The Food Advisory Committee will meet to discuss whether available relevant data demonstrate a link between children’s consumption of synthetic color additives in food and adverse effects on behavior. Background material is available at:

Food and Drug Administration [Docket No. FDA–2010–N–0001] Food Advisory Committee

This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be open to the public. The meeting will be held on March 30 and 31, 2011, from 8:30 a.m. to 4:30 p.m. Contact Person: Carolyn Jeletic, Center for Food Safety and Applied Nutrition (HFS–024), Food and Drug Administration, 5100 Paint Branch Pkwy., College Park, MD 20740, 301–436–1913 or FDA Advisory Committee Information Line, 1–800–741–8138 (301–443–0572 in the Washington, DC area), code 3014510564.

Interested persons may present data, information, or views, orally or in writing, on issues pending before the committee. Written submissions may be made to the contact person on or before March 23, 2011.

Mitochondria and Alzheimer's connection

What are the earliest brain changes associated with the risk of developing Alzheimer's disease? A scientific report published in the October Journal of Alzheimer's Disease finds reduced activity of mitochondria in deceased young adult brain donors who carry a common genetic risk factor for Alzheimer's disease -- before the protein changes or microscopic abnormalities commonly associated with the disease and almost five decades before the age at which they might have developed memory and thinking problems.

Arizona researchers studied tissue from a vulnerable part of the brain in 40 young adults who had died and donated their brains for research. 15 of the brain donors carried a common genetic risk factor for Alzheimer's disease, and 25 of the brain donors did not. With the exception of a person with two copies of the APOE4 gene, none of the deceased young adults had the microscopic abnormalities or elevated amyloid protein levels long associated with Alzheimer's disease. However, the activity of an enzyme known as cytochrome oxidase, an energy-making enzyme found in the mitochondria of brain cells, was slightly reduced in the group at increased genetic risk for Alzheimer's disease. "Our findings suggest that mitochondrial brain changes contribute to the risk of Alzheimer's disease," said the study's lead author.

Steve - as we reported earlier regarding the connection between autism and mitochondrial dysfunction, we see a pattern forming around the importance of optimal functioning mitochondria, or what we like to call the powerhouse of the cell. One nutrient we have know for a long time to be beneficial for mitochondria is Co-Enzyme Q10 (CoQ10).

Friday, December 03, 2010

Natural chemicals don't always translate into good drugs

GlaxoSmithKline formally terminated a clinical trial of an experimental drug designed to harness the potential health benefits of red wine, saying it had minimal efficacy in cancer patients and could potentially exacerbate kidney complications. The U.K. drug maker also reiterated that it isn't planning any further testing of the drug, SRT501, because it is focusing on other compounds designed to work similarly to SRT501 but which differ chemically. GlaxoSmithKline obtained SRT501 with its $720 million purchase of Sirtris Pharmaceuticals in 2008.

Mercury Linked to Alzheimer's

Inorganic mercury, which is still widely used in dental amalgams, is likely a contributing cause of Alzheimer's disease (AD) according to the November issue of the Journal of Alzheimer's Disease.

Overall, investigators found that symptoms and features of AD were reproduced or accelerated when mercury was introduced. As a result of these findings, the researchers called for "the removal of mercury from public and ecologic circuits and replacing it wherever possible by less toxic alternatives. This would be a sensible public health measure that is supported by the current data."

Of 40 studies that tested memory in individuals exposed to inorganic mercury, 32 found significant memory deficits. The study authors also note that some autopsy studies also revealed increased mercury levels in the brain tissue of AD patients.

"In vitro models showed that inorganic mercury reproduces all pathological changes seen in AD, and in animal models inorganic mercury produced changes that are similar to those see in AD," the study authors write.

Bonnie - this should not be a surprise for anyone who reads our blog consistently.

Wednesday, December 01, 2010

Sweet Potatoes are coming on fast.

Sweet Potatoes step out from under the marshmellows.
New York Times

Top Ten Healthy Holiday Tips

For Healthy Holiday Parties and Family Celebrations
  1. Eat before you go to a party, especially foods high in protein and healthy fats. Your blood sugar will be more stable so you won’t eat as much.

  2. Alcohol is loaded with calories. Try substituting with sparkling water or club soda (an added benefit is feeling more full with water so you won’t eat as much). The best advice is choosing non-alcoholic, low calorie beverages such as a virgin bloody Mary, fruit flavored tea, or flavored water (without sugar or sugar substitutes added). If you do consume alcohol, remember that alcohol may inhibit your ability to make smart food choices. Sip your drinks slowly. For each alcoholic beverage, have 8 oz. sparkling water or club soda in between. Add a small amount of lemon, lime, or other fruit juice to your water for added flavor.

  3. Don’t make a meal out of appetizers. Sample one or two, then wait for the main course. If fresh vegetables are served as appetizers, fill up on low carbohydrate, low calorie tomatoes, peppers, cucumbers, artichoke hearts, celery, and zucchini. At a buffet, graze to take a taste of enticing items, but spend most of your time with the raw vegetables and heart healthy guacamole and humus dips. Socialize away from the food table so you won’t be tempted to continue eating while talking.

  4. If you know you’ll want to have a rich dessert (instead of fruit), keep the fat and carbohydrate calories low the rest of the day to compensate. Also, forego second helpings of the dinner to save “calorie” room for dessert. Encourage family and friends to take a brisk walk between dinner and dessert. You’ll be surprised by how much less you’ll crave!

  5. Watch out for raw foods (raw fish, steak tartar and eggnog made with raw eggs) or foods left out too long at room temperature. They could harbor harmful pathogens such as salmonella, shigella, listeria, or e coli.

  6. Eat your meal slowly so that you’ll feel full with less food. It typically takes your stomach about 20 minutes to let your brain know that you are full. Try to avoid or limit foods high in saturated fat like heavy gravies. These are typically very high in calories. For example: 8 oz. eggnog = 340 calories, 1 slice pie with whipping cream = 520 calories; 1 cup standard poultry stuffing = 500 calories.

  7. Exercise more to burn more calories during the holidays. Cycling, fast-walking, and cross-country skiing are great ideas. Even shoveling the snow off of your driveway and sidewalk counts.

  8. Offer to bring your favorite healthy recipe to the party and spend most of your time eating it. Let your host keep the leftovers from your dish. If you’re hosting the meal or party, send leftovers home with your guests. It’s a friendly gesture and saves your from temptation!

  9. If you have food sensitivities or allergies, call your host before the party to determine what foods would be safe. There is nothing worse than having an allergic reaction or digestive distress when you are trying to have fun.

  10. Don’t begin a diet during the holidays or become obsessive about avoiding tempting holiday fare. If you restrict yourself too much, you’ll either be depressed or “pig out” later. Remember that the average adult gains 6 lbs. from Thanksgiving Day through New Year’s Day. If you can even maintain your weight during the holidays, you’ll be one step ahead when it is time to make your New Year’s resolutions.
© Copyright 2010, Nutritional Concepts

Children with autism have mitochondrial dysfunction

Children with autism are far more likely to have deficits in their ability to produce cellular energy than are typically developing children, a new study by researchers at UC Davis has found. The study, published in the Journal of the American Medical Association (JAMA), found that cumulative damage and oxidative stress in mitochondria, the cell's energy producer, could influence both the onset and severity of autism, suggesting a strong link between autism and mitochondrial defects.

After the heart, the brain is the most voracious consumer of energy in the body. The authors propose that deficiencies in the ability to fuel brain neurons might lead to some of the cognitive impairments associated with autism. Mitochondria are the primary source of energy production in cells and carry their own set of genetic instructions, mitochondrial DNA (mtDNA), to carry out aerobic respiration. Dysfunction in mitochondria already is associated with a number of other neurological conditions, including Parkinson's disease, Alzheimer's disease, schizophrenia and bipolar disorder.

The researchers obtained blood samples from each child and analyzed the metabolic pathways of mitochondria in immune cells called lymphocytes. Previous studies sampled mitochondria obtained from muscle, but the mitochondrial dysfunction sometimes is not expressed in muscle. Muscle cells can generate much of their energy through anaerobic glycolysis, which does not involve mitochondria. By contrast, lymphocytes, and to a greater extent brain neurons, rely more heavily on the aerobic respiration conducted by mitochondria. The researchers found that mitochondria from children with autism consumed far less oxygen (66 percent) than mitochondria from the group of control children, a sign of lowered mitochondrial activity. For example, the oxygen consumption of one critical mitochondrial enzyme complex, NADH oxidase, in autistic children was only a third of that found in control children. Reduced mitochondrial enzyme function proved widespread among the autistic children.

Mitochondria also are the main intracellular source of oxygen free radicals. Free radicals are very reactive species that can harm cellular structures, including DNA. Cells are able to repair typical levels of such oxidative damage. Giulivi and her colleagues found that hydrogen peroxide levels in autistic children were twice as high as in normal children. As a result, the cells of children with autism were exposed to higher oxidative stress.If researchers find some kind of blood marker that is consistent with and unique to children with autism, it changes the way we diagnose this difficult-to-assess condition. The real challenge now is to try and understand the role of mitochondrial dysfunction in children with autism.

Bonnie - what is the most significant nutrient we know of that supports mitochondria? Co-Enzyme Q10

Importance of Beta Carotene

A role of β-carotene in fulfilling the recommended intake for vitamin A is apparent from a variety of studies. Thus, besides elucidating the various functions, distribution, and uptake of β-carotene, researchers publishing in December's Journal Nutrition placed special emphasis on the provitamin A function of β-carotene and the role of β-carotene in the realization of the required/recommended total vitamin A intake in both developed and developing countries. There was consensus that β-carotene is a safe source of vitamin A and that the provitamin A function of β-carotene contributes to vitamin A intake.

State of the Nutritionist 2010

2010 in Review.

Three Topics That Dominated the Public Health Landscape
  • Recalls, Warning Label Modification, Drug Rejections
    Recalls of eggs, children's medicine (Tylenol, cough medicine, and more), Lipitor, Similac infant formula, Hyland Teething Tablets, among others dominated the media. The optimist in us thinks the reason for this is the FDA is doing a better job of testing and delivering punishment.

    Rotarix Vaccine, Reflux Meds, Zocor, Bone Drugs, and Asthma Meds were just a few of the many drugs that received more severe warning label adjustments from the FDA. It is encouraging to see the FDA taking steps to make prescription labels more transparent concerning the potential dangers that can occur.

    There were more high profile rejections of new drug applications for lack of safety than we can remember in recent years. The FDA forcing the removal of Meridia was also shocking.

  • Patient Affordable Care Act (PPACA).
    While this piece of legislation proved to be incredibly polarizing, it did deliver with regards to promoting prevention. Whether or not Americans take advantage of it remains to be seen. To find out how this legislation can help you from a nutritional as well as overall health standpoint, click here.

  • Gluten-Free Is Hip.
    Whether the gluten-free diet went mainstream for the right reasons or not, we are happy that it is getting so much attention. The mere fact that Big Food is creating more variety/alternatives is a win-win for those who actually have gluten intolerance and celiac disease. However, two negatives produced by the trend are that many of the gluten-free products are of poor quality and/or ingredients. In addition, people are putting themselves on gluten-free diets without the guidance of a health professional, which can have detrimental effects on their calorie and nutrient needs.

    The reality is that those with celiac disease and gluten-intolerance is up four-fold over the last decade. In our opinion, this is a conservative estimate. Add to the equation that it is not just gluten in wheat that can be dangerous (read The Wheat Bombshell), we have a very hard time justifying eating wheat (especially whole wheat) at all.

Wellness Victories.
It always makes us proud to see wellness principles that we have touted forever become mainstream.

  • Low fat diet finally gets the boot. Even the American Dietetic Association is giving in. Read what the experts at their 2010 annual meeting had to say, as well as two other research studies that put low fat to bed.

  • These supplemental nutrients appeared over and over in prestigious research journals from all over the world, touting myriad benefits (for a list of studies, perform a search by typing the nutrient in the search box at the top left corner of our blog).

    • CoQ10
    • Iodine
    • Magnesium
    • Multivitamins
    • Potassium
    • Probiotics
    • Quercetin
    • Vitamin D
  • The amount of locally grown food consumed in the United States this year jumped by 20%.

  • Two of our favorite researchers studying the origin of humans and diet, Boyd Eaton and Loren Cordain, reaffirmed that from a dietary standpoint, we are no different from our ancestors. Their February research study further enhanced what they already published in 2000.
  • Tai Chi, Meditation, and Yoga takes their place at the table for overall health and stress reduction. While in the past it seems like these therapies were on the outside looking in, copious amounts of data now confirm their effectiveness and they should not take a back seat to any other forms of wellness therapy.

  • Sales of vitamin D supplements and the non-caloric sweetener stevia were up 91% and 255% respectively.

  • Testing of Hemoglobin A1C is now mainstream for more accurately identifying prediabetes.

  • The FDA made a statement warning against taking quinine for leg cramps.

  • Taking too much, taking alone, and/or taking a poor source of calcium can do more harm than good.
  • The School Lunch Program is now considered a threat to national security because the ramifications of its unhealthy nature affects the capability of youths to defend our nation. This statement, along with First Lady Michelle Obama's proposed legislation, started to make an impact this year.

  • The government announced that they will start to go after Big Pharma executives on criminal charges because multi-billion dollar settlements have not deterred them from consistently breaking the law.
The Battles Still Rage On.
  • The IOM's new recommendations for vitamin D intake tripled, but fell far short of what Americans need. Here are our comments.

  • The 2010 Dietary Guideline Recommendations presented by the DGA Commission were an absolute joke. Once again, pandering to special interest dominated the recommendations. Click here to read Bonnie's analysis.

  • Environmental allergy is on the rise due to: 1) pollen content is at its worst level in years 2) there is virtually no discussion from the allergy community or the media about avoiding cross-reacting foods to reduce allergy severity.

  • Despite the FDA studying statin medication's negative effect on memory, an FDA rebuke for Pfizer for failing to report serious adverse effects from Lipitor, several disparaging high-profile studies on its adverse effects, and experts suggesting statins' preventive effect may be dubious, millions more around the world are taking them. It has gotten so crazy that a British study are suggested that they be given out free with fast food. All of this pales in comparison to the most egregious act: since the 1980's, Merck has sat on a patent for a statin/CoQ10 combination, ignoring the negative affects this decision has had on patients taking statins.

  • H1N1 never materialized into the pandemic it is made out to be. One study found that complications from H1N1 were the same as the regular flu. An investigation found that experts making recommendations to the World Health Organization were linked to vaccine manufacturers. Hundreds of millions of dollars worth of unused vaccine supply had to be destroyed. Yet the WHO and the CDC have been mum on culpability.

  • Despite the continued rise of prescription-related deaths, prescription drug use continues to explode in the US, even though there are many other alternatives for treatment that exist.
What Did We Accomplish in 2010?
We celebrated our 25th year in business. Enough said.

Our Client Appreciation Event at the beginning of the year was a blast. We were honored for the second year in a row by Constant Contact for our eNewsletter content excellence. Our NCI Media Channel featuring Brand Buzz Video and Bonnie Unplugged drew thousands of views. Our clientele as a whole saved a ton of money from the first year of our NCI Well Rewards Loyalty Program. We made a much more concerted effort to have our clients submit our services for insurance reimbursement with much success. We could not be happier with the reaction to our subscription-based eNewsletter, NCI Insider.

What's in Store for 2011?
  • FDA Comes After Dietary Supplements Hard
    FDA will crack down on meds and dietary supps. May use European action as model for taking them down once and for all. The one constant holding them back has been the consumer and his/her right to choose.

  • Big Pharma Gets More Involved in the Supplement Business.
    Look for Big Pharma to get deeper into the supplement business. “If you can’t beat em, join em.”

  • Food Labels Get New Look
    A push from the Department of Health and Human Services spurred retailers to place simplified nutrition labels on the front of their food packaging beginning early 2011. Until we see the prototype, we will reserve comment.

  • Eat for Longevity.
    You’ll be hearing this phrase a lot in 2010, especially after a recent study found that subjects with the best diets reduced their risk of death by up to 25 percent over a 10-year period. What better impetus could there be to eat well?

  • Focus on Mental Health.
    Nearly one in five adult Americans experience mental illness, according to a new SAMHSA government survey, with women, the unemployed, and young adults more likely than others to be affected. Among those, one in five -- representing 45 million Americans -- also had substance dependence or abuse problems in the previous year. This issue cannot be swept under the floor any longer.

Have a Happy, Healthy Holiday & New Year,

Bonnie, Steve, Carolyn, Sharron, and Lilo

Tuesday, November 30, 2010

IOM's new vitamin D recommendations flawed

We consider the new vitamin D recommendations made by the Institute of Medicine (IOM) woefully inadequate and detrimental to public health. It is very simple to discount much of this report because the IOM is basing their new recommendations assuming minimal sun exposure and on individuals who DO NOT have the following special concerns:
  • Adiposity (overweight or obese)
  • Persons living at the upper latitudes in North America
  • Persons who experience reduced vitamin D synthesis from sun exposure
    Dark skin
    Use of sun screen
    Indoor environments and institutionalized older persons
  • Alternative diets or changes in dietary patterns
    Dairy and animal product exclusion
  • Use of calcium supplements
  • Oral Contraceptive use
  • Premature infants
  • Interaction between vitamin D and prescription drugs
What would be the percentage of the population who get minimal sun exposure (without sunscreen) and DO NOT have one or more of the aforementioned? It would be very small. Much of the country is overweight or obese. Much of the population receives inadequate sun exposure, spends much of their time indoors, and uses sunscreen when they are in the sun. We cannot understand why the IOM would not come up with more individualized recommendations to include all of the aforementioned groups.

At least they leave wiggle room between the RDAs and upper tolerated levels (which we still think are too low). If you are a client of ours, stick with your individualized recommendations.

We are not alone in discounting the IOM's recommendations. We have already heard from clients that their own doctors are telling them to ignore the recommendations. Here is a smattering of quotes from doctors and other health professionals across the country:

  • Robert Rountree, MD, a medical author and practicing physician in Boulder, Colorado. “This report does not represent the views of researchers who are true experts in the field,” Rountree said. “For reasons that I don't understand, the panel members deliberately chose to ignore a large body of published information regarding the effects of vitamin D in cancer, cardiometabolic disease, obesity, autoimmune disease and mood regulation and instead focused almost exclusively on studies related to bone health. They also failed to make the case that vitamin D supplements are toxic in the dose ranges currently being recommended (2000 IU to 10,000 IU daily). There is nothing in the IOM report that makes me want to change my current recommendation to aggressively monitor vitamin D levels with frequent blood testing in my patients and to supplement as necessary to maintain adequate levels.”
  • John Jacob Cannell, MD, takes issue with the new vitamin D guidelines. “After 13 years of silence, the quasi governmental agency, [the IOM’s FNB] recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman,” Cannell writes. “While that 400 IU/day dose is close to adequate for infants, 600 IU/day in pregnant women will do nothing to help the three childhood epidemics most closely associated with gestational and early childhood vitamin D deficiencies: asthma, auto-immune disorders, and, as recently reported in the largest pediatric journal in the world, autism.”
  • "There's no way that people will satisfy those recommendations for vitamin D without supplements," says Elizabeth Ward, a registered dietitian in Boston in a USA Today interview.

  • "This is a stunning disappointment," said Dr. Cedric Garland, one of the top researchers who has studied the ability of vitamin D to prevent cancer.
Since the IOM announcement Tuesday, these vitamin D studies have been published:
  • A study from American Journal of Clinical Nutrition investigated the associations between vitamin D status and changes in body mass index, skinfold-thickness ratio, waist circumference, and height in child subjects living in warm weather climates. Vitamin D–deficient children had a greater change in BMI than did vitamin D–sufficient children. Similarly, vitamin D–deficient children had a greater change in subscapular-to-triceps skinfold-thickness ratio and a greater change in waist circumference than did vitamin D–sufficient children. Vitamin D deficiency was related to slower linear growth in girls but not in boys. Vitamin D status was inversely associated with the development of adiposity in school-age children.

  • A Journal Nutrition study confirms that serum 25(OH)D concentrations undergo strong seasonal variation at high latitudes and are influenced by vitamin D intake, skin pigmentation, and sun exposure.

  • Emerging evidence suggests a high prevalence of suboptimal vitamin D (as defined by serum 25(OH)D levels of less than 32 as well as an association between lower serum levels and higher mortality in cancer. Researchers in Nutrition Journal investigated the effect of oral vitamin D supplementation as a means for restoring suboptimal levels to optimal levels in 2198 cancer patients. Patients with baseline levels less than 32 were considered to have suboptimal serum 25(OH)D levels and were supplemented with 8000 IU of Vitamin D3 (four 2000 IU D3 capsules) daily as part of their nutritional care plan.

    The response to supplementation from suboptimal to optimal levels was greatest in patients with prostate and lung cancer as well as those with baseline levels between 20-32. Because of this, the impact of improved serum 25(OH)D levels on patient survival and quality of life needs to be further investigated.
IOM's New Vitamin D Recommendations By Life Stage:
Adequate Intake (AI)
Tolerable Upper Level Intake (UL)
Recommended Daily Allowance (RDA)

Infants 0-12 months
400IU - AI
1000IU-1500IU - UL

Children 1-3 years old
600IU - RDA
2500IU - UL

Children 4-8 years old
600IU - RDA
3000IU - UL

Females (including pregnant or lactating) and Males 9-70
600IU - RDA
4000IU - UL

Females and Males 70 and above
800IU - RDA
4000IU - UL

Monday, November 29, 2010

Once Again: magnesium and risk of sudden cardiac death in women

Researchers examined the association between magnesium, as measured in diet and plasma, and risk of Sudden Cardiac Death Syndrome. The analysis, which appeared in the American Journal of Clinical Nutrition, was conducted within the Nurses' Health Study. The association for magnesium intake was examined prospectively in 88,375 women who were free of disease in 1980. 505 cases of sudden or arrhythmic death were documented over 26 y of follow-up. The relative risk of SCD was significantly lower in women in the highest quartile compared with those in the lowest quartile of dietary and plasma magnesium. In conclusion, higher plasma concentrations and dietary magnesium intakes were associated with lower risks of SCD in women. If the observed association is causal, interventions directed at increasing dietary or plasma magnesium might lower the risk of SCD.

This adds more evidence to the even stronger October study in American Heart Journal

Wednesday, November 24, 2010

Bifidus crucial for a baby's digestion

Infants may more efficient at digesting and utilizing nutritional components of milk than adults due to a difference in the strains of bacteria that dominate their digestive tracts. Researchers report on genomic analysis of these strains in the November 2010 issue of the journal Applied and Environmental Microbiology identifying the genes that are most likely responsible for this difference.

"Human milk oligosaccharides (HMOs) are the third-largest solid component of milk. Their structural complexity renders them non-digestible to the host," say the researchers. "Bifidobacterium longum strains often predominate the colonic microbiota of exlusively breast-fed infants. Among the three recognized subspecies, B. longum subsp. infantis achieves high levels of cell growth on HMOs and is associated with early colonization of the infant gut."

The results of this study suggest that B. longum has at least 2 distinct subspecies: B. longum subsp. infantis, adapted to ultilize milk carbon and found primarily in the digestive tract of children, and B. longum subsp. longum, specialized for plant-derived carbon metabolism and associated with the adult digestive tract. "Although early gut colonization is likely dependent on a multitude of dietary and nondietary factors, the delivery of complex oligosaccharides through milk creates an ideal and unique nutrient niche for the establishment of, and colonization by, B. longum subsp. infantis strains," say the researchers. "During weaning, a gradual transitioning from milk-based to plant-based diets generates a shift in carbon availability in the gastrintestinal tract favorable for the expansion and formtion of an adult-like gastointestinal tract microbiota."

Bonnie - this is why it is paramount for formula-fed infants especially to supplement with bifidus and acidophilus as the study below alludes to.

Lactobacillus rhamnosus strain GG (LGG) reduces the frequency and severity of abdominal pain in children with irritable bowel syndrome (IBS), with persistent benefit once treatment is stopped, according to the results of a randomized, double-blind, placebo-controlled trial reported in Pediatrics.

The main study endpoint was overall pain at the end of the intervention period. Frequency and severity of abdominal pain were reduced from baseline with LGG but not with placebo. More than half (59%) of participants had abnormal intestinal permeability test results at study entry. This percentage decreased significantly in the LGG group but not in the placebo group.

Cough meds off the market, kids ER visits drop 50%

The number of babies and toddlers who go to the emergency room because of cough and cold medicines fell by more than 50% after manufacturers stopped selling products labeled for children under 2 in October 2007, says the Centers for Disease Control and Prevention. Because kids' respiratory systems are still developing, the meds can cause abnormal heart rhythms and seizures, or cause kids to stop breathing. To address safety concerns in older children, the Consumer Healthcare Products Association updated cough and cold medicine labels in October 2008, warning not to give them to children under 4.

Steve - this is very good news and the FDA should be applauded for taking these measures.

Low Fat Finally Gets the Boot.

Bonnie and Steve:
In one of the biggest missteps of the last forty years, public health educators convinced most Americans that eating low-fat foods was good for their health. After seeing our population become fatter than any time in its history, FINALLY, researchers are putting that catastrophic notion to bed.

The chief proponent of this dietary faux pas, American Dietetic Association (ADA), finally swallowed their pride and admitted at their annual conference there is strong evidence that replacing fat with carbohydrates could be harmful to health. Recommendations to reduce saturated fat intake are largely based on the notion that high levels increase risk of cardiovascular disease, but unless saturated fat is replaced with other fats, many studies have suggested that fat reduction could increase risk of heart disease.

At the conference, four leading experts presented evidence suggesting that low fat diets may be less healthy than those containing at least a moderate amount of fat. In particular, all four agreed that replacing saturated fat with carbohydrates – as has been widely recommended in the United States – is likely to raise the risk of cardiovascular disease. "The emphasis should be on displacing saturated fat and trans fat with unsaturated fat because that is where the data is,” one researcher said. “…‘Displace saturated fat with polyunsaturated fat’ was simplified to ‘low fat’. Then ‘low fat’ became ‘low calorie’. The low fat message is still very pervasive, especially in the lay press.”

Chair of the Harvard School of Public Health’s nutrition department Dr. Walter Willett took it even further. “If anything, the literature shows a slight advantage of the high fat diet,” he said. “The focus on fat in dietary guidelines has been a massive distraction…We should remove total fat from nutrition facts panels on the back of packs.” He added that while the pervasive dietary guidance given to consumers has been to eat fats sparingly, to load up on starch and eat non-fat products, “the food industry quickly realized sugar was cheaper than fat and laughed all the way to the bank.” “It was really the type of fat that was important,” he said. “If you replaced saturated fat with polyunsaturated fat there was a reduction of risk.”

“The biggest problem in America at the moment is eating behavior,”
Professor of public health and professor of epidemiology at the University of Pittsburgh’s Graduate School of Public Health, Dr. Lewis Kuller said. “…Eating is a social pleasure and not a therapeutic challenge. We have done a great job of confusing the public.”

Assistant professor of medicine at Harvard Medical School Dr. Mozaffarian agreed with the other speakers about a lack of evidence linking total fat consumption and cardiovascular disease risk. High levels of low density lipoprotein (LDL cholesterol) and high triglyceride levels have both been linked to increased risk of cardiovascular disease, but Mozaffarian said there has often been overreliance on single biomarkers in drawing conclusions about fats’ impact on heart health, “even one as hallowed as LDL cholesterol”. “Overall dietary quality is very important for cardiovascular risk,” he said. “Saturated fats may raise LDL cholesterol but increasing levels of all fats lowers triglycerides…You can’t look at data across countries and draw conclusions. Nor can you look at animal studies or a single biomarker and draw conclusions from that.”

Concluding the discussion, Dr. Lichtenstein warned against focusing on single nutrients for disease risk reduction. She said: “We need to stop focusing on individual dietary components because when one goes down, another goes up.”

Don't these comments sound awfully similar to what somebody you know has been saying for a long, long time now? This next piece adds even more fascinating fuel to the fire.

Reducing Carbs the key to Quality Longevity?

Excerpts from a recent article in The Daily Mail

The problem is that this longevity does not mean a healthier life, thanks to chronic diseases such as diabetes and arthritis. But now a U.S. geneticist is thought to have discovered a secret to a long life, full of health and energy. And the answer might be as simple as cutting down on carbohydrates.

University of California, San Francisco Professor Cynthia Kenyon, whom many experts believe should win the Nobel Prize for her research into aging, has discovered that the carbohydrates we eat directly affect two key genes that govern youthfulness and longevity. She made her remarkable breakthrough after studying roundworms. By tweaking some of their genes she has been able to help these worms live up to six times longer than normal, as well as make them stay healthy all that time as well.

Professor Kenyon’s work has been successfully repeated in labs around the world — the genes she found controlling aging in worms do the same thing in rats and mice, probably monkeys, and there are signs they are active in humans, too. This work has revolutionized our understanding of aging. Ten years ago, scientists thought aging was probably the result of a slow decay, a sort of rusting. But Professor Kenyon has shown that it’s not about wear and tear, but instead it is controlled by genes.

At 18 days old the average roundworm is flabby, ­sluggish and wrinkled. Two days later it will probably be dead.
Professor Kenyon found that damping down the activity of just one of their genes had a dramatic effect. Instead of dying at about 20 days, the first set of mutant worms carried on living to more than 40 days. They weren’t sluggish and worn out — they behaved like youngsters. In human terms it was the equivalent of talking to someone you thought was about 30 and finding they were actually 60. With more sophisticated genetic manipulation, she now has some worms that have lived for an astonishing 144 days. An increase of that proportion would allow humans to live to 450.

Professor Kenyon found out was why ­drastically reducing calories has such a remarkable effect. She discovered that it changed the way two crucial genes behaved. It turned down the gene that controls insulin, which in turn switched on another gene, which acted like an elixir of life. We jokingly called the first gene the Grim Reaper because when it’s switched on, the lifespan is fairly short. The ­second ‘elixir’ gene seems to bring all the anti-aging benefits — its proper name is DAF 16, but it was quickly nicknamed ‘Sweet Sixteen’ because it turned the worms into teenagers. It sends out instructions to a whole range of repair and renovation genes. Your supply of natural anti­oxidants goes up, damping down damaging free radicals. The Sweet Sixteen gene also boosts compounds that make sure the skin and muscle-building ­proteins are working properly, the immune system becomes more active to fight infection and genes that are active in cancer get turned off.

Discovering the Grim Reaper gene has prompted the professor to ­dramatically alter her own diet, ­cutting right back on carbohydrates. That’s because carbs make your body produce more insulin (to mop up the extra blood sugar carbs ­produce); and more insulin means a more active Grim Reaper. So the vital second gene, the ‘elixir’ one, won’t get turned on.

To test this, last year she added a tiny amount of ­sugary glucose to the normal diet of some of her worms that had had their genes engineered so they were living much longer, healthier lives. The effect was remarkable. The sugary glucose blocked the “youthful” genes and they lost most of the health gains.

Following Kenyon’s lead, other researchers started looking for the Grim Reaper/ Sweet Sixteen combination in other animals — and of course in humans. They found it. One clue came from a small remote community of dwarves living in northern Ecuador who are cancer-free. They are missing the part of the Grim Reaper gene that controls a hormone called insulin-like growth factor. The downside is they only grow to 4ft tall because the hormone is needed for growth.
But this missing bit of the Grim Reaper gene also means they don’t develop cancer and are less likely to suffer from heart disease or obesity.

Research is at its early stage, but raised insulin triggers an increase in cholesterol production in the liver, makes the walls of blood vessels ­contract so blood pressure goes up and stimulates the release of fats called triglycerides.

Besides dietary modification, Kenyon says, another way to reduce insulin levels is to exercise, which makes you more sensitive to it, which in turn means you need less of it. It also gives another health benefit in a surprising way. Exercise actually increases the level of damaging free radicals which stimulates the body to produce more protective anti-oxidants.

Results of the Largest Study on Diet Ever Done

Researchers at the Faculty of Life Sciences (LIFE), University of Copenhagen, can now unveil the results of the world's largest diet study: If you want to lose weight, you should maintain a diet that is high in proteins with more lean meat, beans and fewer finely refined starch calories such as white bread and white rice. With this diet, most people can also eat until they are full without counting calories and without gaining weight. Finally, the extensive study concludes that the official dietary recommendations are not sufficient for preventing obesity.

The design comprised the following five diet types:
-A low-protein diet (13% of energy consumed) with a high glycemic index (GI)
-A low-protein, low-GI dietA high-protein (25% of energy consumed), low-GI diet
-A high-protein, high-GI diet
-A control group which followed the current dietary recommendations without special instructions regarding glycemic index levels
-A high-protein, low-GI diet works best A total of 938 overweight adults with a mean body mass index (BMI) of 34 kg/sq m were initially placed on an 800-kcal-per-day diet for eight weeks before the actual diet intervention was initiated.

The average weight regain among all participants was 0.5 kg, but among the participants who completed the study, those in the low-protein/high-GI group showed the poorest results with a significant weight gain of 1.67 kg. The weight regain was 0.93 kg less for participants on a high-protein diet than for those on a low-protein diet and 0.95 kg less in the groups on a low-GI diet compared to those on a high-GI diet.

The study was conducted by eight European research centers and headed by Thomas Meinert Larsen, PhD, and Professor Arne Astrup, DrMedSc and Head of Department at the Faculty of Life Sciences (LIFE) and is funded by an EU grant of EUR 14.5 million.

Tuesday, November 23, 2010

Gratitude Good for Health

Melinda Beck of the Wall Street Journal wrote a fascinating piece about research that suggests maintaining an attitude of gratitude can improve psychological, emotional and physical well-being. You can also take a "How Grateful Are You" Test.

Thank You. No, Thank You.

Monday, November 22, 2010

Iron deficiency in babies

Iron deficiency in babies and toddlers is getting increased attention. Up to 15% of babies and toddlers don't get enough iron. This can lead to long-term developmental problems, even in babies who aren't deficient enough to become anemic. New guidelines from the American Academy of Pediatrics recommend supplements for some babies, especially breastfed babies aged 4-6 months and preterm babies. When a supplement is needed, consider using a plain iron drop or a combination product for breastfed babies to provide both iron and vitamin D. Keep in mind that iron concentration can vary from product to product. Please work with your doctor or licensed health professional to make the right choice.

Healthy Lifestyle or Genetics?

Two large studies confirm a healthy lifestyle has the biggest impact on cardiovascular health. One study shows the majority of people who adopted healthy lifestyle behaviors in young adulthood maintained a low cardiovascular risk profile in middle age. The other study shows cardiovascular health is due primarily to lifestyle factors and healthy behavior, not heredity. The studies will be presented at the American Heart Association Scientific Sessions 2010.

"Health behaviors can trump a lot of your genetics," said Donald Lloyd-Jones, M.D., chair and professor of preventive medicine at Northwestern University Feinberg School of Medicine and a staff cardiologist at Northwestern Memorial Hospital. "This research shows people have control over their heart health. The earlier they start making healthy choices, the more likely they are to maintain a low-risk profile for heart disease."

The first Northwestern Medicine study investigated why most young adults, who have a low-risk profile for heart disease, often tip into the high-risk category by middle age with high blood pressure, high cholesterol and excess weight. The unhealthy shift is the result of lifestyle, the study found. More than half of the young adults who followed five healthy lifestyle factors for 20 years were able to maintain their low-risk profile for heart disease though middle age.

Researchers tracked participants' diet, physical activity, alcohol consumption, smoking, weight, blood pressure and glucose levels at the baseline year, year seven and year 20. After 20 years, the prevalence of a low-risk profile was 60 percent for participants who followed all five healthy lifestyle factors, 37 percent for four factors, 30 percent for three factors, 17 percent for two and 6 percent for one or zero. The results were similar for men only, women only, black only and white only.

The second Northwestern Medicine study examined three generations of families from the Framingham Heart Study to determine the heritability of cardiovascular health. Heritability includes a combination of genetic factors and the effects of a shared environment such as the types of foods that are served in a family. Only a small percentage of the United States population -- 8 percent -- has ideal levels of all the risk factors for cardiovascular health at middle age. The study found that only a small proportion of cardiovascular health is passed from parent to child; instead, it appears that the majority of cardiovascular health is due to lifestyle and healthy behaviors. "What you do and how you live is going to have a larger impact on whether you are in ideal cardiovascular health than your genes or how you were raised," said Norrina Allen, the lead study author and a postdoctoral fellow in preventive medicine at the Feinberg School. The Northwestern Medicine study looked at three generations of families including 7,535 people at age 40 and a separate group of 8,920 people at age 50. The goal was to see who was in ideal cardiovascular health at these two critical periods in middle age.

Piggybacking on the aforementioned studies, regular exercise can reduce around two dozen physical and mental health conditions and slow down how quickly the body ages. Health conditions covered by the review include: cancer, heart disease, dementia, stroke, type 2 diabetes, depression, obesity and high blood pressure.

Published in the December issue of IJCP, the International Journal of Clinical Practice, the study says that apart from not smoking, being physically active is the most powerful lifestyle choice any individual can make to improve their health. Health benefits identified by the review include:
  • Regular moderate to intense physical activity is associated with decreased risk of coronary heart disease and ischaemic and haemorrhagic stroke.
  • A growing body of evidence suggests that increasing physical activity can also reduce the risk of certain types of cancers, osteoporosis, type 2 diabetes, depression, obesity and high blood pressure.
  • Evidence of the beneficial effects of physical activity in the primary prevention and management of cancer is growing and there is an association between higher levels of physical activity and lower cancer death rates.
  • Research has found that walking or cycling for at least an half-an-hour a day is associated with a reduction in cancer and that when this is increased to an hour cancer incidence falls by 16 per cent.
  • Evidence is mixed when it comes to specific cancers. Research has shown a strong relationship between increased physical activity and reduced colon cancer in both sexes. And men who are more active at work -- not just sitting at a desk -- have lower rates of prostate cancer.
  • Other cancer studies show that physical activity after diagnosis can aid recovery and improve outcomes.
  • Studies have also shown that men who are physically active are less likely to experience erection problems.
  • There is growing evidence that physical activity could decrease the risk of dementia in the elderly.
Recommendations identified by the review include:
  • Healthy adults aged between 18 and 65 should aim for 150 minutes of moderate intensity physical activity a week, such as 30 minutes of brisk walking, five days a week. And people who undertake more vigorous intensity exercise, such as jogging, should aim for 20 minutes three days a week.
  • Healthy adults should aim for two strength-training sessions a week that work with the body's major muscle groups.
  • Older people can benefit from exercise that helps to maintain their balance and flexibility.
  • People who are physically active should continue to exercise even when they become middle aged or elderly and those who aren't should increase their physical activity.Not smoking and following a healthy diet is also important.
  • Ideally, to gain maximum health benefits people should exercise, not smoke, eat a healthy diet and have a body mass index of less than 25.

Friday, November 19, 2010

Merck keeping secret from statin users.

Secret Revealed
Merck has had a patent on a statin/coQ10 combination since the late 1980's.
The following claim from one of two 1990 Merck patents (4,933,165) states that adding add CoQ10 to statin drugs overcomes statin induced myopathy: "A pharmaceutical composition comprising a pharmaceutical carrier and an effective antihypercholesterolemic amount of an HMG-CoA reductase inhibitor and an amount of Coenzyme Q.sub.10 effective to counteract HMG-CoA reductase inhibitor-associated skeletal muscle myopathy."

Unfortunately, the combination was never introduced into the marketplace. This should have been a no-brainer given that research shows patients on the combination live an average of 8 years longer versus only 5 for statins alone. This should not come as a surprise given the fact that statins deplete the body of coQ10, rendering the performance of the mitochondria in our cells less effective. Excuse the sarcasm, but three more years of selling statins - what's not to like for Merck?

All About Cost
In our opinion, Merck knew the world supply of CoQ10 was limited, was costly to produce, and predicted that production would only supply one-sixth of the world's statin users. In 1990, when Merck sought and received the patent for Mevacor and other statin drugs formulated with up to 1,000 mg of coenzyme Q10 to prevent or alleviate cardiomyopathy, a serious condition that can cause congestive heart failure, they realized the cost of the drug would be too exorbitant to make it a worldwide blockbuster.

Why Not Make Amends Now?
Lawyers note that to launch such a product would be a tacit acknowledgment that statins alone do indeed cause earlier deaths, and the class-action suits would fly.

The Ramifications
As a result of their tremendously reckless decision, Merck made the issue worse by not educating physicians about the important of supplementing CoQ10 to offset the dangers of these drugs. And because they hold the patent, other drug companies are prevented from coming out with a statin/CoQ10 product. To add insult to injury, a new study says that the global campaign to use statins as a preventive therapy in healthy individuals is misguided.

New Data Says Preventive Statin Therapy Campaign Misguided

Rolling back suggestions from previous studies, a Johns Hopkins study of 950 healthy men and women has shown that taking daily doses of a cholesterol-lowering statin medication to protect coronary arteries and ward off heart attack or stroke may not be needed. The Johns Hopkins team found that nearly 95 percent of all heart attacks, strokes or heart-related deaths occurred in the half of study participants with some measurable buildup of artery-hardening calcium in the blood vessels; hence, only this subgroup might have benefited from preventive drug therapy.

Seventy-five percent of all heart emergencies occurred in the quarter with the highest calcium scores. The 47 percent of study participants with no detectable levels of calcium buildup in their blood vessels suffered about 5 percent of heart-disease related events during the six-year study, meaning that drug therapy may not have offered any coronary protection. "
Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease. These are lifelong medications with potential, although rare side effects, and physicians should only consider their use for those patients at greatest risk, especially those with high coronary calcium scores," says researchers. "As many as 5 percent of people on statins develop serious side effects, such as muscle pain. One in 255 will develop diabetes."

Results of the study do underscore the importance of measuring coronary artery calcium deposits in predicting who is really at risk of suffering a heart attack. And the long-term ramifications of a CoQ10-depleted world population from high statin drug is unknown.

Your thoughts?

Thursday, November 18, 2010

Slim Down Your Favorite Recipes

  • Substitutes for high fat milk or cream:
    Use lowfat milk or milk substitute (preferably with no added sugar); if a recipe calls for one cup ½ & ½ use ¼ - 1/3 cup with the rest water.
  • Substitutes for high fat cheese:
    Blue cheese> Feta
    High fat mozzarella> low fat mozzarella
    Other cheeses> use half the amount called for in the recipe and flavor the rest with Parmesan, Romano, Asiago, and/or Manchego cheese
  • Substitute for sour cream:
    Use the same amount of lowfat or no fat Greek yogurt (this will also give you an extra boost of protein and calcium.
  • Make soups and stews the day before and refrigerate so that you can easily remove the hardened fat (or made on the same day, use the fat skimmer).

  • To make delicious “skinny” gravy:
    Remove all fat (with a fat skimmer) from the pan drippings. Add homemade or low sodium organic broth, and optional wine, for enhanced flavor.
  • To reduce saturated fat and salt:
    Trim all fat before cooking meat and poultry. Boost flavor with aromatic herbs, pureed vegetables, low sodium organic vegetable/chicken broth/V-8, and lots of onion, garlic, and/or shallots to add flavor while removing excess fat and sodium. If you add a little salt directly before serving, the salt flavor will be stronger. Reheating with microwaving will also enhance a salty taste.
  • To reduce sugar for homemade baked goods:
    Cut the amount of sugar called for in half. Enhance a “sweet flavor” with spices such as vanilla, nutmeg, cinnamon, ginger, and allspice. Also, using strong flavored sugars such as pure maple syrup, agave, honey and molasses enhance the taste of “sweet” while using lower amounts.
  • To reduce saturated and trans fats for homemade baked goods:
    If a recipe calls for more than one egg, use one whole egg with the rest egg whites (2 egg whites= one whole egg). Cut the amount of butter in half. Substitute the rest with fruit purees (such as applesauce) and/or a healthy oil such as canola, avocado, or safflower. Make sure to add extra flour if switching from a solid to a liquid. If a recipe calls for lard or margarine, substitute with one of the healthy, no trans fat spreads (our favorite is Earth Balance). Add nuts or nut butters to recipes to enhance the “mouth feel” and flavor of fat (it also keeps you more satisfied with a smaller portion).
Copyright 2010, Nutritional Concepts

Wednesday, November 17, 2010

Best antibiotic treatment for ear infection? No antibiotic treatment at all.

Using antibiotics to treat newly diagnosed acute ear infections among children is modestly more effective than no treatment, but comes with a risk of side effects. Researchers found no evidence that name-brand antibiotics work any better in general than generic antibiotics and that careful examination of the eardrum by a clinician for signs of infection is critical for accurate diagnosis of acute ear infections. The study is published in the Journal of the American Medical Association. "Our findings reinforce the existing knowledge that the best antibiotic treatment for common childhood ear infections may be no antibiotic treatment at all," said the lead author. "Prescribing antibiotics early may help cure ear infections a little bit faster, but also raises the risk that children will suffer antibiotic-related side effects such as a rash or diarrhea."

Of 100 average-risk children with acute ear infections, about 80 would be expected to get better within about three days without antibiotics. If all were treated with antibiotics immediately at diagnosis, evidence suggests an additional 12 would improve, but three to 10 children would develop a rash and five to 10 would develop diarrhea.

Bonnie - because of the devastating effects antibiotic's have on healthy gut flora, reoccurring infections and other gut related issues are likely.

CFS may be linked to bowel

by Dr. Patrick Massey
Contributor to The Daily Herald

Chronic fatigue syndrome can be a devastating medical condition. Theories abound as to the cause, including chronic viral and bacterial infections, weakened immune system, endocrine abnormalities and even psychosocial connections (it’s all in your head). The exact number of Americans affected by CFS is unknown, but there are estimates of between three and 3,000 cases of CFS per 100,000 people in the U.S., which translates to 3,000 to 3 million people affected.

Although the exact cause has not been determined, there is ample evidence that CFS may be related to another chronic medical condition involving the bowel, leaky gut syndrome. CFS usually starts after flu-like illness or a period of chronic stress. It is generally defined as having at least four of the following symptoms: profound exhaustion after exercise, impaired memory/concentration, unrefreshing sleep, muscle/joint pain, headaches, tender lymph nodes and recurring sore throat without obvious infection. CFS patients often have symptoms of irritable bowel (in my experience 100 percent), new onset food allergies and chemical sensitivities, and low blood pressure with dizziness when standing up too quickly. No medications seem to be effective and the success of many nontraditional medicine therapies is limited. CFS shares many symptoms with chronic infections, but a causal association with viral infections and Lyme disease is inconsistent. However, the symptoms of CFS do closely mimic the common symptoms of leaky gut syndrome.

Leaky gut syndrome is a condition where the bowel literally becomes “leaky” and toxins can be introduced into the blood stream in high concentrations. These toxins often come from bacteria and yeast and can affect many organ systems. LGS is related to chronic poor food selection, medications especially antibiotics and stress. It is related to a condition called bacterial dysbiosis, where “bad” bacteria colonize the bowel and, in some cases, can result in life-threatening illnesses. Symptoms of LGS include fatigue, muscle and joint pain, insomnia, headaches, changes in memory and irritable bowel symptoms. In a recent medical publication (BMC Medicine, 2010), the correlation between CFS and chronic inflammation associated with LGS was examined. This paper explored the research on CFS and concluded that a chronic inflammatory state may be one of the foundation stones of CFS. They also suggested that a “leaky” gut would be a likely source for the regular introduction of pro-inflammatory and toxic compounds into the body. These compounds can damage DNA and inhibit energy production resulting in fatigue, muscle weakness and pain, and changes in memory and cognition. Many of these pro-inflammatory and toxic compounds may be related to many of the symptoms of both CFS and LGS. Therefore, a reasonable argument can be made that the root cause of CFS may originate in the bowels.

Although there are no specific tests for CFS, LGS can be measured by a simple urine test. Treatment for LGS focuses on select supplements, food choices and other simple lifestyle changes. In my personal experience, many people with CFS can get significantly better with lifestyle changes including improving bowel function.

• Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Hospital Network.

Tuesday, November 16, 2010

1 in 7 harmed during hospitalization

Courtesy of Wall Street Journal

Medicare's new chief called for more steps to improve patient safety, in the wake of a government report that said one in seven hospitalized Medicare patients is harmed during their stay. About 1.5 percent of those patients, or 15,000 people a month, suffered a complication that contributed to their death, the inspector general for the Department of Health and Human Services said.

"We have to do better," Dr. Donald Berwick, a well-known quality-care specialist, told reporters. His agency unveiled a new Medicare "innovation center" designed to develop and test ways to improve quality of care and lower health care costs for everyone, not just Medicare recipients. The program is one of several established by the new health care law to help Medicare spur improvements in patient safety. Initial projects focus on helping primary care physicians better coordinate care across multiple health providers, countering today's fragmented care that too often leaves one doctor not knowing what tests or treatments someone received or missed elsewhere.

The Institute of Medicine a decade ago warned that up to 98,000 people a year die from medical mistakes alone. The new HHS report analyzed the records of 780 Medicare patients hospitalized in October 2008 to examine mistakes and unavoidable consequences of treatment, such as previously unknown drug allergies or medication side effects. During that month, 134,000 Medicare patients suffered at least one adverse event while hospitalized, 44 percent of which were preventable, the report concluded.

Steve - suffice it to say, for what Americans pay for health care, this is inexcusable.

Alcoholic energy drinks to be banned

Alcoholic energy drinks will be effectively banned by U.S. regulators after reports of deaths and hospitalizations in young people, according to Senator Charles Schumer. The Food and Drug Administration plans to announce that caffeine isn’t a safe addition to alcoholic beverages, ending a yearlong review of the products. The Federal Trade Commission will tell manufacturers that marketing these products is potentially illegal. Washington, Michigan, Utah and Oklahoma and some colleges banned the drinks after reports of young people being sick or injured after consuming them.

Bonnie - the official ruling from the FDA about this issue cannot come soon enough as far as I am concerned.

Monday, November 15, 2010

Childhood weight affected by vitamin D deficiency

Kids who are deficient in vitamin D accumulated fat around the waist and gained weight more rapidly than kids who got enough vitamin D, a new study that appears in American Journal of Clinical Nutrition suggests. The investigators recruited a group of 479 school children ages 5-12 from Bogota, Colombia, in 2006 and followed them for about 30 months. They measured vitamin D in blood taken at the beginning of the study, and then examined the link between vitamin D levels and changes in three indicators of body fat over time: body mass index, waist circumference and subscapular-to-triceps skin fold ratio.

Researchers found that the kids with the lowest vitamin D levels at the beginning tended to gain weight faster than the kids with higher levels, who added that children with the lowest vitamin D levels had more drastic increases in central body fat measures. Vitamin D deficiency was also linked to slower growth in height among girls but not boys.

Of all the children tested, 10 percent were vitamin D deficient, and another 46 percent of kids were insufficient, which meant they were at risk of becoming deficient. Bogota, Colombia is in a subtropical zone where one may not expect to find a lot of vitamin D deficiency since the assumption is that sunlight is abundant there.

Lovaza no help for atrial fibrillation

Atrial fibrillation (AF) is common, yet there remains an unmet medical need for additional treatment options. Current pharmacological treatments have limited efficacy and significant adverse events.

To evaluate the safety and efficacy of prescription omega-3 fatty acids (prescription omega-3) for the prevention of recurrent symptomatic AF, a prospective, randomized, double-blind, placebo-controlled, parallel-group multicenter trial involving 663 US outpatient participants with confirmed symptomatic paroxysmal (n = 542) or persistent (n = 121) AF, with no substantial structural heart disease, and in normal sinus rhythm at baseline was performed.

Lovaza (a prescription omega-3) at 8 grams/day or placebo were given for the first 7 days; prescription omega-3 (4 g/d) or placebo thereafter through week 24. At 24 weeks, in the paroxysmal AF stratum, 129 of 269 participants (48%) in the placebo group and 135 of 258 participants (52%) in the prescription group had a recurrent symptomatic AF or flutter event. In the persistent AF stratum, 18 participants (33%) in the placebo group and 32 (50%) in the prescription group had documented symptomatic AF or flutter events. There was no difference between treatment groups for recurrence of symptomatic AF in the paroxysmal stratum. JAMA 11/12/2010

Among participants with paroxysmal AF, 24-week treatment with prescription omega-3 compared with placebo did not reduce recurrent AF over 6 months.

Bonnie - maybe they should have used another omega-3 supplement for this study. I have never been a supporter of Lovaza because it contains trans-fat, to which experts have agreed that there is no safe level. What's worse is that as recently as last year, partially hydrogenated vegetable oil was posted on Lovaza's label (go to page 12). Now, it is not listed (see page 7). We contacted GlaxoSmithKline, the manufacturer of Lovaza and pharmaceutical goliath. They could not tell us why partially hydrogenated vegetable oil was not on the label, because the formula had not changed.

I'll tell you why. If GSK wanted to change the formula, they would probably have to put in a new application for FDA approval. It is much easier to change words on a label.

Does this surprise you?

D-deficiency doubles stroke risk in whites

Vitamin D deficiency does not appear to confer an increased risk of fatal stroke among blacks -- in contrast to findings among white populations, according to an analysis of U.S. population data. Analysis of National Health and Nutrition Examination Survey (NHANES) data encompassing almost 8,000 people, showed that over a median of 14 years, whites with levels of 25-hydroxyvitamin D level below 15 ng/mL had double the risk of dying from stroke compared with those who had higher levels. However, no such association was found in black NHANES participants -- despite their lower overall vitamin D levels and greater fatal stroke risk compared with whites. The finding was surprising because it was thought that vitamin D deficiency might explain the higher stroke rate observed in blacks. Johns Hopkins researchers speculated that African-Americans might have developed an adaptive resistance to the adverse effects of low vitamin D levels -- an idea supported by their lower rates of fractures and osteoporosis compared with whites. Sources of vitamin D include exposure to ultraviolet B rays in sunlight, as well as fatty fish, egg yolks, and fortified foods such as milk products and breakfast cereals.

Friday, November 12, 2010

Blood Sugar Imbalance, Diabetes Update

November is American Diabetes Month. Considering that public health experts predict that one in three US adults may have diabetes by 2050, we thought it prudent to pay homage by sharing with the you what we have learned recently.

Diabetic Retinopathy
A new study has found that patients with diabetic retinopathy, especially the proliferative type, are more likely to have insufficient serum vitamin D levels than people without diabetes, suggesting a link between vitamin D deficiency and one of the leading causes of blindness in adults. The findings were presented at the American Academy of Ophthalmology and Middle East Africa Council of Ophthalmology 2010 Joint Meeting.

Mean levels of 25-hydroxyvitamin D in adults with type 2 diabetes were well below 30 ng/mL, the cutoff the researchers used to define vitamin D "insufficiency" (deficiency). More than 75% of patients with diabetic retinopathy were deficient in vitamin D. They excluded patients with type 1 diabetes, vitamin D intake greater than 1000 IU/day, and disorders that change the metabolism of vitamin D. To minimize differences in sun exposure, the investigators performed vitamin D testing for all subjects from December 2009 through March 2010.

People with no eye disease had the highest serum vitamin D levels and those with proliferative retinopathy had the lowest levels (mean, 21.1 ng/mL).

After performing a linear multivariate analysis to control for potential confounders, the authors found only 1 factor that remained statistically significant: daily multivitamin use. "The use of daily multivitamins was somewhat protective against the development of vitamin D insufficiency," researchers said. However, even those who took daily multivitamins had a 44% incidence of vitamin D insufficiency because the mean intake of vitamin D from the multivitamins was less than the recommended daily intake of 400 IU.

Potential Link Between Obesity and Diabetes Explained?
Inflammation-causing cells in fat tissue may explain the link between obesity and diabetes. The discovery may open the way for new anti-inflammatory treatments that prevent insulin resistance (where the body is unable to respond to and use the insulin it produces) and other complications associated with obesity.

Macrophages, white blood cells derived from the bone marrow, are immune cells that normally respond to infections. In obese people, macrophages move into the fat tissue where they cause inflammation and release cytokines, which are chemical messenger molecules used by immune cells to communicate. Certain cytokines cause cells to become resistant to the effects of the hormone insulin, leading to diabetes and heart disease.

The findings, published in the journal Diabetes, provide the first evidence in humans that macrophages in the fat tissue are producing cytokines that prevent cells from appropriately responding to the presence of insulin. Encouragingly, the study also showed that when obese people lost weight the macrophages in the fat tissue disappeared, as did the risk of developing insulin resistance and diabetes.

If Harvard researchers are correct in their assumption that 42% of Americans will be obese before the epidemic reaches its peak (it is currently at 34%), the link to diabetes will get worse before it gets better.

Coffee, Tea, Alcohol and Risk of Diabetes in African American Women
The study included 46,906 Black Women's Health Study participants aged 30–69 y at baseline in 1995. During 12 y of follow-up, there were 3671 incident cases of type 2 diabetes. Intakes of decaffeinated coffee and tea were not associated with risk of diabetes. However, women who drank moderate amounts of caffeinated coffee or alcohol had a reduced risk of type 2 diabetes. American Journal of Clinical Nutrition, October 2010

Women With Polycystic Ovary Syndrome (PCOS) Improve With Low Glycemic Diet
Researchers compared changes in insulin sensitivity and clinical outcomes after similar weight losses after consumption of a low-GI diet compared with a conventional healthy diet in women with PCOS. Overweight and obese premenopausal women with PCOS consumed either a low-GI diet or a macronutrient-matched healthy diet and for 12 mo or until they achieved a 7% weight loss. Among completers, oral glucose-intolerance test improved more with the low-GI diet than with the conventional healthy diet. There was even greater improvement in the oral-glucose tolerance test among women prescribed both metformin and the low-GI diet. Compared with women who consumed the conventional healthy diet, more women who consumed the low-GI diet showed improved menstrual cyclicity (95% compared with 63%, respectively). Among the biochemical measures, only serum fibrinogen concentrations showed significant differences between diets. To the best of our knowledge, this study provides the first objective evidence to justify the use of low-GI diets in the management of PCOS.

Corticosteroid Use and Diabetes Risk
The use of inhaled corticosteroids, whether for asthma or chronic obstructive pulmonary disease (COPD), increases the likelihood of diabetes onset and diabetes progression, according to a study in The American Journal of Medicine. Systemic corticosteroids are known to increase diabetes risk, but the effects of inhaled corticosteroids are unknown. Of 388,584 patients newly treated for respiratory disease from 1990 to 2005 and followed through 2007, use of inhaled corticosteroids was associated with a significant 34% increase in the rate of diabetes. It translates into an additional 5 cases of diabetes per 1000 patients every year from the medication.

Father's Status at Time of Conception Linked to Diabetes Risk in Offspring
Medical researchers have for the first time shown a link between a father's weight and diet at the time of conception and an increased risk of diabetes in his offspring. The finding, reported in the journal Nature, is the first in any species to show that paternal exposure to a high-fat diet initiates progression to metabolic disease in the next generation. While researchers are aware that overweight women are more likely to have overweight babies, and that a woman's weight before and during pregnancy can play a role in future disease in her children, partly due to the critical role the intrauterine environment plays in development, the impact of the father's environment -- in terms of his diet -- on his offspring had not been investigated.

Paternal environmental factors such as diet and weight are important contributors to disease in the next generation. The research showed that overweight fathers can play a role in "programming" epigenetic changes in their offspring, possibly through effects on their sperm caused by their consumption of high-fat food.

Sugar-Sweetened Beverages Increase Risk of Diabetes
A new study has found that regular consumption of soda and other sugar-sweetened beverages is associated with a clear and consistently greater risk of metabolic syndrome and type 2 diabetes. According to the Harvard School of Public Health (HSPH) researchers, the study provides empirical evidence that intake of sugary beverages should be limited to reduce risk of these conditions. In the journal Diabetes Care, the researchers claim that many previous studies have examined the relationship between sugar-sweetened beverages and risk of diabetes, and most have found positive associations but their study provides an overall picture of the magnitude of risk and the consistency of the evidence.

The studies included more than 300,000 participants and 15,043 cases of type 2 diabetes and 19,431 participants and 5,803 cases of metabolic syndrome. The findings showed that drinking one to two sugary drinks per day increased the risk of type 2 diabetes by 26% and the risk of metabolic syndrome by 20% compared with those who consumed less than one sugary drink per month.

Potassium Deficiency, Diabetes Link
Serum potassium level is an independent predictor of incident type 2 diabetes mellitus, according to the Archives of Internal Medicine. Serum potassium levels affect insulin secretion by pancreatic β-cells, and hypokalemia associated with diuretic use has been associated with dysglycemia. Researchers hypothesized that adults with lower serum potassium levels and lower dietary potassium intake are at higher risk for incident diabetes, independent of diuretic use. Data from 12,209 participants who had 9 years of in-person follow-up and 17 years of telephone follow-up. showed that incident diabetes developed in 1475 participants during 9 years of in-person follow-up. Serum potassium level was inversely associated with the risk for incident diabetes, based on multivariate analyses. Compared with adults who had a high-normal serum potassium level, those with serum potassium levels less than 4.0 mEq/L, 4.0 to less than 4.5 mEq/L, and 4.5 to less than 5.0 mEq/L had a higher incidence of diabetes. During an additional 8 years of telephone follow-up, those with a serum potassium level of less than 5.0 mEq/L had a persistently increased risk for self-reported diabetes. Low dietary potassium intake was significantly associated with the risk for incident diabetes.

The association between increased risk of diabetes and low serum potassium levels seen in this cohort should be assessed in other populations.

Mediterranean Diet Halves Diabetes Risk
Use of the Mediterranean diet among nondiabetics at high cardiovascular risk halved the incidence of new-onset diabetes over four years compared with a low-fat diet. This is the first randomized clinical trial to look specifically at use of the Mediterranean diet for the prevention of diabetes, according to researchers of the study in Diabetes Care.

The diabetes risk reduction occurred in the absence of significant changes in body weight or physical activity, so the reduction can be attributed only to the diet, not to weight loss. Energy restriction was not advised in the trial, nor was physical activity promoted. The findings indicate that a non–energy-restricted traditional Mediterranean diet high in unsaturated fat could be a useful tool for preventing diabetes.

Aspirin Should Not Be a Primary Preventive Diabetes Therapy
According to US Pharmacist, low-dose aspirin remains a secondary prevention strategy in patients with diabetes and a history of CVD, yet it is no longer advocated as primary prevention for all patients aged 40 years and older with diabetes. Low-dose aspirin is now recommended for patients with an increased CV risk (10-year risk >10%), including men older than 50 years and women older than 60 years with at least one additional major risk factor. As far as we are concerned, there are other options besides pharmaceuticals that are just as effective than aspirin for this group.