Friday, May 28, 2010

Bone: Quality vs. Quantity

Bonnie and Steve:

Bone is a living tissue made of a hard outer shell and spongy inner tissue. Bone is constantly reforming and resorbing. This delicate balance allows the body to remodel the bone. Resorption breaks down bone tissue before it is reformed. Osteoclasts are cells that break down the skeleton and osteoblasts are cells that build bones. In present-day humans, the entire skeleton is replaced approximately every seven years. With age, the balance shifts from formation to resorption, which means more bone is broken down than built. Peak bone mass, when bone density is at its maximum, is usually reached between the ages of 18 and 25. After that, bone loss occurs. For women at about age 30 and men a bit later in life, bone resorption will begin to outpace bone formation. When women hit menopause, bone resorption significantly exceeds formation, due to shifts in hormones. The weakening of bones can lead to osteoporosis
.

When diagnosed with osteoporosis, bisphosphonate drug treatment is almost always suggested. Most patients do not give it a second thought. But they should. In journal Menopause, The North American Menopause Society suggest that management should first focus on nonpharmacologic measures, such as balanced diet, adequate supplemental nutrients, adequate exercise, avoidance of cigarette smoke, avoidance of excessive alcohol intake, and fall prevention, before pharmacological measures are considered.

As we have seen consistently since bisphosphonates were introduced, while there may be an increase in bone quantity, there certainly is not an increase in quality. Two recent studies bring the pharmacological treatment into question:
  1. Bisphosphonates may adversely affect bone quality and increase risk of atypical fractures of the femur when used for four or more years, according to research presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons. Two separate studies revealed data suggesting that long-term suppression of bone remodeling by bisphosphonate treatments may alter the material properties of bone, potentially affecting the bone's mechanical integrity and potentially contributing to the risk of atypical fractures. "Although bisphosphonates have demonstrated an improvement in bone quantity, little if anything is known about the effects of these drugs on bone quality," said a lead researcher. The studies found that bisphosphonate use improved structural integrity early in the course of treatment, but those gains were diminished with long-term treatment.

    Both studies noted that the culprit behind the diminishing results may be the fact that bisphosphonates suppress the body's natural process of remodeling bone. "Recent research suggests that suppressed bone remodeling from long-term bisphosphonate use might result in brittle bone that is prone to atypical fractures," said one of the research team.

  2. Clinical Endocrinology, March 2010 - long-term bisphosphonate therapy may increase the risk of unusual long bone mid-shaft fractures. This is probably due to prolonged suppression of bone turnover, which could lead to accumulation of microdamage and development of hypermineralized bone. At present, the scope of this complication in the larger context of patients receiving bisphosphonate therapy remains unknown.
Steps to Prevent Osteoporosis and Preserve Not Just Bone Quantity, But Quality

While most of the following is part our protocol for individualized osteoporosis prevention, we summarized the latest recommendations from The North American Menopause Society for Management of Osteoporosis.

Genetics Link
According to the newest data, the greatest influence on peak bone mass is heredity. Studies have shown up to 80% of variability of peak bone mineral density may be attributable to genetic factors. First-degree relatives of women who have had osteoporatic fractures have lower BMD than those with no family history.
Bonnie - as such, public health focus should be on preventative efforts to quell epigenetic expression in those with a family history. Pharmacological treatment is a band-aid approach. It takes environmental, lifestyle, emotional, dietary, and supplemental action to keep osteoporatic genetic expression under lock and key.

Lifestyle Factors
Several lifestyle factors are associated with the risk of low BMD and fracture. These include poor nutrition, insufficient physical activity, cigarette smoking, and heavy alcohol consumption.

Menopause Status
The increased rate of bone resorption immediately after menopause clearly indicates a hormonal influence on bone density in women. The most likely explanation for this increased resorption is the drop in ovarian estrogen production that accompanies menopause. Bone loss begins to accelerate approximately 2 to 3 years before the last menses, and this acceleration ends 3 to 4 years after menopause.
Bonnie - balancing estrogen production naturally is paramount during this stage.

Secondary Causes of Bone Loss
Various medications, disease states, and genetic disorders are associated with bone loss. There is some early evidence that certain disease states may provide a risk of fracture over and above that provided by BMD.

Medications
Aromatase inhibitors
Cytotoxic agents
Excessive thyroxine doses
Gonadotropin-releasing hormone agonists or analogues
Heparin
Immunosuppressives (eg, cyclosporine)
Intramuscular medroxyprogesterone
Long-term use of certain anticonvulsants (eg, phenytoin)
Oral or intramuscular use of glucocorticoids for >3 mo
Genetic disorders
Hemochromatosis
Hypophosphatasia
Osteogenesis imperfecta
Thalassemia
Disorders of calcium balance
Hypercalciuria
Vitamin D deficiency
Endocrinopathies
Cortisol excess
Cushing's syndrome
Gonadal insufficiency (primary and secondary)
Hyperthyroidism
Primary hyperparathyroidism
Type 1 diabetes mellitus
Gastrointestinal diseases
Billroth I gastroenterostomy
Chronic liver disease (eg, primary biliary cirrhosis)
Malabsorption syndromes (eg, celiac disease, Crohn_s disease)
Total gastrectomy
Other disorders and conditions
Ankylosing spondylitis
Chronic renal disease
Lymphoma and leukemia
Multiple myeloma
Nutritional disorders (eg, anorexia nervosa)
Rheumatoid arthritis
Systemic mastocytosis

Diet
Inflammation is the key. The hunter-gatherer diet, to which our genes are most closely related, were net-acid producing, mostly from consumption of animal protein. However, fruits, nuts, and vegetables were the only other dietary sources, which were all alkaline. The modern Western-style diet has greatly increased the acid/alkaline disparity because of increased grain, cow's milk, and processed food consumption. This does not take into account stress, which creates an acidic environment as well. As the acid load increases, so does inflammation. Inflammation creates bone imbalances. And for those who may be unaware, osteoporosis is an inflammatory disorder.

Please do not take this to mean that to reduce your acid load, you need to take reflux meds. Reflux meds block stomach acid, but do not reduce total cellular acidity. Reflux meds have also been found to increase the risk of bone fractures (the FDA just last week added this warning to PPI labels).

The way to reduce excess cellular acidity is to increase alkaline foods such as fruits, vegetables, nuts, water, and naturally-sparkling water. Do not reduce high quality, organic animal protein, however.
Sufficient animal protein intake may help minimize bone loss. Dietary protein overall is positively linked to the maintenance of bone and muscle health. In the June issue of Osteoporosis International, research states that the current recommended intake of protein may be inadequate for optimum skeletal and muscle health.

Supplemental Nutrients
  • Calcium is the ruler when it comes to natural bone support and many other nutrients are helpful in that they support calcium in its bone-building ways. There is no data that supports more than 1500 mg. of total calcium intake daily (total from food and supplements). Supplemental sources vary widely in absorption.
  • Vitamin D is actually a steroid prohormone rather than a vitamin, as it can be produced in the human body through the interaction of sunlight with the skin. It is essential for the physiologic regulation and stimulation of intestinal absorption of calcium. Public health experts are finally coming to the realization that the majority of the human population living in the Northern Hemisphere is vitamin D-deficient.
  • With 50 percent of total body magnesium found in bone, it’s no wonder that it’s essential to good bone health. Magnesium helps calcium regulation. Magnesium deficiency has been shown to alter calcium metabolism and the hormones that regulate calcium, which can lead to a reduced BMD.
  • Vitamin K can help calcium do its job more efficiently. Osteoblasts produce a vitamin K-dependent protein called osteocalcin, which helps remove calcium from the blood and bind it in the bone matrix as mineral content. Osteocalcin needs vitamin K to function, and long-term deficiency in vitamin K will lead to reduced BMD and bone quality.
  • Many soy foods are naturally high in calcium, which may be why it is beneficial to bone health. Soy also contains magnesium and boron. Soy isoflavones in soy foods may inhibit the breakdown of bones, but the data has been mixed. Only certified organic soy should be consumed.
  • Vitamin C and Vitamin B6 are needed to make collagen, an essential part of the organic material that holds bone together.
  • Fish Oil is beneficial to bone because of its anti-inflammatory properties.
  • Strontium, a trace mineral, is approved as a preventative medication in very high doses in Europe. While one large study exhibited benefits, overall, the data is scant. Strontium does produce side effects when taken in doses used in the studies.
Exercise
Weight-bearing and strength-training exercises are beneficial to bone development and maintenance.

Medications
Note for those with osteopenia: with the exception of estrogen, the effects of pharmacological therapies on fracture have been demonstrated only in patients with either the clinical or BMD diagnosis of osteoporosis, not osteopenia.

Current evidence does not support recommendations regarding the optimal duration of bisphosphonate therapy. This is scary considering many people have been on it for well over a decade.

Adverse Effects (in addition to recent fracture studies)
Oral bisphosphonates may cause upper GI disorders such as dysphagia, esophagitis, and esophageal and gastric ulcer. All bisphosphonates carry precautions on hypocalcemia and renal impairment. Serum calcium and serum creatinine should be measured in all patients before beginning osteoporosis therapy. A transient flu-like illness, often called an acute-phase reaction, occurs infrequently with large doses of oral or IV bisphosphonates. Jaw lesions, usually after dental extraction (known as osteonecrosis of the jaw), have been observed with bisphosphonate use.

Other pharmacologic treatments such as estrogen receptor modulators (Evista), parathyroid hormone anabolic agents (Forteo), both come with side effects and have no safety record beyond five years. Synthetic estrogen and/or progestin's awful safety record has been well studied. Experts believe the dramatic reduction in breast cancer cases coincided with the millions of women who went off hormone therapy.

Osteoporosis Testing
Fracture risk can be estimated by a variety of technologies at numerous skeletal sites. Bone Mineral Density measured by DXA is the only diagnostic technology by which measurements are made at hip, spine, and radius.

Repeat DXA testing in untreated postmenopausal women is not useful until 2 to 5 years have passed, given the rate of bone loss of 1% to 1.5% per year. Postmenopausal women, after substantial BMD losses in early postmenopause, generally lose about 0.5 T-score units in BMD every 5 years.

For women receiving osteoporosis therapy, BMD monitoring may not provide clinically useful information until after 1 to 2 years of treatment.

While often ignored, biochemical markers of bone turnover can be measured in serum or urine. They can indicate either osteoclastic bone resorption (breakdown products of type I collagen in bone: N-telopeptides, C-telopeptides, deoxypyridinoline) or osteoblast functioning (bone matrix synthesis: bone-specific alkaline phosphatase, procollagen type I N-terminal propeptide, osteocalcin). We believe bone turnover testing should be as important in osteoporosis screening as DXA.

Recipe Du Jour - Avocado Ice Cream

Avocado Ice Cream

1 1/2 cups avocado puree from 3 ripe large avocados
1 1/2 cups filtered water
1 1/3 cups raw sugar or 1 cup organic agave nectar
1/4 cup lime juice
1/3 cup tequila (optional)
Lime zest for garnish

Directions:
Puree, peel and pit 3 avocados and process in food processor until smooth. Measure out 1 1/2 cups for ice cream.

After making puree, add water, sugar, lime juice, and tequila to the food processor with 1 1/2 cups of the puree. Pulse until well combined. Refrigerate the mixture for one hour or overnight.

Transfer the avocado mixture to the canister of an ice cream maker. Freeze according to the manufacturer's directions. If desired, place the ice cream in the freezer to firm up before serving. Garnish with lime zest.

Makes 4 cups or 8 servings

Brief exercise as aging tonic?

Exercise can buffer the effects of stress-induced cell aging, according to new research from UCSF that revealed actual benefits of physical activity at the cellular level. The scientists learned that vigorous physical activity as brief as 42 minutes over a 3-day period, can protect individuals from the effects of stress by reducing its impact on telomere length. Telomeres are tiny pieces of DNA that promote genetic stability and act as protective sheaths by keeping chromosomes from unraveling, much like plastic tips at the ends of shoelaces. A growing body of research suggests that short telomeres are linked to a range of health problems, including coronary heart disease and diabetes, as well as early death. "Telomere length is increasingly considered a biological marker of the accumulated wear and tear of living, integrating genetic influences, lifestyle behaviors, and stress,'' said Elissa Epel, PhD, who is one of the lead investigators and an associate professor in the UCSF Department of Psychiatry.

While the exact mechanisms have remained elusive, the ramifications of stress stretch deep into our cells. The findings also build on previous studies showing that exercise is linked to longer telomeres, but this is the first study to show that exercise -- acting as a "stress-buffer'' -- can prevent the shortening of telomeres due to stress.

The Centers for Disease Control and Prevention (CDC) suggests 75 minutes of vigorous activity a week for adults, or 150 minutes of moderate activity in addition to weight-bearing exercises. For children and adolescents, recommended levels are 90 minutes per day.

Metformin linked to B-12 deficiency

In type 2 diabetes, long-term metformin treatment is linked to vitamin B12 deficiency, according to the results of a multicenter, randomized, placebo-controlled trial reported in the BMJ. "Metformin is considered a cornerstone in the treatment of diabetes and is the most frequently prescribed first line therapy for individuals with type 2 diabetes," write Jolien de Jager, from the Academic Medical Center in Amsterdam, the Netherlands, and colleagues. "In addition, it is one of a few antihyperglycemic agents associated with improvements in cardiovascular morbidity and mortality, which is a major cause of death in patients with type 2 diabetes....Metformin does, however, induce vitamin B-12 malabsorption, which may increase the risk of developing vitamin B-12 deficiency — a clinically important and treatable condition."

Thursday, May 27, 2010

Weight-loss drug now carries new warning

The Food and Drug Administration said Wednesday that it is ordering a revision of the labels of the weight-loss drugs Xenical and Alli to warn of the risk of very rare cases of severe liver damage associated with their use. The active ingredient in both drugs is orlistat, which blocks the absorption of fats in the intestines. Xenical is a prescription form of the drug. Alli is an-over-the-counter version which contains lower doses. The agency said it had identified 13 cases of severe liver damage associated with the drugs, one in the United States and 12 abroad. Two of the patients died from liver failure and three others required liver transplants. The FDA said it could not positively say that the drug caused the damage because there is insufficient data in most of the cases. Some of the patients, for example, might have been taking other drugs or had other medical conditions that could have caused the injury. Worldwide, more than 40 million people have taken either Xenical or Alli, so the cases are very rare. Patients taking the drugs should contact their physicians if they develop itching, yellow eyes or skin, dark urine, loss of appetite, or light-colored stools, all of which are signs of liver damage.

Wednesday, May 26, 2010

GAO report comes down hard on herbal supplements

Courtesy of the New York Times

Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found. The levels of heavy metals — including mercury, cadmium and arsenic — did not exceed thresholds considered dangerous, the investigators found. However, 16 of the 40 supplements tested contained pesticide residues that appeared to exceed legal limits, the investigators found. In some cases, the government has not set allowable levels of these pesticides because of a paucity of scientific research. Investigators found at least nine products that made apparently illegal health claims, including a product containing ginkgo biloba that was labeled as a treatment for Alzheimer’s disease and a product containing ginseng labeled as a treatment to prevent diabetes and cancer. The report, which was prepared by the Government Accountability Office, was provided to The New York Times and was made public at a Senate hearing on Wednesday.

Bonnie - herbs inherently contain more heavy metals and pesticides because they are plants and are harvested from the soil. However, I have said in the past that you have a higher risk from contamination with herbs than vitamins and minerals.

I have also said incessantly that dietary supplements need more oversight. The average consumer does not have the time to look at raw material assays, research the safety of specific ingredients, and go through research like we do. There are a lot of bad apples selling adulterated dietary supplements and they need to be reigned in.


Do I have confidence that the FDA can accomplish this? Their track record with pharmaceutical oversight does not give me confidence.

Johnson & Johnson OTC med probe widens

Courtesy of Reuters

U.S. health regulators are investigating hundreds of reported complications with dozens of recalled children's medications made by Johnson & Johnson (JNJ.N), including 30 deaths, but so far no direct link has been found, according to a congressional report. The Food and Drug Administration does not consider the 775 reported adverse events a "spike" and there is no "clear pattern" indicating the problems were caused by the recalled products,

Since the April 30 recall, several hundred more cases of complications, including seven deaths, have been reported to the FDA, the report said. When the recall was announced, FDA officials said the chance of getting sick from the products was "remote." On Thursday, the committee will hold a hearing with officials from both the FDA and J&J over manufacturing lapses that led to contamination and a nationwide recall of liquid children's versions of Tylenol pain reliever and other medications. Infant and children's versions of pain medicine Motrin and allergy drugs Benadryl and Zyrtec were also recalled. In total, about "70 percent of the market for over-the-counter pediatric liquid medicines were involved," the staff said. "It is the largest recall of children's medicine in the history of the FDA," they wrote in the memo to committee lawmakers.

FDA weighs in on reflux meds with strong warning

The U.S. Food and Drug Administration said that studies suggest a possible increased risk of bone fractures with the use of proton pump inhibitors for one year or longer, or at high doses.Package insert labels for the drugs will be changed to describe the possible increased fracture risks, the FDA said."Because these products are used by a great number of people, it's important for the public to be aware of this possible increased risk," Joyce Korvick, deputy director for safety in the FDA's Division of Gastroenterology Products, said in an agency statement."When prescribing proton pump inhibitors, health care professionals should consider whether a lower dose or shorter duration of therapy would adequately treat the patient's condition," Korvick said.Moreover, the FDA said doctors and patients should weigh whether known benefits of the drugs outweigh potential risks.Other proton pump inhibitors used to treat heartburn, known formally as gastroesophageal reflux disease (GERD), include generically available Protonix, Johnson & Johnson's prescription Aciphex brand and Novartis AG's over-the-counter Prevacid.

Tuesday, May 25, 2010

Special diet does not help kids with autism

A popular autism diet free of cereal grains and dairy products did not improve symptoms in children, shows a small study reported at the International Meeting for Autism Research in Philadelphia. Still, many parents and teachers say they've seen improvement when children with autism stop eating these foods. But, Hyman says, behavioral therapy, not their diets, might deserve credit.

The scientists say theirs is the most tightly controlled autism diet study so far. They tried to ensure that their subjects were as similar as possible, cutting the chance that factors besides diet would affect symptoms. Fourteen children with autism, ages 2½ to 5½, completed the 18-week study. None had celiac disease, in which the lining of the small intestine is damaged from gluten, or milk allergies. Their families stuck to a strict diet free of gluten — proteins in wheat, rye, barley — and casein, the main protein in milk and other dairy products. After they had been on the diet for at least four weeks, they were "challenged" once a week with a snack containing wheat flour, non-fat dried milk, both or neither.

Parents, teachers and a research assistant completed standardized surveys about their behavior the day before they received the snack, then two hours and 24 hours afterward. Parents also kept a diary of their children's diet and their sleep and bowel habits. The researchers assessed social interaction and language by watching taped play sessions. They found no adverse changes in behavior after the snacks containing wheat, milk or both.

The lead researcher admits, "This is a small study. Families will continue to try the diet, and that's OK." But, she says, they must ensure their growing children receive adequate nutrition. Pamela Compart, co-author of The Kid-Friendly ADHD and Autism Cookbook, calls the study "clean and well thought out." But, says Compart, a pediatrician in Columbia, Md., who trained with Hyman, researchers may have seen behavioral changes if they had looked 72 hours after the snacks or if they also had eliminated soy from kids' diets. "If you're able to keep them well-nourished, I think it's worth every child trying it," Compart says of the special diet. "People would not stay on this diet if they didn't think it was working."

Bonnie - a tiny study to receive so much attention. The other huge issue is that one is unlikely to see any noticeable improvement in behavior after removing grains and dairy for at least three months to one year. In addition, most experts know that any challenge of this nature should not occur until after two months of removal, not one month.

Monday, May 24, 2010

Fruits & veggies equals reduced inflammation

Increased intakes of fruit and vegetables may decrease markers of inflammation linked to a range of chronic diseases. Using the nutrigenomics technique, scientists report in Nutrition & Metabolism that people with the highest intakes of fruit and vegetables have significantly lower levels of markers of inflammation, and thereby supporting recommendations to consume five servings of fruit and vegetables a day.

Chronic inflammation has been linked to range of conditions linked to heart disease, osteoporosis, cognitive decline and Alzheimer's, type-2 diabetes, and arthritis. The highest intake of fruit and vegetable consumption – at least 660 grams per day – associated with significant reductions in levels of markers of inflammation, including C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). In addition, the highest intakes of antioxidants (at least 11.8 milligrams per day) were also associated with lower levels of CRP, and the gene expression in white blood cells.

Friday, May 21, 2010

Statin side-effect risk uncovered

GPs should think more carefully about prescribing cholesterol-busting drugs say researchers who highlighted a range of "unintended" side effects. Some doses and types of statins are linked with a greater risk of adverse effects, including liver problems and kidney failure, the UK research showed.

There are plans to prescribe statins in around one in four adults aged over 40. The UK Department of Health had predicted prescriptions for the drugs would rise by 30% a year, as GPs find more and more people eligible. But there has been much debate over side effects and the latest research set out to confirm where the problems may lie in a "real life" population.

Researchers looked at data from more than two million 30-84 year-olds from GP practices in England and Wales over a six-year period. Adverse effects identified in the study, published in the British Medical Journal, include liver problems, acute kidney failure, muscle weakness and cataracts. For kidney failure and liver dysfunction, higher doses of the drugs seemed to be associated with greater risk. Risks of side-effects were greatest in the first year of use. On the positive side, the analysis also showed no significant association between the use of statins and the risk of Parkinson's disease, rheumatoid arthritis, blood clot, dementia, osteoporotic fracture, or many cancers including gastric, colon, lung, renal, breast or prostate.

For every 10,000 women treated with statins: 271 fewer cases of cardiovascular disease 8 fewer cases of esophageal cancer 23 extra patients with acute kidney failure 73 extra patients with liver dysfunction 307 extra patients with cataracts 39 extra patients with muscle weakness. Figures were similar for men, except there would be 110 extra cases of muscle weakness.

Fat-Free Means What?

A recent survey from New Hope and iVillage showed that of the top ten label claims women respond to on food packaging, fat-free came in second only to high fiber. Fat-free? Really? Have we not gotten past this awful and misleading term?
  1. Fat is not always the enemy. Unless you are consuming trans fat, copious amounts of saturated animal fat, or excessive amounts of corn/soybean oil, fat is extremely healthful and necessary to maintain optimal weight.
  2. Fat-free almost always means chemical-laden, sodium-saturated, beyond sugary, or often all three.
  3. As we our now even beginning to see in public health policy, excess carbohydrates are the problem when it comes to weight.
Let's break down popular fat-free products shall we?
Note: we didn't bother delving into fat-free snacks, candies, or desserts for obvious reasons.

Wishbone Fat-Free Red Wine Vinaigrette Dressing
Water, High Fructose Corn Syrup, Red Wine Vinegar, Cabernet Sauvignon Wine, Sugar, Salt, Soybean Oil (Adds An Insignificant Amout of Fat), Garlic, Onion, Lemon Juice Concertrate, Xanthan Gum, Tocopheryl Acetate (Vitamin E), Calcium Disodium Edta (Used to Protect Quality), Natural Flavor, Sulfiting Agents.

Kraft Fat-Free Mayonnaise
Water, Modified Food Starch, Sugar, High Fructose Corn Syrup, Vinegar, Soybean Oil, Contains Less Than 2% Of Salt, Cellulose Gel, Natural Flavor, Artificial Color, Egg Yolks*, Xanthan Gum, Mustard Flour, Lactic Acid, Cellulose Gum, Phosphoric Acid, Vitamin E Acetate, Lemon Juice Concentrate, Dried Garlic, Dried Onions, Spice, Yellow 6, Beta Carotene, Blue 1, With Potassium Sorbate And Calcium Disodium Edta As Preservatives.

Coffee-Mate Fat-Free Powdered Coffee Creamer
Corn Syrup Solids, Vegetable Oil (Partially Hydrogenated Coconut or Palm Kernel, Hydrogenated Soybean), Sugar, Sodium Caseinate (MSG), Dipotassium Phosphate, and less than 2% of Color Added, Mono- and Diglycerides, Sodium Aluminosilicate, Artificial and Natural Flavors, Salt, Annatto Color.

Dannon Activia Light Probiotic Yogurt Fat Free Vanilla
Cultured Grade A Non Fat Milk, Inulin, Water, Contains Less than 1% of Fructose, Corn Starch, Modified Corn Starch, Kosher Gelatin, Natural Vanilla Flavor, Sodium Citrate, Malic Acid, Sucralose (Splenda).

Stonyfield Fruit on The Bottom Yogurt Fat Free Strawberry Organic
While the ingredients are natural, it packs a walloping 21 grams sugar per serving!

Weight Watchers Yogurt Non-Fat Vanilla
Milk Fat and Nonfat Milk, Fruit Base (Crystalline Fructose, Inulin Fiber, Vanilla Flavor with Other Natural Flavors, Food Starch-Modified, Citric Acid, Sucralose (Splenda), Potassium Sorbate as Preservative), Inulin, Whey Protein Concentrate, Food Starch-Modified, Kosher Gelatin, Sodium Citrate, Tricalcium Phosphate, Cultures, Vitamin A Palmitate, Vitamin D3. Contains: L. Acidophilus and Bulgaricus, Bifidobacterium SP. and S. Thermophilus.

Bush's Best Baked Beans Vegetarian Fat Free
Prepared White Beans, Water, Brown Sugar, Sugar, Tomato Paste, Salt, Modified Corn Starch, Mustard (Water, Vinegar, Mustard Seed, Salt, Turmeric, Spices), Onion Powder, Spices, Extractive of Paprika, Garlic Powder, and Natural Flavor.

Campbell's Condensed Healthy Request Soup Chicken Noodle 98% Fat Free
Chicken Stock, Enriched Egg Noodles (Wheat Flour, Egg Solids, Niacin, Ferrous Sulfate, Thiamine Mononitrate, Riboflavin, Folic Acid), Chicken Meat, Carrots, Water, Chicken Fat, Contains Less than 1% of: Salt, Potassium Chloride, Potato Starch, High Fructose Corn Syrup, Onion Powder, Dehydrated Cooked Chicken, Lower Sodium Natural Sea Salt, Flavoring (MSG), Disodium Inosinate, Disodium Guanylate, Dehydrated Garlic, Modified Food Starch, Milk Solids, Maltodextrin, Spice Extract (MSG), Beta Carotene for Color, Soy Protein Isolate, Sodium Phosphates, Nonfat Dry Milk, Chicken Flavor (MSG), Beef Extract (MSG), Ascorbic Acid Added to Protect Flavor.

Hebrew National Franks Beef 97% Fat Free
520 mg. sodium per serving!

Beef, Water, Modified Food Starch (Ingredient in Excess of Amount Permitted in Regular Beef Franks), Contains 2% or Less of: Sodium Lactate, Salt, Hydrolyzed Soy Protein (MSG), Flavorings (MSG), Paprika, Potassium Chloride, Sodium Diacetate, Sodium Erythorbate, Sodium Nitrite.

Get the picture?

In the 70's, fat became public enemy number one and Big Food started to put more carbs and added sugars in their products. Let's hope we don't make the same mistake again by replacing carbs and added fats with chemicalized/bad fats.

Forget fat-free, sugar-free. Big Food needs to find a way to make their food real and balanced, pure and simple!

Summer Well-Guide

Adhering to many of these preventative measures can make for summer of safety and wellness.

Vitamin D

  • How much you need supplementally during the summer months is dependent on how much sun (or lack thereof) you get. Fifteen minutes of sun exposure without sunscreen five times weekly is the minimum. If you are unable to accomplish this, then stick with your current dosage. If you get the minimum sun exposure, cut your vitamin D dose in half until early fall. For those with clinically low vitamin D3 levels, it may be warranted to stay with your winter supplemental dose even with sun exposure. Refer to your health professional for individualized advice.
Hydration
  • It is very easy to become dehydrated if outdoors for long periods of time (especially if playing sports or exerting yourself for an extended period of time). Make sure you carry water with you wherever you go. Reusable plastic bottle are acceptable if #2, #4, or #5 (look at the bottom of the bottle). Stainless steel, not aluminum, is preferred.
Pool Safety
  1. Do not swallow pool or lake water at all costs. Besides the high content of chlorine (which is toxic), public swimming areas are loaded with water-borne pathogens. A recent CDC study found that one in eight pools were shut down in 2008 because of dirty water and other problems. If you have children, reinforce the idea of keeping the mouth closed as much as possible when in the water. Pathogens are becoming more chlorine-resistant each season, and most public works departments have not installed the latest technology (for example, ultraviolet radiation machines) to adequately kill them off.

  2. Shower before and after entering a pool or lake. If everybody could adhere to this rule, the risk of picking up a pathogen would be much less. Not to be disgusting, but showering removes any fecal remnants from the body and does not make it into the pool. Showering after helps remove anything lingering on your skin as well as removes chlorine residue, which is especially for asthmatics.

  3. Do not enter a pool if you have an open sore or wound. If you do, pathogens and bacteria have an easy entry into your body and can infect the wound or fester elsewhere.

  4. If you have or had diarrhea recently, do not enter a pool under any circumstances. This is the easiest way to transmit a pathogen to everyone else who joins you!

  5. If your child has allergies or asthma, new data shows that chlorinated pools further irritates nasal and lung airways. A journal Pediatrics study found that adolescents who swam regularly had between a three to six-fold higher incidence of hay fever and allergic rhinitis.
Grilling
  • Do not char your food, especially animal products. That black, chalky substance contains carcinogenic substances called heterocyclic amines (HCA). A competent grillmaster can properly cook food thoroughly without HCA's. Marinating your poultry, fish, and meat will greatly reduce carcinogens because of the antioxidant effect of the herbs and spices as well as blocking acid.
  • Keep grilling utensils clean. Besides undercooked meat, the easiest way to pick up salmonella/food poisoning is using dirty utensils.
Sunscreen

Many sunscreens contain harsh chemicals that are thought to exhibit estrogenic effects. The two active, chemical-free ingredients we suggest to protect your skin are nano-free titanium dioxide and zinc oxide. Please refer to Environmental Working Group's Database to find out where your brand stacks up.

Avoiding common mistakes that parents make when using sun block can help you avoid painful sunburns. These mistakes include:

  1. Not using sun block. This is especially common early in the spring or summer, when you don't think it is sunny enough to get a burn. People sometimes forget to use sunscreen when it is late in the day, when they underestimate how long their kids will be outside, or when it is cloudy outside.

  2. Not using enough sun block. The average person uses less than half the recommended amount of sun block. So apply a thick layer to each section of your child's body, to the point that it is actually hard to work it all in.

  3. Missing areas of their child's body when they apply sun block. Many kids, especially younger ones, don't like to have sun block put on them. This can make applying sun block quite the battle, making it easy to miss a shoulder, thigh, or nose.

  4. Not reapplying sun block every few hours, especially when your kids are in the water or sweating a lot. Even sun block that is waterproof should be reapplied often.

  5. Waiting too long to put sun block on. Remember, to be effective, sun block should be applied about 30 minutes before your kids go outside. If you wait until your kids are already outside, they will be unprotected for about 30 minutes until the sun block is most effective, which is more than enough time to get a tan or sun burn.

  6. If you or a family member gets sunburn, immediately apply pure aloe vera gel, which is soothing and incredibly healing.
Insects

Preventing mosquitoes is job one: Control starts at home.

  • Avoid shaded areas where mosquitoes may be resting.
  • If possible, schedule your activities to avoid dawn and dusk, when mosquitoes are most active.
  • If you have a deck or patio, light it using General Electric yellow “Bug Lights”. These lights are not repellent, per se, but do not attract mosquitoes like other incandescent lights.
  • Mosquitoes are relatively weak fliers, so placing a large fan on your deck or patio can provide an effective low-tech solution.
  • Wear protective clothing such as long pants and long sleeve shirts when outdoors.
  • Taking 100 mg. of vitamin B-1 orally has been shown in some cases to be a preventative.
  • Use insect repellents properly. Besides DEET, which we do not suggest because of toxicity in addition to the yellow fever mosquito recently developing a resistance to it, Picaridin and Oil of Lemon-Eucalyptus are proven to be the most effective. We have heard accounts from clients that Skin-so-Soft by Avon is effective as well. Limit the use of chemical repellents as much as possible.
  • Check your door and window screens for holes and tears that mosquitoes can use to enter your home.
  • Eliminate all standing water on your property. Don't forget to remind your neighbors, too. Their mosquitoes may also be your mosquitoes.
  • Don't use scented soaps, perfumes or hair sprays on your child.
  • Avoid dressing your child in clothing with bright colors or flowery prints.
  • If bitten by an insect, immediately apply peppermint essential oil. It only works if applied very soon after the bite occurs. Crushed fresh garlic is also occasionally suggested as an anecdotal, if not smelly, topical.
Ticks, which can carry Lyme's Disease, have increasingly been a problem over the last decade:
  • Check yourself before going back into the house (humans as well as pets) after being outdoors. Scrutinize your hair and scalp, in particular.
  • If you discover a tick attached to your body, follow the proper procedure to remove it.
Energy Conservation

In a sense, helping to conserve energy will help our long-term safety by reducing the negative effects of climate change. Here are a few easy-to-implement suggestions:
  • Keeps shades down during the hottest daylight hours. In turn, your house will stay cooler without excess use off the A/C.
  • Turn the A/C off during peak hours of use (3PM-7PM). You'll save $ on your electric bill to boot!
  • Do not water your lawn plants between 10AM-5PM. It is wasteful for water conservation. It is the worst time for your plants to receive water and it costs you the most.
  • Invest in rain barrels. They usually come in 50 or 100 gallon tanks. Rain barrels catch rain water from your home's downspouts. You can use to water your bed areas, pots, or hook up a hose and water your trees. It can take a bite out of your water bill as well.

Poison Ivy, Oak, and Sumac

Rashes from poison ivy, oak, or sumac are all caused by urushiol, a substance in the sap of the plants. Poison plant rashes can't be spread from person to person, but it's possible to pick up a rash from urushiol that sticks to clothing, tools, balls, and pets.

  • What you can do: Learning what poison ivy looks like and avoid it. According to the American Academy of Dermatology, while "leaves of three, beware of me," is the old saying, "leaflets of three, beware of me" is even better because each leaf has three smaller leaflets. Hikers who have a difficult time avoiding poison ivy may benefit from a product called Ivy Block. It's the only FDA-approved product for preventing or reducing the severity of rashes from poison ivy, oak, or sumac. The OTC lotion contains bentoquatam, a substance that forms a clay-like coating on the skin.

    If you come into contact with poison ivy, oak, or sumac, wash the skin in cool water as soon as possible to prevent the spread of urushiol. If you get a rash, oatmeal baths and calamine lotion can dry up blisters and
    bring relief from itching. Treatment may include OTC or prescription corticosteroids and antihistamines.
Playgrounds
  • If you are at a playground with a wood apparatus, check to see if the wood has a greenish tint to it. If it does, go to the next playground. Chances are the wood is treated with Chromated Copper Arsenate (CCA), an arsenic treatment compound.

Wednesday, May 19, 2010

Leading demographic for prescription drugs: US children

Children were the leading growth demographic for the pharmaceutical industry in 2009, with the increase of prescription drug use among youngsters nearly four times higher than in the overall population, according to a report by Medco Health Solutions Inc (MHS.N). More than one in four insured children in the United States and nearly 30 percent of adolescents aged 10 to 19 took at least one prescription medicine to treat a chronic condition in 2009, according to an analysis of pediatric medication use conducted as part of Medco's drug trend study.

Medco is forecasting overall pharmaceutical spending to rise up to 18 percent through 2012, driven by diabetes, cancer and rheumatology treatments. Spending is expected to rise 3 percent to 5 percent this year, and 4 percent to 6 percent the next two years.

"Looking at children was the real shocker for us," Dr Robert Epstein, Medco's chief medical officer, said on a conference call from Medco's drug trend symposium in Orlando, Florida. "What's surprising is the type of drugs these kids are taking. All these adult drugs are popping up in children, which is really disturbing," Epstein said. "The obesity problem is contributing not just to diabetes but to a lot of other problems," he said, noting a 50 percent increase since 2001 in use of cholesterol lowering drugs among those aged 10 to 19, a 24 percent increase in use of blood pressure medicines, and a whopping 147 percent jump in adolescents taking heart burn and acid reflux drugs.

Girls between the ages of 10 and 19 showed the greatest jump at nearly 200 percent over nine years. "We've got to get our arms around some very fast lifestyle modification or we're going to have a real problem, having these adult illnesses show up in children who will have a changing life expectancy if they're going to be sick from a very young age," Epstein cautioned.

Among the trends was the rise in children taking antipsychotics -- powerful drugs traditionally used to treat schizophrenia, but increasingly prescribed for other conditions, such as depression and anxiety. Use of such drugs has doubled since 2001 and more than doubled for girls, according to Medco's nine-year analysis. Use of some antipsychotics has also been associated with significant weight gain and increased risk of developing type 2 diabetes, potentially compounding health problems.

Bonnie - from an epigenetic perspective, I shutter to think what effect this drug use will have on this generation and its offspring. This is just beyond reproach.

Cancer society pandering to corporations?

Courtesy of the Salt Lake Tribune

When I ask audiences to raise their hand if someone they love has had cancer, almost every hand goes up. That's because 50 percent of men and 33 percent of women will get cancer in their lifetimes. One hundred years ago your chance of dying of cancer was 1 in 33. It is now 1 in 4. That difference is not explained just by a longer life expectancy today giving us more years to develop cancer. Childhood cancer rates have risen 40 to 60 percent in the past 25 years. Last week the President's Panel on Cancer announced a remarkable report echoing a message the Utah Physicians for a Healthy Environment have been delivering for several years: Environmental degradation is responsible for a much larger portion of our cancer burden than previously thought. Gathering the latest research from hundreds of new medical studies, the panel stated "the true burden of environmentally induced cancer has been grossly underestimated." They called for a paradigm shift in emphasis from treatment to prevention, and changing the search for causes from genes to environmental impacts on gene function -- a branch of science called epigenetics.

The World Health Organization has estimated that 80 percent of cancer and 30 percent of the world's overall disease burden is environmentally caused. Sources of contaminants include pesticide residues in food, chemicals leaching from packaging, plastics, personal care products, radiation, and air and water pollution. The air inside the average home harbors more than 400 different chemicals, some originating from air pollution in the community and others from household products. Common fruits and vegetables often contain residues of 60 or more different pesticides. In their cover letter to President Obama, the panelists wrote, "American people -- even before they are born -- are bombarded continually with myriad combinations of these dangerous exposures."

Virtually from the moment of conception, human embryos in their mothers' wombs are contaminated by hundreds of environmental toxins capable of wreaking havoc even at infinitesimally low levels of exposure, leading to cancer, birth defects, diminished intellectual capacity, behavior disturbances and numerous chronic diseases later in life. Some of these environmentally caused epigenetic changes can be passed on to subsequent generations thus jeopardizing their health as well. On many painful realities -- the climate crisis and a diminishing global oil supply come to mind -- scientists are already struggling to get the public and politicians to discard their denial pacifiers. An environment choked with carcinogens will be another reality for which denial will prove much more comforting.

Ironically, the American Cancer Society (ACS) nurtures that denial. Immediately after the report, the ACS issued essentially a rebuttal, criticizing it as speculative, and diverting attention from "more significant" factors like poor lifestyle choices -- smoking, overeating and lack of exercise. To suggest that Americans can only contemplate one cause of cancer is bewildering. But this "blame the victim" philosophy has been promoted by the ACS for more than 40 years, with a trivialization of environmental risks and a determined dismissal of new research.

Dr. Samuel Epstein, author of The Politics of Cancer and former head of a congressional committee on cancer, is only one of many critics who argue the ACS "priorities remain fixated on after the fact damage control -- screening, diagnosis, and treatment" -- to the virtual exclusion of cause and prevention. The ACS has long-standing conflicts of interest with a wide range of industries that manufacture chemotherapy drugs, agrichemicals and radiation therapy equipment. In fact, ACS spokesman Dr. Michael Thun admits the society's corporate connections. "The American Cancer Society views relationships with corporations as a source of revenue for cancer prevention," said Dr. Thun. "That can be construed as an inherent conflict of interest, or it can be construed as a pragmatic way to get funding to support cancer control." Or it can be construed as what it is: undermining cancer prevention for financial gain -- like the Goldman Sachs of health care. It's hard to think of an issue that reaches deeper into our personal lives than cancer. Six members of my family have had cancer, including two of my children. They illustrate the need to emphasize prevention over treatment. If the ACS can't muster the integrity to help prevent environmentally induced cancer it should at least stop obstructing the efforts of others who try.

Brian Moench is a founder of Utah Physicians for a Healthy Environment

Bonnie - ACS is not the only organization tied to corporate coffers. The AMA, the AHA, and even recently, the Alzheimer's Association. One of the several reasons I never joined The American Dietetic Association is the huge sums of money they get from Big Food. It is a conflict of interest and completely hypocritical. Brian is right on here.

Aspirin increases risk of Crohn's fivefold

People who take aspirin regularly for a year or more may be at an increased risk of developing Crohn's disease, according to a new study presented at the annual Digestive Disease Week conference. Though there are likely to be many causes of the disease, previous work on tissue samples has shown that aspirin can have a harmful effect on the bowel. To investigate this potential link further, the UEA team followed 200,000 volunteers aged 30-74 in the UK, Sweden, Denmark, Germany and Italy. The volunteers had been recruited for the EPIC study (European Prospective Investigation into Cancer and Nutrition) between 1993 and 1997. The volunteers were all initially well, but by 2004 a small number had developed Crohn's disease. When looking for differences in aspirin use between those who did and did not develop the disease, the researchers discovered that those taking aspirin regularly for a year or more were around five times more likely to develop Crohn's disease. Further work must now be done in other populations to establish whether there is a definite link and to check that aspirin use is not just a marker of another risk factor which is the real cause of Crohn's disease. The UEA team will also continue its wider research into other potential factors in the development of Crohn's disease, including diet.

Tuesday, May 18, 2010

Urinary Tract Infections Becoming Harder to Treat

Researchers writing in the Journal of Medical Microbiology will help health experts to assess how using antibiotics in food-producing animals can affect the treatment of common human infections. Scientists examined Escherichia coli bacteria responsible for causing human urinary tract infections (UTIs) and bacteria in fecal samples from humans and food-producing animals. They found an identical gene for antibiotic resistance was present in all the samples in similar proportions and locations, suggesting that the gene is likely to be transferred between bacteria residing in different hosts. Surveys in recent years have shown that antibiotic resistance in this bacterium is increasing, making infections increasingly difficult to treat. The ability of antibiotic resistance genes to transfer between human and animals could make the problem harder to control. "These resistance genes may possibly spread to the human gut via the food chain, through direct contact with animals or by exposure to contaminated water sources.

Steve - we have seen this in our clients well. We find that the patented cranberry extract in pill or syrup form usually does the trick without having to resort to antibiotics. If not enough, GSE (grapefruit seed extract), in addition the cranberry extract, has proven successful in most cases.

Caffeine May Slow Alzheimer's Disease and Other Dementias

Although caffeine is the most widely consumed psychoactive drug worldwide, its potential beneficial effect for maintenance of proper brain functioning has only recently begun to be adequately appreciated. Substantial evidence from epidemiological studies and fundamental research in animal models suggests that caffeine may be protective against the cognitive decline seen in dementia and Alzheimer's disease (AD). A special supplement to the Journal of Alzheimer's Disease, "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases," sheds new light on this topic and presents key findings.

Key Findings:
  • Multiple beneficial effects of caffeine to normalize brain function and prevent its degeneration.
  • Caffeine's neuroprotective profile and its ability to reduce amyloid-beta production.
  • Caffeine as a candidate disease-modifying agent for Alzheimer's disease.
  • Positive impact of caffeine on cognition and memory performance.
  • Identification of adenosine A2A receptors as the main target for neuroprotection afforded by caffeine consumption.
  • Epidemiological studies corroborated by meta-analysis suggesting that caffeine may be protective against Parkinson's disease.
Several methodological issues must be solved before advancing to decisive clinical trials Mendonça and Cunha also observe that "the daily follow-up of patients with AD has taught us that improvement of daily living may be a more significant indicator of amelioration than slight improvements in objective measures of memory performance. One of the most prevalent complications of AD is depression of mood, and the recent observations that caffeine might be a mood normalizer are of particular interest.

Monday, May 17, 2010

Vitamin E preventative for CPOD

Long-term, regular use of vitamin E in women 45 years of age and older may help decrease the risk of chronic obstructive pulmonary disease (COPD) by about 10 percent in both smokers and non-smokers, according to a study presented by researchers at Cornell University and Brigham and Women's Hospital at the ATS 2010 International Conference in New Orleans. "The findings from our study suggest that increasing vitamin E prevents COPD," said researchers. "Previous research found that higher intake of vitamin E was associated with a lower risk of COPD, but the studies were not designed to answer the question of whether increasing vitamin E intake would prevent COPD.

Data was compiled from the Women's Health Study, a multi-year, long-term effort ending in 2004 that focused on the effects of aspirin and vitamin E in the prevention of cardiovascular disease and cancer in nearly 40,000 women aged 45 years and older. Study participants were randomized to receive either 600 mg of vitamin E or a placebo every other day during the course of the research.

Pesticides' link to development disorders

A new analysis of U.S. health data links children's attention-deficit disorder with exposure to common pesticides used on fruits and vegetables. While the study couldn't prove that pesticides used in agriculture contribute to childhood learning problems, experts said the research is persuasive. "I would take it quite seriously," said Virginia Rauh of Columbia University, who has studied prenatal exposure to pesticides and wasn't involved in the new study.

Children may be especially prone to the health risks of pesticides because they're still growing and they may consume more pesticide residue than adults relative to their body weight. In the body, pesticides break down into compounds that can be measured in urine. Almost universally, the study found detectable levels: The compounds turned up in the urine of 94 percent of the children. The kids with higher levels had increased chances of having ADHD, attention-deficit hyperactivity disorder, a common problem that causes students to have trouble in school. The findings were published in Pediatrics.

Researchers said people can limit their exposure by eating organic produce. Frozen blueberries, strawberries and celery had more pesticide residue than other foods in one government report. A 2008 Emory University study found that in children who switched to organically grown fruits and vegetables, urine levels of pesticide compounds dropped to undetectable or close to undetectable levels.

Steve - but didn't the pundits say organic produce was a complete waste of money?

Friday, May 14, 2010

CSL Vaccine Probe Widens in Australia After Seizures

Courtesy of Bloomberg News

Australia’s drug regulator widened an investigation into CSL Ltd.’s seasonal flu vaccine, the first to include the H1N1 pandemic strain, after the shot was linked to fevers and convulsions among children. The Therapeutic Goods Administration asked the nation’s eight states and territories to examine all reports of fevers among children under 5 years, even cases not directly involving vaccination, for evidence of a pattern that may help explain the incidents, Kay McNiece, a spokeswoman for the regulator, said in a telephone interview from Canberra today.

The regulator said April 23 that children aged 5 and younger should stop receiving CSL’s Fluvax and the company said it stopped distributing the product after complaints of seizures and fevers among children. Fifty-five children in Western Australia, 5 years and younger, have been identified with possible convulsions after receiving the shot and a further 196 had less serious reactions such as fever, vomiting and inflammation at the injection site, Western Australia’s health department said. Between 20,000 and 30,000 children in the age group have been vaccinated so far this year, the department estimates.

A study of Fluvax among 298 children aged between 6 months and 8 years published in the journal Influenza and Other Respiratory Viruses last year found that 3.4 percent suffered severe fever, and one child had convulsions. “The risk of whether or not children have a convulsion with a fever is usually age-related,” said Jodie McVernon, a senior research fellow at the University of Melbourne who participated in the research. “The younger you are, the more likely you are to have a fit with a fever, and it’s something that you grow out of.”

Eating Nuts Improves Lipid Levels

The consumption of nuts of nearly any type improves blood lipid levels, lowering total- and LDL-cholesterol levels, and improves important lipid ratios. The cholesterol-lowering effects of nuts are dose related and more pronounced in individuals with higher baseline LDL-cholesterol levels and in those with a lower body-mass index (BMI), according to investigators in the May issue of the Archives of Internal Medicine.

The authors add that a recent summary of these previous epidemiological studies suggested that the risk of coronary heart disease was nearly 40% lower among individuals who ate at least four servings of nuts per week, compared with those who rarely or never ate nuts. In 2003, the Food and Drug Administration issued a qualified claim stating that the consumption of specific nuts--almonds, hazelnuts, pecans, pistachios, walnuts, and peanuts--might reduce the risk of heart disease.

There was no significant effect on HDL-cholesterol levels and no effect on triglycerides.The effect of consuming nuts was similar in men and women and across different age groups and was observed regardless of the specific nut consumed and regardless of the study funding source.

Bonnie - theseresults should not come as a surprise to my clients. Nuts are a staple not only of my Circle of Health, but the Mediterranean Diet.

Thursday, May 13, 2010

Breast vs. Formula? It's in the Genes.

Is breast milk so different from infant formula? The ability to track which genes are operating in an infant's intestine has allowed University of Illinois scientists to compare the early development of breast-fed and formula-fed babies. They say the difference is very real. "For the first time, we can see that breast milk induces genetic pathways that are quite different from those in formula-fed infants. Although formula makers have tried to develop a product that's as much like breast milk as possible, hundreds of genes were expressed differently in the breast-fed and formula-fed groups," said Sharon Donovan, a U of I professor of nutrition.

Although both breast-fed and formula-fed babies gain weight and seem to develop similarly, scientists have known for a long time that breast milk contains immune-protective components that make a breast-fed infant's risk lower for all kinds of illnesses, she said. "The intestinal tract of the newborn undergoes marked changes in response to feeding. And the response to human milk exceeds that of formula, suggesting that the bioactive components in breast milk are important in this response," she noted. "What we haven't known is how breast milk protects the infant and particularly how it regulates the development of the intestine," she said.

Many of the differences found by the scientists were in fundamental genes that regulate the development of the intestine and provide immune defense for the infant. In this small proof-of-concept study, Donovan used a new technique patented by Texas A&M colleague Robert Chapkin to examine intestinal gene expression in 22 healthy infants -- 12 breast-fed, 10 formula-fed. The technique involved isolating intestinal cells shed in the infants' stools, then comparing the expression of different genes between the two groups. Mothers in the study collected fecal samples from their babies at one, two, and three months of age. Scientists were then able to isolate high-quality genetic material, focusing on the RNA to get a gene expression or signature. Donovan said that intestinal cells turn over completely every three days as billions of cells are made, perform their function, and are exfoliated. Examining the shed cells is a noninvasive way to examine intestinal health and see how nutrition affects intestinal development in infants.

Understanding early intestinal development is important for many reasons, she said. "An infant's gut has to adapt very quickly. A new baby is coming out of a sterile environment, having received all its nutrients intravenously through the placenta. At that point, babies obviously must begin eating, either mother's milk or formula. "They also start to become colonized with bacteria, so it's very important that the gut learns what's good and what's bad. The baby's body needs to be able to recognize a bad bacteria or a bad virus and fight it, but it also needs to recognize that even though a food protein is foreign, that protein is okay and the body doesn't want to develop an immune response to it," she said. If anything goes wrong at this stage, babies can develop food allergies, inflammatory bowel disease, and even asthma. "We're very interested in frequent sampling at this early period of development," she added.

Donovan also would like to learn how bacteria in the gut differ in formula- and breast-fed babies, and this technique should make that possible. "Now we'll be able to get a complete picture of what's happening in an infant -- from the composition of the diet to the microbes in the gut and the genes that are activated along the way." Of potential clinical importance: The study will appear in the June 2010 issue of the American Journal of Physiology, Gastrointestinal and Liver Physiology.

Steve - incredible work from this group (they just happen to be from my alma mater). What a great concept to consider when trying to discern the differences between formula and mother's milk. While it confirms what we already know, it taps into to the epigenome and affects how it will be expressed later in life.

This Bacteria a Silent Killer

Bonnie - while the bacteria, C. Difficile, is presently the "bug du jour" in the media, and its devastating effects should not be taken lightly, there is another bacteria that flies under the radar because its effects are more cumulative than acute, yet can be just as devastating. Helicobacter pylori (H. pylori), a microaerophilic Gram-negative bacterium, infects the stomach of more than 50% of the human population worldwide and is a major cause of chronic gastritis, peptic ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, gastric cancer, and is also associated with coronary artery disease and its risk factors such as diabetes mellitus, atherogenic lipids and low-grade inflammation. A clinical review in the April issue of the New England Journal of Medicine provides information on how to detect, diagnose, treat, and manage Helicobacter pylori infection.

Methods of Testing
Routine testing for H pylori infection is not recommended because the vast majority of patients with this infection do not have any associated clinical disease. However, confirmed gastric or duodenal ulcers and gastric MALT lymphoma are definite indications for detecting and treating H pylori infection. After surgical removal of early gastric cancers, it may also be reasonable to test for and eradicate H pylori infection.
Bonnie - I disagree with this. While H.pylori is something I focus on after many other gastrointestinal issues are ruled out, it surely has its merits as a preventative screening tool. I have discovered and help eradicate H. pylori in many of my clients, including my own husband, well before ulcers and cancer occurred.

For younger patients with upper gastrointestinal tract symptoms but without alarm symptoms such as weight loss, persistent vomiting, or gastrointestinal tract bleeding, it is reasonable to use a noninvasive test-and-treat strategy for H pylori infection.

Options for noninvasive testing include the urea breath test, fecal antigen test, and serologic test. Patients with positive test results should undergo eradication therapy. For patients with alarm symptoms, or for older patients with new-onset dyspepsia, endoscopy is recommended.

Treatments
Antibiotics (twice per day for 7-14 days) with short-term Proton Pump Inhibitor therapy is the standard treatment to eradicate H. pylori. However, a percentage of H. pylori strains have become antibiotic-resistant.
Bonnie - while the NEJM recommends treating with two specific antibiotics, I always recommend that your physician cultures your H. pylori strain against several classes of antibiotics to discover which will be the most effective for eradication.

After Eradication Therapy: What Next?
Retesting to make sure the treatment was successful may include a urea breath test or fecal antigen test performed at least 4 weeks after treatment is completed, so that false-negative results from suppression of H pylori are avoided.

When treatment fails to eradicate H pylori infection, therapeutic options include empiric acid-inhibitory therapy, endoscopy to detect underlying ulcer or another cause of symptoms, and subsequent use of the noninvasive test-and-treat strategy. Clinicians should also consider another cause for the symptoms, such as biliary tract, pancreatic, musculoskeletal, or cardiac disease or psychosocial stress. Poor compliance with initial treatment may also be implicated and mandates adherence to the second treatment regimen.

Cardiovascular Disease and Diabetes
Many studies have revealed a close relationship between H, pylori (HP) infection and insulin resistance. The aim of this study in the April issue of
Southern Medical Journal was to investigate the effects of H. pylori eradication on insulin resistance, serum lipids and low-grade inflammation. The study confirms the beneficial effects of H. pylori eradication on insulin resistance, atherogenic lipid abnormalities and low-grade inflammation, and in turn, may prevent coronary artery disease and metabolic syndrome.

H. pylori in the Elderly
Eradication of H. pylori infection improved gastric muscle atrophy (gastritis) and prevented the progression of intestinal metaplasia (the transformation of mucosa, particularly in the stomach, into glandular mucosa resembling that of the intestines, although usually lacking villi.) in the elderly population during the long-term follow-up periods. H. pylori eradication for the elderly population is effective according to this study in the April issue of Journal of Gastroenterology and Hepatology.

Bonnie -
if conventional treatment is not effective, zinc carnosine is a dietary supplement with 24 research studies behind it. I have found it to be effective in limiting the effects of H. pylori in those who have it, have had it in the past, or have a family history of it and want to be proactive.

Have you had H. pylori? If so, feel free to share your experience below.

Wednesday, May 12, 2010

Will USDA doom locally produced meat?

The U.S. Department of Agriculture's Food Safety Inspection Service recently proposed a set of new regulations that will require all meat processors to submit their products to a new series of tests, a procedure that can cost hundreds of thousands of dollars for even a modestly scaled operation, enough to cripple many small processors.

What worries fans of small farms and locally produced food is that the closing of small processors will mean the closing of small farms. Slaughter and processing is the biggest challenge for small-scale meat; they're operations simply too costly and complex for farms to handle themselves. As it is, farmers have few options for meat processing without selling their animals to massive feedlot-meat operations, and without that piece of the puzzle, many farmers may quit.

Why is the USDA considering the new testing regime? Some producers wonder if the machinations of Big Food are in play. The rest of this piece can be found at the following link:

http://www.salon.com/food/feature/2010/04/26/usda_testing_end_local_meat/

Steve: this sounds very much like Monsanto's intent to corner the market on all seeds, making it impossible for small growers to use their own.

If you would like to respond to the USDA, here is your recourse:

THE DEADLINE for COMMENTS is June 19, 2010

What YOU can do NOW:

OPTION 1: Contact FSIS via email at:

DraftValidationGuideComments@fsis.usda.gov

Cut and paste the following letter (making sure to fill in the highlighted areas and edit as you see/feel fit)

OPTION 2: Make your changes and send off the hard copy of the following letter to the address at the top

Docket Clerk, FSIS

Room 2-2127

5601 Sunnyside Avenue

Beltsville, MD 20705

Re: Comments – Draft Guidance on HACCP System Validation


Dear Mr. Almanza:

I respectfully submit these comments regarding the Draft Guidance on HACCP System Validation that were publically released on March 19, 2010.

As a consumer of livestock products who depends upon local, small independent meat processors, my concern regarding the process validation in inspected establishments HACCP programs has prompted me to submit these comments. I am not an industry big-wig; I am only one person who is concerned with the damage that I foresee these new validation requirements causing my local, independent meat processors. When HACCP was implemented, the meat industry saw a decrease in establishments. This initiative and new interpretation has the potential to decimate the remaining very small to small establishments, upon which so many Americans, including myself, depend. There is nothing wrong with the current HACCP system, whereas independent, small processors are concerned – nor is there any reason to believe the extraneous requirements would produce a safer end product. It has been estimated that the potential cost to validate a processors entire food safety system could easily run upward of $500,000 initially and over $100,000 for ongoing validation. No food safety problem has been identified to require this shift in agency interpretation of validation; I don’t understand why this is necessary when there is a system in place that is working. All I see this shift in interpretation accomplishing is:

Devastating the remaining small meat processors (hinders commerce)
Large decrease in the variety of products available
Discouraging the introduction of new products, therefore reducing the number of employees (increased unemployment)
Increasing the cost of production, therefore increasing what I have to pay

None of these sound like they would be for the good of the American consumer. I know, believe in and trust my local meat processors; therefore, I respectfully request that the Draft Guidance on HACCP System Validation be revised to clearly state that no in-plant microbial testing is required when an establishment is following the long-standing, safe processes of HACCP.

I appreciate the chance to comment on the Draft Guidance on HACCP System Validation. Thank you for your time and consideration.

Sincerely,

(Name and Address)

cc: [Your State Legislators- Congressmen and Senators]

Many of those with lactose intolerance mistaken?

Researchers found that in fact, more than half the patients who thought they couldn't digest lactose were mistaken. When they drank a lactose solution corresponding to an entire quart of milk in the lab, their gut absorbed the sugar normally and they experienced less cramping, gas and other bowel trouble than at home. The journal Clinical Gastroenterology and Hepatology explains that the ability to digest lactose depends on an enzyme in the gut called lactase. When there isn't enough of this enzyme, bacteria feast on the leftover sugar, producing lots of gasses in the process. In contrast to this so-called lactose malabsorption or maldigestion, lactose intolerance refers to the symptoms -- for instance, flatulence and stomach pain -- that occur after ingesting lactose. The new study adds to a body of evidence showing that perceived lactose intolerance may actually not be rooted in a biological inability to absorb the sugar. Of 353 individuals referred to specialists for suspected lactose maldigestion, as many as 189 turned out to absorb the sugar normally, with fewer symptoms than at home. It's not entirely clear why people who have no trouble digesting lactose would get symptoms.

Bonnie - the reason why people who do not have lactose intolerance yet still have digestive issues is because of
casein, a main dairy protein. For my clients, if it is not the lactose, then it is usually the casein. The fact that experts don't know this is shocking.

Govt. panel acknowledging food intolerance?

A report appearing in The Journal of the American Medical Association, is part of a large project organized by the National Institute of Allergy and Infectious Diseases to try to impose order on the chaos of food allergy testing. An expert panel will provide guidelines defining food allergies and giving criteria to diagnose and manage patients. They hope to have a final draft by the end of June.

A new report, commissioned by the federal government, finds the field is rife with poorly done studies, misdiagnoses and tests that can give misleading results. While there is no doubt that people can be allergic to certain foods, with reproducible responses ranging from a rash to a severe life-threatening reaction, the true incidence of food allergies is only about 8 percent for children and less than 5 percent for adults, said Dr. Marc Riedl, an author of the new paper and an allergist and immunologist at the University of California, Los Angeles.
Bonnie - I totally agree.

Yet about 30 percent of the population believe they have food allergies. And, Dr. Riedl said, about half the patients coming to his clinic because they had been told they had a food allergy did not really have one.
Bonnie - he is correct about this as well. However, most of these people have food intolerances (IgG responses or missing enzymes).
I am going to send a complementary copy of our Conquering Allergy and Intolerance Action Plan to this panel, which explains the differences in detail.

People who receive a diagnosis after one of the two tests most often used — pricking the skin and injecting a tiny amount of the suspect food and looking in blood for IgE antibodies, the type associated with allergies — have less than a 50 percent chance of actually having a food allergy, the investigators found. One way to see such a reaction is with what is called a food challenge, giving people a suspect food disguised so they do not know if they are eating it or a placebo food. If the disguised food causes a reaction, the person has an allergy. But in practice, most doctors are reluctant to use food challenges, Dr. Riedl said.

“We were approached as in a sense the honest broker who could get parties together to look at this question,” said Dr. Matthew J. Fenton, who oversees the guidelines project for the allergy institute. Part of the confusion is over what is a food allergy and what is a food intolerance, Dr. Fenton said. Allergies involve the immune system, while intolerances generally do not. For example, a headache from sulfites in wine is not a food allergy. It is an intolerance. The same is true for lactose intolerance, caused by the lack of an enzyme needed to digest sugar in milk.
Bonnie - bingo! I just hope beyond hope that they include this in their final draft.

Two very different Vitamin D outcomes for the elderly

Daily dose needs to be increased
Daily recommended intakes for older adults should be increased to 1,000 IU in order to ensure bone health and help reduce the risk of falls, says the International Osteoporosis Foundation. A new position statement by the foundation, published in Osteoporosis International, examined all available evidence to support new recommendations for optimal vitamin D status, and found that older adults should consume between 800 and 1,000 International Units (IU) per day in order to ensure sufficient blood levels of the vitamin. “Global vitamin D status shows widespread insufficiency and deficiency,” said the statement’s lead author Professor Bess Dawson-Hughes of Tufts University. “This high prevalence of suboptimal levels raises the possibility that many falls and fractures can be prevented with vitamin D supplementation. This is a relatively easy public health measure that could have significant positive effects on the incidence of osteoporotic fractures.”

The influential Institute of Medicine (IOM) in the US is conducting a review of the available vitamin D science and is due to deliver its findings this summer. Many expect the IOM to recommend RDIs much above the current levels of 400 IU.

• The estimated average vitamin D requirement of older adults to reach a serum 25OHD level of 75 nmol/l (30ng/ml) is 20 to 25 micrograms per day (800 to 1,000 IU per day).

• Intakes may need to increase to as much as 50 micrograms (2,000 IU) per day in individuals who are obese, have osteoporosis, limited sun exposure (e.g. housebound or institutionalized), or have malabsorption.

• For high risk individuals it is recommended to measure serum 25OHD levels and treat if deficient.

The dangers of a single annual dose
The findings of study in the high-profile Journal of the American Medical Association (JAMA) that concluded that a once-a-year high dose of vitamin D may increase an elderly woman’s rate of falls and fractures compared to women who received placebo. The trial randomly assigned 2,256 community-dwelling women over the age of 70 to receive either placebo or an annual oral dose of 500,000 IU of vitamin D3 (cholocalciferol) for between 3 to 5 years. Australian researchers found that women in the vitamin D group experienced 15 per cent more falls than women in the placebo group. Furthermore, women in the vitamin D group had 26 per cent more fractures and a 31 per cent higher incidence of falls than women in the placebo group. “This is the first study to demonstrate increased risk of falls associated with any vitamin D intervention and the second study to demonstrate an increased fracture risk associated with annual high-dose vitamin D therapy in elderly women,” wrote the researchers. “Thus, it is reasonable to speculate that high serum levels of vitamin D or metabolites resulting from the large annual dose, subsequent de­crease in the levels, or both might be causal.

Bonnie - 500,000IU! I'm surprised there were not other major health issues associated with this high of a dose. Some of my clients take 50,000IU as a loading dose for a short period of time to ramp up their levels quickly. I am horrified that a study would be performed using this high of a dose.