This Doctor Gets It.

Nutraceuticals, Vitamins, Antioxidants and Minerals in the Prevention and Treatment of Hypertension and Cardiovascular Disease
Therapeutic Advances in Cardiovascular Disease, July 28, 2010
Mark C. Houston MD, MS, FACP, FAHA
Hypertensive Institute
Nashville, TN

Summary
Macronutrient and micronutrient deficiencies are very common in the general population and may be even more common in patients with hypertension and cardiovascular disease due to genetic, environmental causes and prescription drug use. The Hypertension Institute in Nashville, TN, has evaluated micronutrient deficiencies and oxidation status, in a group of hypertensive versus normotensive patients. There are significant differences in numerous intracellular micronutrients and oxidation status between these two groups. Replacement of the micronutrient deficiencies, as well as high-dose therapy of selected nutraceuticals in combination with optimal diet, exercise and weight management resulted in control of blood pressure to goal levels in 62% of the hypertensive population over a period of 6 months with complete tapering and discontinuation of antihypertensive drugs.

These deficiencies will have an enormous impact on present and future cardiovascular health and outcomes such as hypertension, myocardial infarction, stroke and renal disease and overall health costs. It is estimated that the annual savings in drug costs alone for the treatment of hypertension could be as much as US$10 billion.

Optimal nutrition, nutraceuticals, vitamins, antioxidants, minerals, weight loss, exercise, smoking cessation and moderate restriction of alcohol and caffeine in addition to other lifestyle modifications can prevent and control hypertension in many patients. An integrative approach combining these lifestyle suggestions with the correct pharmacologic treatment will best achieve new goal blood pressure levels, reduce cardiovascular risk factors, improve vascular biology and vascular health, reduce cardiovascular target organ damage and reduce healthcare expenditure.

Diet
The transition from the Paleolithic diet to our modern diet has produced an epidemic of nutritionally related diseases including hypertension, atherosclerosis, coronary heart disease (CHD), myocardial infarction (MI), congestive heart failure (CHF), cerebrovascular accidents (CVA), renal insufficiency (RI), renal failure (RF), type 2 diabetes mellitus (DM), metabolic syndrome and obesity.

Humans have evolved from a preagricultural, hunter–gatherer society to a commercial agriculture with highly processed, refrigerated and fast foods that have imposed an unnatural and unhealthy nutrition. The human genetic makeup is 99.9% that of our Paleolithic ancestors, yet our nutritional, vitamin and mineral intakes are vastly different. The macronutrient and micronutrient variations contribute to the higher incidence of hypertension and other CVDs through a complex nutrient–gene interaction. Poor nutrition, coupled with obesity and a sedentary lifestyle have resulted in an exponential increase in nutritionally related diseases. In particular, the high sodium/potassium ratio of modern diets has contributed to hypertension, stroke, CHD, CHF and renal disease. In addition, the relatively low intake of omega-3 polyunsaturated fatty acids (PUFA), increase in omega-6 PUFA saturated fat and trans fatty acids, has contributed to the increased incidence of CHD, hypertension, DM and hyperlipidemia.

Protein
Studies demonstrate a consistent association between a high protein intake and a reduction in BP. The protein source is an important factor in the BP effect, animal protein being less effective than nonanimal protein. However, lean or wild animal protein with less saturated fat and more essential omega-3 and omega-6 fatty acids may reduce BP, lipids and CHD risk. Low protein intake coupled with low omega-3 fatty acid intake may contribute to hypertension in animal models.

Fats
Omega-3 PUFA significantly lower BP. The studies on the effects of fish oil on BP have shown a dose-related response in hypertension as well as a relationship to the specific concomitant diseases associated with hypertension. Studies indicate that DHA is very effective in reducing BP and heart rate. However, formation of EPA and ultimately DHA from ALA is decreased in the presence of increased linoleic acid in the diet (omega-6 fatty acid). The ideal ratio of omega-3 fatty acid to omega-6 fatty acid is between 1:1 to 1:2 with a polyunsaturated to saturated fat ratio greater than 1.5 to 2:0.

Omega-9 Fatty Acids such as olive oil is rich in monounsaturated fats (MUFA), which have been associated with BP and lipid reduction in Mediterranean and other diets. In one study, the need for antihypertensive medications was reduced by 48% in the MUFA group versus 4% in the PUFA (omega-6 FA) group. Extra virgin oil has 5 mg of phenols in 10 g of olive oil, a rich polyphenol antioxidant. About four tablespoons of extra virgin olive oil is equal to 40 g.

Carbohydrates
Reduce or eliminate refined sugars and simple carbohydrates. Increase fiber, vegetables, beans, and legumes. Soluble fibers such as guar gum, guava, and oat bran reduce BP and reduce the need for antihypertensive medications in hypertensive subjects, diabetic subjects and hypertensive–diabetic subjects.

Magnesium
Magnesium supplements showed a significant reduction in BP over an 8-week period documented by 24-hour ambulatory BP, home and office BP. Magnesium competes with sodium for binding sites on vascular smooth muscle and acts like a calcium channel blocker, increases prostaglandin E (PGE), binds in a necessary-cooperative manner with potassium, inducing vasodilation and BP reduction. Magnesium is an essential cofactor for the delta-6-desaturase enzyme that is the rate-limiting step for conversion of linoleic acid to gamma-linolenic acid (GLA). GLA elongates to form dihomogamma-linoleic acid (DGLA), the precursor of prostaglandin E1, a vasodilator and platelet inhibitor. Magnesium regulates systolic and diastolic BP, intracellular calcium, sodium, potassium and pH, as well as left ventricular mass, insulin sensitivity and arterial compliance.

Zinc
Low serum zinc levels correlate with hypertension as well as CHD, type II DM, hyperlipidemia, elevated lipoprotein a, 2-hour postprandial plasma insulin levels and insulin resistance.

Tea: Green and Black
Green tea, black tea and extracts of active components in both teas have demonstrated reduction in BP.

Seaweed Wakame (Undaria pinnatifida) is the most popular edible seaweed in Japan. In humans, 3.3 g daily of dried Wakame for 4 weeks significantly reduced both the systolic BP and the diastolic BP. Seaweed and sea vegetables contain almost all of the seawater's 77I minerals and rare earth elements, fiber and alginate in a colloidal form.

Vitamin C
A potent water-soluble antioxidant that recycles vitamin E, improves ED and produces a diuresis. Numerous epidemiologic, observational and clinical studies have demonstrated that the dietary intake of vitamin C or plasma ascorbate concentration in humans is inversely correlated to systolic and diastolic BP and heart rate. Long-term epidemiologic and observational follow-up studies in humans also show a reduced risk of CVD, CHD and CVA with increased vitamin C intake.

Vitamin D
Epidemiological, clinical and experimental investigations all demonstrate a relationship between the plasma levels of vitamin D3, the active form of vitamin D, and BP, including a vitamin-D-mediated reduction in BP in hypertensive patients. Vitamin D may have an independent and direct role in the regulation of BP and insulin metabolism. Vitamin D3 influences BP by its effects on calcium-phosphate metabolism, RAAS, immune system, control of endocrine glands and ED. Vitamin D3 markedly suppresses renin transcription by a Vitamin D receptor (VDR)-mediated mechanism in cell cultures. Its role in electrolytes, volume and BP homeostasis indicates that Vitamin D3 is important in amelioration of hypertension.

Vitamin B6
Low serum vitamin B6 levels are associated with hypertension in humans.

Flavanoids
Over 4000 naturally occurring flavonoids have been identified in such diverse substances as fruits, vegetables, red wine, tea, soy and licorice. Flavonoids (flavonols, flavones and isoflavones) are potent free radical scavengers that inhibit lipid peroxidation, prevent atherosclerosis, promote vascular relaxation and have antihypertensive properties. In addition, they reduce stroke and provide cardioprotective effects that reduce CHD morbidity and mortality.

Coenzyme Q-10 (CoQ-10)
CoQ-10 is a potent lipid phase antioxidant, free radical scavenger, cofactor and coenzyme in mitochondrial energy production and oxidative phosphorylation that lowers systemic vascular resistance (SVR), lowers BP and protects the myocardium from ischemic reperfusion injury. Serum levels of CoQ-10 decrease with age and are lower in patients with diseases characterized by oxidative stress such as hypertension, chronic heart disease, hyperlipidemia, DM, atherosclerosis and in those who are involved in aerobic training, patients on total parenteral nutrition, those with hyperthyroidism and patients who take statin drugs.

Oral administration of CoQ-10 in hypertensive patients takes time to reach its peak level, usually at about 4 weeks, then BP remains stable. The antihypertensive effect is gone within 2 weeks after discontinuation. Approximately 50% of patients on antihypertensive drugs may be able to stop between one and three agents. Both total dose and frequency of administration may be reduced. Even high doses of CoQ-10 have no acute or chronic adverse effects.

Other favorable effects on cardiovascular risk factors include improvement in the serum lipid profile and carbohydrate metabolism with reduced glucose and improved insulin sensitivity, reduced oxidative stress, reduced heart rate, improved myocardial LV function and oxygen delivery and decreased catecholamine levels.

Natural Antihypertensive Compounds
Categorized by Antihypertensive Class A's, many of the natural compounds in food, certain nutraceutical supplements, vitamins, antioxidants or minerals function in a similar fashion to a specific class of antihypertensive drugs. Although the potency of these natural compounds may be lower than the antihypertensive drug, when used in combination with other nutrients and nutraceuticals, the antihypertensive effect is magnified. In addition, many of these nutrients and nutraceuticals have varied, additive or synergistic mechanisms of action in lowering BP.

It is clear from the clinical studies presented that replacement of deficiencies of micronutrients and macronutrients as well as treatment with higher therapeutic doses of vitamins, minerals and antioxidants can lower BP as well as improve vascular health and function. Nutritional treatment although very effective in reducing BP, may take longer than pharmacologic therapies. In some cases, it may be 4–6 months before the maximal antihypertensive effect is seen. In my hypertensive patients (n=671), compared with the general population, there were significant differences in many of the micronutrients tested as well as a significantly higher oxidative stress, a lower oxidative defense and higher incidence of insulin resistance as measured by the glucose-insulin test. Replacement of these deficiencies as well as high-dose therapy of selected supplements and nutraceuticals in combination with optimal diet, exercise and weight management resulted in control of BP to goal levels in 62% of the hypertensive population over a period of 6 months with complete tapering and discontinuation of antihypertensive drugs.

Daily Recommendations

• Potassium/sodium ratio >5 : 1
• Magnesium 1000 mg
• Calcium 1000 mg
• Zinc 25–30 mg
• Protein: total intake (30% total calories): nonanimal sources preferred but lean or wild animal protein in moderation is acceptable; whey protein; soy protein (fermented is best); cold water fish; poultry
  Fats: 30% total calories Omega-3 fatty acids PUFA (DHA, EPA, cold water fish); 2–3 g Omega-6 fatty acids PUFA (canola oil, nuts); 1 g Omega-9 fatty acids MUFA (extra virgin olive oil) (olives) 4 tablespoons or 5–10 olives; Saturated FA (lean, wild animal meat) <10%>
• Carbohydrates (40% total calories): reduce or eliminate refined sugars and simple carbohydrates, increase fiber, vegetables, beans, and legumes
• Exercise
• Alcohol Restriction <20>
• Caffeine Restriction <100>
• Vitamin C 250–500 mg daily
• Vitamin E (mixed tocopherol/tocotrienols) 400–800 IU daily
• Vitamin B6 100 mg daily
• Coenzyme Q-10 60 mg daily
• Lipoic acid (with Biotin) 100–200 mg daily

Conclusions

• Vascular biology (ED and VSMD) plays a primary role in the initiation and perpetuation of hypertension, CVD and TOD.
  
• Nutrient–gene interactions are a predominant factor in promoting beneficial or detrimental effects in cardiovascular health and hypertension.
  
• Nutrition (natural whole food, nutraceuticals) can prevent, control and treat hypertension through numerous vascular biology mechanisms.
  
• Oxidative stress initiates and propagates hypertension and CVD.
• Antioxidants can prevent and treat hypertension.
• Whole food and phytonutrient concentrates of fruits, vegetables and fiber with natural combinations of balanced phytochemicals, nutrients, antioxidants, vitamins, minerals and appropriate macronutrients and micronutrients are generally superior to single component or isolated artificial or single component natural substances for the prevention and treatment of hypertension and CVD.
  
• However, there is a role for the selected use of single and component nutraceuticals, vitamins, antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies as a complement to optimal nutritional, dietary intake from food and other lifestyle modifications.
  
• Exercise, weight reduction, smoking cessation, alcohol and caffeine restriction as well as other changes in lifestyle must be incorporated.
  
• The annual cost savings for this type of integrative treatment of hypertensive patients could be as much as US$10 billion.
  

Steve - financial disclosure: this doctor is speaker for and uses diagnostic equipment made by Spectracell Laboratories, which sells systems for testing nutrient deficiencies. We have never been proponents of this form of diagnostic testing. That said, while our methods may differ, we agree with almost everything he states in this paper.

GSK will settle Paxil birth defect lawsuit

According to Bloomberg Businessweek, it is believed that GlaxoSmithKline, the manufacturer for the antidepressant medication Paxil, will agree to pay $1 billion to resolve more than 800 cases alleging the drug caused birth defects in some of the user's children.

Data confirms that diets are not one-size-fits-all

According to research published in the July 2010 issue of Genetics, using fruit flies, researchers have found that genes interacting with diet, rather than diet alone, are the main cause of variation in metabolic traits, such as body weight. This helps explain why some diets work better for some people than others, and suggests that future diets should be tailored to an individual's genes rather than to physical appearance.

"There is no one-size-fits all solution to the diseases of obesity and type-2 diabetes," said Laura K. Reed, Ph.D, a researcher from the Department of Genetics at North Carolina State University, the lead investigator in the work. "Each person has a unique set of genetic and environmental factors contributing to his or her metabolic health, and as a society, we should stop looking for a panacea and start accepting that this is a complex problem that may have a different solution for each individual."

To make this discovery, the scientists studied 146 different genetic lines of fruit flies that were fed four different diets (nutritionally balanced, low calorie, high sugar, and high fat). Researchers then measured a variety of metabolic traits, including body weight, in each group. Flies in some of the genetic lines were highly sensitive to their diets, as reflected by changes in body weight, while flies of other lines showed no change in weight across diets. The scientists were able to ascertain what portion of the total variation in the metabolic traits was determined by genetics alone, by diet alone, or by the interaction between genotype and diet.

Results showed that diet alone made a small contribution to the total variation, while genotype and genotype interactions with diet made very large contributions. This study strongly suggests that some individuals can achieve benefits from altering their dietary habits, while the same changes for others will have virtually no effect unless it is tailored to their specific genetic needs.

Bonnie - yet another reaffirmation of my favorite phrase: "we are not one-size-fits-all."

Looking at lap band surgery for your child? Read this first.

http://www.reuters.com/article/idUSTRE66P2UM20100726?type=domesticNews

Ramifications of Childhood Obesity

Literature reviews show that most studies on the consequences of childhood overweight have focused on early symptoms or risk factors for later chronic diseases such as diabetes and cardiovascular disease. For overweight children and their parents, current overweight-related health problems, might be more reason for concern than the risk of adverse health effects in future. The objective of a BMC Public Health study was to investigate the general health status of overweight children and the possible impact of overweight on diseases that have a high prevalence in childhood.

Data were used from a general population sample of 3960 8-year-old children. Weight and height, measured by the investigators, were used to define BMI status (thinness, normal weight, moderate overweight, obesity). BMI status was studied cross-sectionally in relation to the following parental reported outcomes: a general health index, GP visits, school absenteeism due to illness, health-related functional limitations, doctor diagnosed respiratory infections and use of antibiotics.

Obesity was significantly associated with a lower general health score, more GP visits, more school absenteeism and more health-related limitations. Obesity was also significantly associated with bronchitis and with the use of antibiotics.

Results showed that obese children were more likely to be ill, to be absent from school due to illness, to experience health-related limitations and had a higher consumption of medical care than normal weight children. Data suggest that childhood obesity is not only associated with risk of disease in adulthood, but that obese children may experience more illness and health related problems already in childhood. The high prevalence of the health outcomes studied imply a high burden of disease in terms of absolute numbers of sick children.

Details
Our data showed associations between obesity and respiratory infections and between obesity and the use of antibiotics. Moreover, a low quality diet with a high energy and a low nutrient content could increase the risk of both overweight and respiratory infections. The researchers think that it is more likely that obesity may increase the severity and/or duration of respiratory infections than that it increases the incidence of infection. The observations on obese Influenza A (H1N1) patients seem to point in this direction. While more study is required, possible explanations for an association between obesity and duration or severity of respiratory infections could be that excess body fat reduces lung volume, resulting in suboptimal ventilation and reduced clearance of micro-organisms from the airways. Additionally, obesity may influence immune responses to infection.

Bonnie - this study is important and relevant to current public health policy because the new healthcare legislation focuses fervently on obesity counseling and prevention. This adds even more validity to the notion that the American insured/taxpayer will not only be penalized in the future if we do not reign in obesity, but are being penalized as we speak.

Research confirms effects of fatty acid imbalance

Chronic excess of linoleic acid (omega 6), coupled with a deficiency in alpha-linoleic acid (omega 3), can increase obesity down the generations. The researchers exposed several generations of male and female adult and young mice to a "Western-like" diet of this type, and then assessed the consequences of such a lipid environment in the human diet. These findings are published in Journal of Lipid Research.

Omegas 6 and 3 are essential polyunsaturated fatty acids: they are indispensable to the human body, which cannot produce them itself and must therefore source them from food. Omega 6 are normally found in corn, which is itself consumed in large quantities by the farmed animals eaten by humans (half of our lipid intake comes from meat and dairy products). As for omega 3, they are mainly present in grass, linseed, rapeseed and fatty fish such as salmon, sardine or mackerel (which contain very high levels of alpha-linoleic acid).

In the past forty years, there has been a steady rise in obesity over the generations in Western societies. During the same period, the diet in industrialized countries has seen a quantitative increase in the calories ingested (lipids account for 35 to 40% of food intake), high levels of linoleic acid (omega 6) and low levels of alpha-linoleic acid (omega 3). Indeed, the amount of omega 6 consumed during the past forty years has rocketed (+250%) while that of omega 3 has fallen by 40%, thus destabilizing the omega 6/omega 3 ratio when compared with the recommended intakes. Omega 6/omega 3 ratio of between 3/1 and 5/1 is ideal, actual consumption is 15 omega 6 for 1 omega 3 in Europe. In the US, this ratio can even reach 40 omega 6 for 1 omega 3.

To perform their experiments, the researchers exposed four generations of mice to a Western-style diet, characterized by these same omega 6/omega 3 ratios. As a result, they saw a gradual increase in fat mass over several generations. They also observed the onset of metabolic disorders such as insulin resistance, which is the first step in the development of type 2 diabetes and a stimulation of the expression of the inflammatory genes involved in obesity. Thus, in a genetically-stable animal population, exposure to a diet similar to that of developed or developing countries was sufficient to cause the emergence of transgenerational obesity, in line with the data collected in humans. The agrifood industry needs to take greater account of the implications of these findings.

Courtesy of Science Daily

Bonnie - bingo! This study backs what Eaton and Cordain have said for two decades in their research. We have changed very little genetically over the last 10,000 years yet our diet has. And we are paying dearly for it.

Limiting junk food ads to kids stalls

I have seen this type of legislation come to a head and then deflate so many times over the last three decades.

http://www.nytimes.com/2010/07/24/business/media/24food.html

How physical activity prevents early death

A new study by researchers from the London School of Hygiene and Tropical Medicine (LSHTM), Cambridge University and the Karolinska Institute in Sweden has found that even light or moderate intensity physical activity, such as walking or cycling, can substantially reduced the risk of early death.

The study, published by the International Journal of Epidemiology, combined the results from the largest studies around the world on the health impact of light and moderate intensity physical activity. It showed that the largest health benefits from light or moderate activity (such as walking and cycling) were in people who do hardly any physical activity at all. Although more activity is better -- the benefits of even a small amount of physical activity are very large in the least physically active.

The good news from this study is that you don't have to be an exercise freak to benefit from physical activity. Just achieving the recommended levels of physical activity (equivalent to 30 minutes daily of moderate intensity activity on 5 days a week) reduces the risk of death by 19%, while 7 hours per week of moderate activity (compared with no activity) reduces the risk of death by 24%.

Lead researcher, James Woodcock said, "This research confirms that is not just exercising hard that is good for you but even moderate everyday activities, like walking and cycling, can have major health benefits. Just walking to the shops or walking the children to school can lengthen your life -- as well as bringing other benefits for well-being and the environment."

What Makes Your Body Tick

Ticking away inside almost all cells are tiny clocks composed of protein gears. Scientists have known that these molecular clocks govern the daily rhythms of life, from mealtimes and bedtimes to the rise and fall of hormone levels, body temperature and blood pressure. New research shows that circadian clocks, as the daily timekeepers are known, do more than just control day-to-day schedules. Such clocks, some scientists say, have the potential to play a role in nearly every biological function as diverse as cellular division and aging.

Some of the new insights come from studying the brain’s master clock, a pair of structures known as the suprachiasmatic nucleus, or SCN, that set the body’s daily rhythms. Other work, meanwhile, suggests that the SCN is not a single monolithic clock but more a set of interrelated nodes that help coordinate clocks throughout the body. And still other researchers have found that the SCN may not even be the ultimate arbiter of the body’s time, and that other organs control biological rhythms on their own without much, if any, help from the SCN.

Think of the SCN as the atomic clock in this network of ATM. Each body cell has its own clock, just as individual cash machines do. And periodically those peripheral clocks check in with a central timekeeper to stay synchronized.

The rhythm of the SCN is set mainly by light, as special cells in the retina relay a message to the brain when they sense daylight. The light cues affect the gears of the molecular clock inside the SCN’s neurons, which then somehow control the cells’ firing rates — the frequency at which neurons zip off electrical messages to other brain cells.
Bonnie - this shows the great importance of getting restful, unobtrusive sleep in a bedroom devoid of any light that may throw off your rhythm.

Scientists have also discovered that the SCN is actually a clock confederation with several different clusters, or nodes. The nodes form a relay team, passing electrical activity from one to another. "One node fires, then the second, third and so on, and then the whole thing is quiet for a few minutes,” researchers say in Journal of Biological Rhythms. Having independent nodes instead of one monolithic clock may make the brain clock more robust and allow it to adjust more quickly to environmental changes.

While many researchers continue to probe the mysteries of the brain clock, others think it gets too much credit for controlling circadian rhythms in the rest of the body. The liver, for instance, who's clock corresponds to mealtimes, works fine without much input from the SCN.

Whichever process is found to be the right one, the results have implications for our health. Many scientists think that one role for circadian clocks is to separate biological processes, such as digesting food and replicating DNA; multitasking such activities at the same time could lead to DNA damage. Having a more crisply defined circadian rhythm could help improve the efficiency of metabolism. A recent study in Cell Metabolism found that high serum triglycerides can be caused by a disrupted circadian rhythm.

Researchers are trying to sharpen circadian rhythms in mice by restricting feeding to certain times of day to see if it will have beneficial effects on health over the long-term. New data from studies of fruit flies also suggest that robust circadian rhythms are one key to a long and healthy life. These results indicate that circadian clocks may help control more than just daily rhythms of life. Researchers are confident that anything that messes up the phase of the clock probably affects aging and life span. After all, circadian rhythms tend to wind down in elderly people and rodents. Further research may suggest ways to reset the health and aging clock. And that, in turn, could underscore yet again the most important lesson of circadian clocks: that timing is everything.
Bonnie - this research correlates with other research showing that calorie restriction in mice increases lifespan dramatically. Eating optimal portions of real food at designated times, with plenty of time in between to digest, throw in the occasional fast/smart detox, along with an optimal sleep pattern, and you are doing your circadian rhythm good.

Excerpts taken from "Keeping Time," by Tina Hesman Saey for Science News

Tazo falls into same trap as Coke and Pepsi

As we reported in this month's Brand Buzz Video, there are a slew of zero calorie drinks about to flood market shelves that contain stevia. However, you must read the fine print. Coke, Pepsi, and even Tazo Tea's version of naturally sweetened beverages still contain a second sweetener: erythritol. Erythritol is a corn-based sweetener that we do not recommend. An argument is raging about whether erythritol should be considered artificial or natural. According to information on Cargill's website (the manufacturer), a chain in the corn sugar molecule is altered by a chemical process. In our minds, that makes it artificial.

Why do they put this into the stevia drinks? Many people do not like the taste of straight stevia, so they have to blend it with something to make it palatable to the masses.

On a positive note, acceptance among consumers for stevia-sweetened foods and beverages is nearing levels for existing products made with aspartame and sucralose, according to a study.

The NPD Group, Inc. finds 35 percent of U.S. consumers have already consumed or would consider eating products that contain stevia. Comparatively, 39 percent of consumers say the same for aspartame-sweetened items.

While other non-sugar sweeteners have held steady among consumers who say they would eat or drink products that contain them during the past year, stevia has been on the rise, moving from 28.5 percent acceptance in September 2009 to nearly 35 percent in June of this year, according to NPD.

Probiotics Use in Mothers May Limit Eczema, Diabetes in Their Babies: Studies

Eczema
Mothers who drank milk with a probiotic supplement during and after pregnancy were able to cut the incidence of eczema in their children by almost half, a new randomized, double-blind study published in the British Journal of Dermatology has shown. Use of the probiotic milk -- which the mothers drank beginning at week 36 in their pregnancy up through to three months after birth -- reduced the incidence of eczema by 40 percent in children up to age two, the researchers found.

The study is a part of a larger research project at the university called the Prevention of Allergy Among Children in Trondheim, or PACT, an ongoing population-based intervention study in Norway focused on childhood allergy. Previous studies have shown that ingestion of some probiotics by children may prevent eczema, but this is the first study to show a preventative effect when the mother alone consumed the probiotics. To participate in the study mothers had to have planned to breastfeed their children. "We believe that probiotic bacteria affects breast milk composition in a positive way," researchers said.

Diabetes
Combining probiotics with perinatal dietary counseling could help reduce the risk of diabetes in mothers and provide a “safe and cost-effective” tool in addressing obesity in children, according to a new study from the British Journal of Nutrition. “Taken together, long-term health benefits for mothers and children may be conferred by balanced maternal nutrition during pregnancy and lactation and by promoting the healthy gut microbiota in the mother and the child. The results of the present study add weight to the argument that the continuing burden of Western lifestyle diseases is modifiable,” write the researchers.

The intervention group received additionally intensive dietary counseling at every study visit provided by a nutritionist, the aim being a dietary intake complying with current recommendations. The intervention group was further randomized at baseline in a double-blind manner to receive either placebo capsules or probiotics (Lactobacillus GG, and Bifidobacterium lactis Bb12). The capsules were taken once per day, and the intervention period extended from the first trimester of pregnancy to the end of exclusive breast-feeding.

All pregnancies were of normal duration, and there were no adverse events noted in mothers or in children, which confirms the safety of this approach. Researchers noted that those women who had taken probiotics had a reduced frequency of gestational diabetes mellitus (GDM): 13 percent for the diet/probiotics group, compared to 36 percent for the diet/placebo group and 34 percent for the control group. In addition, the dietary counseling during pregnancy reduced the risk of fetal overgrowth, which is thought to predispose to later obesity.

A warning to young weight-loss surgery patients

More young adults are having weight-loss surgery in order to prevent obesity-related diseases like diabetes and improve their quality of life. But a possible complication has arisen in this strategy that women should know about.Australian doctors reported Friday on a case in which a woman who had obesity surgery — specifically, biliopancreatic diversion — developed severe vitamin deficiencies in pregnancy and gave birth to a child who is blind. The woman had the surgery seven years before she became pregnant. But during the pregnancy, the woman was diagnosed with deficiencies in vitamins A, D, K and iron.

Vitamin deficiencies are a common side effect of weight-loss surgery.The woman was treated for the deficiencies, but her levels of vitamin A remained low throughout the pregnancy, and her infant son was born with malformations of the eyes and is blind, reported the lead author of the case report, Dr. Glen Gole of the University of Queensland in Brisbane. The report was published in the Journal of the American Assn. for Pediatric Ophthalmology and Strabismus.

Yeast Sufferers: You're Not Crazy!

Bonnie - I thank John for being so brave about sharing his journey of discovering yeast. Many of my clients feel like they are on an island because 99% of physicians do not believe that yeast issues exist, and hence, never test for it. He is also correct about celiac sufferers being more susceptible to yeast issues.

For a Celiac Sufferer, a New Mystery Illness
By Jonathan Papernick
New York Times

The problems began not long after I moved in with my future wife. I was losing weight at an alarming rate, drifting for hours after meals in a confused fog. My acid reflux was so bad I felt like I had a golf ball lodged in my throat. I suffered from otherworldly constipation and had no sex drive. My tongue swelled like a wet sponge. It seemed everything I ate contributed to my misery. These symptoms weren’t the ones familiar to me from my mid-20s, when I’d learned I had celiac disease. People with celiac can’t tolerate gluten, a protein in wheat found in many foods and everyday products. When I ate gluten, my sides ached and my small intestines felt as if they had been rubbed raw by sandpaper; I felt tremors throughout my body and deep, deep exhaustion. My mother lived with celiac disease for most of her life, and after overcoming years of willful ignorance of my mother’s condition, my health finally improved when I began avoiding wheat and other gluten-containing grains.

Now even gluten-free foods caused my throat to tickle and my head to throb, and I had no idea why. I had painful canker sores all the time. I couldn’t understand how I could have solved one mystery by removing gluten from my diet, only to be baffled by another, more frightening, condition. My future wife was afraid I was dying and wondered seriously whether I was somehow allergic to her. By the time we were married a year later, several allergists had told me that I had no allergies at all. Gastrointestinal doctors blamed my mysterious affliction on stress. An acupuncturist said my chi was out of whack. I was tested for parasites and came up clean. More than a few friends and family members suggested indelicately that my problems were all in my head, or worse still, that I was simply seeking attention. I couldn’t even look at the skeleton resembling myself in the mirror anymore.

Illness can do strange things to an ordinarily rational mind, and I was desperate to find a solution. A friend told me about a new-age treatment that claimed to resolve undiagnosed health problems. After shelling out several hundred dollars for a consultation, I was informed that my problems were caused by “energy blockages,” disruptions in the normal flow of energy through my body’s electrical circuits. The practitioner said she could permanently cure me simply by treating my pressure points while I held in my hand a vial of charged water containing the same properties as the allergen. Apparently, a minimum of 30 to 40 treatments would be necessary to help me gain back chicken, potatoes, rice, beans and other staples that I had relied on my entire life. For more than six months I paid good money for treatments that did nothing to help me, the practitioner always promising that next time I was due for a breakthrough that would allow me to once again eat my favorite foods. I should have been more skeptical of this miracle cure. But with more and more foods finding their way onto my blacklist, I could not afford cynicism. I needed a miracle and nothing less.

My wife had had enough of my indulgence in expensive, unproven “voodoo” medicine, and she put out a frantic call to her friends and colleagues asking for help. A friend passed along the name of a doctor known to have success with people thought of as incurable — the last resort for many seemingly hopeless cases. Within minutes of meeting the doctor and explaining my symptoms, he was certain that he had pinpointed the source of all my problems. Yeast. He took a blood test just to be sure, and as predicted, my yeast levels were off the charts. He explained how Candida albicans, an aggressive sugar-eating yeast that had been colonizing my intestines, is a common concern for celiacs, whose tiny, hair-like villi in their intestines have been flattened and damaged by gluten.

Under normal circumstances, the majority of the human population lives with Candida albicans in their digestive systems without any problems. But I listened with horror as he explained how the roots of the Candida were starting to break through the walls of my intestinal tract, causing a leaky gut through which microscopic bits of food were entering my bloodstream. I was ordered to cut out all sugar, alcohol, fruit, starch, peanuts and mushrooms and told to eat protein and vegetables with low sugar content. I was allowed kale and collard greens, but carrots and red peppers were off the list. I was taking no less than 12 different supplements, including probiotics and digestive enzymes, to heal my system. My compromised digestive system couldn’t even handle ordinary calcium supplements, and my wife and I sat at our coffee table filling gelatin capsules with white calcium powder. (You can imagine what it looked like to an unknowing visitor.)

The doctor prescribed an antifungal that would work slowly to kill off the unwelcome aggressor. Every time I took the medication, even at the lowest possible dose, I felt like I’d been struck down by the flu as the invading yeasts died off — evidence of how serious my problem was. It would take a long time to reverse the damage that the Candida had done, but I was finally on the right track. When I didn’t improve as quickly as my doctor expected, he sent a mold remediation specialist out to our apartment to check out our living situation. There was black mold in our closets and on our walls, and the air shaft that was supposed to provide fresh air to three of our rooms was full of pigeon feces and filth. I was shocked to learn that our New York City apartment was slowly killing me. My doctor explained that others could live perfectly normal lives with this mold, but in my case, with a compromised immune system, the toxic mold was simply piling on a heavily taxed system and adding fuel to the Candida — the literal last straw. We were ordered to clean our walls with hydrogen peroxide and to purchase an industrial-strength air filter with an infrared beam to get rid of the mold. The hydrogen peroxide had little effect, as the tenacious mold seemed to reappear within days. I slowly reintroduced foods back into my diet, starting with a simple forkful at a time. However, with every slice of potato, mouthful of rice, nibble of chicken, I felt my head throb, my throat tickle. My doctor suggested that we move, and before long, a job opened up in Boston.

I packed up and left town — four months ahead of my wife, who still needed to wrap up things with her job. Within weeks of living in New England, I started to improve, slowly, ever so slowly, and I found the courage to reintroduce foods back into my diet. It took years, not months, as I followed the doctor’s strict diet, which included egg whites and spinach and tuna for breakfast. Eventually, gradually, thankfully I got better. I have since gained the weight back (and then some) and have started a family. With the increased availability of allergen-free medicines and supplements, and my own hard-learned lessons, I am now able to enjoy life all over again. But I can’t help but wonder how many people with celiac disease have suffered unnecessarily because so many doctors are not prepared to deal effectively with the condition.

Jonathan Papernick is the author of three books, including the new short story collection, “There Is No Other.”

A Robot Weight-Loss Coach?

Bonnie - am I being put out to pasture by a robot? I think not.

A Robot That Helps You Diet

How obese prefer to lose weight

Obese adults prefer noncommercial, nonstigmatizing interventions designed to help them improve their lifestyles over programs that just promote weight loss, according to a study in BMC Public Health. The aim of this study was to explore the opinions and attitudes of obese individuals toward population and individual interventions for obesity in Australia.

The participants were asked about their attitudes to 6 interventions: media-based social marketing campaigns,public health interventions and initiatives,regulation (eg, banning junk food advertising aimed at children),obesity surgery,commercial diets (specifically Weight Watchers and Jenny Craig), and specialized fitness programs (eg, women-only gyms such as Curves and public funding for personal trainers).

The researchers found that about two thirds of participants thought that regulation was one of the most effective solutions for the obesity epidemic in Australia. Public health interventions and initiatives were favored by 42% of the participants. One third of the participants thought that media campaigns were effective, especially ones based on positive messages and incentives, rather than scare tactics. The researchers also report that most participants were somewhat skeptical about the long-term success of obesity surgery, voicing concerns about the commercial marketing of the surgery and also about the associated short- and long-term risks.

Only 18% thought that commercial dieting programs were effective interventions for weight loss, and only a small number thought that diets were effective for weight loss. Weight Watchers was deemed to be better than other commercial programs, with participants calling the program's approach "genuine," "sensible," and "[health-]promoting," according to the study authors. The authors also found that participants distrusted the commercial marketing techniques of the diet industry and wanted the industry regulated. Some participants also described commercial diets as unsafe — particularly those that provide prepared meals. They used terms such as "greedy," "a scam," and "a rip-off" to describe the dieting industry.

Bonnie - this study is very telling. Obese individuals know there are no quick fixes to losing weight and ultimately keeping it off. Long-term, individualized lifestyle changes are needed. However, progress could move much quicker with major public health reforms.

Large waistline, high triglycerides increases cardiac risk

People with a larger waistline and high triglyceride levels are at increased risk of coronary heart disease, according to a research study published in CMAJ (Canadian Medical Association Journal).

The CMAJ study examined whether a hypertriglyceridemic waist type could be a useful, cost-effective screening tool to identify people at risk of type 2 diabetes and coronary heart disease. It looked at a group of 21 787 men and women aged 45 to 79 years. Out of the total sample, 1295 men and 814 women developed coronary heart disease during the follow up period of up to 8 to 10 years. In both men and women, increased waist circumference (even without higher triglyceride levels) and increased triglyceride levels (even without higher waist circumference) increased the risk of developing coronary heart disease. However, the key finding of the study was that the combined presence of increased waist circumference and increased triglyceride levels was associated with the highest risk of coronary heart disease.

Bonnie - as I have said in the past, there is much more to coronary artery disease risk than cholesterol.

Local hospitals serving antibiotic-free meat

Courtesy of Chicago Tribune

The evening's menu featured grass-fed, antibiotic-free beef over pasta, fresh seasonal vegetables and fresh organic peaches -- items right at home in the city's finest restaurants. Instead, the dishes were prepared for visitors, staff and bed-bound patients at Swedish Covenant Hospital. The Northwest Side hospital is one of 300 across the nation that have pledged to improve the quality and sustainability of the food they serve, not just for the health of their patients but, they say, the health of the environment and the U.S. population. For many of these institutions, the initiative includes buying antibiotic-free meats. Administrators say they hope increased demand for those products will reduce the use of antibiotics to treat cattle and other animals, which scientists believe helps pathogens become more resistant to drugs.

According to the Association for Healthcare Foodservice, the institutions spend about $9.6 billion on food and drink a year. An early adopter of healthier hospital menus, Swedish Covenant's director of nutrition, Maria Simmons, started serving grass-fed antibiotic- and hormone-free Tallgrass beef nearly five years ago. While the hospital's purchases of other sustainable foods have fluctuated with budgets and availability, this item has been a constant. Simmons said the hospital uses the beef in one menu item a day served to patients and in the cafeteria, including "meat sauces, Salisbury steaks, meatloaf, beef stew and in our Korean seaweed soup."

Diane Imrie, director of nutrition services at Fletcher Allen Health Care in Vermont, also started serving antibiotic-free beef at the hospital in recent years as part of her plan to switch to local, seasonal, sustainable food. "When we started a sustainability council at the hospital a few years ago, antibiotic reduction was one of the first things on my list," she said. "I think it has the most impact on farming, the environment and public health." Imrie estimated that her food costs rose about $67,000 last year when she switched to antibiotic-free chicken from conventional. "But that's also about the same cost as treating a single MRSA infection," she said, referring to drug-resistant staphylococcus bacteria. Like Simmons, Imrie said she has found inventive ways to offset the cost of the antibiotic-free meats, such as choosing ground beef and stewing cuts instead of more expensive options.

Simmons said the beef she buys ranges from 50 cents to $1 more a pound. Simmons also said she is able to negotiate with vendors because the hospital buys food in large amounts. "Once they realize the volume and the fact that you will keep buying this, they work with you," she said.

Carolyn Lammersfeld, national director of nutrition at Cancer Treatment Centers of America, oversees a menu full of organic, antibiotic-free chicken, beef and dairy at the organization's facilities across the country. Using the ingredients is primarily a response to patient demand, Lammersfeld said, but the centers are also "watching the controversy over the nontherapeutic use of antibiotics and their potential to cause resistant strains of bacteria." The issue is of particular concern for cancer patients, who have compromised immune systems, she noted. "Many also might already being taking antibiotics, so they don't want additional ones in food if they can avoid it," Lammersfeld said.

Simmons said she buys the Tallgrass beef "not only because is it antibiotic- and hormone-free but it's higher in omega-3 fatty acids, conjugated linoleic acids and lower in saturated fats." But she is also aware of the effects that creating a demand for the meat may have on animal raising practices. "The push was for healthier food all around and the fact that it was antibiotic- and hormone-free and could support the new legislation on antibiotic resistance just worked well together," Simmons said. "It's a natural progression."

Bonnie - this is extremely exciting!

Breast cancer drug did not extend lives

Courtesy of AP

Federal health scientists said Friday that follow-up studies of a Roche breast cancer drug show it failed to slow tumor growth or extend patient lives, opening the door for a potential withdrawal in that indication.

The Food and Drug Administration approved Roche's blockbuster Avastin in 2008 based on early-stage trials showing it shrank tumors caused by breast cancer. The decision was controversial because drugs for cancer patients who have never been treated before must usually show evidence they extend lives. Avastin's so-called "accelerated approval" was based on the condition that later studies would show a survival benefit. But in briefing documents posted online, FDA reviewers said two follow-up studies recently submitted by Roche failed to show that Avastin significantly extended lives compared to chemotherapy alone. Additionally, the FDA said more recent data did not confirm the tumor shrinkage seen in earlier studies.

Patients taking Avastin showed significantly more side effects, including high blood pressure, fatigue and abnormal white blood cell levels. On Tuesday the FDA will ask a panel of outside cancer experts to review the evidence on Avastin. The panel's recommendations are not binding, but the FDA usually follows their guidance. The FDA has the option to remove drug's approval for breast cancer.

Avastin is also approved for colon, lung, kidney and brain cancer. The drug was Roche's top-selling cancer treatment last year with global sales of $5.9 billion. Avastin was the first drug to fight cancer by stopping nutrients from reaching tumors. Such "targeted therapies" were thought to hold promise for eliminating chemotherapy, but the two approaches are now used in combination. Since 1992, the FDA has granted accelerated approval to drugs based on so-called surrogate endpoints, or initial measures that suggest the drug will make real improvements in patient health. For cancer drugs, tumor shrinkage is considered a predictor of increased survival. Drugmakers favor the program because it helps them get products to market sooner. But the program has not escaped criticism from government watchdogs.

Last fall the Government Accountability Office issued a report saying the FDA should do more to track whether drugs approved based on preliminary results actually have live up to their promise. According to the GAO, the FDA has never once pulled a drug off the market due to missing or unimpressive follow-up data.

Steve - this is appalling behavior by all parties involved. For individuals already going through chemo, these results are just disgusting, not to mention the financial waste.

7/22/10 Update: A Food and Drug Administration advisory committee Tuesday recommended that the agency withdraw approval of Avastin for treating breast cancer

Slimming supplements under scrutiny

Bonnie - and there is every reasons for them to be under scrutiny. We have found maybe two or three safe substances that can mildly assist with weight reduction. However, without individualized dietary and lifestyle measures, almost all slimming supplements are a waste of money.

New research evaluating the effectiveness of a broad selection of popular slimming supplements sold in pharmacies and health food shops has found no evidence that any of them facilitate weight loss beyond the placebo effect, according to a study presented at the International Congress on Obesity.

Nine popular supplements were tested against placebo pills in a randomized controlled trial. The supplements tested included L-Carnitine, polyglucosamine, cabbage powder, guarana seed powder, bean extract, Konjac extract, fiber pills, sodium alginate formulations and selected plant extracts. The researchers bought the supplements from German pharmacies, changed the packaging and product names to make them look neutral and rewrote the information leaflet inserts to eliminate the product name from the text. They then gave consumers packages of either fake pills or of one of the nine supplements, each week for eight weeks, in doses recommended by the manufacturers. Some of the products came with dietary advice, while others didn't, so the researchers provided exactly the same advice as that written in the relevant product leaflets. Average weight loss was between 1 kg and 2 kg across seven of the products, depending on the supplement, and was 1.2 kg in the group getting the placebo pills. No statistically significant difference in weight loss was found for any of those products when compared with the placebo.

Magnesium's affect on dementia

Normalizing brain levels of magnesium may help fight deposition of aggregated beta-amyloid as seen in Alzheimer’s disease and related dementias, according to the July issue of Journal Alzheimer Disease.

Researchers observed magnesium's affect on many neurological processes, and previous studies have shown low magnesium levels in Alzheimer’s patients. In this in vitro study, the team examined the effects of physiological, low and high concentrations of extracellular magnesium on processing of the precursor to Abeta and Abeta secretion. They found the effects on processing to be both time- and dose-dependent, with higher levels supporting retention of the precursor on plasma membrane, while low levels upped the secretion of Abeta in the system. Further, decreased total intracellular magnesium levels impaired cell viability, which could be restored by readjusting magnesium levels to the physiological level.

Bonnie - while just an in vitro study, I do not need a double blind to know the importance of magnesium in protecting the brain from a host of outside agitators.