Vitamin D deficiency an epidemic.

Vitamin D has dominated the health headlines lately.

• "People with a vitamin D deficiency are twice as likely to die."

• "Lack of vitamin D rampant in infants, teens."

• "Breast cancer patients deficient in vitamin D."

• "Vitamin D protects against heart attacks in men."

• "Vitamin D deficiency increases chances of getting influenza."

• "Prostates protected by vitamin D."

• "Ensuring levels of vitamin D never get low could be a way of protecting against cancer."

• "Vitamin D to boost mood in older adults."

These studies are only from within the last two months.

Why so much press? Vitamin D deficiency is officially considered an epidemic in the United States as well as in many other countries.

Rickets from vitamin D deficiency was common well into the twentieth century. Although antirichatic procedures (first cod liver oil and then adding vitamin D to milk) were routine in Northern countries in the 1940's, the practice waned in the 1950's and 1960's. Subsequently, a rise in rickets ensued until vitamin D milk fortification was once again implemented in the late 1970's. So why are we now seeing so many diseases, including an upswing in rickets, from vitamin D deficiency even though the vitamin fortification policy is unchanged? Several explanations are believed to be contributing:

1. Lack of unencumbered sun exposure -
   Exposure to ultraviolet rays from the sun prevents deficiency, but public skin cancer policy has scared many of us away from sufficient sun exposure. This is why we are seeing deficiencies even in sunny climate populations. Many people can make enough vitamin D in the summer to last them through the winter months, but current lifestyle does not promote adequate outdoor time.
   
   
2. Recommended Daily Allowance (RDA) for Vitamin D needs to be revised -
   Besides the vitamin D in fortified milk and milk substitutes, which is usually 400IU, the Western Diet contains little vitamin D. Fortified milk (and milk substitutes) may stave off a rickets epidemic, but it is now apparent that humans need much higher amounts of vitamin D to prevent chronic disease and it is time for the FDA as well as the WHO to make changes to their recommendations.
   
   
3. Mothers of breast-fed infants are often nutrient depleted and infants are exposed to very little sunlight -
   This could be easily remedied if mother's like the ones we counsel are on the proper nutrient and dietary regimen. Unfortunately, until very recently, little attention has been paid to prenatal, pregnant, and nursing women. All pregnant and nursing women should have a minimum of 400IU of vitamin D in their prenatal. In addition, when a nursing infant is six months old, 400IU of vitamin D3 should be added to their diet. It is also imperative for infants to be exposed to some sun without sunscreen. The fifteen minutes of sun should apply to infants and young children as well as adults. which is sufficient enough even if they did not want to expose their infants to the sun.
   
   The deficiencies are not limited to just breast-fed children. A recent Archives of Pediatrics and Adolescent Medicine study found that 40% of infants, toddlers, and adolescents, many of which were not breast-fed, were vitamin D deficient.
   
   
4. The elderly, who are indoors almost exclusively, are probably at greatest risk for vitamin D deficiency. Especially when living in assisted living facilities, the diets of the elderly are often nutrient-poor, increasing their chances of developing chronic and acute diseases.
   
   
5. Milk consumption in some individuals has been eliminated due to intolerance and allergy.
   Often in these cases, the vitamin D is not being replaced by milk substitutes, vitamin D-rich foods, and/or supplements. Very little vitamin D is naturally present in our food. Oily fish, including salmon, mackerel, and herring; cod liver oil; and sun-dried mushrooms typically provide 400-500IU of vitamin D per serving. The major foods that are fortified with vitamin D in the United States include milk, milk substitutes (such as rice milk, soy milk, and nuts milks), orange juice, cereals, and some breads.
   
   
6. Most health care professionals have ignored the evidence for vitamin D deficiency.
   According to the Journal Nutrition and American Journal of Clinical Nutrition, it is estimated that the body requires daily 3000-5000IU of vitamin D for optimum functioning. The reason for this is that essentially every tissue and cell in the body has a Vitamin D receptor and therefore has a requirement for vitamin D. When health care professionals do not consider diet a major factor in diagnosing health issues, of course vitamin D deficiency is going to be overlooked.
   
   

BONNIE'S PUBLIC HEALTH POLICY TO ADDRESS THE VITAMIN D EPIDEMIC

• Attitude Must Change Regarding Sun Exposure.
  Sensible sun exposure in the spring and summer, and education of the public about the beneficial effects of some limited sun exposure to satisfy their body's vitamin D requirements should be implemented. Exposure to sunlight for usually no more than 15 minutes daily (between 10 AM and 3 PM) on arms and legs or hands, face and arms, provides the body with its required 1000IU of cholecalciferol. After the limited exposure, this should be followed by the application of a broad spectrum sunscreen with an SPF of at least 15 to prevent damaging effects due to excessive exposure to sunlight and to prevent sun burning. In the absence of sun exposure, 1000IU of cholecalciferol (vitamin D3) through food and supplements should be the minimum required daily for both children and adults.
  

• Vitamin D Blood Test Should be Standard for Physicals.
  Vitamin D status has such important health implications that, while we have always recommended much higher doses of supplemental vitamin D than the RDA, we now are asking that a measurement of 25(OH)D be part of your routine physical examination for children and adults of all ages. The measurement of the major circulating form of vitamin D, 25(OH)D, is the gold standard for determining the vitamin D status of a patient. The normal range is typically 25-37.5 nmol/L (10-15 ng/mL) to 137.5-162.5 nmol/L (55-65 ng/mL) by most commercial assays. The measurement of 1,25(OH)2D provides no insight about the vitamin D status of a patient. It is often normal or on occasion elevated in vitamin D deficient patients.
  

• 1000IU of Total Vitamin D3 Daily.
  In the absence of any sun exposure, 1000IU of cholecalciferol a day is necessary to maintain a healthy blood level of 25(OH)D. Dietary sources and vitamin D supplements can satisfy this requirement. Cod Liver Oil and Multivitamins typically contain 400IU of vitamin D3. Vitamin D3 supplements alone are available in dosages ranging from 400-10,000IU. To date, the only pharmaceutical preparation of vitamin D in the United States is vitamin D-2. Although it is only 20-40% as effective as cholecalciferol (D-3, widely available as a dietary supplement) in raising blood levels of 25(OH)D. It is only effective in high doses (usually 50,000IU doses taken once weekly), which would translate to about 2857IU per day absorption-wise.
  
  
• Toxicity.
  For years, physicians and nutritionists were taught that because vitamin D is fat soluble and must be processed in the liver, excess oral vitamin D could be toxic. This fear has not been borne out. People who have taken the pharmaceutical megadoses for years have shown no adverse effects. However, self-medicating with long-term oral doses over 2000IU daily is not recommended unless prescribed by a licensed health professional. This is also why the sun is so beneficial. The stored vitamin D derived from the sun does not have to be processed by the liver!

CONCLUSION
Now that we marked out a clear path of what needs to be done to ameliorate the vitamin D epidemic, please pass the information along to friends, loved ones, and work colleagues. You can have a hand in changing public health policy for the greater good. Who knows, maybe the FDA and WHO will finally catch on?

Two worrisome statistics

1) According to the Centers for Disease Control, eight percent of the US population (24 million) have diabetes, up 3 million from just two years ago, and 57 million have blood sugar abnormalities.

2) One-third of the US population has hypertension and are becoming increasingly resistant to drugs that lower it, according to the American Heart Association. The rise in drug resistance is due to the hypertensive patients being sicker to begin with and require more drugs at greater dosages.

Bonnie - as a public health educator, these statistics are very disappointing. From a dietary perspective, one can postulate that because of the increase in diabetes cases from 2005-2007, the revised 2005 Dietary Guidelines and Food Pyramid should be considered a failure. These guidelines increased grain and dairy servings while ignoring protein.

The hypertension stat is no surprise because of the amount of stress the average American endures. When you complement the stress with a Western-style diet and ever-growing environmental toxic exposure, you have the perfect storm for hypertension.

Green tea extract useful for genital warts

A botanical ointment containing sinecatechins, a green tea extract, is an effective and well tolerated treatment for external genital and anal warts, results of a controlled study confirm. "Green tea catechins exert multiple biologic activities, involving potent antiviral and antioxidant activity," Dr. Silvio Tatti, now at the Hospital Clinicas, Universidad de Buenos Aires, Argentina, and colleagues note in the journal Obstetrics and Gynecology. Given that genital and anal warts are caused by human papillomavirus (HPV) and that effective, well tolerated treatments are lacking, there has been interest in treatment with sinecatechins ointments. In their study, Tatti's team randomly assigned 502 adults with 2 to 30 warts to either sinecatechins ointment (15% or 10%) or inactive ointment for up to 16 weeks or until the warts cleared. In both sinecatechins groups, warts cleared completely in roughly 57% of patients compared to just 34% of subjects in the control group - a significant difference. Clearance rates of at least 50% were seen in roughly three-quarters of patients who applied sinecatechins ointment compared with 51% of those who applied the inactive ointment.

Red yeast rice reduced risk of heart attacks

Chinese red yeast rice, or rice fermented using a certain yeast species reduced the risk of repeat heart attacks in people who have already had one. The Chinese study, published on June 15 in The American Journal of Cardiology, tested 4,870 men and women who had had heart attacks within five years. They were randomly assigned to take 600 milligrams a day of yeast rice extract or a placebo. Neither researchers nor patients knew which patients received the active extract. Over five years, those who took the extract reduced their relative risk of a coronary event by 45 percent. The risk of death from cardiovascular disease and from all causes in the extract group was about one-third that of the placebo group, and the need for an operation to improve blood supply to the heart was also reduced by about a third. The rice is used as a food preservative, a spice and an ingredient in rice wine. Dr. David M. Capuzzi, the senior author and a professor of medicine at Thomas Jefferson University, emphasized that the finding did not apply to the red yeast extract sold in health food stores. “This study,” Dr. Capuzzi said, “was done with a carefully constituted compound totally different from what is available over the counter.”

Bonnie - I have only recommended red yeast rice as a last resort before going on a synthetic statin. The reason it is a last resort is because red yeast rice, while natural, has almost the exact same effect as do synthetic statins. Thus, some get the same unsavory side effects that go with statin therapy.

Topical NSAID's more effective as oral

Gels or creams containing painkillers are better than tablets for chronic knee pain. A study of almost 600 patients over age 50 found the anti-inflammatory creams worked as well as the oral versions and had fewer side-effects. And although they cost more initially, topical treatments may save money in the long run, the Queen Mary University of London researchers said. Those in the study treated with oral medication had more adverse effects such as indigestion, increased blood pressure, or worsening asthma. NSAIDs are well-known to be associated with sometimes serious side effects but the topical preparations deliver a smaller dose directly to the affected area and so are less likely to cause such problems. Patients also preferred the gels and creams, the study which is published on the UK's National Institute for Health Research website.

Parents seek ways to make kids eat vegetables

Excerpts courtesy of LA Times

Everyone hopes that their kids will eat their fruits and vegetables so they'll grow into big, strong adults who will eat the nine daily servings recommended by the U.S. government. But everyone also knows kids rarely put "broccoli" at the top of a list of favorite foods.

So an increasing number of parents are loading the foods their kids will eat with produce they think they should be getting. And food makers are lending a hand, offering a growing array of processed foods that sneak vegetables and fruits into chips, juice and nuggets.

But some nutritionists and public health experts wonder if parents these days are relying too much on the sneak attack. They doubt if kids will ever develop a taste for vegetables in all their leafy glory if they are hidden in smoothies and macaroni and cheese. Some say this well-intentioned sneaking could produce kids less likely -- not more -- to eat greens.

"Children should learn to make healthy choices," says Pat Crawford, co-director of the Center for Weight and Health at UC Berkeley. "It really comes down to whether we are feeding our children for nutrients, or for the potential development of healthy patterns that are lifelong."

Many mothers say they were turned on to hiding vegetables in their kids' foods by bestselling cookbooks such as Jessica Seinfeld's "Deceptively Delicious" and Missy Chase Lapine's "The Sneaky Chef." Both offer kid-friendly recipes with hidden vegetable and fruit purées in such items as pizza and pasta. Lapine advocates mixing jars of vegetable baby food into soups and sauces if parents don't have time to cook and mash produce themselves.

A mother of a picky eater with multiple food allergies, Lapine said hiding foods was a last resort for her, but it "should have been the first and predominant method" all along. She still believes in putting vegetables on the plate, she just wants to take pressure off guilt-ridden parents. "The people who tell me 'You shouldn't be doing this' have never reasoned with a 2-year-old," she says. "We don't have the time and luxury to wait until they get on board."

Some of the homemade recipes in the books are not all that healthy altogether. Rochester, N.Y., mom Nicole Lehner, a fan of Seinfeld's book, said even she was shocked at one recipe that called for a cup of powdered sugar in a chocolate avocado pudding. "If you are going to give your kid that much sugar to get the avocado in, aren't you negating the [healthy] effect?"

Children develop tastes largely on the food most available to them, says Dr. Jennifer Orlet Fisher, assistant professor of pediatrics at Baylor College of Medicine. "These foods need to be in the home and not just in the home occasionally, but on a regular basis."

"We do know that repeated exposure to . . . foods does lead them -- when they are a bit older -- to accept them and like them, even if they don't eat them initially," says study lead author Leann Birch, professor of human development at Pennsylvania State University, who has researched nutrition and behavior in children for more than 30 years.

Indeed, in her landmark 1982 study, "I Don't Like It, I've Never Tried It," published in the journal Appetite, it took 14 preschool children as many as 10 tastes over a period of weeks before they embraced a new food -- in this case, unfamiliar cheeses or fruits. The foods the kids tasted most often were the ones they most preferred.

Yet, Birch says, most parents give up on introducing a vegetable long before they've offered it to a kid 10 times. If they would only persist in getting their tots to taste a few vegetables a couple of times a week, Birch says -- even if their picky eater ends up just licking them or spitting them out -- it would help them develop a greater affinity for the stuff.

But let's face it: some kids are very picky eaters. Thus, Birch says, it might make sense to combine two approaches: sneak vegetables in while still putting them front-and-center on a child's plate.

If sneaking vegetables into meals is counterproductive, then what's a kosher way to get your kids to eat them willingly? Here are some pointers from veteran food behavior researcher Leann Birch of Pennsylvania State University.

* Be persistent. Birch's studies have found that kids need repeated exposures to food to develop a taste for them -- in one landmark experiment she conducted with preschoolers, it took at least 10 exposures over a period of several weeks. Don't give up.

* Set a good example by eating the vegetable yourself. "You need to let them see you eating it and liking it," Birch says.

* Be matter-of-fact. Many parents unwittingly short-circuit their efforts, appearing shocked when kids eat the vegetables on their plate and making comments such as, "That's amazing! I can't believe you ate that." This makes kids feel like they did something weird.

* Don't punish kids for not finishing the vegetables on their plate. It simply reinforces a negative association with vegetables.

* Don't offer rewards such as ice cream or television for finishing vegetables -- it makes kids believe that vegetables are something that must be endured, not enjoyed.

Bonnie - I think this is a very informative piece and one that reaffirms much of my approach over the years. There is a happy medium for introducing healthy foods that we can find for our children. While I agree with most of the aforementioned tips, I most strongly suggest adhering to persistence. Reintroducing foods at least 8 times usually does the trick. However, if you have to reintroduce fifty times, don't give up!

Fluoride's glory may be cresting

Courtesy of the Chicago Tribune

The great American assault on tooth decay began here 63 years ago, earning Grand Rapids a special place in the annals of dental history: the first city in the world to fluoridate its public water system.

So it is more than a little head-scratching that fluoride, the chemical widely credited with dramatically cutting cavities and promoting oral hygiene, is having its scientific credentials questioned in the city that literally swallowed it first.

The belated questioning of fluoride in the most unlikely of places stems partly from unsettled questions—some new, some old—about possible links to cancer and thyroid and kidney problems if too much fluoride is ingested. But the push here mirrors a spreading nationwide awareness and re-examination of the health impact of a wide variety of chemicals added to food, health-care products and water, as well as the use of pesticides.

Local and state governments around the nation are taking a second — and in some cases a first — look at chemical practices and their potential impact. "I think this pattern has been growing because there is better environmental health research that draws connections between low levels of chemical exposure and changes in our bodies," said Dr. Howard Hu, chairman of environmental health sciences at the University of Michigan.

"As the research has become more sophisticated, it shows that environmental toxicants can do other things beyond just kill you—they can stunt your growth, change behavior and increase the risk of cardiovascular disease," Hu said.

'Fluoride fights stretch back more than a half-century. Recent studies, though, suggest a possible link to thyroid trouble and problems for people on dialysis. The U.S. Centers for Disease Control and Prevention maintains that water fluoridation is a safe and cost-effective way to prevent tooth decay, but some scientists say questions about the long-term impact cannot be dismissed.

Recent studies, while not conclusive, convinced Corky Overmyer, the director of environmental sustainability for Grand Rapids, that a review was needed to study fluoride's impact on the 11 communities served by the city's water system.

"This has been on my radar screen for a while," said Overmyer, who several years ago led the effort to remove chlorine from the city's water. Overmyer insists he has drawn no conclusions about the safety of fluoride.

Overmyer said he is taking heat.

"I had no idea [fluoride] was that sensitive an issue," he said, noting he has "teeth marks" in his backside from his dentist and the city's mayor, who declined to return phone calls to discuss fluoride.

"If Grand Rapids falls, that could be the beginning of the end of fluoride," said Paul Connett, a retired chemistry professor and director of the Fluoride Action Network, which advocates against fluoridation.

There is strong political and medical resistance to reversing the fluoride policy. Dr. Tim Gietzen, who has practiced dentistry in Grand Rapids for 30 years, said he can tell which of his patients grew up with fluoridated water just by looking in their mouths.

Gietzen said fluoride should remain in the water system "unless someone is causing problems."

That's the question to be pursued by Overmyer, who said, "I'm just trying to be honest and open, and I've become a lightning rod."

Bonnie - I have never understood why we needed fluoridated water if we have fluoridated toothpaste. Is it really helping that much? The state of dental caries in US children is poor. And once again, a chemical was exposed to most of the US population without long-term studies on its health effects. For a long time, I have been wary of the negative health effects of this policy.

Hormone may help dieters keep weight off

Falling levels of a hormone called leptin that helps the brain resist tempting foods may explain one reason why people who lose weight often have a hard time keeping it off. Restoring leptin to pre-diet levels may reverse this problem, according to research that appears in the Journal of Clinical Investigation.

Leptin is a natural appetite suppressant secreted by fat cells in the body. The researchers found that after weight loss, areas in the brain responsible for regulating food intake were less active when people were shown food images. Areas in the brain responsible for emotion were more active. When the researchers restored leptin to the levels before the dieting, these changes were largely reversed.

Bonnie - as we have discussed many times before, fat cells are an endocrine organ and secrete hormones. The health of these fat cells warrants either calming, healthy messages, or inflammatory messages. Except in rare genetic cases, leptin functions ideally in an optimally healthy host.

Consumers Stick With Healthy Foods

Consumers have increased their spending on healthy foods in the past several months despite price inflation, according to a study released here yesterday at the inaugural Healthy Foods International Exposition and Conference. The study — which solicited feedback from the industry and from more than 1,000 consumers in November 2007 and again in May 2008 — found that respondents indicated they were spending approximately 7.7% more on healthy foods in May than they did in November — $191.45 per household per month, compared with $177.69. “This appears to be both an acceptance of actual inflation in organic food prices and a deepening desire to find alternatives to conventionally produced goods,” the study noted. The survey indicated that 97.7% of respondents spent a portion of their grocery budgets on healthy foods in May, up from 96.5% in November; it also said 47.6% of households reported that at least half their purchases consisted of healthy foods.

Steve - actually, organic food prices have not inflated as much as conventional food has, especially if you buy your produce, meat, and poultry locally. Additionally, consumers realize that eating healthier saves money in the long-run on health care.

Golfers may be at increased risk for diabetes

Licensed pesticide applicators who used chlorinated pesticides on more than 100 days in their lifetime were at greater risk of diabetes, according to researchers from the National Institutes of Health (NIH). The associations between specific pesticides and incident diabetes ranged from a 20 percent to a 200 percent increase in risk, said the scientists with the NIH's National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute (NCI).

"The results suggest that pesticides may be a contributing factor for diabetes along with known risk factors such as obesity, lack of exercise and having a family history of diabetes," said Dale Sandler, Ph.D., chief of the Epidemiology Branch at the NIEHS and co-author on the paper. "Although the amount of diabetes explained by pesticides is small, these new findings may extend beyond the pesticide applicators in the study," Sandler said. Some of the pesticides used by these workers are used by the general population, though the strength and formulation may vary. Other insecticides in this study are no longer available on the market, however, these chemicals persist in the environment and measurable levels may still be detectable in the general population and in food products. For example, chlordane, which was used to treat homes for termites, has not been used since 1988, but can remain in treated homes for many decades.

More than half of those studied in the National Health and Nutrition Examination Survey in 1999-2002 had measurable evidence of chlordane exposure. "This is not cause for alarm," added Sandler "since there is no evidence of health effects at such very low levels of exposure." Overall, pesticide applicators in the highest category of lifetime days of use of any pesticide had a small increase in risk for diabetes (17 percent) compared with those in the lowest pesticide use category (0-64 lifetime days). New cases of diabetes were reported by 3.4 percent of those in the lowest pesticide use category compared with 4.6 percent of those in the highest category. Risks were greater when users of specific pesticides were compared with applicators who never applied that chemical.

For example, the strongest relationship was found for a chemical called trichlorfon, with an 85 percent increase in risk for frequent and infrequent users and nearly a 250 percent increase for those who used it more than 10 times. In this group, 8.5 percent reported a new diagnosis of diabetes compared with 3.4 percent of those who never used this chemical. Trichlorfon is an organophosphate insecticide classified as a general-use pesticide that is moderately toxic. Previously used to control cockroaches, crickets, bedbugs, fleas, flies and ticks, it is currently used mostly in turf applications, such as maintaining golf courses.

"This is one of the largest studies looking at the potential effects of pesticides on diabetes incidence in adults," said Freya Kamel, Ph.D., a researcher in the intramural program at NIEHS and co-author in the paper appearing in the May issue of the American Journal of Epidemiology. "It clearly shows that cumulative lifetime exposure is important and not just recent exposure," said Kamel. Previous cross-sectional studies have used serum samples to show an association between diabetes and some pesticides.

To conduct the study, the researchers analyzed data from more than 30,000 licensed pesticide applicators participating in the Agricultural Health Study, a prospective study following the health history of thousands of pesticide applicators and their spouses in North Carolina and Iowa. The 31,787 applicators in this study included those who completed an enrollment survey about lifetime exposure levels, were free of diabetes at enrollment, and updated their medical records during a five-year follow-up phone interview. Among these, 1,171 reported a diagnosis of diabetes in the follow-up interview. The majority of the study participants were non-Hispanic white men. Researchers compared the pesticide use and other potential risk factors reported by the 1,171 applicators who developed diabetes since enrolling in the study to those who did not develop diabetes. Among the 50 different pesticides the researchers looked at, they found seven specific pesticides — aldrin, chlordane, heptachlor, dichlorvos, trichlorfon, alachlor and cynazine - that increased the likelihood of diabetes among study participants who had ever been exposed to any of these pesticides, and an even greater risk as cumulative days of lifetime exposure increased. All seven pesticides are chlorinated compounds, including two herbicides, three organochlorine insecticides and two organophosphate pesticides. "The fact that all seven of these pesticides are chlorinated provides us with an important clue for further research," said Kamel.

Previous studies found that organochlorine insecticides such as chlordane were associated with diabetes or insulin levels. The new study shows that other types of chlorinated pesticides, including some organophosphate insecticides and herbicides, are also associated with diabetes. The researchers also found that study participants who reported mixing herbicides in the military had increased odds of diabetes compared to non-military participants.

Bonnie - I have always been critical of the chemical load used on golf courses. Beyond diabetes, there are a slew of other conditions that may come from consistent exposure, cancer being one of them. My suggestion for avid golfers is to make sure you methylate well, that is, to detoxify properly. Otherwise, you build up an inordinate amount of toxic chemicals in your body. There are several nutrients you can take to aid the process, such as maca root, DIM, and I3C.

Thoughts on Time Magazine's "Our Super-Sized Kids"

In response to the lead article in the June 23rd issue, where does it mention blatant deficiencies of micronutrients? 75% of the US population is deficient in magnesium, a catalyst for over 300 bodily functions including energy and blood sugar regulation. 50% are deficient in zinc, necessary for growth, cholesterol regulation, and the immune system. Many more are deficient in vitamin D, but there are no raw numbers as of yet.

Maybe kids do not feel energetic enough to exercise, feel lethargic, and keep foraging for food due to lack of key micronutrients? The government could save a lot of money in the long run by handing out free, or at a reduced cost, all recommended dietary allowances of vitamins and minerals. Bonnie

New rating system in the works for nursing homes

The U.S. has five-star rankings for restaurants and hotels. So why not five-star rankings for nursing homes? The Bush administration announced Wednesday that it will put in place such a rating system by the end of the year. It’s designed to give consumers another tool to consider when shopping for a nursing home. The ratings would be placed on a government Web site.

Bonnie - this is a "no-brainer." I wonder if they are going to rate menus?

Americans Are Eating Better-for-You Foods Instead of Dieting

The percentage of adults on a diet has decreased by 10 percentage points since 1990, while the number of Americans eating healthier has increased, according to NPD Group’s National Eating Trends report. It finds that at least once in a two-week period, more than 70% of Americans are consuming reduced-fat foods, and over half of them are eating reduced-calorie, whole-grain or fortified foods. In addition to these foods, other “better-for-you” items consumed include diet, light, reduced-cholesterol, reduced-sodium, caffeine-free, sugar-free, fortified, organic and low-carb foods. The average American, according to National Eating Trends, has at least two better-for-you products a day. “While dieting for both women and men remain huge markets, they are not growing markets,” said Harry Balzer, vice president, the NPD Group, in a statement. “The desire to lose weight really was a 90s trend. Today consumers appear to be making healthier food choices.”

Steve - it is very good news to hear about less "dieting." However, we do not consider "better-for-you" items as"diet, light, and sugar-free." That usually means chemical-laden fake food. How about consider "real food" as a "better'-for-you" product?

Fruits & Vegetables reduce Barrett's esophagus

An increased intake of antioxidant vitamins C and E, and beta-carotene may cut the risk of Barrett's esophagus, a precursor to esophageal cancer. The antioxidants, linked to fruit and vegetable intake, were associated with risk reductions over 50 per cent in the occurrence of Barrett's esophagus, according to the new study involving 913 people and published in the American Journal of Gastroenterology.

"This is the first U.S. population-based case-control study that examined the association between intake of antioxidants and the risk of Barrett's esophagus," wrote lead author Ai Kubo from Kaiser Permanente Northern California.

"The study demonstrated that antioxidant intake was inversely associated with the risk of developing Barrett's esophagus and that the effects appear to come mainly from dietary sources, rather than from supplemental sources."

The highest dietary intakes of vitamin C (184 mg/d) and beta-carotene (6.8 mg/d) were associated with a 52 and 44 per cent reduction in Barrett's esophagus risk than people with the lowest intakes (43 and 1.8 mg/d, respectively).

In addition, the highest dietary intake of vitamin E (19 micrograms/d) was associated with a 75 per cent reduction in Barrett's esophagus risk than people with the lowest intake (5.4 micrograms per day).

Steve - this is the second study published within the last two months on this issue. I think it is safe to say that increased fruit and veggie consumption is a good thing!

Big breakfast aids weight loss

Breakfast really could be the most important meal of the day when it comes to losing weight. Over several months, obese women who ate half their daily calories first thing fared better than those eating a much smaller amount. Dr Daniela Jakubowicz of Virginia Commonwealth University told a San Francisco conference having a small breakfast could actually boost food cravings.

Dr Jakubowicz has been recommending a hearty breakfast to her patients for 15 years. In a study of 96 obese and physically inactive women, her "big breakfast" diet involved a low proportion of fat and more carbohydrates and protein. After eight months, the big breakfasters lost on average 16.5 pounds each. They lost a fifth of their total body weight.

Dr Jakubowicz reported that the big breakfasters said they felt less hungry, particularly in the mornings.

Bonnie - there is a reason why I emphasize breakfast more than any other meal. While a small study, it reaffirms hundreds of other studies lauding the benefits of breakfast. Satiety, high energy, and mood are the most important reasons to eat breakfast. However, when I say eat breakfast, I am not referring to the Standard American Breakfast. I am referring to a breakfast consisting of lean protein, fruits and vegetables, and healthy fats.

Change in diet could change your genes

Comprehensive lifestyle changes including a better diet and more exercise can lead not only to a better physique, but also to swift and dramatic changes at the genetic level, U.S. researchers said on Monday.

In a small study, the researchers tracked 30 men with low-risk prostate cancer who decided against conventional medical treatment such as surgery and radiation or hormone therapy.

The men underwent three months of major lifestyle changes, including eating a diet rich in fruits, vegetables, whole grains, legumes and soy products, moderate exercise such as walking for half an hour a day, and an hour of daily stress management methods such as meditation.

As expected, they lost weight, lowered their blood pressure and saw other health improvements. But the researchers found more profound changes when they compared prostate biopsies taken before and after the lifestyle changes.

‘’After the three months, the men had changes in activity in about 500 genes — including 48 that were turned on and 453 genes that were turned off.

The activity of disease-preventing genes increased while a number of disease-promoting genes, including those involved in prostate cancer and breast cancer, shut down, according to the study published in the journal Proceedings of the National Academy of Sciences.

The research was led by Dr. Dean Ornish, head of the Preventive Medicine Research Institute in Sausalito, California, and a well-known author advocating lifestyle changes to improve health.

“It’s an exciting finding because so often people say, ’Oh, it’s all in my genes, what can I do?’ Well, it turns out you may be able to do a lot,” Ornish, who is also affiliated with the University of California, San Francisco, said in a telephone interview.

“’In just three months, I can change hundreds of my genes simply by changing what I eat and how I live?’ That’s pretty exciting,” Ornish said. “The implications of our study are not limited to men with prostate cancer.”

Ornish said the men avoided conventional medical treatment for prostate cancer for reasons separate from the study. But in making that decision, they allowed the researchers to look at biopsies in people with cancer before and after lifestyle changes.

“It gave us the opportunity to have an ethical reason for doing repeat biopsies in just a three-month period because they needed that anyway to look at their clinical changes (in their prostate cancer),” Ornish said.

Bonnie - this study, while small, should be headline news everywhere. Of course, it was a small Reuters story that garnered little attention. Why? Because the path these subjects chose was not easy to follow. What these men chose to do was unconventional. However, the results should be astounding to the allopathic medical community.

Big Pharma budges a smidge in advertising

Under pressure from Washington, top drug makers including Merck, Johnson & Johnson and Pfizer are agreeing a six-month moratorium on advertising new drugs to consumers and will limit how doctors are used in their ads.

The changes were unveiled today in letters drug marketers sent the House Energy and Commerce Committee responding to a request from committee Chairman John Dingell, D-Mich., and Rep. Bart Stupak, D-Mich., who head the committee's oversight and investigations panel.

Mr. Dingell and Mr. Stupak had wanted the companies to impose a two-year voluntary moratorium on advertising of new prescription drugs to consumers -- and possibly even longer in the case of drugs for which not all studies have been completed. The lawmakers also asked the drug companies to limit the use of doctors in their advertising and agree to "black box" warnings on ads if the Food and Drug Administration requested them.

In the letters, executives of Johnson & Johnson, Merck & Co., Merck/Schering-Plough and Pfizer agreed to take several steps, while the Pharmaceutical Research and Manufacturers of America agreed to hold further meetings with the committee.

The companies will start following the American Medical Association's guidelines about using actors to portray doctors, and at least one marketer -- J&J -- said it will not use doctors in ads to discuss the benefits of a drug.

The drug companies said in their letters that the six-month moratorium formalized industry practice, which is to educate doctors before moving to consumer communications. "We have adopted internal guiding practices on direct-to-consumer advertising for prescription drugs [that] requires that our operating companies spend at least six months after approval of a new medicine educating health professionals before commencing a direct-to-consumer advertising campaign," wrote William C. Weldon, chairman-CEO of Johnson & Johnson.

He added that the company "does not believe a particular fixed period of time for an advertising moratorium is appropriate in all circumstances."

Mr. Dingell and Mr. Stupak said they were pleased with the response, but wanted the drug companies to go further, with a two-year limit.

"Although we appreciate the drug companies' willingness to change some of their business practices, they have not agreed to all of our requests, which would protect consumers from misleading and deceptive advertising," said Mr. Stupak.

"We accept PhRMA's offer to discuss these issues seriously. We hope the discussions with PhRMA will result in an industry position that addresses the concerns that Pfizer, Merck, Schering-Plough and Johnson & Johnson continue to ignore."

Bonnie - this is a baby step. Nothing more, Nothing less. How can any drug be marketed without sufficient long-term safety studies? Here is what I would want Senators' Dingel and Stupak to ask for: each commercial and advertisement must explain or list every side effect and contraindication that is listed on the insert. You know why they would never ask for this? Because it would take up the entire commercial or ad space!

NY Times piece looks at nondrug ADHD options

A piece written by New York Time's reporter Tara Parker examines nondrug treatments for ADHD. While most of the piece was more of the same, the slant was more transparent than we expected with regard to the dangers of ADHD drugs.

What was most interesting to us was the quote she chose from a physician's group when discussing the link between diet and A.D.H.D. “The overall findings of the study (link between artificial colors and behavior) are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong,” reported a February issue of AAP Grand Rounds, a publication of the American Academy of Pediatrics.

We also found this comment interesting. "The challenge is finding a doctor who will help explore the range of options. For instance, the best way to tell whether dietary changes may help is to eliminate the foods and then reintroduce them, monitoring the child’s behavior all the while." She is not a doctor, but I know a licensed dietitian nutritionist who does this kind of work, and has been doing it for almost 25 years. Who could she be :)

Flavonols may reduce colorectal cancer risk

An increased intake of antioxidant flavonols from tea, onions, beans, and apples may slash the risk of colorectal cancer by a whopping 76 per cent, according to findings published in this month's Cancer Epidemiology Biomarkers & Prevention.

The study adds to a growing body of science linking increased consumption of flavonol-rich foods, such as fruit and vegetables, to risk reductions for a range of cancers, including lung, pancreatic, and breast cancer.

Flavonoids, found in certain wine, fruits, vegetables, tea, nuts, and chocolate, have received extensive research due to their potent antioxidant activity and purported health benefits. Many have also been implicated in possible protection against diseases such as cancer and cardiovascular disease.

The researchers, led by Gerd Bobe from the National Cancer Institute, used data from the flavonoid database from the US Department of Agriculture to quantify the intake of 29 individual flavonoids, total flavonoids, and six flavonoid subgroups among participants of the Polyp Prevention Trial.

The trial studied the effect of a low-fat, high fibre diet, rich in fruit and vegetables on the recurrence of pre-cancerous polyps in the colon and rectum. Over 2,000 men and women were randomly assigned to either the 'healthy' diet, or a normal diet.

Using food frequency questionnaires, Bobe and co-workers analysed dietary consumption of the polyphenols, and, after adjusting for potential confounding factors such as age, fibre intake, BMI, sex, and the use of regular non-steroidal anti-inflammatory medication, they found that an increased intake of flavonols was linked to a 76 per cent reduction in the recurrence of advanced tumors.

Foods set switches for better health

Everyone reacts differently to foods, but the reasons for this have become clearer only recently.
Some of the answers are coming from the new field of nutrigenomics, now the focus of a nationwide research program in New Zealand. The term is a truncation of nutritional genomics.

"It's the interaction between your food and your genetic make-up," said Matthew Barnett, who has been working in the field since 2004. "Different foods can affect different people in different ways, and that's because they have slight variations in their genes." Coffee is an obvious example. While some people can drink several cups a day with only minor effects, a single cup will keep others awake all night. It comes down to how fast your body breaks down caffeine and your genetic make-up plays a large part in that. "If you don't metabolise it quickly it floats around in your bloodstream for longer, whereas some people metabolise it extremely quickly and within an hour they're ready for their next cup." Dr Barnett is a research scientist in AgResearch's food, metabolism and microbiology section.

The nutrigenomics program is investigating whether whole foods can be targeted to population groups.
"We might genotype someone and say, on the basis of your genetic variation maybe you should eat blueberries, or drink green tea or something like that. But also, can we add something to a food? We may be able to make a milk-based shake that has desirable ingredients. Enhancing sports performance is another possibility."

But genes are only the beginning of the story. Although there are hundreds of different cell types in the human body, they all carry the same genes. But in each cell only a subset of the genes is turned on the genes all have switches which can be set by other chemical substances within the cell. The study of how some of these switches can be modified to change gene expression without changing the underlying DNA sequence is known as epigenetics. "If you look at development, you don't want certain genes turned on in certain organs. Your eye is quite different from your kidney and so you never want some genes turned on in your eye. There are systems that make those genes unable to be turned on there. And that could be an epigenetic change."

There are many ways in which genes can be switched on and off. One common way is to attach a small molecular subunit called a methyl group next to the gene. This acts as a marker which tells the cell's DNA-reading mechanisms to ignore the gene or, in a few cases, to transcribe it into a protein. What's exciting about these epigenetic switches is that, unlike the genes themselves, they can be altered, and this is what Dr Barnett's work is now focusing on.

"We're trying to find out how food interacts with the epigenetic machinery. Because with epigenetics there's no change to the genetic sequence, there's the potential for it to be reversed. So an epigenetic change that might cause you to be more at risk of diabetes might be reversible, and it's possible that a food can do that because there are certain foods that act through the mechanisms of the epigenetic machinery."

Folate (vitamin B9) is one example. This plays an important role in methyl metabolism and a shortage of folate at a key stage of development may mean that methyl groups are not attached to the correct genetic switches. "So what we're trying to understand is when does that happen and how does it happen?"

Some of these epigenetic changes can be inherited. The children of mothers who have grown up in a nutrient-poor environment, for example, may have genetic switches set to make the most of any available food. If those children grow up in a nutrient-rich environment they may be prone to obesity.

The disease model Dr Barnett is working on is crohn's disease, an inflammatory bowel disease believed to have a strong genetic component. The work is centered around varieties of mice which have symptoms similar to the human disease and studying the genetic make-up and food preferences of human crohn's sufferers. Foods which are identified as either helpful or aggravating are tested on cells containing a genetic variant commonly associated with the disease, to see whether they switch the gene's activity on or off. "If a food component is harmful, one explanation might be that the gene isn't metabolising that food and it's causing an inflammatory reaction, but if the food is beneficial it may be turning on an epigenetic switch, which is allowing people to deal with their condition more easily.
"Essentially we're trying to see whether the foods `fix' the gene to make it function as it would in a person who doesn't have crohn's disease."

The data so far are preliminary, but there are indications that some fruits seem to be helpful. Nutrigenomics is about making people as well as they can be, as naturally as possible through food and nutrients. "Ultimately it's less about disease and more about health, but it's easier to diagnose a disease than to diagnose a degree of healthiness. Essentially our long-term goal is to learn how foods might reverse or prevent certain conditions, and how to either change a food or select the right food for a given person.

Steve - this is what we have been talking about for the last several years. How these researchers differ from the rest are that instead of looking to create chemicals to block or cut epigenetic messages, they are looking to harmonize or calm the messages. This is exactly what we try to do in our practice.

La Leche League Pioneer, Is Dead

Edwina Froehlich, who was inspired to help found La Leche League to support breast-feeding after being told at the age of 35 that she was too old to make breast milk for her baby, died Sunday in Arlington Heights, Ill. She was 93 and lived in Inverness, Ill. Her death followed a stroke two weeks earlier, said her son, Assemblyman Paul D. Froehlich.

Edwina made the controversial decision to forgo giving birth in a hospital in favor of a more natural delivery in her Franklin Park, Ill., home, with an obstetrician attending. At a time when most pediatricians encouraged formula and bottle-feeding and when there were few scientific studies demonstrating the health benefits of breast milk, Mrs. Froehlich chose to breast-feed all of her babies.

In 1956, when Mrs. White and a friend, Marian Tompson, decided to start a community organization to support and educate local breast-feeding mothers, Mrs. Froehlich was one of the first women they approached. Soon, monthly meetings were being held in Mrs. Froehlich’s home, and a new phone line was installed so she could answer questions coming in from mothers across the country, Mrs. White said. “We didn’t have any information,” said Mrs. Tompson, another of the original group of seven La Leche League founders. “There weren’t any books out there, and women just didn’t talk about these things. Only 18 percent of women in the U.S. left the hospital breast-feeding at that time.” As La Leche League of Franklin Park grew, becoming La Leche League International in 1964, Mrs. Froehlich took on additional roles, including serving as assistant executive director for many years and, more recently, as a board member and a member of the Founders’ Advisory Council. Mrs. Froehlich donated her body to the University of Illinois for research; her children think she wanted to continue serving science even after her death.

Bonnie - Edwina was a courageous woman who should be honored for her vision and steadfast beliefs. La Leche League has been instrumental in creating the high numbers of women now breastfeeding in the United States.

Low levels of key brain chemical sparks anger

Serotonin, the brain chemical linked to mood, plays a key role in regulating emotions such as aggression, according to a study in the journal Science. The chemical's precise role in impulse control has been controversial but this study is one of the first to actually show a causal link. The research also helps explain why some people become combative or aggressive when hungry because the essential amino acid needed for the body to create serotonin is only obtained through diet.

Bonnie - while not exactly ground breaking news, it is nice to see it proven in research. There are numerous mood-boosting foods that I commonly recommend. In addition, I have found magnesium and 5-HTP to be safe serotonin-boosters. Do not "self-medicate" with these supplements, however, especially if on medication. Seek the advice of a licensed health professional.

Vitamin D may protect against heart attack in men

Men classified as deficient in vitamin D were about 2 1/2 times more likely to have a heart attack than those with higher levels of the vitamin. "Those with low vitamin D, on top of just being at higher risk for heart attack in general, were at particularly high risk to have a fatal heart attack," study author Dr. Edward Giovannucci of the Harvard School of Public Health and Brigham and Women's Hospital in Boston said in a telephone interview. The study involved 454 health professionals ages 40 to 75 who had suffered a nonfatal heart attack or died of heart disease, as well as 900 other men with no history of cardiovascular disease. They were followed for 10 years after providing blood samples to measure their vitamin D levels. The researchers compared those who were deficient in vitamin D -- no more than 15 nanograms per milliliter of blood -- to men who were in at least the lower end of the normal range -- at least 30 nanograms per milliliter of blood.

Giovannucci said there is enough evidence about the value of vitamin D to encourage people to ensure they have normal levels. He said people can learn their vitamin D levels by having their doctor give them a blood test. Those whose levels are too low can take vitamin D supplements, he said. "Many people have low vitamin levels," Giovannucci said. "Traditionally, physicians have only been concerned about the bone effects. But perhaps having these chronically low levels of vitamin D may be having these subtle physiological changes in a lot of tissues," Giovannucci added.

The study was published in the journal Archives of Internal Medicine.

Bonnie - as I have said many times before, like magnesium, vitamin D is a catalyst for almost every function in the human body. So is it a surprise that those with low levels are more susceptible to chronic disease?

Niacin's cholesterol-lowering mechanism proposed

The cholesterol-lowering effects of niacin may by located in the liver, suggests new research that fills in the gaps in our understanding of the heart healthy benefits of the B vitamin.

The cell study indicates that niacin may reduce the removal of HDL 'good' cholesterol by about 35 per cent, according to findings published in the Journal of Lipid Research.

"Although niacin has been commonly used to increase plasma HDL levels, the mechanism(s) by which niacin exerts its action is not clearly understood," wrote the authors from the University of California, Irvine and the Atherosclerosis Research Center, VA Healthcare System in Long Beach.

In simple terms, the results indicate niacin hinders the liver from removing HDL from the blood, thus maintaining high plasma HDL levels.

Interestingly, the researchers did not document any affect on another major pathway known as "Reverse Cholesterol Transport", which allows for the removal of other cholesterol types.

The B vitamins act as coenzymes in numerous biochemical reactions in the body. They are essential for proper growth and maintenance of cells, tissue and organs.

Bonnie - niacin has been used for decades by preventive Cardiologists as a great, safe way to increase HDL levels.

Food Allergies Trigger Multibillion-Dollar Specialty Market

Consumers with food allergies are increasingly coveted by corporations and entrepreneurs who see an economic opportunity in catering to the needs of people who have food allergies or celiac. Marketing to the food-sensitive has become so widespread that the Girl Scouts now sell three kinds of milk-free cookies, Anheuser-Busch has a gluten-free beer and Kellogg's makes Pop-Tarts in nut-free factories.The market for food-allergy and intolerance products is projected to reach $3.9 billion this year, according to Packaged Facts, a New York research firm. And the market for gluten-free foods and drinks is expected to hit $1.3 billion by 2010, up from $700 million in 2006, according to research firm Mintel.

Bonnie - gone are the days where one with food allergies had to make everything from scratch! Those of you who have recently been diagnosed don't know how good you have it :)

Number of FDA warning letters have plunged

Over the past 10 years, there was a drop by about half, in fact, Dow Jones reports. A big falloff began in 2002, when the agency began requiring all warnings go through its chief counsel office, which was supposedly designed to make the letters legally consistent and credible, the wire notes. The year before this change took effect, in fiscal year 2001, the FDA issued 1,032 warning letters. In 2006, the FDA sent 538 letters, and in 2007 it sent 471, FDA data show.

Some members of Congress, FDA staffers and former FDA officials have criticized the change, suggesting it favored industry. “The number of warning letters has always been one of the surrogate measures of FDA’s enforcement performance,” David Kessler, who was FDA commish from 1990 to 1997, tells Dow Jones. “It’s not the only measure, but any significant drop raises significant questions of what’s going on.” Andy von Eschenbach, the current FDA commish, tells Dow Jones that letters now going out are for transgressions “that we think are going to be important.”

Other findings: the FDA has ordered more product recalls From 1996 to 2000, the agency recalled an average of 3,500 products annually. From 2001 to 2006, that average rose to 4,700 a year. Foreign and domestic plant inspections by the FDA have fallen in the last 5 years, data from the agency’s Web site show. In 2003, the FDA conducted 22,543 inspections. In 2004, that figure was 21,805, in 2005 it was 19,803 and in 2006, the agency inspected 17,641 plants.

Consumers not seeking Pharmacist's advice

As new prescription drugs and over-the-counter remedies migrate into medicine cabinets across the United States, consumers should be asking pharmacists more about dosage and interactions. Yet many aren't talking to pharmacists at all, according to a recent survey of more than 40,000 Consumer Reports readers. CR found that readers sought pharmacists' advice about prescription drugs at just 38 percent of walk-in visits during the course of a year, and they asked about over-the-counter remedies at just 29 percent. That's far less than in CR's 2002 survey, when the figures were 50 percent and 37 percent, respectively.

Steve - this is disturbing but not surprising. It is a pharmacist's job to know these things. Use them! You cannot rely on your doctor for this information. If you choose not to speak with your pharmacist, at least read the medication insert before you take any medication.

The other side of the coin is: doctors and pharmacists could be offering up their assistance in these matters, not waiting for us to ask. A simple sentence such as, "Would you like me to discuss the potential side effects and contraindications that may occur with this medication," would suffice. Does this ever happen? Rarely. But it should be commonplace.

Co-ops growing as demand for organic veggies rises

Courtesy of the Daily Herald

Side dishes took on a whole new sense of urgency last year in the Riemer household. There was steamed squash, raw squash, squash in salads, squash mixed with other vegetables and even -- for dessert -- squash pie. If they ate it, it likely contained a vegetable. Like thousands of families across the area, the Riemers discovered the abundance of fresh produce that hails from Community Supported Agriculture, or CSA. "I can't buy tomatoes and peppers (at the store) anymore," said Jen Riemer of Crystal Lake. "They just don't taste the same."

For a one-time fee or weekly installments, customers with CSAs sign up for weekly bushel baskets of fresh, predominantly organic vegetables and fruits from farms throughout the region. Most of the delivery seasons start in early June, but some begin as early as mid-May, depending on whether farms are able to grow food in protected hoop houses. Generally speaking, the household cost for a season share ranges between $500 and $700. And with a continuing rise in demand for chemical-free and locally grown food, the popularity of CSAs is escalating. Wellhausen Farms, which distributes throughout DuPage County, began as an effort to provide healthy food for members of the Wheaton family themselves. "Dad started reading and hearing stuff on the news about grocery stores and sprayed and unhealthy (food)," said Jamie Wellhausen. "We started growing vegetables for our family, then decided to share with our neighbors. Then we put together the idea of the CSA program. We wanted to share with other people. We started with 16 clients, then 25, then 40, 50, then 100." That sort of growth isn't uncommon. In fact, many of the same small growers who dedicated themselves to farmers markets are turning to selling shares. Gray Wiechern's Mother Earth Organic Farm in Plainfield is in its second year as a cooperative. And frankly, it's a much better deal for Wiechern. There's no weekly setup, no tiring travel, and she's got a prepaid audience.

Then there's the help. "I offer an incentive for those that want to put some work in," she said. Essentially, share owners can work off the equivalent of about $7.50 an hour by helping out in the field or greenhouse. Most folks, however, choose simply to pay full price for their vegetables and wait eagerly for their weekly delivery.

Many cooperative farmers limit themselves to the number of households, or shares, they'll sell. They could grow much more if they wanted, but practicality requires they scale back. Sixteen years ago, John Peterson started Angelic Organics in Caledonia, Ill., with an experimental 30 shares. Now the farm -- which delivers across the suburbs as well as in Chicago -- capped its limit at 1,200 shares. "Most people come to us because we're local and we're organic," General Manager Bob Bower said. They're expanding their farm operations now to focus on biodiversity, or the concept of being self-sustaining. It's not that their market has slowed. Elliot Hamilton can attest to that: His Arlington Heights house serves as a regional drop-off site for Angelic where about 80 customers pick up their weekly deliveries. That usually means between 20 and 30 pounds of produce per box. Hamilton said he's been a CSA convert for more than a decade, and his wife, Tenja, helped put together recipes and a cookbook for other shareholders to help get their money's worth out of their purchases. That tends to be one of the bigger problems newbies face: Simply eating all the fresh food. "I suppose that's why we give away a third of the box," Hamilton said.

Most of the cooperatives send out newsletters with suggested recipes and even explanations about the identities of the food. "Some people are used to buying the food in the grocery and they're not used to seeing vegetables that aren't already chopped up and prepared," Jamie Wellhousen said. "Some people will put (squash) on the counter for decoration, and when they see (our weekly) e-mail they'll be like, 'Oh, I can eat it?' " There's a whole new range of food education involved with cooperatives, said Peg Shaeffer, of Sandhill Organics in Grayslake. Not only do buyers learn new ways of cooking old standbys and discover new vegetables, but they appreciate the times of year when the food truly grows. Shopping in grocery stores gives people a distorted perception of the growing process because food is shipped in from all over the world year-round, Shaeffer said. "One of the things people talk about is it's a joy to learn to eat with the seasons," she said. "You learn so much about the world and what grows when." Riemer's family helps out each week at their cooperative of choice, Walkup Farms in Crystal Lake. It gives them a better feel for what they're eating and makes the entire effort even more fun. Their season's already started for 2008 and she's looking forward to finding out what will arrive in their box. "I was surprised at the number and variety of vegetables we got," she said. "I got things I'd never cooked. We really tried to eat it all."

Steve - as being a proud participant of the Sandhill Organics CSA, there are many more positive aspects to it than just the produce (which is great by the way). The emotional attachment about your food being grown close to home as well as the education, for parents and children, is invaluable.

Salmonella outbreak spreads to 16 states

Salmonella poisoning first linked to uncooked tomatoes has spread to 16 states, federal health officials said Saturday.

Investigations by the state health departments of Texas and New Mexico as well as the U.S. Indian Health Service have tied 56 cases in Texas and 55 in New Mexico to raw tomatoes.

"We're seeing a steady increase," Deborah Busemeyer, New Mexico Department of Health communications director, said Saturday.

An additional 50 people have been sickened by the strain known as Salmonella Saintpaul in Illinois, Arizona, California, Colorado, Connecticut, Idaho, Indiana, Kansas, Oklahoma, Oregon, Utah, Virginia, Washington and Wisconsin, the federal Centers for Disease Control and Prevention reported.

Investigators are trying to determine if raw tomatoes also are responsible for the illnesses in those states, said Arleen Porcell, a CDC spokeswoman.

The source of the tomatoes responsible for the illnesses has not been pinpointed, but health officials in Texas and New Mexico said none of them was grown in those two states.

At least 23 people have been hospitalized, but no deaths have been reported, Porcell said. Patients ranged in age from 1 to 82.

Cherry tomatoes, grape tomatoes, tomatoes sold with the vine still attached, and homegrown tomatoes are likely not the source of the outbreak, Busemeyer said.

Steve - another good reason to support local!

Probe: Child experts kept mum on income from drug firms

Courtesy of The New York Times

A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful anti-psychotic medicines in children earned at least $1.6 million in consulting fees from drugmakers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given to congressional investigators.

By failing to report income, the psychiatrist, Dr. Joseph Biederman and a colleague in the psychiatry department at Harvard Medical School, Dr. Timothy Wilens, may have violated federal and university research rules designed to police potential conflicts of interest, according to Sen. Charles Grassley (R- Iowa). Some of their research is financed by government grants.

Like Biederman, Wilens belatedly reported earning at least $1.6 million from 2000 to 2007, and another Harvard colleague, Dr. Thomas Spencer, reported earning at least $1 million after being pressed by Grassley's investigators. But even these amended disclosures may understate the researchers' outside income because some entries contradict payment information from drugmakers, Grassley found.

In one example, Biederman reported no income from Johnson & Johnson for 2001 in a disclosure report filed with the university. When asked recently to check again, he reported receiving $3,500. But Johnson & Johnson said it paid him $58,169 in 2001, Grassley found.

The Harvard group's consulting arrangements with drugmakers were already controversial because of the researchers' advocacy of unapproved uses of psychiatric medicines in children.

In an e-mail, Biederman said, "My interests are solely in the advancement of medical treatment through rigorous and objective study," and he said he took conflict-of-interest policies "very seriously." Wilens and Spencer said that they thought they had complied with conflict-of-interest rules.

John Burklow, a spokesman for the National Institutes of Health, said: "If there have been violations of NIH policy—and if research integrity has been compromised—we will take all the appropriate action within our power to hold those responsible accountable. This would be completely unacceptable behavior, and NIH will not tolerate it."

Alyssa Kneller, a Harvard spokeswoman, said the doctors had been referred to a university conflict committee for review.

Bonnie - this is inexcusable behavior, especially after the supposed steps to "reforms the process" led by the NIH, universities, doctor and research associations, and Big Pharma.

Safe solutions for pregnant women with acne

Bonnie - A recent New York Times article explored the difficulty physicians have in treating acne in pregnant women. Medications such as Accutane and Isotretinoin are forbidden because of miscarriages and severe birth defects. Few creams and ointments are effective and some can be harmful. Most doctors prescribe antibiotics because they believe they are safe. However, antibiotics deplete nutrients, are not always effective for acne, disrupt healthy gut microflora, and contribute to the ongoing issue of bacteria-resistant superbug proliferation.

Any decision must be discussed with your physician, but I have several suggestions to try:

• Zinc Sulfate Solution - applied 2-3 times daily on affected areas can be helpful

• Milk of Magnesia, applied on affected areas before showering (do not wash off face until the end of the shower), appears to help in some cases.

• Photopneumatic therapy, in which the skin is suctioned with a vacuum-like device, bringing the bad stuff to the surface, then beamed with intense pulsed light. The process stuns and deactivates hyperactive oil glands and kills the bacteria they nourish. The process is performed by dermatologists and takes twenty minutes.

• Nicomide (by prescription only) - nicotinamide has been used by dermatologists for years for acne; the PDR says large doses of nicotinamide (form of the B-Vitamin niacin), zinc, or copper should be avoided during pregnancy. However, if you were to take one pill, it is not too much and is also a great source of folic acid

Pomegranates here to stay.

Courtesy of the Associated Press

Until recently, America's pomegranate lovers could indulge their passion for its ruby red seeds for less than half the year. Now, the trendy fresh fruit that's packed with health benefits will be available in the United States year-round.

"I've seen fads for all kinds of fruit, like kiwi and blueberries, but not like this — it just keeps growing and won't peak," said Kevin Day, a pomegranate expert at the University of California, Davis.

Pomegranates — about the size of an apple, with a thick, reddish skin and hundreds of seeds embedded in tough, white pulp — grow in temperate climates in the fall and winter. U.S. domestic supply comes largely from California's San Joaquin Valley, augmented by imports from Israel, Turkey, Lebanon, Greece and Mexico.

In the past, fresh pomegranates disappeared from U.S. stores in spring and summer. While the fruit thrives in the Southern Hemisphere and India, those countries had not exported it in large quantities until last week.

It's not just the seeds that are popular. Annual sales of pomegranate juice sold by California-based POM have risen from $12 million a year in 2003 to more than $100 million.

In the past two years, "pomegranates have exploded in consumption as the public has found out about the health benefits," said Dorn Wenninger, vice president of the international division of importer S. Katzman Produce.

Steve - unlike acai, mangosteen, and the other hyped super fruits that are all the rage right now, pomegranate will outlast them all.

Sweet Leaf Stevia to self-label as GRAS

Arizona-based Wisdom Natural Brands has self-affirmed its version of stevia - Sweet Leaf - as being generally regarded as safe (GRAS) and said the ingredient would be available in a soda or food product by year's end.

Wisdom Natural Brands chief executive officer and founder, Jim May, said at least one major beverage manufacturer had shown strong interest in Sweet Leaf.

In the meantime it would be available at retail level as a table-top sweetener that would be labeled as a sweetener not a dietary supplement as has been the case in the past.

This was significant because for the first time stevia would be sold alongside other sweeteners and not among dietary supplements on store shelves.

"We have produced 40,000-50,000 units that will be on the shelf across the US in a week," May said.
Wisdom Natural Brands had completed a review of available science on March 5, which had prompted it to make the self-affirmed GRAS announcement.

"We had third-party, former-FDA analysts assess the science and so feel confident about the is GRAS affirmation," he said. "We would have liked to delay the announcement but there is a war of attention happening right now with Coke and Cargill's announcement so we felt we should go ahead with this now."

Coca-Cola and Cargill recently published science backing their ingredient Truvia but have yet to bring it to market although a launch looks imminent.

May said Sweet Leaf-branded, table-top sweetener products would be on shelves next week, and all existing Wisdom Brands sweeteners marketed as dietary supplements would be phased out except in export markets.

But Daniel Fabricant, PhD, science and regulatory affairs vice president at the Washington DC-based Natural Products Association (NPA), said Wisdom Brands was pursuing a risky strategy by pursuing incorporation into the "food matrix" without FDA GRAS approval.

May said Wisdom Natural Brands had given up waiting for such approval after first submitting a GRAS application in 1995 that included 900 studies demonstrating stevia's safety.

"Of course a company can go ahead and incorporate the ingredient into different foods without FDA approval but if the FDA cracks down on them it can be a public relations disaster," Fabricant said.

This happened in 2007 with a tea product called Celestial Seasonings the FDA determined was not labeled clearly enough as a dietary supplement, and which required re-labeling with the words 'dietary supplement' appearing more prominently.

But the fact the product remained on market in the form of a tea, highlights a regulatory grey area that allows products containing stevia to be labeled as dietary supplements when they are clearly being consumed in the manner of foods.

Although Coke/Cargill's science relates only to their own proprietary version of stevia, the science around the ingredient's safety is growing to the point where it is going to be increasingly difficult for FDA to refuse it, especially as consumer demand for natural low-calorie sweeteners grows.

Steve - it is pretty obvious that they want to get their brand on store shelves before Coke and Cargill do. Sweet Leaf is a brand we recommended.

Mercury teeth fillings may harm some: FDA

Silver-colored metal dental fillings contain mercury that may cause health problems in pregnant women, children and fetuses, the Food and Drug Administration said on Wednesday after settling a related lawsuit. As part of the settlement with several consumer advocacy groups, the FDA agreed to alert consumers about the potential risks on its website and to issue a more specific rule next year for fillings that contain mercury, FDA spokeswoman Peper Long said. Millions of Americans have the fillings, or amalgams, to patch cavities in their teeth. "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses," the FDA said in a notice on its Web site. "Pregnant women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking dental care, but should discuss options with their health practitioner," the agency said.

The FDA said it did not recommend that people who currently have mercury fillings get them removed. The FDA must issue the new rules in July 2009, Long said. Such a rule could impact makers of metal fillings, which include Dentsply International Inc and Danaher Corp unit Kerr. The new rule will give the agency "special controls (that) can provide reasonable assurance of the safety and effectiveness of the product," Long said. The lawsuit settlement was reached on Monday with several advocacy groups, including Moms Against Mercury, which had sought to have mercury fillings removed from the U.S. market.

While the FDA previously said various studies showed no harm from mercury fillings, some consumer groups contend the fillings can trigger a range of health problems such as multiple sclerosis and Alzheimer's disease. In 2006, an FDA advisory panel of outside experts said most people would not be harmed by them, but said the agency needed more information. Mercury has been linked to brain and kidney damage at certain levels. Amalgams contain half mercury and half a combination of other metals. Charles Brown, a lawyer for one of the groups called Consumers for Dental Choice, said the agency's move represented an about-face. "Gone, gone, gone are all of FDA's claims that no science exists that amalgam is unsafe," he said in a statement.

Bonnie - sooner or later, the truth comes out. Most of the time, unfortunately, it is later, and in this case, much later! I have been trumpeting the removal of dental amalgams for well over a decade. Mercury is a lethal toxin, period.

Breast cancer patients deficient in vitamin D

Women who had a vitamin D deficiency when they were diagnosed with breast cancer were 94% more likely to have their cancer metastasize and 73% more likely to die within 10 years.

The team also found that only 24% of the women in its study had what are normally considered adequate levels of vitamin D at the time of the diagnosis.

The study represents "the first time that vitamin D has been linked to breast cancer progression," said Dr. Pamela Goodwin of Mount Sinai Hospital in Toronto, who led the study.

The results are "very provocative," said Dr. Joanne Mortimer, a breast cancer specialist at City of Hope Comprehensive Cancer Center in Duarte, who was not involved in the study.

"There is some evidence that some of the drugs we use to treat breast cancer, such as aromatase inhibitors, need vitamin D to be activated and metabolized."

Some women who take the drugs get joint aches, Mortimer said, and when they are put on vitamin D, "they get better."

The study was released by the American Society for Clinical Oncology.

Separately, a team from UC San Diego reported Thursday in the Breast Journal that global breast cancer incidence was linked to the amount of sunlight received annually. The skin makes vitamin D when exposed to sunlight.

Dietary supplements show promise in cancer fight

By Dr. Patrick Massey, Columnist
Daily Herald

One bone of contention between traditional and nontraditional medicine is whether vitamins and dietary supplements can prevent cancer.

Many proponents of the nontraditional arena suggest that they can, while traditional medicine takes the position that diet is an adequate source of vitamins and micronutrients in preventing cancer.

Although epidemiologic studies strongly suggest that people with higher levels of vitamins and antioxidants tend to have a lower risk of developing cancer, prospective studies with dietary supplements have been lacking, usually due to lack of funding.

Several years ago, I predicted that as these prospective studies were done, we would learn that supplementation prevents cancer. The main reason for this is because the American diet is so deficient in vitamins and micronutrients.

Over the past decade, there has been an increase in the incidence of reflux esophagitis. Reflux is a medical condition in which the acid in the stomach is released into the throat. Ultimately, chronic reflux can result in the development of a scar-tissue-like condition called Barrett's esophagus.

Barrett's esophagus is a precursor for esophageal cancer. The usual treatment is medication that limits the production of stomach acid. Although this medical approach seems to be effective, the question is whether the use of dietary supplements in vitamins further reduces the risk of developing esophageal cancer. The answer is yes.

In a recent study, conducted at the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle, 339 men and women with Barrett's esophagus were prospectively followed over a five-year period. During the study, 37 participants developed esophageal cancer, while an additional 76 participants developed significant precancerous lesions.

The participants were divided into two groups - those who took vitamins and dietary supplements on a daily basis and those who did not take vitamins and dietary supplements. Participants who consumed at least one multivitamin, 250 mg of vitamin C and 180 mg of vitamin E per day had a 25 to 30 percent lower risk of developing esophageal cancer, the researchers found.

The root of most cancer is chronic inflammation. Chronic inflammation results in oxidation (or rusting) of DNA and important biochemicals in the cell. Oxidation is very damaging and directly related to the development of cancer.

The human body has a number of exquisite mechanisms for dealing with inflammation and oxidation. One of the mainstays for fighting oxidation is antioxidants, made either by the body or consumed in food.

Over the past 50 years, our stress-based lifestyles have significantly increased the risk of chronic inflammation. At the same time, dietary antioxidant levels have dropped almost 50 percent.

Taking vitamins and dietary supplements, in reasonable amounts, is increasingly supported by good medical research.

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

MD explains why osteoporosis drugs can make your bones weak and brittle

According to Dr. Susan Lark, MD, osteoporosis drugs called bisphosphonates (Fosomax, Actonel, Boniva) work by disabling osteoclasts. Bone is always renewing itself by osteoclasts breaking down old bone and osteoblasts building new bone. If the drugs block the osteoclasts from breaking down old bone, the osteoblasts do not build new bone. So one is left with dense bone, but it is old, weak, and brittle. This is not what one wants as one ages.

Recent research has shown that these drugs cause necrosis (death) of the jaw bone. Why the jaw? It regenerates itself faster than any other bone in the body. So it makes sense that adverse bone changes would show there first. It has been ten years since the introduction of osteoporosis drugs, so it would not be surprise us if necrosis shows up in places other than the jaw over the next ten years.

Dr. Lark goes onto to mention a successful therapy that she has used for brittle bones. It is called Electromagnetic Therapy (EMT) and is commonly used in hospitals to heal broken bones. It involves sending a mild electrical current to weakened bones. When applied, it creates the same electrical impulses that are created in your bones when you are doing high intensity, weight-bearing exercise.

Survey of Medical Schools Is Critical of Perks

Courtesy of the NY Times

Most medical schools in the United States fail to police adequately the money, gifts and free drug samples that pharmaceutical companies routinely shower on doctors and trainees, according to a ranking by the American Medical Student Association. Only 7 of the 150 medical schools included in the rankings received a grade of A while 14 were given a B. Sixty got a failing grade, and the student association found that 28 schools, or nearly one in five, were in the midst of revising their conflict-of-interest policies. “These policies are incredibly important to protect the educational experience students have at school and the quality of the education they’re getting,” said Dr. Brian Hurley, president of the student association. Schools that shield students from marketing messages will produce doctors who provide better care to patients, Dr. Hurley said. "Attention to how students evaluate policies in fields that are of substantial importance to the future of the students.”

Steve - this should not be a surprise to anybody. It is no different than shoe companies wooing junior high school basketball players. Big Pharma wants to ingratiate itself with the up and coming medical talent.