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Health Care Business
Folic Acid Update
Macular Degeneration Update
Pesticides and Parkinson’s Disease
Ask Dr. J: Sulfa and Sulfate
References
In The Health News
Diet and Disease
Recipe of the Month: Yams and Black Bean Salsa
Dear Friends,
I was recently listening to some business analysis regarding
the state of the economy in the United States and predictions
for its future. Prominent in the report were the comments
that one of the “stellar performers” in the economy
was the business of health care, with the implication that
this was a positive contributor to national economic growth,
and therefore good.
My mind immediately jumped to the economist Henry Hazlitt
who noted that it is a common belief that destruction, such
as a vandal throwing a brick through a shop window, is a good
business stimulant. After all, he points out, the shopkeeper
then has to spend money to clean up the mess, buy plywood
to cover the opening until he can hire the glazier to replace
the glass, the plasterer to repair the wall, and the painter
to finish the job. This flurry of business puts money into
the hands of each contractor that they then spend on other
things and the economy grows.
The fallacy is in ignoring that the shopkeeper would have
spent that money on other things–a new suit, a home
improvement, a bicycle for his child–which would have
been just as good for the economy, without the destruction
of resources (and the associated headaches and lost time).
I am all for innovation, research, the development of new
devices, procedures, and safe, effective medications. However,
in the overall picture, expansion of health care as a business
is an indication that the health of the population is worsening,
which can’t be desirable. In addition to the strain
on resources, from hospital beds, nursing care, physician
time, and medical supplies, as well as the side effects of
expensive and often unnecessary drugs, this economic and resource
loss in no way reflects the human tragedy of illness.
The medical-pharmaceutical complex in the United States is
already a more than 1.5 trillion dollar industry, making up
a far greater percentage of overall business activity (GDP)
than in any other country, but neither health nor health care
is better here than in many other developed nations that spend
less. High health care costs result in part from the high
cost of drugs, doctors practicing defensive medicine (ordering
extra tests, visits, and expert consultations to protect themselves
from lawsuits), and the high expense of end-of-life care.
However, for the most part, the expansion of health as a business
reflects the unhealthy lifestyles that people follow, resulting
in obesity, diabetes, heart disease, cancer, and other chronic,
degenerative diseases, as well as accelerated aging.
Controlling health care costs through health education and
lifestyle change would not be harmful to the economy, even
though the medical industry would contract. On the contrary,
we would see a more productive work force and a redirection
of resources toward life-enhancing activities.
Folic acid (or folate) at doses that are above what is found
in the typical diet (from greens, beans and citrus fruits)
has many health benefits, reducing birth defects, cancer,
heart disease, and other atherosclerotic circulatory disorders,
such as strokes. New research shows that folate is also valuable
for preserving brain function in elderly people, and at a
dose that is most likely to come from supplements rather than
food alone.
Folic acid supplements lower serum homocysteine levels. Homocysteine
has been associated with an increased risk of atherosclerosis,
strokes, and congestive heart failure. In addition, in patients
who have had balloon angioplasty, the likelihood of those
vessels closing up again (restenosis) is much greater if homocysteine
levels are high, and this risk is reduced by folate supplements
(along with B6 and B12, which also help to lower serum homocysteine
levels). Other research shows that low folate is associated
with arterial damage independent of homocysteine.
Earlier studies have shown an association of low levels of
folate with an increased incidence of Alzheimer’s disease
(AD). These patients have a higher level of homocysteine (a
neurotoxin), indicating that this is a risk factor for AD
as well as heart disease. One study showed that patients with
the lowest folate levels had triple the risk of AD compared
to those with the highest levels, and low levels were associated
with faster progression of the disease. The researchers suggested
that people take 500 to 5000 mcg (5 mg) of folate supplementation.
(Vitamin B12, which also lowers homocysteine levels, showed
a similar association with AD.)
Research also suggests that folate can prevent and treat
depression. People with low folate levels are more likely
to have clinical depression. Depressed patients treated with
Prozac respond sooner and they are less likely to have relapses
if they have adequate folate levels. A study of 123 patients
with acute psychiatric disorders, including depression and
schizophrenia showed a significant response if they were given
high dose supplements (15 mg) of a form of folate.
The new study shows that folate supplements can enhance memory
and slow the decline seen with aging. Researchers studied
818 people with normal brain function, aged 50 to 75 years
old, and gave them either a placebo or 800 mcg of folate for
three years. Those on the supplements, (well above the usual
recommended amount) had better memory scores, comparable to
people 5.5 years younger. (To prevent memory decline, it also
helps to keep the brain active, do regular physical exercise,
and maintain social interactions.) Some high-potency multivitamin
formulas contain 800 mcg of folate. Doses of 5 to 20 mg of
folate may have additional benefits.
Macular degeneration, an age-related deterioration of the
retina with declining visual function, can be reduced with
better nutrition and dietary supplements, such as the carotenoid
lutein, trace minerals, and vitamins C and E and beta-carotene.
It may also be beneficial to take supplements that help small
vessel circulation, such as ginkgo biloba.
New research shows that in combination even small doses of
coenzyme Q10, acetyl L-carnitine, and omega-3 oils can reverse
some early signs of macular degeneration and prevent progression.
These nutrients all influence mitochondrial function and enhance
cellular energy production. Also, macular degeneration might
result from compromised circulation to the retina, and these
supplements may help circulation.
In this double-blind study of 106 patients, half were given
the supplement combination and half a placebo and they were
followed for one year. The subjects given the supplement improved
in every parameter that was evaluated, including changes in
visual field defects, visual acuity, sensitivity of the retina
in the most sensitive area, and the anatomical appearance
of the retina.
In the supplement group, only one patient had disease progression,
while nine patients in the placebo group worsened. An earlier
pilot study had suggested these benefits, but this was the
first controlled study to show these results.
These nutrients have a number of other health benefits, including
benefits for the heart, the brain, circulation, and immune
function. Combining them with other antioxidants and trace
minerals as part of a total health program will help to preserve
and restore eyesight.
Pesticides are not confined to commercial farms and gardens.
They are commonly used in and around the home, and particularly
in both flower and vegetable gardens. However, you don’t
have to be a farmer to be damaged by exposure to these toxic
compounds. A team of researchers studying 2756 people in five
European countries published their findings in New Scientist
(www.newscientist.com/channel/health/mg18625014.900). They
found that exposure to pesticides was directly related to
the risk of developing Parkinson’s disease.
The researchers suggested that people using pesticides should
wear protective clothing, but a far better choice would be
to practice organic gardening, eliminating the use of toxic
pesticides entirely. These substances are neurotoxins and
likely carcinogens, and they also damage the soil and the
beneficial organisms in the soil that help to control pests.
In addition, residues of pesticides get into the food supply,
poisoning consumers, and children playing in the garden are
even more likely to be exposed to high levels.
People concerned about Parkinson’s disease, especially
those with a family history of the condition, should consider
eating organic foods and especially legumes, which are protective.
They should also take supplements of vitamins C and E, and
particularly high doses of coenzyme Q10, which have been shown
to protect the brain.
Q. I am beginning to have osteoarthritis,
but I am allergic to sulfa drugs. Can I still take glucosamine
sulfate?
—TW, via email
This is a common confusion. Sulfa drugs (a class of antibiotics
more properly called sulfonamides) contain sulfur deeply embedded
in a complex structure that also contains nitrogen, carbon
and other elements. They are effective for many bacterial
urinary tract and other infections, but many bacteria are
now resistant to these medications. They are also often used
to treat inflammatory bowel disease.
Sulfa drugs do have side effects though, and many people
are allergic to them. However, it is not the sulfur itself
that causes allergies to these drugs but the entire complex
molecule to which some people react.
Sulfur is a required nutrient present in many foods, such
as beans, eggs, dairy products, fish, garlic, and onions,
and it is essential for protein production (hair, skin, muscles,
collagen), bone formation, and bile production to aid digestion.
It is a component of many important nutrients, such as glutathione,
taurine, cysteine, and alpha-lipoic acid with its antioxidant
activity and support in detoxifying heavy metals.
Glucosamine sulfate is unrelated to sulfa drugs other than
having sulfur as one component. You should still be able to
take it safely for arthritis (typically 1500 to 2000 mg daily).
Some people report hypersensitivity to this and other dietary
supplements. If that is your situation, try any combination
of alternatives such as vitamin B3 (niacinamide, 1500 to 3000
mg), SAMe (200 to 800 mg), fish oil containing omega-3 oil
(1200 to 2400 mg of EPA/DHA), and MSM, another sulfur source
(1500 to 3000 mg) that helps arthritis.
Hazlitt, Henry, Economics in One Lesson,
Harper & Brothers, 1946
President Bill Clinton Interview, Talk
of The Nation Science Friday, National Public Radio, June
3, 2005
Study: Folic Acid May Aid Seniors’
Memory, Alzheimer’s Association International Conference
on Prevention of Dementia, Washington, D.C., June 18-21, 2005,
as reported in WebMD Health
Durga J, Low concentrations of folate,
not hyperhomocysteinemia, are associated with carotid intima-media
thickness. Atherosclerosis. 2005 Apr;179(2):285-92.
Seshadri S, et al., Plasma homocysteine
as a risk factor for dementia and Alzheimer’s disease.
N Engl J Med. 2002 Feb 14;346(7):476-83.
Wang HX, et al., Vitamin B(12) and folate
in relation to...Alzheimer’s disease. Neurology. 2001
May 8;56(9):1188-94.
Snowdon DA, et al., Serum folate and the
severity of atrophy of the neocortex in Alzheimer disease:
findings from the Nun study. Am J Clin Nutr. 2000 Apr;71(4):993-8.
Clarke R, et al., Folate, vitamin B12,
and serum total homocysteine levels in confirmed Alzheimer
disease. Arch Neurol. 1998 Nov;55(11):1449-55.
Godfrey PS, et al., Enhancement of recovery
from psychiatric illness by methylfolate. Lancet. 1990 Aug
18;336(8712):392-5.
Papakostas GI, et al., The relationship
between serum folate, vitamin B12, and homocysteine levels
in major depressive disorder... Int J Neuropsychopharmacol.
2005 May 9;1-6 [Epub ahead of print]
Papakostas GI,
et al., Serum folate, vitamin B12, and homocysteine in major
depressive disorder... J Clin Psychiatry. 2004 Aug;65(8):1096-8.
Feher J, et al., Improvement of visual
functions and fundus alterations in early age-related macular
degeneration treated with a combination of acetyl-L-carnitine,
n-3 fatty acids, and coenzyme Q10. Ophthalmologica. 2005 May-Jun;219(3):154-66.
Age-Related Eye Disease Study Research
Group. A...trial of high-dose supplementation...for age-related
macular degeneration and vision loss: Arch Ophthalmol. 2001
Oct;119(10):1417-36.
Weight loss of even moderate amounts reduces the likelihood
of developing high blood pressure. Obese middle aged subjects
who lost 15 pounds decreased the risk by 21 percent, while
older subjects fared even better, with a 29 percent risk reduction.
(Moore LL, et al., Weight loss in overweight adults and the
long-term risk of hypertension: the Framingham study. Arch
Intern Med. 2005 Jun 13;165(11):1298-303.) Even as little
as 4 pounds reduction in weight made a significant difference.
The data were derived from the Framingham study, and evaluated
1228 overweight adults.
Hypertension increases heart and kidney disease and strokes
and shortens life. It reduces lifespan by five years, and
adds seven years of heart disease. Researchers followed 3128
subjects for 28 years. (Franco OH, et al., Blood Pressure
in Adulthood and Life Expectancy With Cardiovascular Disease...Hypertension
2005 August; online 27 June.) These effects were much greater
than previously thought. Blood pressure rises with poor diet,
obesity, and lack of exercise, and is helped with many dietary
supplements, including coQ10, vitamins C and E, and magnesium,
among others.
Eating more than 5 to 6 ounces of red meat per day increases
the risk of developing bowel cancer, according to a large
study of 478,040 men and women from 10 European countries
followed for five years. Fish consumption in the same group
was associated with a reduction in risk. The researchers estimated
that the risk was about 40 percent increased in the meat eaters
and 30 percent reduced in the fish eaters. Processed meat
consumption was associated with an even higher risk. (Norat
T, et al., Meat, fish, and colorectal cancer risk: the European
Prospective Investigation into cancer and nutrition. J Natl
Cancer Inst. 2005 Jun 15;97(12):906-16.)
After cutting into 1-inch cubes, steam some sweet potatoes
or garnet yams until soft. Make salsa with diced tomatoes,
organic fresh or frozen sweet corn, chopped onions, crushed
garlic, minced fresh cilantro, cumin, fresh diced hot peppers
or powdered cayenne, chili powder, and a small amount of olive
oil, lemon or lime juice (or cider vinegar), and a pinch of
salt if you choose. Add a small amount of cooked black beans
(pressure cook them for 20-25 minutes to save hours of cooking
time; or you can use organic canned beans). You can vary any
of the amounts to taste. (In a pinch, you can buy jars of
organic black bean and corn salsa.) Mix the salsa and yams
and let it sit in the refrigerator for a while to infuse the
flavors. This can be served chilled with some organic whole
wheat or corn tacos, or as a side dish for those summer cookouts.
drjanson@drjanson.com
November
through May: 386-409-7747
June
through October: 603-878-2256
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