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Healthier Health Foods
Hypertension Update
Hypertension and Lifestyle
Digestion and Food Allergies
Ask Dr. J: Combining Cholesterol Agents
References
In The Health News
Diet and Disease
Recipe of the Month: Curry Carotene Soup
Dear Friends,
I recently went to two health restaurants, serving organic
foods with vegetarian choices. While I was pleased that healthier
organic foods are increasingly available, I was somewhat disappointed
that neither of these establishments served any foods containing
whole grains. Although their wheat was organic, it was made
from white flour, devoid of the healthiest parts of the grain–the
nutritious germ and fibery bran.
I have been so encouraged to see the growth of the health
food industry in the past twenty-five years, but it has come
with some compromise of the ideals that were present when
it started. Until the late 1960s, a health food store contained
a collection of dry goods, canned foods, and boxes of dietary
supplements. The packaged breads that they sold were mostly
heavy, dry, and dense, although they were made from whole
wheat.
It was about that time that the interest in healthier and
more tasty foods became part of the revolution of the sixties.
Perhaps all that European travel contributed to the interest
in fresher and tastier foods, but it was the macrobiotic movement
that gave the largest push to healthier foods, including organic
produce, organic whole grains, and the elimination of refined
sugars and artificial ingredients. At that time, Michio and
Aveline Kushi, macrobiotic teachers, developed a following,
and they opened grocery stores to supply them with their organic,
whole foods, including whole wheat and brown rice.
Although only one store is left, in Los Angeles, the influence
that the Kushi’s and macrobiotics had on the health
food industry was dramatic. Organic food is now the fastest
growing segment of the entire grocery business. It is taking
off across the country and in Europe and Japan (where the
dietary choices that macrobiotics encouraged had their start).
Health food stores are proliferating.
Unfortunately though, white flour and sugar (taboos in the
earlier health food stores) have become pervasive throughout
health stores and restaurants. At one time, as the stores
and restaurants grew and prospered, they added a small amount
of white flour and natural sweeteners to appeal to a wider
audience. Then organically produced sugar became available,
and these two ingredients came to dominate the market, with
the assumption that the larger audience for health foods no
longer cared about the health benefits of whole grains and
fiber. Organic, whole-grain breads are hard to find.
I applaud the healthier, organic foods restaurants. I have
been to many around the world (recently to O’Naturals
and Flatbread in New England). I would like it even more if
they and health food stores would make a commitment to less
sugar and healthier whole grains, which have consistently
been shown to be associated with improved health and lower
risks.
I noted last month that conventionally defined hypertension
shortens lifespan by five years and adds seven years of heart
disease. New information confirms earlier evidence that even
modest elevations of blood pressure, not enough to be considered
hypertension, can have a negative influence on heart health.
Normal blood pressure is below 120 (systolic) over 80 (diastolic),
but mild elevations (diastolic pressure between 80 and 90,
for example) have long been considered of little significance.
Recently, “prehypertension” has been considered
a risk factor, with blood pressures from 120-140 systolic
and 80-90 diastolic. In this current report, researchers reviewed
data on 8986 participants in the National Health and Nutrition
Examination Survey followed for 18 years. They found that
prehypertension (levels above 130 systolic and 85 diastolic)
significantly increased the risk of heart disease by 32 percent,
and heart attacks by 42 percent.
These blood pressures have also been associated with an increased
risk of strokes and other illness. In a 2004 report, researchers
estimated the effects of prehypertension on health. Their
projections estimated that the condition accounted for 3.4
percent of hospital admissions, 6.5 percent of nursing home
stays, and 9.1 percent of deaths. Drug companies seized on
this information to promote increased use of pharmaceuticals
to control blood pressure.
However, while this information shows that it is important
to control blood pressures even if elevations are modest,
most of the time medications are unnecessary. Moderately high
blood pressure can be controlled more safely by following
a healthy low-salt, low-animal-fat diet, controlling weight,
exercising, learning to relax, and taking dietary supplements.
Salt in the diet is a contributor to increased blood pressure.
Although some reports (particularly reviews from the salt
industry) suggest that only some sensitive individuals show
increased blood pressure in response to dietary salt, some
thorough reviews suggest that the relationship is common and
consistent. Research in the journal Hypertension indicates
that excessive salt intake may be a problem for most people.
The International Study of Salt and Blood Pressure (INTERSALT
study) evaluated more than 10,000 people in 52 population
groups from 32 countries and salt was clearly shown to influence
blood pressure in both normal and hypertensive groups. It
also appears that salt sensitivity increases with age, and
if someone develops a habit of eating salty foods when they
are younger, they may find it difficult to change if they
develop health problems later in life. Typical daily salt
consumption is from 5-13 gms, while our needs are only 1/2
to 1 gm per day (1/5th teaspoon).
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
Food allergies have recently been shown to be related to
irritable bowel syndrome (IBS). Typical symptoms of IBS are
gas, bloating, cramps, diarrhea alternating with constipation,
and general abdominal discomfort. Most of the medical profession
has been skeptical that food sensitivities might play any
role in the condition, other than recognizing that lactose
intolerance might be one contributor, as most adults lack
the enzyme that digests milk sugar (lactase).
While some studies have shown that elimination of specific
foods often helps to reduce symptoms of IBS, now, researchers
have found that people with IBS have high levels of antibodies
to common foods, including wheat, beef, pork, lamb, soy, and
eggs. While the researchers were unable to correlate the level
of antibodies with the severity or frequency of symptoms,
but symptoms might be more related to quantity and frequency
of consuming the offending foods.
Food sensitivities that are not allergies will not show up
in antibody tests. IBS may also be related to stress, abnormal
intestinal bacteria, caffeine, alcohol, low dietary fiber,
overgrowth of intestinal yeasts, and excessive dietary sugars.
Treatment options include avoiding offending foods, taking
supplements of probiotics such as acidophilus and bifidus
bacteria, and eating a high fiber diet. Fiber tends to absorb
water, which helps to increase the bulk of the stool and improve
elimination. Supplements of L-glutamine (2000-8000 mg), gamma
linolenic acid (240-480 mg), and enteric-coated peppermint
can all be helpful, as can fiber supplements, such as freshly
ground flaxseeds or psyllium powder.
Q. To lower cholesterol, can I safely take
policosanol, guggulipids, and niacin together?
—TT, via Internet
Natural substances tend to be much safer than the drugs that
lower cholesterol, and they can be just as effective. Policosanol
(labeled as from Saccharum officanarum or sugar cane), has
been well studied in comparison with the statin drugs, and
it appears to be of equal benefit for the cholesterol level
and protection of the arterial lining cells (endothelium).
It is a mixture of waxy alcohols, including octacosanol, but
the specific mixture seems to make a difference in its effect.
However, sometimes additional cholesterol-lowering supplements
are helpful.
Niacin, guggulipids, and red yeast rice may all contribute
to maintaining a normal cholesterol level, and they are unlikely
to have any negative interactions with each other or with
policosanol. For most of my patients, a combination of policosanol
and red yeast rice has been very effective, but I have also
recommended these with guggulipids, niacin, or garlic in various
combinations, as well as soy protein.
The usual doses: policosanol, 20 mg per day; red yeast rice,
1000-2000 mg; guggulipid, 500-1500 mg; garlic (deodorized),
1000-2000 mg; and niacin, 2000-3000 mg. You will probably
not need to take more than one or two of these to be effective.
You might also benefit from fish oil supplements (EPA/DHA,
1000-2000 mg), and soy protein (30 gms, or 20 gms if replacing
meat protein), with its isoflavones and other beneficial components.
Gary Hirshberg, How Business Can Save the
World, Monadnock Summer Lyceum, June 26, 2005
Liszka HA, et al., Prehypertension and
cardiovascular morbidity. Ann Fam Med. 2005 Jul-Aug;3(4):294-9.
Russell LB, Effects of prehypertension
on admissions and deaths: a simulation. Arch Intern Med. 2004
Oct 25;164(19):2119-24.
Chobanian AV, Hill M, National Heart, Lung,
and Blood Institute Workshop on Sodium and Blood Pressure:
a critical review of current scientific evidence. Hypertension.
2000 Apr;35(4):858-63.
Appel LJ, et al., Effects of comprehensive
lifestyle modification on blood pressure control: main results
of the PREMIER clinical trial. JAMA. 2003 Apr 23-30;289(16):2083-93.
Miller ER 3rd, et al., Results of the Diet,
Exercise, and Weight Loss Intervention Trial (DEW-IT). Hypertension.
2002 Nov;40(5):612-8.
Keenan JM, et al., Oat ingestion reduces
systolic and diastolic blood pressure... J Fam Pract. 2002
Apr;51(4):369.
Pins JJ, Do whole-grain oat cereals reduce
the need for antihyper-tensive medications...? J Fam Pract.
2002 Apr;51(4):353-9.
Fujita H, Yoshikawa M.LKPNM: a prodrug-type
ACE-inhibitory peptide derived from fish protein. Immunopharmacology.
1999 Oct 15;44(1-2):123-7.
Marczak ED, et al., New antihypertensive
peptides isolated from rapeseed. Peptides. 2003 Jun;24(6):791-8.
He J, et al., Effect of soybean protein
on blood pressure: a randomized, controlled trial. Ann Intern
Med. 2005 Jul 5;143(1):1-9.
Zar S, et al., Food-Specific Serum IgG4
and IgE Titers to Common Food Antigens in Irritable Bowel
Syndrome. Am J Gastroenterol. 2005 Jul;100(7):1550-7.
Santelmann H, Howard JM, Yeast metabolic
products, yeast antigens and yeasts as possible triggers for
irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2005
Jan;17(1):21-6.
Malhotra S, et al., Dietary fiber assessment
of patients with irritable bowel... Indian J Gastroenterol.
2004 Nov-Dec;23(6):217-8.
Just after writing about folic acid last month, a new article
appeared showing that folate lowers the risk of hemorrhagic
strokes. In an evaluation of 396 patients, folate levels were
inversely related to the risk of hemorrhagic strokes (Van
Guelpen B, et al., Folate, vitamin B12, and risk of ischemic
and hemorrhagic stroke...Stroke. 2005 Jul;36(7):1426-31).
The researchers were surprised that no association was seen
with ischemic strokes (clots), but noted that folate levels
in Sweden are possibly too low to find such a link (foods
are not fortified and vegetable intake is relatively low).
Chromium is essential for fat and carbohydrate metabolism,
and has been associated with improved diabetic sugar control
and better management of hypoglycemia. New research in a nine-country
case-control study of 1408 men shows that subjects with the
highest levels of chromium had a 40 percent reduction in the
risk of a heart attack compared to men with the lowest levels
(Guallar E, et al., Low toenail chromium concentration and
increased risk of nonfatal myocardial infarction. Am J Epidemiol.
2005 Jul 15;162(2):157-64.)
A Japanese study evaluated 42,000 adults on a Western-style
diet, with high amounts of red meat, poultry, cheese, white
flour, and butter, a Japanese diet, high in some traditional
foods, such as pickled vegetables and salted fish, and a healthy
diet, high in fruits, vegetables, soy, and beans. Colon cancer
was double in both the Western diet and the Japanese traditional
diet compared with the healthy diet. (Kim MK, et al., Dietary
patterns and subsequent colorectal cancer risk by subsite:
a prospective cohort study. Int J Cancer. 2005 Jul 10;115(5):790-8.)
Meat and saturated fats have often been linked to increased
colon cancer risk.
Peel and seed about 3 pounds of butternut squash, and steam
with 3 yams or sweet potatoes until they are all soft. In
olive oil, sauté 2 diced onions, 3 diced large carrots,
a minced, thumb-sized piece of peeled fresh ginger, 4 minced
cloves of garlic, and 1-3 Tbsp of curry powder, depending
on your taste. After browning, add the juice of a half lemon,
1 cup of organic coconut milk (a creamy blend of coconut pulp,
available canned), and a cup of shredded coconut, and lightly
cook these together. Mash the steamed vegetables in the cooking
water, adding extra water as needed, and add the other mixture
to the pot. Simmer this until everything is blended and the
flavors are well mixed. You can add some sea salt to taste
(or just extra lemon if you want to avoid the sodium). You
can use the food processor or blender to make it smoother,
and serve it hot or cold.
drjanson@drjanson.com
Practice phone: 603-878-2256
180 Massachusetts Ave., Suite 303
Arlington, MA 02474
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