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Health Foods in Supermarkets
Skin Protection Update
Oral Supplements for Skin
Exercise Helps the Brain
Ask Dr. J: Gastritis and Drugs
References
In the Health News
Diet and Disease
Recipe of the Month: Millet-Yam-Veg Patties
Dear Friends,
Our local supermarket carries a selection of natural and
organic foods in a separate shelf area of each department,
so their customers have an opportunity to make healthier choices.
Just the availability of these foods in a conventional market
increases health awareness among people who would not otherwise
be exposed to better foods. This is a significant change from
just a few years ago, when it was difficult or impossible
to find whole grains and organic products in a supermarket.
I was pleased to see a flyer published by the market promoting
these foods, and providing educational articles that were
formerly only found in health food stores. This pamphlet covered
a variety of topics, including the antibiotic properties of
goldenseal, the nutritional value of sweet potatoes, cancer
protection from lycopene (in tomatoes and watermelon), the
importance of organic foods (and why they are more expensive),
and why you should avoid tap water (using bottled or filtered
water instead).
While not all of the information in this pamphlet was accurate
(they cautioned against taking vitamin C in doses above 2000
mg per day, which is perfectly safe, recommended cheese pizza
and ice cream as alternative sources of calcium, and sugary
ketchup for lycopene), it is certainly a step in the right
direction, and is one more piece of evidence that healthier
foods are becoming more mainstream. At the same time, health
food stores are growing rapidly and becoming more like supermarkets,
slightly beginning to blur the distinction between the two.
Unfortunately, some of this “blurring” has come
through large health food stores starting to carry more commercial
products with lots of white flour and refined sugar (even
though some of these are organic, they are still not healthful).
I also recently met a colleague in conventional medicine
at a brunch, and he pointed out how “alternative”
medicine is becoming more accepted in mainstream circles.
We both noted the use of glucosamine sulfate and fish oil
by rheumatologists to treat arthritis (he was aware that vets
have been using glucosamine for a long time for horses, and
taking it themselves), and he knew that niacin (vitamin B3)
is effective to lower cholesterol and raise the HDL (good)
cholesterol. While this is encouraging, I still see that there
is a long way to go. Much of the food marketplace (both markets
and restaurants) is still filled with junk masquerading as
food, and most of the medical community has negative feelings
about complementary/alternative/integrative medicine, even
when it is documented in the medical literature.
Unlike my thoughts on these issues 30 years ago, I am now
hopeful that the merging of the best of these worlds will
happen in my lifetime (although that could still mean it is
a long way off).
The skin is our first layer of protection from the elements,
but it needs protection itself from damaging environmental
exposures. I reviewed skin health in July, 2004, but new research
continues to provide information that may further help to
reduce aging and skin disease (important not only for cosmetic
benefits but also for cancer prevention and improved general
health).
Topical application of niacinamide (vitamin B3) to facial
skin can increase elasticity and reduce fine lines, hyperpigmentation,
redness, and poor texture of the skin, which are all signs
of photoaging (ultraviolet damage). In a study on 50 subjects,
researchers applied 5% niacinamide to one side of the face
and a placebo cream to the other to serve as the control.
After 12 weeks of treatment, all of the improvements above
were noted by both observation and instrumental measurements
on the treatment side, but not on the control half of the
face. A 5% cream would have approximately 1500 mg in one ounce.
Adding 3000 mg (the contents of six 500-mg capsules) to a
2-oz tub of natural face cream would provide this concentration.
Earlier studies have shown that topical vitamin C protects
the skin against ultraviolet damage (from both UVA and UVB).
It has now also been shown to help treat photoaging of the
skin. Vitamin C promotes collagen formation, lightens hyperpigmentation,
and reduces inflammation, in addition to its antioxidant protection.
In one six-month, double-blind study, a cream with 5% vitamin
C was applied to skin of the lower neck and arms (areas with
evidence of photoaging) in otherwise healthy female volunteers.
In addition to observation of the skin by both the subjects
and by dermatologists, the researchers did biopsies to determine
the effects of the treatment. The biopsied tissues showed
increased density of the skin, reduced wrinkling, and evidence
of repair of the elastic tissue.
Green tea extracts containing EGCG (epigallo-catechin gallate)
have antioxidant and anti-inflammatory properties. They have
become popular as components of skin creams and as oral supplements.
In a study combining treatment with a cream containing 10%
green tea extract and oral supplements of 300 mg twice a day,
skin biopsies showed improved elastic tissue content. The
study lasted only eight weeks, during which time the benefits
were not visible other than on biopsy. The authors speculated
that longer studies would be needed to show observable benefits.
Another double-blind study last year showed similar results
in reversing skin aging with oral supplements. In 40 subjects,
20 were treated with supplements of alpha-lipoic acid, proantho-cyanidins,
and a mixture of vitamins and minerals, while the other 20
were treated with placebo. Objective measurements of skin
thickness and elasticity showed improvement with active treatment
compared to placebo. Skin roughness and both fine and coarse
wrinkles were also better, based on clinical assessment. In
subjective evaluation by participants, the active treatment
was significantly better.
In a study of a combination of orally administered nutrients,
62 women from 45 to 73 years old were given either the supplements
or a placebo for a total of 12 weeks. Their skin elasticity
was improved after six weeks with the treatment as measured
by optical equipment, and skin roughness was lessened significantly
after 12 weeks. The nutrients included vitamins C and E, carotenoids,
selenium, and zinc, as well as blueberry extract and proanthocyanidins.
Lycopene is a red carotenoid found in tomatoes, watermelon,
red grapefruit, and red navel oranges (watermelon and red
grapefruit have more lycopene than fresh tomatoes). Oral and
topical lycopene protects against UV damage to skin. In a
study of topical application, lycopene reduced skin wrinkling,
redness, and inflammation, and the effect was greater with
higher doses. In a study of oral lycopene, volunteers ingested
10-mg supplements daily, and were tested for redness following
UV irradiation. By week 12, they had a significantly reduced
response to UV light.
Finally, the hormone progesterone helps to reduce skin wrinkling
associated with aging. A controlled study on 40 subjects using
2% progesterone cream showed increased elasticity and firmness
of the skin, and reduced wrinkling around the eyes, nose,
and mouth. Blood levels of the hormone increased during treatment.
Regular exercise, even if only a very modest amount, appears
to help preserve brain function in elderly people. Researchers
recruited 1740 subjects who had normal cognitive function
at 65 years old and followed them for over 6 years, testing
them every two years.
Those subjects who exercised three or more times per week,
had a 38 percent lower risk of developing any form of dementia
(including Alzheimer’s disease and others) compared
to those who exercised fewer than three times per week.
Even walking for just 15 minutes more than three times per
week provides significant benefit. One value of exercise is
the improvement in circulation to the brain (and other tissues),
but it also has other benefits that might play a role in prevention
of brain degeneration. Physical activity helps to control
blood sugar, and this also reduces age-related tissue deterioration.
High sugar levels lead to advanced glycation end products
(AGEs), toxic substances that interfere with blood vessel
and membrane function.
An earlier study showed that physical activity at least twice
a week was protective, reducing non-Alzheimer’s dementia
by 50 percent and Alzheimer’s disease by 60 percent.
This study followed subjects for 21 years, and this level
of benefit is remarkable for such a small change in physical
activity. Of course, higher levels of physical activity have
other benefits, and brain function is also preserved by good
nutrition and dietary supplements (acetyl L-carnitine, alpha-lipoic
acid, coenzyme Q10, vitamin E, N-acetyl cysteine, and ginkgo
biloba among others).
Q. I’m taking Tagamet for gastritis caused by another
medication. Can I do anything instead of the drug to manage
this problem?
ES, via Internet
A. A number of medications can cause gastric upset, including
aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS
such as Motrin, Advil, and Naprosyn). It can also worsen with
exposure to alcohol and caffeine, and the symptoms are often
increased by sugary, fatty fast foods. Gastritis can be associated
with the bacterium, Helicobacter pylori, which causes a majority
of gastric ulcers, so treatment is very important. If Helicobacter
testing is positive, antibiotics are prescribed to eliminate
the bacteria and help prevent ulcers and gastric cancer.
Tagamet reduces stomach acid production, but it may cause
some side effects. Newer antacid drugs, such as Prilosec (the
precursor to Nexium, which is not really any better), Protonix,
and Prevacid work differently, but they also have side effects
(headaches, diarrhea, dry mouth, cough, and abdominal pain).
You can reduce symptoms by improving your diet–-eliminating
junk and eating foods that are low in sugar and fat, and taking
some dietary supplements. For immediate relief, you can chew
tablets of deglycyrrhizinated licorice, or DGL. Mixed with
saliva, this coats the lining of the stomach and esophagus,
protecting it from acid and relieving heartburn. L-glutamine
(1000-6000 mg daily), vitamins C (4000-6000 mg) and E (400-800
IU), N-acetyl cysteine (1000-2000 mg), and zinc (30-50 mg)
also help gastric healing.
Bissett DL, et al., Niacinamide: A B vitamin
that improves aging facial skin appearance. Dermatol Surg.
2005 Jul;31(7 Pt 2):860-5.
Humbert PG, et al., Topical ascorbic acid
on photoaged skin. Clinical, topographical and ultrastructural
evaluation: double-blind study vs. placebo. Exp Dermatol.
2003 Jun;12(3):237-44.
Farris PK, Topical vitamin C: a useful
agent for treating photoaging and other dermatologic conditions.
Dermatol Surg. 2005 Jul;31(7 Pt 2):814-7.
Segger D, Schonlau F, Supplementation with
Evelle improves skin smoothness and elasticity in a double-blind,
placebo-controlled study with 62 women. J Dermatolog Treat.
2004 Jul;15(4):222-6.
Thom E, A randomized, double-blind, placebo-controlled
study on the clinical efficacy of oral treatment with DermaVite
on ageing symptoms of the skin. J Int Med Res. 2005 May-Jun;33(3):267-72.
Chiu AE, et al., Double-blinded, placebo-controlled
trial of green tea extracts in the clinical and histologic
appearance of photoaging skin. Dermatol Surg. 2005 Jul;31(7
Pt 2):855-60.
Fazekas Z, et al., Protective effects of
lycopene against ultraviolet B-induced photodamage. Nutr Cancer.
2003;47(2):181-7.
Aust O, et al., Supplementation with tomato-based
products increases lycopene...[and] protects against UV-light-induced
erythema. Int J Vitam Nutr Res. 2005 Jan;75(1):54-60.
Holzer G, et al., Effects and side-effects
of 2% progesterone cream on the skin of peri- and postmenopausal
women...Br J Dermatol. 2005 Sep;153(3):626-34.
Larson EB, et al., Exercise is associated
with reduced risk for incident dementia among persons 65 years
of age and older. Ann Intern Med. 2006 Jan 17;144(2):73-81.
Rovio S, et al., Leisure-time physical
activity at midlife and the risk of dementia and Alzheimer’s
disease. Lancet Neurol. 2005 Nov;4(11):705-11.
Virmani A, et al., Effects of Metabolic
Modifiers Such as Carnitines, Coenzyme Q10, and PUFAs against
Different Forms of Neurotoxic Insults.... Ann N Y Acad Sci.
2005 Aug;1053:183-91.
a. High cholesterol levels are associated with an increased
risk of developing hypertension. In a study of 3110 men with
no heart disease or hypertension for 14 years, compared to
subjects with the lowest cholesterol, those with the highest
total cholesterol had a 23 percent higher chance of developing
hypertension, and those with the highest cholesterol relative
to the HDL had a 54 percent increased risk. Men with the highest
HDL had a 32 percent lower risk compared to those with the
lowest HDL. (Halperin RO, et al., Dyslipidemia and the risk
of incident hypertension in men. Hypertension. 2006 Jan;47(1):45-50.)
A previous study showed the same association in women.
b. In a study of 64 subjects with chronic, obstructive lung
disease, omega-3 oil supplements (about 3 Tbsp) reduced inflammatory
markers and improved both walking distance and oxygen saturation.
This condition is otherwise difficult to treat. Those given
omega-6 oils showed no change. (Matsuyama W, et al., Effects
of omega-3 polyunsaturated fatty acids on inflammatory markers
in COPD. Chest. 2005 Dec;128(6):3817-27.)
Eating fish helps to preserve brain function. Researchers
evaluating 3718 subjects over 6 years found that those who
ate fish once a week had a 10 percent slower cognitive decline
(gaining about 3 years of brain preservation) while those
who ate fish twice or more per week gained about 4 years (13
percent slower decline). It was not clear whether it was from
the omega-3 oils in fish or because eating fish reduced consumption
of meat and saturated fat. However, based on other data, the
researchers speculated that the result was likely due to the
essential fatty acids. (Morris MC, et al., Fish consumption
and cognitive decline with age in a large community study.
Arch Neurol. 2005 Dec;62(12):1849-53.
Bake a medium yam until tender (about 1 hour). Mix 1 cup of
millet in 3 cups of water in a saucepan and bring to a boil,
add 1 Tbsp of tamari soy sauce, then simmer until the water
is absorbed (about 25 minutes). Finely mince 1 large onion
and 2 cloves of garlic, and sauté in olive oil with
freshly ground black pepper and 1/2 tsp of thyme. Mince a
green, such as arugula or spinach, add 1 cup to the onions
when they are brown, and mix well. Mash this all together
with the millet and the yam until they are well mixed. Form
patties that are about 1/2 to 3/4 inch thick. It should make
about six patties. Place them in a skillet with a small amount
of olive oil, and pan fry them until the surfaces are just
crisp. You can vary this by using curry powder and cumin,
or you can use oregano for a different flavor. They can be
served as a side dish or as a main dish with a salad.
drjanson@drjanson.com
Practice phone: 603-878-2256
180 Massachusetts Ave., Suite 303
Arlington, MA 02474
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