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2001 updates
2000 updates
 October,
1998- The interpretation and hyperbole that you see when medical
research is reported and when American health habits are revealed
constantly intrigue me. For example, a Dr. Scalia of Australia
reported data from the Study of CoEnzyme Q10 Randomized for
the Treatment for Congestive Heart Failure (SCORCH), which
was sponsored by the Cleveland Clinic. The headline on the
wire service read: "CoEnzyme Q10 not effective in treatment
of congestive heart failure." And just what did the study
show? Well, it turns out 31 patients with severe left ventricular
dysfunction were divided into two groups. One of the groups
received coenzyme Q10 at 100 mg per day, and the other only
a placebo. Oh, except for one detail-both groups were put
on maximal drug therapy! All were on ACE inhibitors, nearly
all had received furosemide, 76% had received hydralazine
and 82% were on digoxin. The authors concluded that the coenzyme
has no role in the current era of "...maximal medical
therapy..." for CHF. What they're really saying is that
if you are willing to risk the side effects and expense of
maximal medications, then coenzyme Q10 may not provide any
further benefit.
You might think that the conclusion should really be: "In
the face of overwhelming drug therapy, coenzyme Q10 may not
add any further benefits, but we haven't a clue from this
study whether coenzyme Q10 helps congestive heart failure
(even though we know from many other studies that it does)."
That is the proper headline, but of course that does not promote
the drug therapies. Proper health care would be to give maximal
coenzyme Q10 and if the response is inadequate add some medications
(or vitamin E, vitamin C, taurine, magnesium, chelation therapy…etc.).
The patient might well do with far less medication.
October 1998- Two new studies shows again the value of
a whole-food, plant-based diet. Whole grains may protect
against chronic disease because of their nutrient density
and high fiber content. The medical literature consistently
shows lower cancer risk in those people with higher whole-grain
intake. The overall likelihood of cancer was only 66 percent
in those people with high compared to those with low whole
grain intake.
The lower risk held true for colorectal cancers and polyps,
gastric and other digestive tract cancers, endometrial and
other hormone-related cancers, pancreatic cancer, and other
cancers.
The second study shows that high intake of whole grain foods
consistently reduced risk of neoplasm at all sites, except
thyroid.
Jacobs DR Jr, et al., Whole-grain intake and cancer: an expanded
review and meta-analysis. Nutr Cancer 1998;30(2):85-96
Chatenoud L, et al. Whole grain food intake and cancer risk.
Int J Cancer 1998 Jul 3;77(1):24-8
November 1998- Magnesium in the treatment of PMS.
Researchers administered 200 mg of magnesium oxide for two
menstrual cycles and found a significant difference in weight
gain, swelling of extremities, breast tenderness, and abdominal
bloating in the second month. J Womens Health 1998
Nov;7(9):1157-65). The effects were highly significant, but
only on these four symptoms of the 22 that they evaluated.
The authors noted that they would like to see the effects
of higher doses on patients with more severe symptoms. (They
might also try a better-absorbed form of magnesium and combine
it with vitamins B6 and E and some essential fatty acids and
herbs.)
November 1998-Cardiologist reports the dangers of stents.
At the American Heart Association meeting on interventional
cardiology in Dallas (November 8-11), Dr. James E Tcheng (Associate
Professor at Duke University Medical Center) said, "For
those of you who think that stent implantation is the ‘end
all and be all,’ because it creates a perfect environment
that cannot support a thrombus, I would suggest that [assumption]
is wrong…What we are doing [with intervention] is creating
heart attacks…whenever you are blowing up a balloon in
a patient’s artery, activating a rotablator, turning
on a laser, etc, you are causing damage to the inside of the
vessel…This sets your patient up for platelet adhesion
and aggregation, vasoactive substance release, thrombus formation
and the potential for abrupt closure and development of acute
ischemic syndrome."
December 1998- Antioxidants reduce cancer risk. In
women with human papillomavirus infection, antioxidants appear
to lower the risk of developing cervical intraepithelial neoplasia.
Researchers at the Albert Einstein College of Medicine in
New York found that high serum levels of vitamin E and vitamin
C conferred protection against these neoplasias. There was
a threshold for vitamin C, which did not show the benefits
unless the blood levels were very high, whereas the vitamin
E levels were inversely correlated in a linear fashion. Int
J Cancer 1998;78:594-599.
December 1998- Leg cramps helped by B-complex vitamins.
A report from Taiwan researchers shows that B-complex vitamins
can treat nocturnal leg cramps as effectively as quinine in
hypertensive elderly patients. The supplements included: fursulthiamine,
50 mg; hydroxocobalamin, 250 micrograms; pyridoxal phosphate,
30 mg; and riboflavin, 5 mg, and were compared with a placebo.
After 3 months, 86% of the treatment group had significant
remission of symptoms. The authors suggested that due to significant
side effects from quinine, the B-vitamins should perhaps be
considered the treatment of choice. Chan P, et al., J Clin
Pharmacol 1998;38:1151-1154.
February 1999- Diet, exercise and gallstones. A recent
report from Italy in the American Journal of Clinical Nutrition
shows that a high body mass index, a high intake of refined
sugar, and high levels of saturated fat in the diet all contribute
to the risk of gallstones. On the other hand, exercise, high
intake of monounsaturated fats, and a high intake of insoluble
fiber all decreased the risk of developing gallstones. Curiously,
cholesterol in the diet was also inversely associated with
gallstones, suggesting it is animal fat, not cholesterol itself
that is the problem. The difficulty is how to have cholesterol
in the diet without animal fat. Trevisan M, et al., Am
J Clin Nutr 1999;69:120-126.
February 1999- Diet and heart disease. A French study,
The Lyon Diet Heart Study, has once again shown that a diet
rich in fruits, vegetables, grains, beans, and fish dramatically
reduces heart disease. As reported in Reuters Medical News,
the "...rate of cardiac death and nonfatal infarction
in the experimental group after 46 months (1.24 per hundred
patients per year) is similar to that observed after 27 months
(1.32). The rate in control subjects was 4.07 after 46 months,
whereas it was 5.55 after 27 months." These results were
even more striking than the evaluation at 27 months. In other
words, the rate of heart disease was less than 25% that of
the control group. And what were they eating in that control
group? -- a "prudent Western-type diet." Makes you
wonder what is "prudent" about it. deLorgeril M,
et al., Circulation 1999;99:779-785,733-735.
March 1999- Heart disease in youth. Dr. Jack Strong
of LSU, reports that atherosclerosis begins as young as age
15. He and a multicenter team of the Pathobiological Determinants
of Atherosclerosis in Youth study (JAMA 1999;281:727-735)
found atherosclerotic lesions in even the youngest subjects,
aged 15 to 19 years. They noted intimal lesions in 100% of
the aortas and more than 50% of the right coronary arteries,
and they worsened with age. It is clear that we must start
lifestyle modifications as early as possible. These problems
are not genetic; intervention must start with the parents
and the schools. It will not help to have fast-food joints
catering in those schools.
March 1999- Meat, iron and heart deaths. A diet that
is high in heme iron, found mainly in meat and meat products,
leads to more myocardial infarctions, and especially more
fatal MIs, than a diet that is low in heme iron. In fact,
the risk was nearly double. It appears that fat in meat is
not the only danger. (Am J Epidemiol 1999;149:421-8.)
March 1999- Whole grains lower mortality. A recent
report from the Iowa Women's Health Study (Am J Public
Health 1999;89:322-329) showed that older women who eat
at least one serving of whole grain food per day are at "substantially
lower risk" of dying from cancer, cardiovascular disease
and other causes than women who do not. Overall mortality
was 15 percent lower for older women who regularly consumed
whole grains compared to those who did not. For refined grains
the opposite was true. Although there are proponents of low
carbohydrate diets, evidence continues to accumulate that
the staples of the healthiest diets consist of vegetables,
grains, legumes, fruits, nuts, and seeds.
April 1999- Exercise helps even if you don't lose weight.
A new study at the Cooper Institute with colleagues at the
University of Houston has shown that even obese men will benefit
from cardiovascular fitness exercise, in spite of their remaining
obese (Am J Clin Nutr 1999;69:373-380). Fitness itself,
independent of weight loss, was the key to decreased mortality
from cardiovascular disease and from all causes. Of course,
it is much less likely that obese people will be exercisers,
but for those who do they can feel good about what they are
doing even if they are not losing weight. They can be encouraged
to continue or start their fitness training, knowing that
they are receiving benefit regardless of their weight. Of
course, exercise is one of the important components of a weight
loss program. .
April 1999- More scientific support for vegetables.
Another article supports the value of vegetables in the diet
(Am J Clin Nutr 1999;69:712-718). Tomatoes, once feared
as a poisonous fruit, contain the carotenoid lycopene. This
study, from researchers at the University of Milan and colleagues
in Connecticut, shows that lycopene can protect immune function
by protecting DNA in lymphocytes from oxidative damage. After
21 days on tomato puree, compared to a control group who ate
no tomatoes during that time, the plasma lycopene level went
up in the study group, and exposure of their lymphocytes to
hydrogen peroxide did markedly less damage than it did to
the controls' cells. Tomatoes have already been associated
with decreased risk of prostate cancer. Lycopene is abundant
in the retina, and it is considered a possible protection
against macular degeneration.
April 1999- Vitamin E prevents strokes. At the annual
meeting of the American Academy of Neurology, researchers
reported that higher intake of vitamin E, primarily from supplements,
could significantly reduce the risk of strokes by 53 percent.
The mean total vitamin E intake of 27 IU per day for stroke
patients was significantly lower than that of nonstroke subjects,
whose mean total daily intake was 58 IU a day. These are relatively
modest levels of vitamin E intake, but far more than the recommended
amount of 15 IU daily. This information is in accord with
the data showing that vitamin E prevents other ischemic diseases,
specifically heart disease.
June 1999- Parathyroid hormone reduces osteoporosis.
Parathyroid hormone added to estrogen supplements restores
bone mass to normal levels in nearly two thirds of postmenopausal
women with osteoporosis, according to the results of the first
placebo-controlled study of parathyroid therapy in this population.
The women on estrogen alone had a 1.5 percent increase in
bone density in two years, but those who added injections
of parathormone had an 11 percent increase in bone mass. (Roe
B, Report at The Endocrine Society meeting, San Diego). This
is significant for another reason -- chelation therapy stimulates
a parathyroid hormone release, and this may be the explanation
for the increased bone density seen in many chelation patients
(they are usually treated with chelation for cardiovascular
disease).
October 1998- In a news report, The Center for Science
in the Public Interest suggested that American youths are
consuming far too many soda pop beverages. Among 12- to
19-year-olds, boys consume 868 cans a year, and girls drink
628 sodas a year. We all know that what CSPI calls "candy
in a can," or "liquid candy," is harmful, and
health problems are the inevitable result.
The National Soft Drink Association called their product
"perfectly safe and enjoyable," but many physicians
and consumer groups note that they can increase the risk of
developing heart and kidney trouble, obesity and tooth decay.
Gene Grabowski of the Grocery Manufacturers of America responded
(perhaps with some commercial bias) that "They won't
be happy until they squeeze every bit of sweetness and joy
out of life it seems." What disturbs me is his equating
sweetness with joy. This insidious concept compounds the obsession
for dietary junk (think of the American average of two doughnuts
a day!). It would be far better to equate joy with health
and vitality, and not relate it to the consumption of junk.
As physicians, we have a tough job countering that kind of
propaganda.
October 1998 - Flavonoids are plant pigments that have
a variety of nutritional and health benefits. They are
often the active substances in therapeutic herbs. They are
a good reason to eat a variety of vegetables and fruits in
the diet, especially the most colorful selections. A new report
confirms what many nutritionally oriented doctors have been
saying for many years.
A Dr. John Folts and colleagues reported at a meeting of
the American Dietetics Association that a mixture of flavonoids
are better than aspirin in reducing the risk of heart attack
by lowering the stickiness of your platelets. If the platelets
are too active, the risk of blood clots in the arteries increases.
Flavonoids inhibit the platelet activity by two mechanisms,
compared to only one for aspirin, and without the risk of
bleeding or other side effects such as ulcers. The flavonoid
supplement that Dr. Folts used consists of extracts of grape
seed, grape skin, bilberries and Ginkgo biloba plus quercetin,
in a simple supplement of 20 milligrams per kilogram of body
weight. This works out to about 1400 mg per day for a typical
man.
February 1999- FDA Loses in court. In a six-year long
suit brought by the American Preventive Medical Association,
Citizens for Health, and Durk pearson and Sandy Shaw, the
Federal Appeals Court ruled against the FDA, and ordered them
to allow disclaimers on dietary supplement labels, and required
them to define what they mean by "significant scientific
agreement." In the past, the FDA would disallow any health
claims on supplement labels, claiming that there was not significant
scientific agreement for the claim, without ever having to
define what they meant. This allowed them to make arbitrary
decisions to reject health claims, which has always been their
policy. Now they cannot do that. As the court pointed out,
"...the FDA appears quite reluctant to approve health
claims on dietary supplements; only two are currently authorized."
The court claimed that the FDA rules violated the First Amendment
to the Constitution, which allows free speech. APMA Attorney
Jonathan Emord stated "This decision invalidates the
FDA's entire review regime for labeling claims on the basis
that it is unconstitutional, arbitrary and capricious."
APMA president Dr. Ralph Miranda said, "...dietary supplement
companies have been afraid to challenge this agency for fear
of retaliation...the FDA will no longer be able to get away
with continually raising the bar for supplement manufacturers
in an effort to prohibit the dissemination of truthful, scientific
information."
February 1999- American Heart Association still negative
about vitamins. In spite of the fact that antioxidant
vitamins can reduce the recurrence of heart disease, and despite
the fact that they are extremely safe and that most cardiologists
are now favorable toward the use of antioxidants, the AHA
still is reluctant to endorse them for prevention. (Tribble
DL, Circulation 1999;99:591-595) They are not happy with the
quality of the studies, they say, but talk to cardiologists
and you will likely find that they are taking antioxidants
themselves. The message is clear. Don't listen to the AHA
for advice on supplements. Adequate studies for them won't
be in until after many people die unnecessarily. Take your
vitamins C and E and natural carotenoids, as well as a comprehensive
multi-vitamin/mineral supplement.
March 1999- Smokers deny risks. Tobacco smokers are
surprisingly unwilling to accept the risks that they face.
Two thirds of them claim that they are not at an increased
risk of cancer or heart disease. (JAMA 1999;281:1019-1021.)
I suppose in spite of the enormous amount of information available
to the public on risks, a tobacco addict is always able to
rationalize their habit. As they say, denial is not a river
in Egypt.
March 1999- Agricultural chemicals increase cancer risk.
Exposure to agricultural fungicides increased the risk of
non-Hodgkin's lymphoma by a factor of 3.7. Exposure to any
type of herbicide increased the risk of non-Hodgkin's lymphoma
by 60%. The risk was more than doubled for men exposed to
either of two particular herbicides, glyphosate or 4-chloro-2-methyl
phenoxyacetic acid. Cancer 1999; 85:1353-1360. This
is just more evidence that organic (biodynamic) agriculture
is the safest. It is important for the health of farmers as
well as consumers. Choosing organic foods in the marketplace
will help your health, and it will encourage your market to
support organic growers.
April 1999- Cruciferous vegetables prevent cancer.
In a report in the Journal of the National Cancer Institute
(J Natl Cancer Inst 1999;91:605-613), cruciferous vegetables
were shown to reduce the risk of bladder cancer in men. This
food family includes broccoli, cabbage, and brussels sprouts.
This particular report showed that this benefit was independent
of the total intake of fruits and vegetables. The data were
gathered as part of the Health Professionals Follow-up Study
at the Harvard School of Public Health. Cruciferous vegetables
(and many others) are consistently being proven helpful in
preventing cancer and other diseases. There is no substitute
for eating a wide range of vegetables, fruits, whole grains
and beans in the diet, as they are consistently being reported
as helpful in prevention. Of course, it is also helpful to
take many dietary supplements in addition to your healthy
diet, but they are really supplements, not substitutes for
eating well.
April 1999- Another nail in tobacco's coffin (or a smoker's?).
Smoking cigars and pipes increases an individual's risk of
developing lung cancer almost as much as cigarette smoking
does, a European study suggests. (J Natl Cancer Inst
1999 April 21;91:660-661,697-701.) Those who smoke cigars,
cigarillos or a combination of the two are nine times more
likely to develop lung cancer than nonsmokers, and pipe smokers
have nearly eight times the risk. Cigarette smokers have almost
15 times the risk of lung cancer compared to nonsmokers. This
is particularly troubling because of the recent rise in the
popularity of cigar smoking among sports figures and the acting
crowd, as though this is glamorous. They seem oblivious of
the risks of smoking, with the mistaken belief that cigars
are safer -- in spite of the known risks of oral cancer, and
these newly reported risks.
May 1999- B6 for premenstrual symptoms. Vitamin B6
(pyridoxine) is helpful for premenstrual symptoms, and this
has recently been confirmed in a review of nine studies of
more than 900 women. Doses of B6 in the range of 50-100 mg
daily were helpful in relieving depression associated with
PMS without side effects. However, the authors were hesitant
to make definitive recommendations until larger studies are
done. (British Medical Journal 1999:318:1375-1381).
May 1999- Fish oil helps depression. In a study of
omega-3 fatty acids derived from fish, researchers showed
that depression could be reduced in patients with manic-depressive
illness (bipolar disorder) with supplements. Improvement was
significantly greater in the omega-3 fatty acid group than
the control group on almost every assessment measure. (Arch
Gen Psychiatry 1999;56: 407-412, 413-414, 415-416). The
authors commented that the study was important for several
reasons, not the least of which was the high patient interest
in the natural treatment.
June 1999- Soy and red clover isoflavones have health
benefits. Research findings presented at the Endocrine
Society meeting in June showed that dietary supplementation
with isoflavones, which are known to have estrogenic activity,
may relieve menopausal symptoms and reduce the risk of osteoporosis
and cardiovascular disease in postmenopausal women. The researchers
reported on the effects of red clover derivatives and soy
products. They found them to be a good alternative for women
who cannot or do not want to take estrogen (or are enlightened
enough to know that they would be better off without it),
and the isoflavones had no side effects. The daily intake
of isoflavones ranged from 40-60 mg, and with the soy study
they noted that after just three months, there were significant
reductions in bone resorption, increases in bone formation,
antioxidant effects, and improvement of HDL cholesterol levels
and the ratio of HDL to total cholesterol.
This means eat your tofu, tempeh, soy nuts, soy milk, and
clover sprouts.
July 1999- Vitamin E and eye disease in diabetics.
High doses of vitamin E have been shown to be helpful in diabetic
retinopathy. This is a degenerative eye disorder due to reduced
blood flow in the highly vascular retina. Kidney function
was also improved, probably for the same reason -- that vitamin
E improves small artery function, and the kidney is also rich
in such vessels. The researchers used 1800 IU of vitamin E,
but if you take a variety of other supplements, such as vitamin
C, bilberry, carotenoids, and ginkgo, you probably do not
need such a high dose of vitamin E to get results. (Diabetes
Care 1999;22:1245-1251.)
September 1999- Vegetarian diet helps diabetes. A
new study in diabetics shows that vegetarian diets improve
sugar control. Contrary to many of the recently touted high
protein diets, this diet is high in fiber and complex carbohydrates.
Those who adhered to the vegan diet (no animal products at
all) lost more weight (twice as much during the twelve weeks
of the study) and more than twice the reduction in sugar levels.
(Prev Med 1999;29:87-91)
drjanson@drjanson.com
Year-round phone: 386-409-7747
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