"Integrative Health Education " Newsletter

Dr. Hugo Rodier publishes a monthly newsletter on the latest integrative medicine news and information. Dr. Rodier researches of over 150 medical journals each month to provide his readers top scientific information for optimal health. The newsletter does not sell any products.

INTEGRATIVE HEALTH EDUCATION

A Monthly Review of 150 Medical Journals

 

Volume 9 Number 4 April-May 2008 

 

EDITOR’S NOTE 

 It’s been a while since I wrote about the problem with the ‘calories in = calories out” paradigm. In light of recent discoveries about how we process food in the intestines, I wish to revisit this issue. In my view, this worn out paradigm needs to be “flushed down the toilet,” literally, as you will see. Perhaps you remember the articles I have previously reported herein on how our intestinal flora modulates our metabolism, influences the amount of calories we extract from food and even sends signals to our brains to talk us into continually feeding them (the organisms dwelling in our gut) the processed foods rich in chocolate and refined sugars we got them addicted to. Naturally, they turn around and demand that we keep that kind of diet up: now them and us are addicted to bad foods.
            There is another reason why we need to abandon the “calories in = calories out” dogma: it never worked.
            The evidence to change these old paradigms has been around for a while, yet, some still profess that there is no such evidence. Soon, the weight of scientific inquiry will be too large to ignore, especially when the NIH awarded 122 grants to nutrition-related investigations, out of 236 grants in 2007 (http://nccam.nih.gov/research/extramural/awards/2007.)

Hugo Rodier, M.D.

Who governs whom?

            Do we control our intestinal flora, or do they control us? Let us astart considering the question by remembering that most of the genetic material within our body is theirs, not ours. Now, read the highlights from this great review article, “Gut Microbiota and Its Possible Relationship with Obesity” (J. Mayo Clinic Proceedings 2008;83:460.)

·        Mice raised on regular food have 40% higher body fat and 47% more gonadal fat content than germ-free mice, even though they consumed less food than their germ-free counterparts. The distal gut microbiota from the [fat] mice was then transplanted into the germ-free mice, resulting in a 60% increase in body fat within 2 weeks without any increase in food consumption or obvious differences in energy expenditure.”

·        Microbiota promotes absorption of monosaccharides, fermentation of indigestible polysaccharides and short-chain fatty acids; also, regulation of genes that promote deposition of fat in lipocytes.

·        Gut microbiota can affect both sides of the energy balance equation, influencing energy harvest from dietary substances and affecting genes that regulate how energy is expended and stored.”

·        “…More end products of fermentation (acetate, butyrate,) and fewer calories in the feces of the obese mice, leading them to speculate that the gut microbiota in these mice facilitate the extraction of additional calories from ingested food…[this] suggests that differences in caloric extraction of ingested food substances may be determined by the composition of the gut microbiota.”

·        Inflammation seen in metabolic syndrome likely related to intestinal microbiota and its effect on high fat diets. Chronic imbalances in microbiota (endotoxemia) have been associated with insulin resistance, diabetes and obesity. Endotoxemia raises levels of inflammatory markers like cytokines, interleukins and TNF.

·        Polymyxin B, an antibiotic active against gram negative organisms in the gut has been shown to reduce fatty liver and IR. Antibiotic Rx decreases the incidence and delayed the onset of diabetes in a diabetes-prone rat model. These rats had less bacteroides, which reduced inflammation of pancreas and cell membranes.

·        Healthy gut organisms (bacteroidetes) increase to 15% of total organisms, up from 3%, when people lose weight by treating the firmicutes, or bacteria associated with weight gain.

·        Methanogenic Archaea, or gut organisms that produce methane, also increase the extraction of calories frrm consumed polysaccharides.

·        Prebiotics (fiber) improve microbiota, thus reducing insulin resistance and metabolic problems by improving processing of food in intestines.

·        Probiotics (friendly bacteria in capsules) resulted in distinct changes in the microbiome with associated metabolic alterations in a variety of tissues affecting energy, lipid, and amino acid metabolism.”

·        The authors feel that “genetic tendencies are more important than diet, age, and lifestyles in determining the composition of the gut microbiota.” I am not sure I totally agree. But, their statement is understandable in light of their extraordinary findings. They are putting great emphasis on their research, which points to a radical departing from established dogma. If I knew how much they understand nutrition and probiotics, I could judge their statement more accurately. In my opinion, they may not have studied the field of nutrigenomics, or cutting edge research in food sciences. Take a look at the next article…

Genes are not all they are cracked up to be

After Mendel and the discovery of DNA we fell in love with the exciting world of genetics, with good reason. But, we may have gone too far, swinging too much to the other side, thus placing genes on an unreachable pedestal. Without intending to de-throne genetics, let’s consider this article, which attempts to restore balance. Simply put, genes have no function, nor influence on our body, until they are copied into functional messages or glycoproteins. This process, called “epigenetics,” is heavily influenced by the food we eat, our environment, and in my opinion, our heart, relationships, emotions and thoughts. Here are the highlights of the article “Epigenetics, a Window on Gene Dysregulation, Disease” (JAMA 2008;299:1249.)

  • Environmental, nutritional signals can increase risk of disease, cancer.
  • Epigenetic changes happen in gestation, neonatal, puberty and old age.
  • Mother’s nutrition during pregnancy can permanently change the epigenetic programming of her offspring.”
  • Maternal supplementation of yellow agouti mice with compounds like folic or genistein during pregnancy blocked the negative effects (DNA hypomethylation) of bisphenol A on th epigenome of the offspring.”
  • Epigenetics at the Epicenter of Modern Medicine” (JAMA 2008;299:1345.) This companion article highlights what the cover issue of the journal Discover reported on last November. Basically, a lack of B vitamins undermines the process of methylation of DNA and Liver detoxification, increasing our chances of developing certain cancers, like colon cancer.
  • Finally, the Cover issue of the J. Science December 21st, 2007 reported the

            “Breakthrough of the year: human genetic variation.”

Back to the intestines

            Every year, about 100,000 people die due to pharmaceutical issues. Most of them succumb to the side effects of anti inflammatory drugs for pain. Here is an article that sheds some light on this serious problem, “NSAID-induced intestinal damage: are luminal bacteria the therapeutic target?” (J. Gut 2008:57:145.)

·        Antibiotics like tetracycline, kanamycin, metronidazole, neomycin attenuate NSAIDs intestinal damage. Why? Could it be that they are working on the intestinal flora? Sulfasalazine, steroids immunosupressive compounds for Chron’s and Ulcerative Colitis may be doing the same thing.

·        Bacterial-host interaction increases cytokine expression, or a tendency to inflammation. Therefore, NSAIDs damage may be due to antibacterial action

·        Probiotics could prevent the problem!

·        Antibiotics may be used cyclically to eliminate certain bacterial populations, followed by exogenous probiotics to fill the open ecologic niche, thereby improving the balance of enteric microbiota for long term efficacy. The availability of specific means to modulate innate immune system is likely to break the link between anti-inflammatory activity and intestinal toxicity of NSAIDs.”

·        Numerous other articles have been herein reported to document why carefully chosen antibiotics are therapeutic to alleviate many conditions that originate from an imbalance of intestinal flora. Visit the archives newsletters for more information.

Apigenin,” J. Skin & Allergy News, March 2008, page 32

  • It’s a flavonoid found in herbs (endine, clove, chamomile,) apples, cherries, grapes, tea, wine, beans, broccoli, celery, leeks, onions, barley, parsley and tomatoes. It has these beneficial actions:
  • Chemopreventive, J. Pharm Sci 1997;86L721
  • Anti inflammatory, J. Skin Pharm Appl Skin Physiol 2001;14:373
  • Antispasmodic, anxiolytic, J. Planta Med 1995;61:213

Still scared?

Living in America, we are familiar with fear mongering as a tool to influence public opinion. Sadly, this is a technique as old as the hills and it does not spare medical practice. As previously reported in a commentary published in the JAMA, the “Myth of Osteoporosis” (book) is well entrenched. Here is another article fearlessly addressing this problem, “Drugs for pre-osteoporosis: prevention or disease mongering?” (British Medical Journal 2008:336:126.)

·        An already controversial condition, osteopenia, or thinning bones before they develop osteoporosis, has been expanded to increase the market for drugs.

·        The cut-off values for bone density “somewhat arbitrary” according to original WHO statement in 1994. Those values were intended for epidemiologic studies, not for clinical treatment.

·        Treating those at risk of being at risk?... Impressive sounding reductions in relative risk can mask much smaller reductions in absolute risk.” A 75% reduction of relative risk by raloxifene translates into 0.9% reduction of absolute risk. The true incidence of fractures is less than 1% a year: this influences the results as above, when risk is overstated.

·        We need to treat 270 women for 3 years to prevent one vertebral fracture

·        Focus on vertebral fractures, not hip fractures. 2/3 of vertebral fractures are subclinical. Meaning we are not even aware they happen, until we notice that we are getting shorter.

·        The side effects of these drugs are played down: diarrhea, GERD, more vascular, neurologic and lab abnormalities. More venous thrombosis or clots are seen with raloxifene. Osteonecrosis, or rotting of the jaw has been reported.

·        Analysis of data done mostly by docs with ties to drug companies

·        Shifting the focus in fracture prevention from osteoporosis to falls” (British Medical Journal 2008;337:124) is an article published along side this one. It reports that over 80% of fractures are seen with no osteoporosis at all…

Bromelain,” J. Skin and Allergy News, February 2008, page 34

·        Proteolytic enzyme from the stem of the pineapple. It is absorbed by white cells which enhances enzymatic activity (J. Derm Therapy 2003;16:106.)

·        Activity: anti inflammatory, fibrinolytic, skin debridement; inhibits platelet aggregation, and growth of malignant cells (J. Ethnopharmacology 1988;22:191, J. Cell Mol Life Sci 2001;58:1234.) Anti inflammatory activity through modulation of arachidonic acid cascade (J. Ethnopharmacology 1988;222;191,) which reduces capillary permeability (J. Med Hypothesis 1980:6:99.) All this translates into a very practical application: bruise reduction after trauma of any kind.

·        Bromelain reduces edema, bruising, pain, and healing time after dental surgery. Recommended before and after surgery (J. Dental Med 1965;20:51, J. Skin Therapy Letters 2000;5:1.)

·        Less swelling after long bone fracture surgery, J. Acta Chir Orthop Traumatol Chech 2001;68:45.

·        Bromelain potentiates antibiotic action in Rx of bronchitis, sinusitis, pyelonephritis and wounds. It also helps Rx of angina, thrombophlebitis (J. Altern Med Rev 1998;3:302.)

·        It inhibits growth of tumors in animals (J. Planta Med 1990;56:249) because it has imunomodulatory activity (J. Cell Mo Life Sci 2001;58:1234.)

Drinking toilet water, like Fido

      We all get grossed out when we catch out doggie drinking out of the toilet. Well, we may not be able to “cast the first stone…” An AP study (Salt Lake Tribune, March 10-12th, 2008) reported that many drugs we discard from our body after we have ingested them are found in our sewage, since most drugs are used or metabolized only 80%. The rest is flushed down the toilet. Antibiotics, antidepressants, anxiolitics, anticonvulsants and hormones are now found in the drinking water of 41 million Americans. Drugs like prozac and prematin and even xanax for anxiety. So, if all makes you anxious, drink more water…

      About 24 major metropolitan areas were involved in this study. Previously no tests have been available to look for the problem, which is still the case in many cities. The EPA doesn’t know what to make of the problem. Philadelphia had 56 types of drugs in its potable water, but studies like this are rarely made available to public. There are no national standards to look into this problem

      Most fish are now hermaphrodites. They swim in waters where 10+ pharmaceuticals have been detected. Every bluegill, black crappie and channel catfish had levels of antidepressants tested. A few parts per million of these drugs may or may not be a problem, but we don’t know for sure, or do we? Previously, you have read about endocrine problems triggered by toxins in the environment… You be the judge, for now.

      As always, rather than get scared about environmental problems, resolve to eat a very good diet, so that you reduce the levels of these toxins, not only by avoiding them, (water filters don’t help this problem,) but by revving up your detoxification pathways.

Telegraphed articles

Neurologic and psychiatric manifestations of gluten sensitivity,”

            J. Pediatric 2008:152:244

Metal chelation and inhibition of bacterial growth in tissue abscesses,”

            J. Science 2008:319:962

Soy protein isolate reduces biomarkers of prostate cancer

            J. Nutrition and Cancer 2008:60:7

Citrus flavonoids inhibit oral cancers

            J. Nutrition and Cancer 2008:60:69

Mushroom ganoderma lucidum has apoptotic effect on premalignant urothelial cells

            J. Nutrition and Cancer 2008:60:109

Mango extract and lupeol has apoptotic effect on mouse prostate cancer

            J. Nutrition and Cancer 2008:60:120

Broccoli extract (sulpharane) may help reduce UV skin damage

            JAMA 2007;298:2731

No negative effects on prostate safety were detected with testosterone treatment in men

            JAMA 2008;299:39

Exercise May Boost Aging Immune System,”

JAMA 2008;299:160

Tonsillectomies are not beneficial in mild-moderate abcesses

            J. Archives Otolaryngology-Head & Neck Surgery 2007;133:1083

Low vitamin E associated with decline in physical function in the elderly

            JAMA 2008;299:308  

 

                   INTEGRATIVE HEALTH EDUCATION

             A monthly review of 150 medical journals

 

                                        Volume 9 Number 3 March 2008                                 

                                                        EDITOR’S NOTE 

 

There were a series of articles in the newspapers recently linking excessive insulin production (from too many twinkies) to more rings around the waist and more strokes in women. Also, mammograms on women who have insulin resistance tend to show poor arterial circulation, which is also associated with a higher risk of strokes. At the same time, an article in the Salt Lake Tribune reported that a lot of docs are afraid to tell women they are obese. A fat patient seems to be an emotionally charged situation for all involved.

 

In my opinion, this problem goes away when a doctor emphasizes insulin resistance and all its nefarious consequences, instead of someone’s weight. Insulin resistance encompasses practically all diseases.

 

I tell patients to stop weighing themselves, throw away the scale and focus on measuring their waist. They concentrate on reversing insulin resistance, and thus they avoid becoming diabetic within 5 years. Soon, they not only shrink their waist size, but they see their blood pressure drop, cholesterol normalize, migraines go away, the need for anti-inflammatory drugs disappear, etc.

 

Overcoming insulin resistance by facing their addiction to refined sugars and getting off medications that only address the symptoms, not the root-cause, becomes such a consuming goal (if the doctor takes the time to teach and motivate) that the obesity issue is quickly diffused. Of course, patients cheat: they still weigh themselves, but they are no longer obsessed, nor do they micromanage calories. In fact, I tell them to forget about counting calories, eat all they want (provided is not refined food of any kind,) and avoid being hungry.

 

They key to this approach? Get the patient to face his/her refined sugar addiction, understand the public health dynamics that result in our whole society being addicted, and resolve to regain control of their lives. For more details, read my book “Sweet Death.” (www.naturestools.com.)

 

Gastric Bypass Surgery

 

Sweet death is becoming such a problem that now these surgeries are being recommended to children (J. Pediatric and Adolescent Surgery, February 2007.) Before we rush into this procedure, it would be wise to try less aggressive treatments or at least improve the surgery techniques. As it is now, 2% of people die within the first 30 days after surgery, 2.8% within 90 days, 4.6% within the first year (JAMA 2005;294:1861) and 40% of people have complications (Agency for Health Care Research and Quality, branch of Public Health Service, July 23rd, 2006).

 

I have no hard evidence, but, in my experience, most patients who have this surgery end up regaining their weight. Could it be that these patients don’t learn to face and overcome their addiction to sugar? Many of them do find new addictions, like gambling, compulsory shopping, alcoholism and smoking. Some of them even “outfox the procedure by taking in calories in liquid form” (New York Times Magazine, November 18th, 2007.)                      

 

Bromelain,” J. Skin and Allergy News, February 2008, page 34

 

Bromelain is a proteolytic enzyme from the stem of the pineapple. It is absorbed by white cells which enhances enzymatic activity (J. Derm Therapy 2003;16:106). Other actions include anti-inflammation, fibrinolysis, skin debridement, inhibition of platelet aggregation, and growth of malignant cells (J. Ethnopharmacology 1988;22:191, J. Cell Mol Life Sci 2001;58:1234). Anti-inflammatory activity is seen through modulation of arachidonic acid cascade (J. Ethnopharmacology 1988;222;191) which reduces capillary permeability (J. Med Hypothesis 1980:6:99). All this translates into a very practical application: bruise reduction after trauma of any kind.

 

Bromelain reduces edema, bruising, pain, and healing time after dental surgery. It is recommended before and after surgery (J. Dental Med 1965;20:51, J. Skin Therapy Letters 2000;5:1). There is also less swelling after long bone fracture surgery (J. Acta Chir Orthop Traumatol Chech 2001;68:45.) Bromelain potentiates antibiotic action in Rx of bronchitis, sinusitis, pyelonephritis and wounds. It also helps Rx of angina, and thrombophlebitis (J. Altern Med Rev 1998;3:302.)

 

Intestinal update: connection to the skin

When a patient has some sort of skin rash, they get a steroid cream about 99% of the time. One has to wonder why bother giving the rash some weird name, if the treatment is almost always the same: treat the inflammation. Granted, the doc wants to make sure that he/she is not dealing with some kind of cancer and that the rash or lesion is not associated with some serious inflammatory condition in the body, i.e., lupus.

            By now you know where most of the inflammation comes from: the intestines, where most of the immune system is found. This is why eczema, or dryness of the skin is associated with an abnormal or unhealthy intestinal flora (“Reduced diversity in the fecal microbiota of infants with atopic eczema,” J. Allergy Clin Imm 2008;121;129.)

            So, instead of putting on some steroid cream on your eczematous lesion, take probiotics (“Bifidobacterium pseudocatenulatum is associated with atopic eczema,” J. Allergy Clin Imm 2008;121:135,) bromelain by mouth, lots of fiber, omega oils, and stop eating refined foods full of processed sugars and transhydrogenated fats. By doing so, you are addressing the real reason behind your dry skin.

            And this will get under your skin: another article linking obesity to an imbalanced intestinal flora: “Divergent Madaptations to Intestinal Parasitic Nematode Iin Mice Susceptible or Resistant to Obesity” (J. Gastroenterology 2007;133:1979.)

 

Medical Groups Release New Guidelines for Treatment of Low Back Pain,”

JAMA 2007;298:2253

Why do we get an X-ray, and in some cases an MRI of the back every time we go to a medical clinic complaining of back pain? Sure, we don’t want to miss some serious issue smoldering in our body. But, it seems to me that if that were the case, the simple treatments available would very quickly fail to bring relief, at which time the more invasive, and lucrative tests, if you are on the other end of the radiation, would make more sense.

            I was pleased to see this article where the authors reached the same conclusions by examining this practice: they concluded that routine imaging should be discouraged. They also added that inexpensive interventions like reading about back pain, exercises are as good as acupuncture or spinal manipulation. Too bad they left out the well-documented fact that spinal surgery, while expensive and overdone, has not been demonstrated to make any economic sense, unless you are the one performing them. This type of surgery is no better than rehabilitation for low back pain; yet, the latter is more cost effective (Annual Meeting of the North American Spine Society, Chicago 2005.

J. Family Practice News, January 1st, 2005.)

            As previously reported,  SEQ CHAPTER \h \r 1an investigation of Spinal Fusion surgeries concluded that they might be driven by money. Many docs own stock in the companies making screws, nuts, and rods used in those surgeries. One screw may be worth $1,000. Talk about getting screwed…. George Carlin would have a field day with this one.

Dr. Drug Rep” (New York Times Magazine, November 25th, 2007, page 64.)

Speaking of money in health scare: a psychiatrist giving “educational talks” for the drug company making the antidepressant Effexor discovered that Effexor’s superior effectiveness, 10% more, over SSRIs antidepressants like Prozac and Paxil was overstated. Also, he found that the high blood pressure elevation with Effexor was erroneously de-emphasized. But, he admitted that the speaking fee initially blinded him. He eventually gave up the gig, but, as he became more truthful, drug reps for Effexor no longer booked him. He is not the one who should be booked.

Telegraphed articles

Nurses (1,500) exposed to chemicals at work (disinfectants, latex, cleansers) have higher rates of asthma and cancer

            Rush University Medical Center, Chicago, November 2007

Fasting for a day each month helps reduce TOIL (toxicity, oxidation, inflammation, less mitochondrial function.)

            University of Utah School of Medicine, Salt Lake Tribune, December 11th, 2007

Patient satisfaction is not linked to antibiotic prescriptions for colds

            J. Family Practice 2007;56:1002

Pneumonia Rx with antibiotics is good enough for 3-5 days

            J. Family Practice 2007;56:1003

Capsaicin in peppers is one of the best treatments for diabetic neuropathy. The other one is the tricyclic antidepressants

            BMJ 2007;335:87

Antioxidants help ease pain in chronic pancreatitis

            J. Family Practice News, Ocotber 15th, 2007, page 38

School scores going down in USA, a result of less reading

            NYT 11/19/07

Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia.” Most of preeclamsia, or toxemia is seen in winter months.

J. Clinical Endocrinology Metabolism 2007;92:351

Oxidation is also seen in osteoporosis

            J. Proc Nat Acad Sci 2007;104:15087

Broccoli extract (sulpharane) may help reduce UV skin damage

            JAMA 2007;298:2731

No negative effects on prostate safety were detected with testosterone treatment in aging men

            JAMA 2008;299:39

Exercise May Boost Aging Immune System.” “May?”

JAMA 2008;299:160

Tonsillectomy is not beneficial in mild-moderate cases of pharyngitis.

            J. Archives Otolaryngology-Head & Neck Surgery 2007;133:1083

 SEQ CHAPTER \h \r 1Low vitamin E levels are associated with decline in physical function in the elderly

            JAMA 2008;299:308  

High homocysteine (low B vitamins) increases Parkinsonism signs

            J. Archives of Neurology 2007;64:1646

Green tea may protect against Parkinsonism

             J. Biological Psychiatry, December 15th, 2007

Lycopene in tomatoes slows the progression of BPH, or prostate swelling

            J. Nutrition 2008;138:49

Pot is related to periodontal disease

            JAMA 2008;299:525, 574

Lead exposure in infancy related to Alzheimer’s later in life

            J. Molecular Neuroscience 2008;28:3

Restless Leg Syndrome is linked to psychiatric conditions…

Annual International Scientific Assembly of the American College of Chest Physicians, Montreal, 2005

                        … strokes, and heart disease, J. Neurology, January 2008.

Only ¼ Americans know signs/symptoms of a heart attack: chest pain, sweating shortness of breath, radiation of pain to arm, face or jaw.

            CDC, February 22nd, 2008

Cat owners have lower rate of heart attacks. Yeah, but they don’t seem to care if you fall to the ground clutching your chest…

            International Stroke Conference, New York, 2008, SLT 2/22/2008

Stress makes you more likely to have clots form

            J. Pathophysiology 2007;44:154

Precancerous lesions more likely to advance to cancer if we lack B vitamins (“Alterations of DNA methylation associated with abnormalities of DNA methyltransferases in human cancers transition from a precancerous to a malignant state,”

            J .Carcinogenesis 2007;28:2434

 “Improvement of glutathione and total antioxidant status with yoga

J. Alternative Complementary Medicine 2007;13:1085

Vegans have good bone health even without dairy

Annual Meeting of the American Society for Bone and Mineral Research, Honolulu, 2008. Reported in J. Skin and Allergy News, February 2008, page 57

                                       

                   INTEGRATIVE HEALTH EDUCATION

             A monthly review of 150 medical journals

 

Volume 9 Number 2 February 2008                                   

                                                         EDITOR’S NOTE 

 

In our male-dominated society we do “male things” that, while not wrong, tend to be unbalanced by the lack of the “female-things” we often de-emphasize. For instance, we glorify logic and high IQs, which are good things, but often the source of much grief and failed policies. Our Harvard-led society cannot be said to be doing too well these days. Dr. Csikszentmihali (“Creativity,” Harper Collins, 1996) makes a very telling point reporting that most Nobel Prize winners are “integrators,” and “synthesizers” who are able to bring together both sides of their brain, thus integrating gut feelings, intuition and a sense of all things being part of an undivided whole. These brilliant people are able to tap into other disciplines and interests in their lives to bring about the breakthroughs they are awarded for. They are able to transcend the narrow limitations of their fields.

            This edition focuses on recent articles that illustrate how we need to honor both sides of our nature and go beyond the limitations of our male-dominated paradigm that discounts these concepts as “soft science,” as a colleague of mine referred to nutrition.

Hugo Rodier, M.D.

 

Asthma linked to psychiatric disorders,”             (JAMA 2008;299:158)

3 possibilities: (1) asthma shares common risk factors with depression and anxiety, (2) asthma increases risk of psychiatric problems, (3) psychiatric problems increase risk of asthma.” No doubt all 3 possibilities have merit. They all underscore the need to transcend our current emphasis on “disease-cataloging,” (male) while ignoring the common mechanisms underlying all diseases (female.) The article “Irregular Menses Linked to Increased Heart Risk” (Annual Scientific Sessions of the American Heart Association, Orlando, 2007) may also be puzzling to those who continue to manage symptoms of diseases, the result of our over-emphasis on pharmacologic treatment (male.) If we  pay attention to our “gut feelings,  we may understand that inflammation in the intestines has been linked to many diseases:

“The increase in mucosal permeability may suggest that antigens (toxins) like protein penetrate into the body and result in systemic reactions such as chronic urticaria/ severe itching (J. Digestive Diseases Science 1998;43:1226), migraine (J. Hepatogastroenterology 1998;45:765) atopic dermatitis/ skin rashes (J. Gastroenterology 1996;31:s77) and so on. It is important to study the implication of increased permeability in relation not only to gastric diseases but also to certain systemic diseases”  (J. Digestion 2001;63:93.)

It turns out that all 4 diseases mentioned above have been linked to energy and information issues that fuel our cell metabolism. In other words, our food, processed in the intestines, is the common denominator to not only these 4 common diseases, but practically all diseases. If you are thinking that diseases also have a significant genetic component, then read the voluminous literature on “nutragenomics:” even our genes require the energy and information in the food we eat to be translated adequately.

Report pools data on cancer and diet, lifestyle. It’s not just the genes!

American Institute for Cancer Research and World Cancer Research Fund (J. Family Practice News, November 15th, 2007, page 5.) These are the factors we need to emphasize to prevent cancer, which is a very “female thing” to do. Ideal weight, physical activity, avoid energy dense foods and sugary drinks, eat mostly plant-based foods, limit read meat and avoid processed meat, limit alcohol and salt, avoid moldy foods (aflatoxins) and emphasize breast feeding.

 

Six arguments for a greener diet,” written by Michale Jacobson and staff at Center for Science in the public Interest (Book review in J. Science 2006;314:762.) The energy and information we harness form the Sun eventually ends up in our bodies to fuel all cellular processes and constitutes all cellular structures. We are not managing this energy very well. If we ate more plants and less meat, we would accrue significant health benefits for ourselves, and Mother Earth, the ultimate female. We would reduce chronic disease, food-borne illness, improve soil, water and air, and reduce animal suffering.

 

Rethinking the Meat-Guzzler,” New York Times, January 27th, 2008

  • Too much energy needed to raise meat = 40% rise in food cost last year
  • 16 times more energy needed to produce a 6 oz steak compared to 1 cup of broccoli, one cup of eggplant, 4 oz cauliflower and 8 oz rice.
  • If Americans reduce meat consumption by just 20%, we would see the same energy savings switching from a Camry to a Prius
  • The CO2 produced by 2.2# beef  = Average European car driven for 155 miles
  • Crops used to feed animals: 2-5 times more calories needed than direct grain consumption. 10 times more with grain-fed animals
  • Grain fed animals linked to more heart disease, cancer, diabetes, etc.
  • 15-20K gallons of water are needed to produce one pound of edible beef. US depleting underground aquifers by 21 billion gallons a day.
  • Livestock producing methane (farting) = 33 million automobiles.

 “Foodborne Illness May Cause Long-Term Problems,” (            Center for Disease Control and Prevention; Salt Lake Tribune January 22nd, 2008.) Animals end up getting over ½ of all the antibiotics used in the world, which leads to problems with bugs that later turn against us? “We are drastically underestimating the burden on society that food borne illnesses representFolks assume once you are over the acute illness, that’s it, you are back to normal and that’s the end of it.” Ten to twenty years after food borne infections we may see high blood pressure, kidney damage (E. coli,) arthritis (salmonella or shigella,) and paralysis (campilobacter.) In my practice, I often trace chronic health problems of all kinds to intestinal infections and indiscriminate use of antibiotics that compromise our healthy intestinal flora’s function. For instance, the enzyme produced by probiotics, beta glucoronidase, is so unhealthy that food-borne carcinogens become genotoxic, or more likely to cause cancer mutations in our genes (J. Carcinogenesis 2007;28:2419.) in other words, messing with our intestinal flora may lead to cancer.

 

Most Yogurt No Match for Infection,” (Annual Meeting North American Society for Pediatric Gaastroenterology and Nutrition, Salt Lake City, 2007.) Misleading advertisement is ubiquitous. Yogurts just don’t have enough probiotics (lactobacillus) to make any difference. The brands found lacking were: Dannon, Danactive, Dannon Fruit, Dannon Activia, Yoplait, Breyers Light Probiotic Plus, Breyers Fruit, Kroger Blended, Kroger Fruit and Great Value. “You would have to eat about 100 containers of these yogurts in order to get enough probiotics to treat gastroenteritis.”  These friendly organisms have been largely ignored, despite Metchnikoff’s Nobel Prize winning research exactly 100 years ago. Why was it ignored? Because the gut and nutrition are “soft sciences,” or too female.

It turns out that “gut feeling” issues also compromise our friendly intestinal flora: “Role of Probiotics in Correcting Abnormalities of Colonic Flora Induced by Stress” (J.Gut 2007;56:1495) and “Probiotic Treatment of Rat Pups Normalises Corticosterone Release and Ameliorates Colonic Dysfunction Induced by Maternal Separation” (J. Gut 2007;56:1522) simply state that our emotional lives also have a significant impact on diseases through several mechanisms, including how we process food in the intestines.

            Would it surprise you to read that “Infection Increases Anxiety-like Behavior?” (J. Brain Behavior Immunology 2007 Oct 2007 Epub). I hope not by now. When researchers injected the bug C. jejuni into intestines, they noted an impact in the brain of recipients (Paraventricular Nuclei, the Amygdala and Bed Nucleus in Stria Terminals,) enough to cause anxiety.

 

A High Fat Meal Induces Low-Grade Endotoxemia: evidence of a novel mechanism of postprandial inflammation” (AJCN 2007;86:1286.) So, if we eat a lot of animal fat, we may be creating a lot of inflammation in the intestines by altering the balance of intestinal organisms. This results in toxins that leak out of the gut (“leaky gut,”) which may cause problems in all organs of the body, including the heart:

Bacterial endotoxin is a potently inflammatory antigen that is abundant in the human gut. Endotoxin circulates at low concentrations in the blood of all healthy individuals, although elevated concentrations are associated with an increased risk of atherosclerosis… Low grade endotoxemia may contribute to the post prandial inflammatory state and could represent a novel potential contributor to  endothelial activation and the development of atherosclerosis.”

 

Another cholesterol drug bites the dust (see “brain droppings” blog.)

            So, we continue to treat high cholesterol with drugs (a male thing) and do very little for the underlying problems that cause arterial inflammation (a female thing.) Often, statin drugs to lower cholesterol, much like all other drugs, get negative pre-marketing studies that are not made public, until troublesome side effects become obvious a few years after their launch. The last example is vytorin, a combination of ezetimibe and simvastatin. This drug sold well, because it did lower cholesterol, but nagging questions remained about its ability to prevent heart attacks or arterial clogging, which are the real end points. A study to look at this little problem concluded in 2006, but the drug companies would not released the results, despite pressure from the FDA to do so. The companies even tried to change the end points after the study was concluded: at the outset, they checked three points on the carotid artery for plaque formation, which they wanted to reduce to only one point after the “secret” results were in.

           

Do Cholesterol Drugs Do Any Good?”( J. Business Week, Cover issue, January 28th, 2008, page 52.) Many doctors are beginning to question the whole cholesterol hypothesis because of the vytorin problem, joining many other doctors who never quite bought into it from the beginning (New York Times, January 17th and 27th, 2008.)

  • They only help those who already have had a heart attack. No benefits for men over 65 and women of any age. A small benefit is seen for middle age men, but no reduction in total deaths, or hospitalizations.
  • If guidelines for cholesterol were followed, 40 million Americans would be taking these drugs. Who made the guidelines? Doctors taking money from the companies that make these drugs, who often ignore the best Rx: diet
  • Lipitor reduces the risk of heart attacks by 36%,” (*) says Dr. Jarvick, the team leader on the first artificial heart implantation in the early 80s. But, the asterisk on the package insert says that the 36% figure comes from the fact that 3% fewer patients taking a sugar pill had a heart attack, compared to 2% taking Lipitor: one fewer heart attack for 100 people taking the drug for five years, paying $1,000/year. When patients are made aware of these numbers, most opt out.
  • The only large study paid by the government showed no benefit from these drugs.
  • Avandia lowers sugar, but no benefits otherwise: “avandia is almost the poster child for everything that is wrong with our system,” Dr. Hoffman, NEJM article.
  • It is almost impossible to find someone who believes strongly in statins who does not get a lot of money from industry,” Dr. Hayward, U,. Michigan Med School
  • I now see it as a myth that everyone should have their cholesterol checked,” Dr. Brody, U. of Texas.

A little review: cholesterol is not the problem.

            It is the oxidized-inflamed cholesterol that becomes sticky when the liver is not well nourished. The same thing happens to the lining of our arteries: they become sticky from inflammation and oxidation, since they are also nutritionally compromised. This problem leads to “leaky arteries,” which the oxidized cholesterol tries to patch up. This healthy elevation of cholesterol is compromised by the stickiness of both the cholesterol and the lining of the arteries, resulting in a “Velcro-like” reaction that leads to plaque formation. Who said all this? Linus Pauling. Remember him? I do, especially when my teachers in Med School scoffed at my recommendations of increasing vitamin C intake when suffering from colds, the flu, or any other acute infection. The male thing to do with infections is to “attack” the invading bug, which is OK. But, what about emphasizing the female thing to do, that is, increase the host’s defenses? There is no money in it, is there? The article “Vitamin C May Affect Lung Infections”(J. Royal Society of Medicine 2007;100:495) is breath of fresh air:

  • Scurvy was often seen with pneumonia
  • Roles of Vitamin C: collagen hydroxylation, enzymatic synthesis of dopamine, carnitine and neuroendocrine peptides. Antioxidant. High concentration in phagocytes and lymphocytes. Helps in production of interferon
  • Infections, including pneumonia, lead to low levels of vitamin C. Less colds with regular intake.
  • Cochran Library: statistically significant benefit of vitamin C against pneumonia
  • Dose: no problems with 100 gm a day by mouth. IV 100 gm also OK.

 

                  INTEGRATIVE HEALTH EDUCATION

             A monthly review of 150 medical journals

 

 

 

                                      Volume 9 Number 1 January 2008                                   

                                                        EDITOR’S NOTE 

 

                        Listerine, the mouthwash most of us gargle before we go to bed at night, or at least before we go on a date, or both, was originally designed to serve as a scrubbing agent for surgeries. As often happens, the bean counters in charge of maximizing profits looked for a way to expand their market. Soon, they convinced the public that the chances of landing a better looking partner was one swig of Listerine away. Today, their product is practically a necessity in our households.

                        The same thing is happening with many other products that originally were intended to treat serious medical conditions. For example, the “purple pill” for heartburn came out in the 80’s for the treatment of serious bleeding ulcers, and antidepressants were originally prescribed for people at the verge of suicide. Today, both of these drugs have slowly “expended their markets,” so that today they are commonly found in just about every household’s medicine cabinet. We may argue that we need these drugs to lead better lives. True, but take a minute to consider these issue’s articles.

Hugo Rodier, M.D.

 

Medical Nemesis

About 30 years ago, a gadfly by the name of Ivan Illich wrote the book “Medical Nemesis,” where he argued that some docs were creating diseases out of normal human conditions that up to then were accepted as part of life. His radical opinion was shocking to most people back then. But, today, he seems more in line with the regular guy in the street: “Is there a new epidemic of medical problems or is it that medicine is better able to identify and treat already existing problems? Or does it mean that a whole range of life’s problems have now received medical diagnoses... despite dubious evidence of their medical nature?” (“The Medicalization of Society: on the transformation of human conditions into treatable disorders,” Book review in JAMA 2007;298:2070.)

 I am of the opinion that the second proposition is more likely: “What better way than to convince otherwise healthy people that they are now ill and need something to treat their malady, something that is conveniently for sale?” (JAMA 2007;298:2070.)

             Other examples of medicalized conditions highlighted in this book: osteoporosis, ADHD, bipolar disorder, fibromyalgia and dyslexia.

 

Overtreated

             Utilization of costly medical and surgical services is highly, often dramatically, variable from place to place, and the degree of utilization has no relationship to favorable outcomes. It follows that much of what is afforded to the patient is unnecessary. Furthermore, the driving force is the cash flow that is necessary to feed what has become a voracious, greedy monster” (“Overtreated: why too much medicine is making us sicker and poorer,” book review in JAMA 2007;298:2070.)

            And why is our health care system so prone to over-treatment? Don’t shoot the messenger: just read the next article:

 

Medical Professionalism in a Commercialized Health Care Market,” JAMA     2007;298:2668. Before you read the highlights of this article, which I transcribed word for word so that my own opinion does not bleed through, you may want to know that this article was written by a Harvard M.D., who works on the Social Medicine department of that august University:

  • Professionals have an ideology that assigns a higher priority to doing useful and needed work than to economic rewards, an ideology that focuses more on the quality and social benefits of work than its profitability… Although this ideology is the most important part of medical professionalism, it is what is now most at risk… [by] the growing commercialization of the US health care system.”
  • The current focus on money-making and the seductions of financial rewards have changed the climate of US medical practice at the expense of professional altruism and the moral commitment to patients.”
  • Technology appeals to new graduates who are burdened by debt from school. They tend to go into specialties “to behave simply as skilled technicians, focused exclusively on their patients’ narrow medical problems and unmindful of their professional obligations to the whole person they are serving.”
  • Big Pharma “now uses its enormous financial resources to help shape postgraduate and CME of physicians in ways that serve its marketing purposes… that sells the drugs physicians prescribe and other tools physicians use… [doctors] are abdicating their ethical commitment to serve as the independent fiduciary for their patients.”
  • Health care is just another industry now, which, by continuing on its present path is heading toward bankruptcy. Docs should work toward making health care a social service, like it is in the rest of the industrialized world.

 

             Them are fighting words… Still, I would not want to indict all docs. Rather, I would look into why this is happening. After all, docs need to take care of their finances so that they may keep their clinics open in order to serve patients. In my opinion, economic incentives created by our health care system are victimizing all of us, including doctors. The solution? Enforce the laws already in our books to police abuse at all levels of our economy. We must stop “corporate welfare,” which is also rampant in our health care system.

 

Where is the beef?

                        Another corporate problem is the way industry is mucking up our food supply in order to maximize profits, regardless of the health effects on consumers. About

70% of antibiotics made are given to farm animals, in order to avoid infections in the crowded conditions the poor creatures are raised. This practice is also welcome in the industry because animals so treated seem to get bigger and fatter. But, this practice, which is banned in the European Union, may well be responsible for mutating organisms that may be escaping the farms and creating drug resistant strains of bugs, like MRSA, the staph infection that is now becoming a major headache in our country. Some also blame this practice for the disappearance of about 20-80% of bees in 24 states. The practice of overusing pesticides and even injecting the pesticides into the DNA of our crops (GMO products) is also blamed for the decimation of our bees (“Our decrepit food factories,” NYT Magazine, December 16th, 2007.)

                        As you know, if bees bite the dust, we will suffer, too, since they are vital for our crops to grow through pollination.

                        What can we do? In my opinion, we need to support local industry and farmers who grow their animals and crops as organically as possible.

 

Watching you eat the beef

                        In the Netherlands, Big Food has started to monitor customers’ reactions to the food they eat in restaurants, in order to maximize their sales by adjusting their advertisement and servings to the preferences thus observed in consumers. In the so-called “restaurants of the future,” your chair will measure your reactions to everything you put in your mouth, how fast you chew and who knows what else. The data will be used to alter the lights, sounds and even scents in the restaurant, in order to respond to the feedback that will cause you to consume the most food. These restaurants will even have “face readers,” to analyze your reaction to the food being served (New York Times, November 26th, 2007.) Will they see my “avian salute?”

                        Now, there will always be marketing. But, how does it feel to know that your so-called “choices” may really be nothing but subtle manipulation to get you to consume more? In my opinion, being in touch with whom we are, and becoming “agents” for ourselves minimizes the chances that we are driven by agendas outside of ourselves. I wish for you to be so inner-driven.

 

Our boys: not driven enough?

                        A somewhat controversial book just came out: “Boys Adrift: the Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men” (JAMA 2007;298:2684.) The author’s opinions are interesting: you may not agree with them, but, there is not much argument that each new generation seems a bit less dynamic to each older generation, a fact that even Plato and Socrates noted.

                        I had a hard time with the #1 reason he listed: Feminization of our education. The author argues that schools now de-emphasize competition and advocate a culture of “no winners.” While this is an understandable argument, I am not sure that this is a factor that would cause boys to lose their drive to reach for higher ground. The other factors made more sense to me: video games, prescription psychotropic meds (Ritalin may cause apathy,) endocrine disrupting chemicals and lack of heroic role models.

                        Whether our boys are really facing this epidemic or not is debatable. But, what is certain is that they will not do well in today’s world if we don’t help them get an affordable higher education. I feel we need to make post high school education as attainable as possible. The less education they get, the poorer and sicker they will be.

 

Health and education

             Here are the main points from the article “Future Health Consequences of the Current Decline in US Household Income,” JAMA 2007;298:1931

  • People with incomes below $50,000 have shorter lifespan. They are more likely to receive poor health care.
  • Education, race, environment also play a role
  • Poverty has gone up from 11.7% to 12.6% since 2000. Those with incomes of $8,000 below poverty level increased by 45%. Except for the rich, personal income has decreased. Income inequality is widening. A booming economy is only benefiting the rich. The ratio between CEOs’ incomes and that of their employees has gone from 26 in 1965 to 245 in 2002.
  • These trends will likely result in worse health in all Americans but the rich. There will be more uninsured people.
  • The answer: education in an information society
  • 40% more heart disease in those without a High School diploma

 

Caffeic acid,” J. Skin & Allergy News, November 2007, page 26

                        It is found in grains, fruits, olives, spinach, grapes, cabbage, wine, asparagus and coffee. The main nutrients therein are phenylpropanoids and ferulic acid, which belong to the family of polyphenosl, like ellagic acid, tannic acid. Caffeic acid has anti cancer and antioxidant effects (J. Nut Cancer 1998;32:81.) It protects against peroxidation of phospholipidic membranes (J. Biochem Biophys Res Comm 1998;253:222) and reduces human skin UVB-induced erythema (Int J. Pharm 2000;199:39.) Caffeic acid is the most effective of polyphenolic acids as tumor-promotion inhibitor (J. Nut Cancer 1998;32:81.) The caffeic acid from bee propolis has anti cancer effects, too (J. Carcinogenesis 1996;17:761.)

 

Garlic,” J. Skin & Allergy News, December 2007, page 21

                         Garlic seems to do just about everything, including keeping vampires away. If you don’t like it because it may ruin your social life, get the others around you to eat it, too! Garlic may prevent cardiovascular disease, arthritis, cancer, cataracts; inhibit platelet aggregation and thrombus formation; mitigate cerebral aging; rejuvenate skin and enhance circulation and energy levels (J. Ageing Res Rev 2003;2:39.) It also has:

·        Detox effects, antifungal, antibacterial, J. Tradit Chin Med 2003;23:198

·        Inhibits proliferation of most human cancers, J. Leuk Res 2004;28:667

·        Diallyl disulfide in garlic lowers the risk of colon, lung, and skin cancers, J. Food & Chem Tox 2004;42:1543, Am J. Contact Derm 1999;10:37, J. Skin Pharm Appl Skin Physiol 2001;14:373, J. Nut 2001;131:1027s

·        Diallyl Sulfide in garlic modulates xenobiotic metabolism and exert antitoxic, antineoplastic, bactericidal and hypolipidemic activity, J. Cancer Letters 1998;131:209

·        Ajoene in garlic inhibits proliferation of human leukemia cells, J. Leuk Res 2004;28:667 and also has antifungal effect. It has been used for the treatment of athlete’s foot (Rx of tinea pedis,) J. Mycoses 1996;39:393

·        Allergic reactions and contact dermatitis may be seen.

 

                        Despite all this evidence, you will still run into docs who will try to tell you that there is no evidence that garlic works at all. By now you have an idea why this is the case ($$$$.)

 

 

                   INTEGRATIVE HEALTH EDUCATION

             A monthly review of 150 medical journals

 

                                    Volume 8 Number 5 December 2007                          

                                                         EDITOR’S NOTE 

 

            At the risk of repeating myself too much, let me remind you that Energy and Information (E&I) are the pillars of reality, according to modern Physics and the teachings of practically every spiritual tradition. This is why I was so pleased to read an article on how this simple concept is beginning to surface in our medical-nutritional journals.  Nutrigenomics and metabolomics will change clinical nutrition and public health practice” (AJCN 2007;86:542) encapsulates the very essence of E&I. They call it metabolomics. Nutrigenomics, if you recall, is how E&I in food influences the translation of DNA’s encoded messages of E&I that orchestrate how our cells renew and recreate themselves.

            The article is saying that these basic concepts will redefine nutrition AND how we view public health issues. I hope you contemplate this simple statement: its implications are enormous. In my opinion, this is the best way to put together so many seemingly disparate and unrelated topics, which, when viewed as independent of each other, serve only to confuse us and delay solutions to our vexing health and social problems.

            For instance, understanding E&I in our society and in our bodies leads to an understanding of how pollution, or toxic molecules derived from energy-making machines that keep our society and economy going, are poisoning our body’s metabolism and DNA, causing practically all diseases. Our own energy-making inside our cells also produces these pollutants: we call them oxidants, or free radicals, but they are nothing more than by-products of energy-making, the same as the ones generated by the pollution our machines generate. Then, these problems are compounded in those of us who cannot detoxify them very well. Think of diets low in antioxidants, and constipation as examples. If you are genetically weak in the pathways of detoxification, like liver detoxification, then, you will be more likely to become ill in the future. For instance, constipation raises the risk of getting Parkinsonism, which has been linked to pesticides.

            Methods of profiling almost all of the products of metabolism in a single sample of blood or urine are being developed,” because each of us has a different way to handle detoxification and the E&I in our food. The future lab evaluation of our metabolism will focus on pinpointing glucose concentration, insulin activity and insulin resistance: sounds familiar?

            But, heretofore, research has not taken into consideration these differences, which has resulted in “one size fits all” approaches to nutrition. If these metabolic and genetic tendencies were considered, each of us would be given optimal advice on what to eat and what to avoid. Remember that the E&I in food fuels not only your DNA that renews your detoxification pathways, but also fuel how they work: nutrigenomics and metabolomics.

            Over 2,000 molecules are involved in the human metabolome, which is the grouping of all the factors that influence how we metabolize E&I. The number goes up by the thousands when we include the bacterial metabolites that come from the gut: “eventually, nutrition scientists will use measures of gut microflora metabolism to develop a better understanding of the role of gut microflora in human nutrition. For example, the altered availability of the micronutrient choline caused by metabolism by gut microflora was associated with fatty liver in insulin resistance” (AJCN 2007;86:542.)

            Complicated? Perhaps. Just focus on this simple truth: you are what you eat.

 

Hugo Rodier, M.D.

 

Cancer and E&I

            A whole symposium on energy from food, how we use it in our body and how our metabolism affects cancer tendencies was presented by the Harvard Medical School Division of Nutrition. The metabolic syndrome and insulin resistance have been shown to increase our risk of getting cancer, especially colorectal, prostate and breast cancer (AJCN 2007;86:817s.) In fact, Otto Warburg won the Nobel Prize in Medicine in 1931 saying the same thing. It is amazing how we soon forget the lessons learned by our parents.

            Other than Toxicity, Oxidation, Inflammation and Less optimal mitochondrial function (TOIL,) researchers have focused on the communication messengers like leptin, TNF, IGF-1 and adiponectin (AJCN 2007;86:858s.) And, what is it that they communicate? E&I.

                        They also looked at epigenetic or post-translation effects of insulin resistance on the genetic tendencies that may lead to cancer. In other words, the copying of potentially cancerous genes is modulated by insulin resistance and the metabolic defects that are triggered by our poor diets (AJCN 2007;86:872s.)

                        They concluded that nutrition to diminish metabolic problems should be explored in depth to reduce our risk of cancer. For instance, reducing animal fat from the diet reduces the risk of breast cancer (AJCN 2007;86:878s.) They also recommended supplementing soy and tea together to reduce the estrogen concentration that drives prostate and breast cancer (AJCN 2007;86:882s.)

 

            This symposium and future research will guide the development of effective