The High Energy Doctor

Fibro and Inflammation

2011-08-26T16:13:00.002-05:00

Let me start off by saying that fibromyalgia is not currently considered an inflammatory condition. However, there is some evidence that inflammation plays a role in fibro.

I have discussed the neuroinflammatory basis of "fibro fog" in another post. There is also some thoughts that inflammation of muscle fascia plays a role in some of the muscle pain of fibro. Many people dealing with fibro also have gut dysfunction. This often presents as diarrhea, constipation and abdominal pain or some combination of the above. This may be related to food sensitivities that leads to gut inflammation. There are many health risks associated with inflammation that go beyond fibro. This includes increased risks of cancer, diabetes and cardiovascular problems.

I have seen many patients show dramatic improvements in their fibro complaints by getting on an anti-inflammatory diet and adding supplements to help minimize inflammation.

Some relatively simple dietary changes that you can make to help reduce the inflammatory load on your body include:

Cut back on junk foods, high-fat meats and highly processed foods.

Cut back on trans fats and saturated fats.

Decrease refined white flours in bread and pasta. Go whole wheat or gluten free instead.

Cut back on consumption of sugar.

Avoid Aspartame and other artificial sweetners. Aspartame is neuroexcitatory and is neurotoxic. STAY AWAY FROM ASPARTAME!

Consider getting a water ionizer.

Consider lab testing or an elimination diet to identify food sensitivities.

Some supplements that can help minimize inflammation include omega 3 oils, curcumin and vitamin C. Increased intake of antioxidants can also help. Probably the ultimate antioxidant for this purpose is glutithione. Unfortunately taking glutithione orally is pretty much worthless as it is very poorly absorbed via that route. I use a nebulizer or a topical version for my patients to get around the absorption issue.

Bruce Lipton Describes Epigenetics in One Minute

2009-05-02T10:42:00.003-05:00

Bruce H. Lipton, Ph.D. is an internationally recognized authority in bridging science and spirit. His research as a cellular biologist at Stanford University’s School of Medicine, between 1987 and 1992, revealed that the environment, operating though the membrane, controlled the behavior and physiology of the cell, turning genes on and off. His discoveries, which ran counter to the established scientific view that life is controlled by the genes, presaged one of today’s most important fields of study, the science of epigenetics. He is regarded as one of the leading voices of the new biology. Dr Lipton’s work summarizing his findings is entitled The Biology of Belief.

The book is one of my favorites and I have read it several times. I strongly recommend it to anyone who is looking for a better understanding genetics and epigenetics. It is a great introduction to, and explanation of the fact that genes represent tendencies NOT destinies.

This link takes you to a short video in which he explains the basic concept in a very brief segment.

http://oneminuteshift.com/videos/bruce_lipton/healing_perceptions

GeneWize Press Release

2008-07-28T09:02:00.002-05:00

MVP Empowerment Group Teams Up with Revolutionary GeneWize Life Sciences DNA Guided Nutrition For Au

(PRWEB) July 25, 2008 -- 'Genewize Life Sciences:' a subsidiary of publicly traded Genelink, --with the launch of its DNA Guided Nutrition System, in conjunction with ThedNaMovement.com Marketing Group, is a category creator as it sphere heads a whole new way of customizing nutritional supplements based on an assessment of an individual's DNA.

World renowned economist and prolific author for New York Times Best Sellers: Paul Zane Pilzer in his recent study: "The Wellness Revolution," reminds us that one-seventh, $1.5 trillion, of the U.S. economy today is devoted to the healthcare business, or what Paul Zane Pilzer better describes as the "Sickness Industry." However, by the year 2010, it is believed that an additional $1 trillion of the economy will be devoted to products and services that keep us healthy, make us look or feel better, will slow down the effects of aging, and will help in preventing diseases from developing altogether. With the technological breakthrough of DNA Guided Nutrition, and other developments in Bio-Genetic research, the implications of the shift to proactive wellness are far reaching from health to beauty to food to medicine.

Harkening back to 1908, Henry Ford's Model T launched the trillion-dollar automobile industry. Likewise in 1981, IBM's PC launched the trillion-dollar personal computer industry, which grew so fast that PC sales surpassed U.S. auto sales in only ten years.

With the launching of GeneWize DNA Guided Nutrition, in conjunction with Dream Team Marketing organizations like: ThedNaMovement.com. and Jonathan Budd, the trillion-dollar industry of the twenty-first century has arrived, and it promises to similarly revolutionize our lives and offer entrepreneurs and investors the opportunity to amass great fortunes.

This next big thing is the wellness industry, and The Wellness Revolution shows you how to state your claim now while the market is ripe..... In The Wellness Revolution, Paul Zane Pilzer--a world renowned economist, lay-rabbi, presidential advisor, college professor, and entrepreneur--shows us how to tap into this next trillion-dollar revolution. Already a $200 billion business, with most of its revenue coming from vitamin sales and health club memberships, the wellness industry is just now taking off. In just ten years, an additional $1 trillion of the U.S. economy will be devoted to providing healthy people products and services to maintain their health.

Whether you're an entrepreneur, investor, or distributor, Paul Zane Pilzer, featured speaker at the August 1st GeneWize Launch in Orlando, demonstrates how to get in on the ground floor of this burgeoning industry which is best illustrated in the launching of the GeneWise DNA Guided Nutrition System, and promoted by dedicated marketing organizations like MVPGeneWise and the DNA Movement Dream Team, headed up by Michael Barrett & Angela Giles in conjunction with Jonathan Budds incredible Mastermind marketing strategies.

Featured members of the dNa Movement /MVP GeneWize team include: Christina Hessel (the Traveling Nanny), Texas based Savanna Moss, Dr. Rusty Dorn, Richard Rizza, who heads up our Scenic Northeast division, and a host of other top leaders and income earners, too numerous to mention at this time. Needless to say, the DNA Movement team is exploding, and is off and running as it attracts the best-of-the-best marketers and health care professionals who are joining by droves to take advantage of the time sensitive benefits which can only be enjoyed by pre-launch founding GeneWise affiliates, who join before August 1st.

How does it work? Three Simple Steps:

1. Assess, Don't Guess - GeneWize offers the only patented, FDA reviewed, non-invasive, self-administered DNA collection system available. The process is easy to understand. It is simple to do and takes just a few minutes. An individual simply swabs the inside of their mouth (the inner cheek), and mails the swab back to the Genewise laboratory in the special envelope provided Everything, along with easy-to-follow instructions, are included. An individual can now find out for the very first time what's right for them as they are nourishing their body with the ultimate personalized formula.

2. Customized: Their product is created specifically for them. NO more one size fits all!

Consumers will receive a comprehensive personal formula created just for them, utilizing over 177,000 possible ingredients combinations. Nothing but product ingredients is stocked on our shelves. All our formulas are made to order. Basically, it works like this:

....For less than $200 a consumer can get their DNA assessed (This only needs to be done once. Your DNA never changes) After that the costs is about $80-$100 per month to have a vitamin/supplement specifically made to support their genetic code. No more guessing.

Barrett & Giles, having been involved in marketing health products in the past, have never seen anything as effective and powerful as this, due to the DNA based personally customized nutritional feature. GeneWise is especially attractive to experienced marketers and distributors because of its generous compensation plan. This is the way of the future for health and nutrition.

To learn more about this exciting technological breakthrough with Genetic Sciences and the GeneWise DNA Guided Nutritional System and Once-in-a-lifetime Business Opportunity, log onto:

http://www.mygenewize.com/?ID=doctordorn

Good News In Our DNA: Defects You Can Fix With Vitamins And Minerals

2008-07-25T17:52:00.005-05:00

This is some exciting stuff. There is now a company that can do genetic testing and then prepare a custom formulation made to compliment your inate strengths and strengthen your weak areas. If you would like to know more go to the link below. This company is the first and only one to bring supplementation technology into the 21st century. Check it out.

Dr. R. Dorn

doctordorngenewize.com

Good News In Our DNA: Defects You Can Fix With
Vitamins And Minerals

ScienceDaily (Jun. 3, 2008) — As the cost of sequencing a single
human genome drops rapidly, with one company predicting a price
of $100 per person in five years, soon the only reason not to look
at your "personal genome" will be fear of what bad news lies in
your genes.
University of California, Berkeley, scientists, however, have found
a welcome reason to delve into your genetic heritage: to find the
slight genetic flaws that can be fixed with remedies as simple as
vitamin or mineral supplements.
"I'm looking for the good news in the human genome," said Jasper
Rine, UC Berkeley professor of molecular and cell biology.
"Headlines for the last 20 years have really been about the triumph
of biomedical research in finding disease genes, which is
biologically interesting, genetically important and frightening to
people who get this information," Rine said. "I became obsessed
with trying to decide if there is some other class of information that
will make people want to look at their genome sequence."
What Rine and colleagues found and report in the online early
edition of the journal Proceedings of the National Academy of
Sciences (PNAS) is that there are many genetic differences that
make people's enzymes less efficient than normal, and that simple supplementation with vitamins can often restore
some of these deficient enzymes to full working order.
First author Nicholas Marini, a UC Berkeley research scientist, noted that physicians prescribe vitamins to "cure"
many rare and potentially fatal metabolic defects caused by mutations in critical enzymes. But those affected by these
metabolic diseases are people with two bad copies, or alleles, of an essential enzyme. Many others may be walking
around with only one bad gene, or two copies of slightly defective genes, throwing their enzyme levels off slightly
and causing subtle effects that also could be eliminated with vitamin supplements.
"Our studies have convinced us that there is a lot of variation in the population in these enzymes, and a lot of it affects
function, and a lot of it is responsive to vitamins," Marini said. "I wouldn't be surprised if everybody is going to
require a different optimal dose of vitamins based on their genetic makeup, based upon the kind of variance they are
harboring in vitamin-dependent enzymes."
Though this initial study tested the function of human gene variants by transplanting them into yeast cells, where the
function of the variants can be accurately assessed, Rine and Marini are confident the results will hold up in humans.
Their research, partially supported by the Defense Advanced Research Projects Agency (DARPA) and the U.S.
Army, may enable them to employ U.S. soldiers to test the theory that vitamin supplementation can tune up defective
enzymes.
"Our soldiers, like top athletes, operate under extreme conditions that may well be limited by their physiology," Rine
said. "We're now working with the defense department to identify variants of enzymes that are remediable, and
ultimately hope to identify troops that have these variants and test whether performance can be enhanced by
appropriate supplementation."
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In the PNAS paper, Rine, Marini and their colleagues report on their initial analysis of variants of a human enzyme
called methylenetetrahydrofolate reductase, or MTHFR. The enzyme, which requires the B vitamin folate to work
properly, plays a key role in synthesizing molecules that go into the nucleotide building blocks of DNA. Some cancer
drugs, such as methotrexate, target MTHFR to shut down DNA synthesis and prevent tumor growth.
Using DNA samples from 564 individuals of many races and ethnicities, colleagues at Applied Biosystems of Foster
City, Calif., sequenced for each person the two alleles that code for the MTHFR enzyme. Consistent with earlier
studies, they found three common variants of the enzyme, but also 11 uncommon variants, each of the latter
accounting for less than one percent of the sample.
They then synthesized the gene for each variant of the enzyme, and Marini, Rine and their UC Berkeley colleagues
inserted these genes into separate yeast cells in order to judge the activity of each variant. Yeast use many of the same
enzymes and cofactor vitamins and minerals as humans and are an excellent model for human metabolism, Rine said.
The researchers found that four different mutations affected the functioning of the human enzyme in yeast. One of
these mutations is well known: Nearly 30 percent of the population has one copy, and nine percent has two copies.
The researchers were able to supplement the diet of the cultured yeast with folate, however, and restore full
functionality to the most common variant, and to all but one of the less common variants.
Since this experiment, the researchers have found 30 other variants of the MTHFR enzyme and tested about 15 of
them, "and more than half interfere with the function of the enzyme, producing a hundred-fold range of enzyme
activity. The majority of these can be either partially or completely restored to normal activity by adding more folate.
And that is a surprise," Rine said.
Most scientists think that harmful mutations are disfavored by evolution, but Rine pointed out that this applies only to
mutations that affect reproductive fitness. Mutations that affect our health in later years are not efficiently removed by
evolution and may remain in our genome forever.
The health effects of tuning up this enzyme in humans are unclear, he said, but folate is already known to protect
against birth defects and seems to protect against heart disease and cancer. At least one defect in the MTHFR enzyme
produces elevated levels in the blood of the metabolite homocysteine, which is linked to an increased risk of heart
disease and stroke, conditions that typically affect people in their post-reproductive years.
"In those people, supplementation of folate in the diet can reduce levels of that metabolite and reduce disease risk,"
Marini said.
Marini and Rine estimate that the average person has five rare mutant enzymes, and perhaps other not-so-rare
variants, that could be improved with vitamin or mineral supplements.
"There are over 600 human enzymes that use vitamins or minerals as cofactors, and this study reports just what we
found by studying one of them," Rine said. "What this means is that, even if the odds of an individual having a defect
in one gene is low, with 600 genes, we are all likely to have some mutations that limit one or more of our enzymes."
The subtle effects of variation in enzyme activity may well account for conflicting results of some clinical trials,
including the confusing data on the effect of vitamin supplements, he noted. In the future, the enzyme profile of
research subjects will have to be taken into account in analyzing the outcome of clinical trials.
If one considers not just vitamin-dependent enzymes but all the 30,000 human proteins in the genome, "every
individual would harbor approximately 250 deleterious substitutions considering only the low-frequency variants.
These numbers suggest that the aggregate incidence of low-frequency variants could have a significant physiological
impact," the researchers wrote in their paper.
All the more reason to poke around in one's genome, Rine said.
"If you don't give people a reason to become interested in their genome and to become comfortable with their personal
genomic information, then the benefits of much of the biomedical research, which is indexed to particular genetic
states, won't be embraced in a time frame that most people can benefit from," Rine said. "So, my motivation is partly
scientific, partly an education project and, in some ways, a partly political project."
Marini and Rine credit Bruce Ames, a UC Berkeley professor emeritus of molecular and cell biology now on the
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research staff at Children's Hospital Oakland Research Institute, with the research that motivated them to look at
enzyme variation. Ames found in the 1970s that many bacteria that could not produce a specific amino acid could do
so if given more vitamin B6, and in recent years he has continued exploring the link between micronutrients and
health.
"Looked at in one way, Bruce found that you can cure a genetic disease in bacteria by treating it with vitamins," Rine
said. Because the human genome contains about 6 billion DNA base pairs, each one subject to mutation, there could
be between 3 and 6 million DNA sequence differences between any two people. Given those numbers, he reasoned
that, as in bacteria, "there should be people who are genetically different in terms of the amount of vitamin needed for
optimal performance of their enzymes."
This touches on what Rine considers one of the key biomedical questions today. "Now that we have the complete
genome sequences of all the common model organisms, including humans, it's obvious that the defining challenge of
biology in the 21st century is not what the genes are, but what the variation in the genes does," he said.
Rine, Marini and their colleagues are continuing to study variation in the human MTHFR gene as well as other folate
utilizing enzymes, particularly with respect to how defects in these enzymes may lead to birth defects. Rine also is
taking advantage of the 1,500 students in his Biology 1A lab course to investigate variants of a second vitamin
B6-dependent enzyme, cystathionine beta-synthase.
He also is investigating how enzyme cofactors like vitamins and minerals fix defective enzymes. He suspects that
supplements work by acting as chaperones to stabilize the proper folding of the enzyme, which is critical to its
catalytic activity. "That is a new principle that may be applicable to drug design," Rine said.
Coauthors with Rine and Marini are UC Berkeley research assistant Jennifer Gin and Janet Ziegle, Kathryn
Hunkapiller Keho, David Ginzinger and Dennis A. Gilbert of Applied Biosystems, which also funded part of the
study. The work was supported by a University of California Discovery Grant, DARPA and the National Institutes
of Health.
Adapted from materials provided by University of California - Berkeley.
Need to cite this story in your essay, paper, or report? Use one of the following formats:
APA
MLA
University of California - Berkeley (2008, June 3). Good News In Our DNA: Defects You Can Fix With Vitamins
And Minerals. ScienceDaily. Retrieved June 7, 2008, from http://www.sciencedaily.com
/releases/2008/06/080602214135.htm

For more on the Genewize Supplements go to- http://www.mygenewize.com/?ID=doctordorn

Interesting Thoughts on Weight Loss

2008-06-10T08:28:00.000-05:00

Tough Talk about You and Weight Loss

By Dr. Matthew Anderson

I want to have an in-your-face, heart-to-heart, conversation with you. If I can get my point across then you will make some significant progress on your journey to complete weight loss. If I fail at this then you might just stay fat for the rest of your life.

Here are some hard facts about people who are consistently overweight. Are they true about 100% of overweight people? Of course not. Are they true about you? Probably.

If you decide that you are an exception to my rule you will be just like most people who are overweight and have a hard time losing it. They imagine that the rules do not apply to them. So they get to stay fat. You get to decide for yourself. Are you one of us (consistently weight-challenged persons) or not? Take a chance and join in. You only have fat to lose.

Here are some tough facts about many overweight persons.

You are overweight because you eat too much -- and you eat too much because you would rather eat than deal with yourself and life.
You frequently feel one or more of these feelings: inadequate, incompetent, afraid, overstressed, or angry in relationship to normal life. When you feel these and related uncomfortable emotions, you eat whether you are hungry or not and most of the time that food is comfort (fattening) food.
If you attempt to take the weight loss journey alone you will probably fail. Losing weight can be tough and most of us, including you, need lots of support. If you join or create a weight loss support group you will greatly increase your chances of succeeding. Tell your Ego to shut up and get support.
If you are chronically at least 20 lbs overweight you are a food addict. If you think of yourself this way you will become far more serious about how and when you lose weight. Admit it and get on with the process of recovery.
Successful recovery from addiction of any kind (especially food addiction) requires a relationship with a Divine Source. Develop one immediately. I know I sound like a 12-stepper, but what can I say except that they really got this part right.
Always remember that the idea that you can simply “eat less and exercise more” and lose weight is a mantra of diet morons. There are four basic and required ingredients/categories for long term healthy weight loss -- Physical (diet and exercise), Mental, Emotional and Spiritual. And the “eat less and exercise more” mantra lacks the other three.

Enough tough talk. Make the appropriate changes in your weight loss practices and you will be well on your way to success.

[Ed. note: Dr. Matthew Anderson is an author (The Prayer Diet), counselor and national columnist/expert on weight loss, motivation, self-management and relationships. To find tough-minded, outside-the-box guidance for taking charge of your life and/or your weight including Eating to Kill, click here.]

The Healthy Way to Good Health

2008-05-30T14:29:00.001-05:00

The Healthy Way to Good Health

To use an oft-repeated cliché, health is wealth, and if we don’t start safeguarding this, there’s no joy in living. To use another, prevention is better than cure, and these natural health improvement tips work wonders in not only keeping illness at bay, but also in keeping you young and fit.

1. A little exercise holds a lot of benefits: Work out, take a walk, go for a jog in the park, take up a game – exercise in any form provides you with good health the natural way. An hour a day is enough to get you in shape and keep sickness away. Even small things count – take the stairs instead of the elevator and walk a few blocks instead of driving to get there. Relaxation techniques like yoga and Tai Chi also help when you’re trying to lose weight and improve your body’s natural processes.

2. Eating right is the key: You are what you eat; your body is a mirror that reflects all that you take in, both good and bad. So do yourself a favor and include more vegetables and fruits in your diet; cut back on the fats and carbohydrates. Find more energy to sustain you through the day with energy-rich foods like nuts, yoghurt, eggs (the white only if you’re prone to high cholesterol levels), beans and lentils and seeds. If you have a sweet tooth or crave junk food, you don’t have to deny yourself. Satisfy cravings with self-control – eat two bites of a piece of chocolate cake instead of the whole slice or half a slice of pizza instead of three. Do not stuff yourself during any meal; instead, increase the number of meals per day and reduce the quantity you take in during each. Limit your caffeine intake, switch to green tea instead; the latter is rich in anti-oxidants that delay aging and prevent cancer.

3. Fill up with fluids: Our body is 80 percent water, so it’s only natural that you drink as much as you can. Water hydrates your skin and leaves it soft and supple. It also flushes out toxins from your body and cleanses your system.

4. Avoid direct and harsh sunlight: While mild sunshine is good for your Vitamin K levels, too much of it tends to give you sunburns and strokes. Exposure to harmful UV rays in the sunlight causes premature aging of the skin and suppresses your immune system leading to skin cancer and melanoma.

5. Maintain your BMI: Your Body Mass Indicator (BMI) is a good reflector of how trim and fit your body is. The ideal BMI, which is the ratio of your weight (in pounds) to the square of your height (in inches), is 25; a BMI under 18.5 indicates malnutrition while one above 30 labels you obese. So if you’re short, you have a lot of work to do to shed those excess pounds of flesh.

6. Harness the power of positive thinking: The stress and tension of day-to-day life cause more damage than you may realize. Ulcers, migraines, nervous breakdowns and insomnia are just a few of the illnesses associated with someone who’s stressed all the time. It’s not easy to take things easy, but if you work at it, the benefits are worth it. Practice relaxation techniques like yoga and Tai Chi, think positive thoughts and rein in your temper.

7. Massage your body and your mind: A body massage or a hot bath at the end of a long day works wonders in relaxing you. At the same time, treat yourself to a mind massage – give yourself an ego boost from time to time by reassuring yourself that you are good at what you do.

8. Say no to drugs and tobacco: Smoking kills in more ways than one and drugs are a definite way to disaster. Alcohol, while in moderation is not very harmful, tends to become an addiction if you do not hold on to your self-control.

9. Stay pollution free: Easier said than done with most cities and towns being inundated with cars and vehicles polluting the atmosphere. But make it a point to get some fresh air everyday – beat the heat and the crowds by waking up at the crack of dawn and taking a walk in the park. Steer clear of restaurants or public areas that allow smoking.

10. Fasting is good once in a while: Every once a month or so, your body needs time to heal itself from all the abuses you put it through. Undergo a detoxification routine – stay home, eat only fresh fruits and vegetables, drink lots of fluids, sleep, meditate and avoid work for a couple of days. Your whole system is rejuvenated.

11. Medicines don’t always help: Stop popping that pill for every common ailment that afflicts you. A simple headache can be cured by a walk in the fresh air or a cup of hot coffee; a cold is reduced with warm fluids and plenty of rest.

A little common sense mixed with a little effort is all it takes to stay healthy and happy.

By-line:

This article is contributed by Sarah Scrafford, who regularly writes on the topic of Care Plans. She invites your questions and writing job opportunities at her personal email address: sarah.scrafford25@gmail.com.

Malic Acid and Magnesium in Fibro

2008-05-02T09:15:00.006-05:00

Malic Acid and Fibromyalgia by Source: Nutritional News
ImmuneSupport.com

12-01-1995 Fibromyalgia Syndrome (fibromyalgia) is a condition which affects principally middle-aged women, characterized by a syndrome of generalized musculoskeletal pain, aches, stiffness, and tenderness at specific anatomical sites. This condition is considered primarily when there are no obvious causes. Since it was first described, fibromyalgia has become recognized as a fairly common rheumatic complaint with a clinical prevalence of 6 to 20%. Additionally, fibromyalgia has been associated with irritable bowel syndrome, tension headache, mitral valve prolapse, and Chronic Fatigue Syndrome.

Numerous treatment modalities have been attempted to treat patients with fibromyalgia, but unfortunately the results have been poor, due to a lack of understanding of the condition’s etiology.

In recent years, evidence has accumulated to suggest that fibromyalgia is the result of local hypoxia to the muscles. For instance, patients with fibromyalgia have low muscle-tissue oxygen pressure in affected muscles, and to a lesser degree the same is true of other tissues. Muscle biopsies from affected areas showed muscle tissue glycolysis is inhibited, reducing ATP synthesis. This stimulates the process of gluconeogenesis, which results in muscle tissue breakdown and mitochondrial damage. Additionally, low levels of the high-energy phosphates ATP, ADP, and phosphocreatine were found. It is hypothesized that in hypoxic muscle tissue, glycolysis is inhibited, reducing ATP synthesis. This muscle tissue breakdown, which has been observed in muscle biopsies taken from fibromyalgia patients, is hypothesized to result in the muscle pain characteristic of fibromyalgia.

Malic acid is both derived from food sources and synthesized in the body through the citric acid cycle. Its importance to the production of energy in the body during both aerobic and anaerobic conditions is well established. Under aerobic conditions, the oxidation of malate to oxaloacetate provides reducing equivalents to the mitochondria through the malateaspartate redox shuttle. During anaerobic conditions, where a buildup of excess of reducing equivalents inhibits glycolysis, malic acid’s simultaneous reduction to succinate and oxidation to oxaloacetate is capable of removing the accumulating reducing equivalents. This allows malic acid to reverse hypoxia’s inhibition of glycolysis and energy production, possibly improving energy production in fibromyalgia, and reversing the negative effect of the relative hypoxia that has been found in these patients.

Because of its obvious relationship to energy depletion during exercise, malic acid may be of benefit to healthy individuals interested in maximizing their energy production, as well as those with Fibromyalgia, or Chronic Fatigue Syndrome.

As a result of the compelling evidence that malic acid plays a central role in energy production, especially during hypoxic conditions, malic acid supplements have been examined for their effects on fibromyalgia. Subjective improvement in pain was observed within 48 hours of supplementation with 1200-2400 mg. of malic acid, and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in fibromyalgia patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in fibromyalgia, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with fibromyalgia. The potential for malic acid supplements however, reaches much farther than fibromyalgia.

Additionally, many hypoxia-related conditions such as respiratory and circulatory insufficiency, are associated with deficient energy production. Therefore, malic acid supplements may be of benefit in these conditions. Chronic Fatigue Syndrome has also been found to be associated with fibromyalgia, and malic acid supplementation may be of use in improving energy production in this condition as well. Lastly, malic acid may be of use as a general supplement, ensuring an optimal level of malic acid within the cells, and thus, maintaining an optimal level of energy production.

Reprinted with permission from Nutritional News, December 1995.

By: http://www.ImmuneSupport.com

Key vitamin deficiency linked to tripled risk of dementia: study

2008-02-05T10:56:00.000-06:00

Lack of folate, also called vitamin B-9, may triple the risk of developing dementia in old age, according to a study published Tuesday.

Researchers in South Korea measured naturally occurring folate levels in 518 elderly persons, none of whom showed any signs of dementia, and then tracked their development over 2.4 years.

At the end of the period, 45 of the patients had developed dementia, including 34 diagnosed with Alzheimer's disease, said the study, published by the British Medical Association's Journal of Neurology, Neurosurgery and Psychiatry.

When the researchers, led by Jin-Sang Yoon of Chonnam National University in Kwangju, South Korea, remeasured folate levels, they uncovered a strong link with the dementia.

Even after other factors were taken into account -- including age, disability, alcohol consumption, weight change -- "the onset of dementia was significantly associated with an exaggerated decline in folate," the researchers concluded.

Folate and folic acid, another form of the compound, are essential for the creation of new cells in the body.

The compound occurs naturally in leafy vegetables such as spinach, turnip greens, lettuces, dried beans and peas and in certain fruits.

An study published last year in The Lancet showed an improvement in short-term memory, mental agility and verbal fluency among persons over 50 who took a daily dose of 800 micrograms (mcg) of folic acid. The US recommended daily dose is 400 mcg.

Taking folic acid before conception and throughout the first trimester helps a mother ensure that her child will not develop certain brain and spinal cord defects, including spina bifida, according to previous research.

Monthly fasting may help heart

2007-12-10T17:07:00.000-06:00

By MARILYNN MARCHIONE

Mormons have less heart disease — something doctors have long chalked up to their religion's ban on smoking. New research suggests that another of their "clean living" habits also may be helping their hearts: fasting for one day each month.

A study in Utah, where the Church of Jesus Christ of Latter-Day Saints is based, found that people who skipped meals once a month were about 40 percent less likely to be diagnosed with clogged arteries than those who did not regularly fast.

People did not have to "get religion" to benefit: non-Mormons who regularly took breaks from food also were less likely to have clogged arteries, scientists found.

They concede that their study is far from proof that periodic fasting is good for anyone, but said the benefit they observed poses a theory that deserves further testing.

"It might suggest these are people who just control eating habits better," and that this discipline extends to other areas of their lives that improves their health, said Benjamin Horne, a heart disease researcher from Intermountain Medical Center and the University of Utah in Salt Lake City.

He led the study and reported results at a recent American Heart Association conference. The research was partly funded by the National Heart, Lung, and Blood Institute.

Roughly 70 percent of Utah residents are Mormons, whose religion advises abstaining from food on the first Sunday of each month, Horne said.

Researchers got the idea to study fasting after analyzing medical records of patients who had X-ray exams to check for blocked heart arteries between 1994 and 2002 in the Intermountain Health Collaborative Study, a health registry. Of these patients, 4,629 could be diagnosed as clearly having or lacking heart disease — an artery at least 70 percent clogged.

Researchers saw a typical pattern: only 61 percent of Mormons had heart disease compared to 66 percent of non-Mormons. They thought tobacco use probably accounted for the difference. But after taking smoking into account, they still saw a lower rate of heart disease among Mormons and designed a survey to explore why.

It asked about Mormons' religious practices: monthly fasting; avoiding tea, coffee and alcohol; taking a weekly day of rest; going to church, and donating time or money to charity.

Among the 515 people surveyed, only fasting made a significant difference in heart risks: 59 percent of periodic meal skippers were diagnosed with heart disease versus 67 percent of the others.

The difference persisted even when researchers took weight, age and conditions like diabetes or high cholesterol or blood pressure into account. About 8 percent of those surveyed were not Mormons, and those who regularly fasted had lower rates of heart disease, too.

Horne speculated that when people take a break from food, it forces the body to dip into fat reserves to burn calories. It also keeps the body from being constantly exposed to sugar and having to make insulin to metabolize it. When people develop diabetes, insulin-producing cells become less sensitive to cues from eating, so fasting may provide brief rests that resensitize these cells and make them work better, he said.

But he and other doctors cautioned that skipping meals is not advised for diabetics — it could cause dangerous swings in blood sugar.

Also for dieters, "the news is not as good as you might think" on fasting, said Dr. Raymond Gibbons of the Mayo Clinic, a former heart association president.

"Fasting resets the metabolic rate," slowing it down to adjust to less food and forcing the body to store calories as soon as people resume eating, Gibbons said.

7 Reasons to Drink Green Tea

2007-12-05T16:46:00.001-06:00

The steady stream of good news about green tea is getting so hard to ignore that even java junkies are beginning to sip mugs of the deceptively delicate brew. You'd think the daily dose of disease-fighting, inflammation-squelching antioxidants - long linked with heart protection - would be enough incentive, but wait, there's more! Lots more.

CUT YOUR CANCER RISK
Several polyphenols - the potent antioxidants green tea's famous for - seem to help keep cancer cells from gaining a foothold in the body, by discouraging their growth and then squelching the creation of new blood vessels that tumors need to thrive. Study after study has found that people who regularly drink green tea reduce their risk of breast, stomach, esophagus, colon, and/or prostate cancer.

SOOTHE YOUR SKIN
Got a cut, scrape, or bite, and a little leftover green tea? Soak a cotton pad in it. The tea is a natural antiseptic that relieves itching and swelling. Try it on inflamed breakouts and blemishes, sunburns, even puffy eyelids. And that's not all. In the lab, green tea helps block sun-triggered skin cancer, whether you drink it or apply it directly to the skin - which is why you're seeing green tea in more and more sunscreens and moisturizers.

STEADY YOUR BLOOD PRESSURE
Having healthy blood pressure - meaning below 120/80 - is one thing. Keeping it that way is quite another. But people who sip just half a cup a day are almost 50 percent less likely to wind up with hypertension than non-drinkers. Credit goes to the polyphenols again (especially one known as ECGC). They help keep blood vessels from contracting and raising blood pressure.

PROTECT YOUR MEMORY, OR YOUR MOM'S
Green tea may also keep the brain from turning fuzzy. Getting-up-there adults who drink at least two cups a day are half as likely to develop cognitive problems as those who drink less. Why? It appears that the tea's big dose of antioxidants fights the free-radical damage to brain nerves seen in Alzheimer's and Parkinson's.

STAY YOUNG
The younger and healthier your arteries are, the younger and healthier you are. So fight plaque build-up in your blood vessels, which ups the risk of heart disease and stroke, adds years to your biological age (or RealAge), and saps your energy too. How much green tea does this vital job take? About 10 ounces a day, which also deters your body from absorbing artery-clogging fat and cholesterol.

LOSE WEIGHT
Oh yeah, one more thing. Turns out that green tea speeds up your body's calorie-burning process. In the every-little-bit-counts department, this is good news!

Do Diet Sodas Make You Fat?

2007-12-05T16:42:00.000-06:00

The short answer(s) to this question is no and, maybe, yes. One recent study has shown that people who drink diet soda still have a 41 percent chance of being overweight.

What is even more interesting about this research is that these diet-soda drinkers have a greater risk for obesity than do those who drink regular sodas.

How is this possible? It can't be that the diet sodas are causing obesity, since they contain no calories.

Some researchers believe that the problem with diet sodas is this: When people consume diet drinks, they think they're doing something "good" for their body — and then they feel free to splurge on other, high-calorie items.

For example, if you are eating at McDonald's and order a diet soda in place of a regular soda, you may think, "Now I can super-size my meal." People don't do this intentionally; it just happens and we don't pay attention to it — and then the extra pounds slip on board and stow away.

There is also some research that suggests diet sodas may actually stimulate the appetite. This explanation of the relationship between diet sodas and obesity is that the overly sweet taste of diet drinks actually creates a craving for still more sweet things, thus upping calorie consumption.

What then should you do about your drink choices?

First, remember: Everything in moderation. If you are drinking a lot of regular or diet soda each day, decreasing your intake of either may help you lose weight. Also, think about when during the day you drink diet sodas; do you then tend to splurge on other calories?

Although escaping the obesity epidemic isn't as easy as avoiding diet sodas, you should think about what you drink.

Honey for Kids Coughs

2007-12-04T09:56:00.000-06:00

Study: Try honey for children's coughs

Carla Johnson

A teaspoon of honey before bed seems to calm children's coughs and help them sleep better, according to a new study that relied on parents' reports of their children's symptoms.

The folk remedy did better than cough medicine or no treatment in a three-way comparison. Honey may work by coating and soothing an irritated throat, the study authors said.

"Many families are going to relate to these findings and say that grandma was right," said lead author Dr. Ian Paul of Pennsylvania State University's College of Medicine.

The research appears in December's Archives of Pediatrics and Adolescent Medicine

Federal health advisers have recently warned that over-the-counter cough and cold medicines shouldn't be used in children younger than 6, and manufacturers are taking some products for babies off the market.

Three pediatricians who read the study said they would tell parents seeking alternative remedies to try honey. They noted that honey should not be given to children under age 1 because of a rare but serious risk of botulism.

For the study, researchers recruited 105 children with upper respiratory infections from a clinic in Pennsylvania. Parents were given a paper bag with a dosing device inside. Some were empty. Some contained an age-appropriate dose of honey-flavored cough medicine containing dextromethorphan. And some contained a similar dose of honey.

The parents were asked about their children's sleep and cough symptoms, once before the bedtime treatment and once after. They rated the symptoms on a seven-point scale.

All of the children got better, but honey consistently scored best in parents' rating of their children's cough symptoms.

"Give them a little time and they'll get better," said Pat Jackson Allen, a professor at Yale University School of Nursing.

The study was funded by a grant from the National Honey Board, an industry-funded agency of the U.S. Department of Agriculture. The agency had no influence over the study design, data or results, Paul said.

Depressed? Get off the couch.

2007-12-03T11:36:00.000-06:00

By Amy Norton

Exercise seems to increase the production of naturally occurring brain chemical with antidepressant effects in mice, researchers reported Sunday.

The findings, published in the journal Nature Medicine, point to potential new ways to treat depression in people.

Studies have found that exercise can help ease depression symptoms, but the reasons for the benefit have not been clear. For the new study, scientists used a tool called a microarray to examine how exercise changed gene activity in the brains of mice.

They focused on a brain region known as the hippocampus, which has been implicated in mood regulation and in the brain's response to antidepressant medication.

The researchers found that mice that had a week's worth of workouts on a running wheel showed altered activity in a total of 33 genes, the majority of which had never been identified before.

In particular, exercise enhanced activity in the gene for a nerve growth factor known as VGF. Nerve growth factors are small proteins important in the development and maintenance of nerve cells.

Moreover, when the researchers infused a synthetic version of VGF into the brains of the mice, it produced a "robust antidepressant effect" in standardized tests of animals placed in stressful situations.

"The major finding is that we have identified a key factor that underlies the antidepressant effects of exercise -- information that could be used for the development of novel therapeutic agents," said senior researcher Dr. Ronald S. Duman of Yale University in New Haven, Connecticut.

Exercise "clearly has effects on the brain," he told Reuters Health, and they are both direct and indirect. It's possible, he explained, that the current findings reflect a direct effect of exercise on nerve cells in the hippocampus, or more general changes in the brain, like better blood flow or increased hormonal activity.

Besides offering more support for the benefits of exercise, the findings also point to VGF as a target for new antidepressants, according to Duman and his colleagues. Such medications, they point out, would work by an entirely different mechanism than existing antidepressants, which are effective for about 65 percent of patients.

Aspartame Don't Even Consider It

2007-11-07T13:07:00.001-06:00

In the keynote address by the EPA at the World Environmental Conference, it was announced that there was an epidemic of multiple sclerosis and system lupus and they did not understand what toxin was causing this to become rampant across the United States. "When the temperature of aspartame exceeds 86 degrees F, the wood alcohol in aspartame converts to formaldehyde and then to formic acid, which, in turn, causes metabolic acidosis. Formic acid is the poison found in the sting of fire ants. The methanol toxicity mimics multiple sclerosis; thus, people are being diagnosed with multiple sclerosis in error. Multiple sclerosis is not a death sentence; methanol toxicity is. "Systemic lupus has become almost as rampant as multiple sclerosis, especially in Diet Coke and Diet Pepsi drinkers. With methanol toxicity, the victims usually drink three to four 12 oz cans per day, some even more. In the cases of systemic lupus, which is triggered by aspartame, the victim usually does not know the aspartame is the culprit. The victim continues its use and aggravates the lupus to such a degree, that it sometimes becomes life threatening. When people quit using aspartame, those with systemic lupus usually become asymptomatic. Unfortunately, this disease cannot be reversed. On the other hand, in the case of those diagnosed with multiple sclerosis, (when in reality, the disease is methanol toxicity), most of the symptoms disappear. In some cases, vision and hearing have returned. This also applies to cases of Tinnitus. If you are using aspartame (NutraSweet, Equal, Spoonful, etc.) and you suffer from fibromyalgia symptoms, spasms, shooting pains, numbness in your legs, cramps, vertigo, dizziness, headaches, tinnitus, joint pain, depression, anxiety attacks, slurred speech, blurred vision or memory loss, you probably have "Aspartame Disease". "The Ambassador of Uganda noted that their sugar industry is adding aspartame. He continued by saying that one of the industry leader's sons could no longer walk due in part to product usage. This is a very serious problem. Additionally, during a visit to a hospice, a nurse said that six of her friends, who were heavy Diet Coke drinks, had all been diagnosed with MS. This is beyond coincidence! "Here is the problem. There were Congressional Hearings when aspartame was originally included as a sweetener in 100 different products. Since this initial hearing, there have been two subsequent hearings. Nothing has been done. The drug and chemical lobbies have very deep pockets. Now, there are over 5,000 products containing this chemical and the patent has expired. At the time of this first hearing, people were going blind. The methanol in the aspartame converts to formaldehyde in the retina of the eye. Formaldehyde is grouped in the same class of drugs as cyanide and arsenic - deadly poisons. Unfortunately, it just takes longer to quietly kill, but is killing people and causing neurological problems. Aspartame changes the brain's chemistry. It is the reason for severe seizures. This drug changes the dopamine level of the brain. Imagine what this drug does to patients suffering from Parkinson's disease. This drug also causes birth defects. "There is absolutely no reason to use this product. It is "not a diet product"/ The Congressional record said, "It makes you crave carbohydrates and will make you FAT." Dr. H. J. Roberts, a diabetic specialist and expert on aspartame poisoning, states that when he took patients off of aspartame, their average weight loss was 19 pounds per person. Aspartame is especially deadly for diabetics. All physicians know what wood alcohol will do to a diabetic. We find that physicians believe that they have patients with retinopathy when, in fact, it's caused by the aspartame. The aspartame keeps the blood sugar level out of control, causing many patients to go into a coma. Unfortunately, many have died. It was reported at the Conference of the American College of Physicians that those patients that switched from saccharin to an aspartame product had eventually gone into a coma. Their physicians could not get their blood sugar levels under control. The patients suffered acute memory loss, and, eventually, coma and death. Memory loss is due to the fact that aspartic acid and phenylalanine are neurotoxins without the other amino acids found in protein. Thus is goes past the blood brain barrier and deteriorates the neurons of the brain. Dr. Russell Blaylock, a neurosurgeon, said "The ingredients stimulate the neurons of the brain to death, causing brain damage of varying degrees." "Dr. Blaylock and Dr. Roberts will be writing a position paper with some case histories and it will be posted on the Internet. According to the Conference of the American College of Physicians, "We are talking about a plague of neurological diseases caused by this deadly poison." Dr. Roberts realized what was happening when aspartame was first marketed. He reported, "My diabetic patients are suffering memory loss, confusion and severe vision loss." At the Conference, doctors admitted not knowing why. They had wondered by seizures were rampant (the phenylalanine in aspartate breaks down the seizure threshold and depletes serotonin, which causes manic depression, panic attacks, rage and violence). Just before the Conference, Norway asked for a possible antidote for this poison because they are experiencing so many problems in their country. This poison' is now available in 90 plus countries worldwide. Fortunately, speakers and ambassadors at the conference from different nations have pledged their help. Take anything that contains aspartame back to the store. Monsanto, the creator of aspartame, knows how deadly it is. They fund the American Medical Association, American Dietetic Association, Congress and the Conference of the American College of Physicians. On November 15, l996 the New York Times ran an article on how the American Dietetic Association takes money from the food industry to endorse their products. Therefore, they cannot criticize any additives or tell about their link to Monsanto. How bad is this? A mother who had a child on NutraSweet was told to get off the product. The child was having grand mal seizures daily. The mother called her physician, who called the ADA and was told not to take the child off of NutraSweet. The mother can not be convinced that the aspartame is causing the seizures. Every time someone gets off aspartame, seizures stop. There are 92 documented symptoms of aspartame, from coma to death. The majority of them are neurological because aspartame destroys the nervous system. Aspartame Disease is partially behind some of the mystery of the Desert Storm health problems. The burning tongue and other problems discussed many cases can be directly related to the consumption of aspartame. Several thousand pallets of diet drinks were shipped to the Desert Storm troops. (Remember: heat can liberate the methanol from the aspartame at 86 degrees F). These diet drinks sat in the 120 degree F Arabian sun for weeks at a time on pallets. The serviceman and women drank them all day long. All of their symptoms are identical to aspartame poisoning. Additionally, Dr. Roberts says, "Consuming aspartame at the time of conception can cause birth defects." According to Dr. Louis Elsas, Pediatrician and Professor of Genetics at Emory University, in his testimony before Congress, the phenylalanine concentrates in the placenta, causing mental retardation. In the original lab tests, animals developed brain tumors; phenylalanine breaks down in DKP, a brain tumor agent. When Dr. Esposito was lecturing on aspartame, one physician in the audience, a neurosurgeon said, "When brain tumors are removed and studies, high levels of aspartame were found in them." "Stevia or Xylitol, a sweet food and "not an additive" helps in the metabolism of sugar. It would be ideal for diabetics and has now been approved as a dietary supplement by the FDA. For years, the FDA has outlawed this sweet food, because of their loyalty to Monsanto. If it says "sugar free" on the label - do not even consider it." Andrea McCreery, Ph.D. is located in Fair Oaks, CA. She may be contacted at www.life-sources.com or 916 536-9930. http://www.wnho.net/aspartame_no_hoax.htm Two reports by Doctors H. J. Roberts and Russell Blaylock regarding Multiple Sclerosis: MS (Multiple Sclerosis) or Aspartame Disease, by H. J. Roberts, M.D., http://www.mpwhi.com/ms_or_aspartame_disease.htm The MS (Multiple Sclerosis) and Aspartame Connection by Russell Blaylock, M.D., http://www.wnho.net/ms_and_aspartame.htm 13 new studies showing Aspartame Toxicity in 24 months: http://www.mpwhi.com/13_aspartame_research_studies.htm Read more proof at the World Environmental Conference: www.dorway.com/nomarkle.html Dr. Russell Blaylock's article: "What To Do If You Have Used Aspartame" www.wnho.net/wtdaspartame.htm Dr. Ralph Walton's article on psychiatric disorders and aspartame: http://www.mpwhi.com/aspartame_and_psychiatric_disorders.htm The timeline on Aspartame from the Ecologist: http://www.mpwhi.com/ecologist_september_2005.pdf

Obesity and and Cancer

2007-10-31T16:05:00.000-05:00

Report stresses link between obesity and cancer

Keeping slim is one of the best ways of preventing cancer, as is avoiding excessive amounts of red meat and wine, a landmark study has revealed.

The World Cancer Research Fund (WCRF) said the link between body fat and cancer is closer than generally realized.

It found convincing evidence of a link to six types of cancer, five more than in its last report, 10 years ago.

Among the new types are colorectal (bowel) and post-menopausal breast cancer.

Professor Michael Marmot, chair of the panel of 21 eminent scientists who compiled the report, said: "We are recommending that people aim to be as lean as possible within the healthy range, and that they avoid weight gain throughout adulthood."

The report, which selected 7,000 studies from a worldwide pool of 500,000 written since records began in the 1960s, includes five key findings.

They are that processed meats, such as ham and bacon, increase the risk of colorectal cancer, and should be eaten sparingly.

Another is the link between red meat and colorectal cancer, for which the evidence is stronger than ever. People should not eat more than 500g of cooked red meat a week -- or between 700g and 750g for "blue" or uncooked meat.

A further finding was the strongest evidence yet that alcohol is a cause of cancer. If people must drink, the report said, they should limit their intake to two units a day for a man or one for a woman. A unit is a half pint of beer or a small glass of wine.

The report recommended mothers breastfeed exclusively for the first six months after birth followed by complementary breastfeeding, after evidence showed breastfeeding protects the mother against breast cancer.

It did not recommend dietary supplements as prevention.

"This report is a real milestone in the fight against cancer, because its recommendations represent the most definitive advice on preventing cancer that has ever been available anywhere in the world," said Professor Martin Wiseman, project director of the report.

Scientists believe there are several reasons for the link between body fat and cancer.

One is the relationship between excess fat and the hormonal balance in the body.

Research has shown that fat cells release hormones such as estrogen, which increases the risk of breast cancer, while fat around the waist encourages the body to produce growth hormones, which can increase levels of risk.

Evidence of a link is most convincing for cancer of the esophagus, pancreas, colorectum, endometrium (womb), kidney and post-menopausal breast cancer.

The report makes 10 recommendations including 30 minutes of moderate activity a day, rising to 60 minutes; drinking water rather than sugary drinks; eating fruit, vegetables and fiber and limiting salt consumption.

The WCRF report can be found at: http://www.dietandcancerreport.org/

Body Mass and Headaches

2007-10-09T09:47:00.000-05:00

This study confirms something I have believed for a number of years, that
migraines headaches are more prevalent in persons who are overweight.
Though this study doesn't answer the why, I believeit has to do with the
hormonal influences from adipose tissue.

Marcelo E. Bigal, MD, PhD; Amy Tsang; Elizabeth Loder, MD; Daniel Serrano, PhD; Michael L. Reed, PhD;Richard B. Lipton, MD; for the American Migraine Prevalence and Prevention Advisory Group

Arch Intern Med. 2007;167:1964-1970.

Background We investigated the influence of the body massindex (BMI [calculated as weight in kilograms divided by heightin meters squared]) on the frequency, severity, and patternsof treatment of migraine, probable migraine (PM), and severeepisodic tension-type headache (S-ETTH).

Methods A validated questionnaire was mailed to 120 000households selected to be representative of the US population.The participants were divided into 5 categories based on BMI:underweight (<18.5),> (25.0-29.9), obese (30.0-34.9), and morbidly obese (>35.0).Analyses were adjusted by covariates that included demographicvariables (age, sex, race, and income), duration of illness,comorbidities, use of preventive medication, and use of opioids.

Results The response rate was 65%. We identified 18 968individuals with migraine, 7564 with PM, and 2051 with S-ETTH.The distribution of very frequent headaches (10-14 d/mo) wasassessed by BMI. Among individuals with migraine, very frequentheadaches (10-14 d/mo) occurred in 7.4% of the overweight (P = .10),8.2% of the obese (P < .001), and 10.4% of themorbidly obese (P < .0001) subjects, compared with6.5% of those with normal weight, in adjusted analyses. Amongindividuals with PM and S-ETTH, the differences were not significant(P = .20). The disability of migraineurs, but notof those with PM or S-ETTH, also varied as a function of BMI.Among migraineurs, 32.0% of those with normal weight had somedisability compared with 37.2% of the overweight (P < .01),38.4% of the obese (P < .001), and 40.9% of themorbidly obese (P < .001) subjects.

Conclusion These findings support the concept that obesityis an exacerbating factor for migraine but not for other typesof episodic headaches.

Author Affiliations: Departments of Neurology (Drs Bigal and Lipton) and Epidemiology and Population Health (Dr Lipton), Albert Einstein College of Medicine and The Montefiore Headache Center (Drs Bigal and Lipton and Ms Tsang), Bronx, New York; The New England Center for Headache, Stamford, Connecticut (Dr Bigal); Spaulding Rehabilitation Hospital, Boston, Massacusetts (Dr Loder); and Vedanta Research, Chapel Hill, North Carolina (Drs Serrano and Reed).

Acupuncture and Back Pain

2007-09-25T09:39:00.000-05:00

Study: Acupuncture works for back pain

By CARLA K. JOHNSON, Associated Press WriterMon Sep 24, 11:09 PM ET

Fake acupuncture works nearly as well as the real thing for low back pain, and either kind performs much better than usual care, German researchers have found. Almost half the patients treated with acupuncture needles felt relief that lasted months. In contrast, only about a quarter of the patients receiving medications and other Western medical treatments felt better.

Even fake acupuncture worked better than conventional care, leading researchers to wonder whether pain relief came from the body's reactions to any thin needle pricks or, possibly, the placebo effect.

"Acupuncture represents a highly promising and effective treatment option for chronic back pain," study co-author Dr. Heinz Endres of Ruhr University Bochum in Bochum, Germany, said in an e-mail. "Patients experienced not only reduced pain intensity, but also reported improvements in the disability that often results from back pain and therefore in their quality of life."

Although the study was not designed to determine how acupuncture works, Endres said, its findings are in line with a theory that pain messages to the brain can be blocked by competing stimuli.

Positive expectations the patients held about acupuncture — or negative expectations about conventional medicine — also could have led to a placebo effect and explain the findings, he said.

In the largest experiment on acupuncture for back pain to date, more than 1,100 patients were randomly assigned to receive either acupuncture, sham acupuncture or conventional therapy. For the sham acupuncture, needles were inserted, but not as deeply as for the real thing. The sham acupuncture also did not insert needles in traditional acupuncture points on the body and the needles were not manually moved and rotated.

After six months, patients answered questions about pain and functional ability and their scores determined how well each of the therapies worked.

In the real acupuncture group, 47 percent of patients improved. In the sham acupuncture group, 44 percent did. In the usual care group, 27 percent got relief.

"We don't understand the mechanisms of these so-called alternative treatments, but that doesn't mean they don't work," said Dr. James Young of Chicago's Rush University Medical Center, who wasn't involved in the research. Young often treats low back pain with acupuncture, combined with exercises and stretches.

Chinese medicine holds that there are hundreds of points on the body that link to invisible pathways for the body's vital energy, or qi. The theory goes that stimulating the correct points with acupuncture needles can release blocked qi.

Dr. Brian Berman, the University of Maryland's director of complementary medicine, said the real and the sham acupuncture may have worked for reasons that can be explained in Western terms: by changing the way the brain processes pain signals or by releasing natural painkillers in the body.

In the study, the conventional treatment included many methods: painkillers, injections, physical therapy, massage, heat therapy or other treatments. Like the acupuncture patients, the patients getting usual care received about 10 sessions of 30 minutes each.

The study, appearing in Monday's Archives of Internal Medicine, used a broad definition for low back pain, but ruled out people with back pain caused by spinal fractures, tumors, scoliosis and pregnancy.

Funding came from German health insurance companies, and the findings already have led to more coverage in Germany of acupuncture.

In the United States, some health plans cover acupuncture for some conditions, but may require pre-approval, according to the National Center for Complementary and Alternative Medicine. An acupuncture session can cost $45 to $100, Young said.

___

On the Net:

Archives: http://www.archinternmed.co

Still More on Malic Acid

2007-09-10T16:06:00.000-05:00

Malic Acid: Top Up Your Body's Own Supplies Of Malic Acid To Increase Your Energy Levels And Overcome Fatigue

Malic acid is a natural substance found in fruit and vegetables - one of the richest sources being apples. It is also naturally present in your body's cells and large amounts of it are formed and then eventually broken down again on a daily basis.
It possesses many health-related benefits such as boosting immunity, maintaining oral health, reducing the risk of poisoning from a build-up of toxic metals and promoting smoother and firmer skin.

However, one of its most significant benefits lies in its ability to stimulate metabolism and increase energy production. This action is linked to the important role it plays in a process known as the Krebs cycle - named after Sir Hans Krebs, a German-born British biochemist.

Krebs won the Nobel price for physiology in 1953 for describing how a complex series of biochemical reactions takes place within the body's cells to transform proteins, fat and carbohydrates into water and energy. This process requires a constant supply of vitamins, enzymes and chemical agents such as malic acid, in order to keep it functioning properly 24 hours a day.

The Krebs cycle is vital to our very existence and without it energy production would literally grind to a halt. Therefore it is essential that you have adequate supplies of malic acid in order to promote the efficient functioning of this cycle.
"Malic acid is safe, inexpensive and it should be considered a valid therapeutic approach for patients with CFS"

In particular, malic acid's involvement in the Krebs cycle means it plays an important role in improving overall muscle performance, reversing muscle fatigue following exercise, reducing tiredness and poor energy levels, as well as improving mental clarity. These actions can make it a beneficial treatment for sufferers of fibromyalgia (which involves muscle pain, joint tenderness and poor energy levels) and Chronic Fatigue Syndrome (CFS), which produces similar symptoms.

According to Dr Jay Goldstein, Director of the CFS Institute in the US: "Malic acid is safe, inexpensive and it should be considered a valid therapeutic approach for patients with CFS".

In relation to fibromyalgia, a six-month study was conducted by scientists working at the Department of Medicine, University of Texas Health Science Centre in the US, to examine the efficacy of 1,200mg of malic acid plus 300mg of magnesium a day on 24 fibromyalgia sufferers. Half of the patients were given the active treatment, while the other half only received placebo.

At the end of the study, all of the patients treated with malic acid and magnesium experienced significant improvements in their symptoms - including less pain, reduced muscle stiffness and a more positive mental outlook - without any side effects.

Dr Russell, who led the team of scientists, concluded: "The data suggest that malic acid and magnesium are safe and may be beneficial in the treatment of patients with fibromyalgia. Future studies should use malic acid at this dose and continue the therapy for at least two months".1

Malic acid has a diverse range of beneficial actions
In addition to increasing energy levels through its involvement in the Krebs cycle, malic acid is also an effective metal chelator. This means it is able to bind to potentially toxic metals that may have accumulated in the body, such as aluminium or lead, and inactivate them. As a result, the risk of toxicity is considerably reduced, which is important as a heavy metal overload has been linked to serious problems like liver disease and brain disorders like Alzheimer's disease.

Malic acid also helps maintain oral hygiene.

It stimulates the production of saliva, which reduces the number of harmful bacteria circulating in your mouth, teeth and gums. It acts as an antiseptic too, which also helps to ensure that germs in the mouth are kept to a minimum and considerably reduces the risk of infection.2

For these reasons, malic acid is commonly used as an ingredient in mouthwashes and toothpastes.

Not only that, but malic acid is also important for maintaining good skin health.
It is classified as an 'alpha hydroxy acid' - a chemical term used to describe fruit acids that are used in many cosmetics because of their ability to help exfoliate the skin and act as mild chemical face peels. These actions help your skin look healthier, younger and firmer. For a natural face peel you can apply thin slices of apple (as mentioned earlier, apples are one of the richest sources of malic acid) directly onto your skin for 20 minutes and then wash off with rose water.

What to take for best results
The recommended dosage for malic acid is 600mg capsules taken one to three times a day before food. There are no known contraindications or toxicity linked to malic acid.3

Taking magnesium alongside malic acid seems to have a much more pronounced effect on muscle fatigue. The recommended dosage for magnesium citrate is 140mg capsules taken twice a day.

1. Russell IJ, Michalek JE, Flechas JD. J Rheumatol 1995, 22(5):953-958
2. Fernandes-Naglik L, Downes J, Shirlaw R. Oral Dis 2001, 7(5):276-280
3. Abraham G, Flechas J. J Nutr Med 1992, 3:49-59

More on Malic Acid

2007-09-10T16:04:00.000-05:00

Malic Acid

Fibromyalgia Syndrome (fibromyalgia) is a condition which is characterized by a syndrome of generalized musculoskeletal pain, aches, stiffness, and tenderness at specific anatomical sites. Since it was first described, fibromyalgia has become recognized as a fairly common rheumatic complaint with a clinical prevalence of 6 to 20%. Additionally, fibromyalgia has been associated with irritable bowel syndrome, tension headache, mitral valve prolapse, and Chronic Fatigue Syndrome, to name a few.

In recent years, evidence has accumulated to suggest that the pain associated with fibromyalgia may be the result of local hypoxia to the muscles. Patients with fibromyalgia have low muscle-tissue oxygen pressure in affected muscles, and to a lesser degree the same is true of other tissues. Muscle biopsies from affected areas showed muscle tissue glycolysis is inhibited, reducing ATP synthesis. This stimulates the process of gluconeogenesis, which results in muscle tissue breakdown and mitochondrial damage. Additionally, low levels of the high-energy phosphates ATP, ADP, and phosphocreatine were found. It is hypothesized that in hypoxic muscle tissue, glycolysis is inhibited, reducing ATP synthesis. This muscle tissue breakdown, which has been observed in muscle biopsies taken from fibromyalgia patients, is hypothesized to result in the muscle pain characteristic of fibromyalgia.

Malic acid is synthesized in the body through the citric acid cycle. Its importance to the production of energy in the body during both aerobic and anaerobic conditions is well established. Under aerobic conditions, the oxidation of malate to oxaloacetate provides reducing equivalents to the mitochondria through the malate-aspartate redox shuttle. During anaerobic conditions, where a buildup of excess of reducing equivalents inhibits glycolysis, malic acid’s simultaneous reduction to succinate and oxidation to oxaloacetate is capable of removing the accumulating reducing equivalents. This allows malic acid to reverse hypoxia’s inhibition of glycolysis and energy production, possibly improving energy production in fibromyalgia, and reversing the negative effect of the relative hypoxia that has been found in these patients.

As a result of the compelling evidence that malic acid plays a central role in energy production, especially during hypoxic conditions, malic acid supplements have been examined for their effects on fibromyalgia. Subjective improvement in pain was observed within 48 hours of supplementation with 1200-2400 mg of malic acid, (with higher doses being more effective), and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in fibromyalgia patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in fibromyalgia, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with fibromyalgia.

It is very important that the L-isomer of Malic acid is used as it is the active form that exists naturally. When synthesised the malic acid produced contains both the D- and L- forms with the D- form being inactive. When extracted from apples only the L-form (active form) is present.

Malic Acid and Magnesium in Fibro

2007-09-10T15:56:00.000-05:00

DESCRIPTION

Malic acid, an alpha-hydroxy organic acid, is sometimes referred to as a fruit acid. This is because malic acid is found in apples and other fruits. It is also found in plants and animals, including humans. In fact, malic acid, in the form of its anion malate, is a key intermediate in the major biochemical energy-producing cycle in cells known as the citric acid or Krebs cycle located in the cells' mitochondria.

Malic acid, also known as apple acid, hydroxybutanedioic acid and hydroxysuccinic acid, is a chiral molecule. The naturally occurring stereoisomer is the L-form. The L-form is also the biologically active one. There is some preliminary evidence that malic acid, in combination with magnesium, may be helpful for some with fibromyalgia. Malic acid sold as a supplement is mainly derived from apples and, therefore, is the L-form. L-malic acid has the following chemical structure:

L-malic Acid
ACTIONS AND PHARMACOLOGY
ACTIONS

Malic acid, in combination with magnesium, has putative antifibromyalgic activity.
MECHANISM OF ACTION

The mechanism of malic acid's putative antifibromyalgic activity is unknown.
PHARMACOKINETICS

Malic acid is absorbed from the gastrointestinal tract from whence it is transported via the portal circulation to the liver. There are a few enzymes that metabolize malic acid. Malic enzyme catalyzes the oxidative decarboxylation of L-malate to pyruvate with concomitant reduction of the cofactor NAD+ (oxidized form of nicotinamide adenine dinucleotide) or NADP+ (oxidized form of nicotinamide adenine dinucleotide phosphate). These reactions require the divalent cations magnesium or manganese. Three isoforms of malic enzyme have been identified in mammals: a cytosolic NADP+-dependent malic enzyme, a mitochondrial NADP+-dependent malic enzyme and a mitochondrial NAD(P)+-dependent malic enzyme. The latter can use either NAD+ or NADP+ as the cofactor but prefers NAD+. Pyruvate formed from malate can itself be metabolized in a number of ways, including metabolism via a number of metabolic steps to glucose. Malate can also be metabolized to oxaloacetate via the citric acid cycle. The mitochondrial malic enzyme, particularly in brain cells, may play a key role in the pyruvate recycling pathway, which utilizes dicarboxylic acids and substrates, such as glutamine, to provide pyruvate to maintain the citric acid cycle activity when glucose and lactate are low.

Clearly, the metabolism of malic acid is complex and what any of the above has to do, if anything, with malic acids' putative activity in those with fibromyalgia is entirely unclear.
INDICATIONS AND USAGE

Malic acid may help some with fibromyalgia.
RESEARCH SUMMARY

Results have been mixed in studies of malic acid's possible effects in those with fibromyalgia. In a double-blind, placebo-controlled crossover study, subjects with primary fibromyalgia syndrome were randomized to receive a combination of 200 milligrams of malic acid and 50 milligrams of magnesium per tablet (three tablets twice a day) or placebo for four weeks. This was followed by a six-month, open-label trial with dose escalating up to six tablets twice a day. Outcome variables were measures of pain and tenderness, as well as functional and psychological measures.

No clear benefit was observed for the malic acid/magnesium combination in the lower-dose blinded trial. But in the open-label trial, at higher doses, there were significant reductions in the severity of all three primary pain/tenderness measures. Follow-up is needed.
CONTRAINDICATIONS, PRECAUTIONS, ADVERSE REACTIONS
CONTRAINDICATIONS

None known for malic acid. See Magnesium.
PRECAUTIONS

Because of lack of long-term safety studies, supplementary malic acid should be avoided by pregnant women and lactating mothers. See Magnesium.
INTERACTIONS

None reported for malic acid. See Magnesium.
DOSAGE AND ADMINISTRATION

The doses used in the fibromyalgia studies were L-malic acid, 1200 to 2400 milligrams daily, and magnesium, 300 to 600 milligrams daily.
HOW SUPPLIED

Tablets — 350 mg
LITERATURE

Russell IJ, Michalek JE, Flechas JD, Abraham GE. Treatment of fibromyalgia syndrome with Super Malic: a randomized, double-blind, placebo-controlled pilot study. J Rheumatol. 1995; 22:953-958.

Young Z, Floyd DL, Loeber G, Tong L. Structure of a closed form of human malic enzyme and implications for catalytic mechanism. Nature Struct Biol. 2000; 7:251-257.

The Super Triumvirate of Energy Supplements

2007-09-10T15:51:00.000-05:00

Acetyl-L-Carnitine (ALC)
Acetyl-L-Carnitine, ALC, Acetylcarnitine, ALCAR

Acetyl-l-carnitine is a molecule that occurs naturally in the brain, liver, and kidney. Natural levels of Acetyl-l-carnitine diminish as we age.

Common uses for supplemental Acetyl-l-carnitine:

* To enhance cognition.
* Involved in the metabolism of food into energy.
* Mild mental impairment in the elderly showed a significant improvement of several performances during and after Acetyl-l-carnitine treatment.
* Reports indicate that Acetyl-l-carnitine may be effective in the treatment of dementia.
* Treated Down syndrome patients showed statistically significant improvements of visual memory and attention both in absolute terms and in comparison with the other groups.
* To significantly reduce severity of depressive symptoms in the elderly.
* To significantly improve items measuring quality of life.
* Improve both spatial and temporal memory, and reduce the amount of oxidative damage to RNA in the brain's hippocampus, an area important in memory.
* Acetyl-l-carnitine is widely used as an energy supplement in Italy.

Alzheimer's

The acetyl group that is part of acetyl-L-carnitine contributes to the production of the neurotransmitter acetylcholine, which is required for mental function. Several double-blind clinical trials suggest that acetyl-L-carnitine delays the progression of Alzheimer’s disease and enhances overall performance in some people with Alzheimer’s disease. Alzheimer’s research has been done with the acetyl-L-carnitine form, rather than the L-carnitine form, of this nutrient.

Several clinical trials have found that acetyl-L-carnitine supplementation delays the progression of Alzheimer’s disease, improves memory, and enhances overall performance in some people with Alzheimer’s disease. Overall, most short-term studies have shown clinical benefits, and most long-term studies (one year) have shown a reduction in the rate of deterioration.

Brain

One double-blind trial has found that acetyl-L-carnitine may be helpful for people with degenerative cerebellar ataxia, a loss of muscular coordination caused by disease in the cerebellum (the hind part of the brain that controls muscle tone and balance).

Several clinical trials suggest that acetyl-L-carnitine delays onset of ARCD and improves overall cognitive function in the elderly. In a controlled clinical trial, acetyl-L-carnitine was given to elderly people with mild cognitive impairment. After 45 days of acetyl-L-carnitine supplementation at 1,500 mg per day, significant improvements in cognitive function (especially memory) were observed. Another large trial of acetyl-L-carnitine for mild cognitive impairment in the elderly found that 1,500 mg per day for 90 days significantly improved memory, mood, and responses to stress. The favorable effects persisted at least 30 days after treatment was discontinued. Controlled and uncontrolled clinical trials on acetyl-L-carnitine corroborate these findings.

Depression

Acetyl-L-carnitine may be effective for depression experienced by the elderly. A preliminary trial found that acetyl-L-carnitine supplementation was effective at relieving depression in a group of elderly people, particularly those showing more serious clinical symptoms. These results were confirmed in another similar clinical trial. In that trial, participants received either 500 mg three times a day of acetyl-L-carnitine or a matching placebo. Those receiving acetyl-L-carnitine experienced significantly reduced symptoms of depression compared to those receiving placebo. At least two other clinical studies of acetyl-L-carnitine for depression in the elderly have reported similar results.

Drug interactions:

Are there any drug interactions? A. Didanosine (Depletion or interference) Didanosine is a drug that blocks reproduction of the human immunodeficiency virus (HIV). HIV is the virus that infects people causing acquired immunodeficiency syndrome (AIDS). Didanosine is used in combination with other drugs to treat HIV infection.

Acetyl-l-carnitine suggested dosage is 500 mg two to three times daily.

Alpha Lipoic Acid (ALA)

Alpha Lipoic Acid serves as a coenzyme in the energy production process in the cells which can provide quick bursts of energy. Alpha Lipoic Acid is unique in that it is both water and fat soluble witch allows it to enter all parts of the cell to neutralize free radicals. Alpha Lipoic Acid contributes to invigorating mental and physical energy and a reduction in muscle fatigue. Dr. Lester Packer, a leading researcher in the area of antioxidants and a professor of molecular and cell biology at the University of California at Berkeley says "Alpha-Lipoic acid could have far-reaching consequences in the search for prevention and therapy of chronic degenerative diseases such as diabetes and cardiovascular disease" .... "and because it’s the only antioxidant that can easily get into the brain, it could be useful in preventing damage from a stroke".

Common uses for supplemental alpha Lipoic Acid:

* Currently used in Europe to treat peripheral nerve degeneration (neuropathy) resulting from diabetes.
* May play a role in controlling blood sugar.
* May help prevent the onset of type 2 diabetes.
* Important for the production of energy inside the cell by utilizing sugar to produce energy contributing to mental and physical stamina.
* Neutralizes free radicals. Unlike Vitamin C which is water soluble and Vitamin E which is fat soluble, alpha Lipoic Acid is both water and fat soluble which allows it to enter all parts of the cell to neutralize free radicals.
* May help reduce LDL (bad) blood cholesterol.
* May help improve memory.
* Chelates (grabs) heavy metals and binds them reducing these oxidants from blood system.
* Inhibits Glycation which is responsible for accelerated tissue damage.
* Recycles and enhances the effects of other antioxidants such as Vitamin E and Vitamin C.
* Significantly increase survival in rats that have suffered a stroke if given before the stroke occurs.
* Prevents tissue damage and death after a heart attack.
* Not only does it act as an antioxidant itself, it also stimulates production of glutathione (an antioxidant produced by the body), giving cells a double dose of antioxidant.
* Easily absorbed when taken orally and once inside cells is quickly converted to its most potent form, dihydrolipoic acid.
* Because both alpha lipoic acid and dihydrolipoic acid are antioxidants, their combined actions give them greater antioxidant potency than any natural antioxidant now known.
* Important for regulating aspects of the immune system, in particular immune cells called T-lymphocytes.
* May be useful in relieving syptoms of stomatopyrosis, or Burning Mouth Syndrome (BMS).

ALPHA-LIPOIC ACID MAY HELP REDUCE INFLAMMATION

October 11, 2002. The incidence of inflammatory diseases such as arthritis increases with age. Free radicals promote inflammatory reactions, which antioxidants have been successful at diminishing. Scientists recently stimulated the inflammatory response of white blood cells, resulting in an increase of Intracellular Adhesion Molecule 1 (ICAM-1), which encourages white blood cells to stick to other cells, thereby inflaming tissues. Alpha-lipoic acid, a potent antioxidant, was then added to the mix. Researchers said the acid reduced the activity of ICAM-1 to levels in normal, un-stimulated cells in a dose-dependent manner. It also lowered the activity of NFkB (NFkB can increase the activity of genes responsible for inflammation). According to the study, these changes suggest that alpha-lipoic acid may help reduce the effects of inflammatory diseases such a rheumatoid arthritis and psoriasis.

Suggested dosage for Alpha Lipoic Acid is 200 mg two to three times daily.

CoQ10 (Coenzyme Q10)

CoQ10 is a vitamin-like compound also called ubiquinone. It is an essential component of cells and is utilized by the mitochondria in the normal process of energy production. It helps convert food into energy at a very basic, cellular level and it is an antioxidant. CoQ10 (Coenzyme Q10) is one in a series of ubiquinones, naturally occurring compounds produced in nearly every cell of the body, and was discovered as recently as 1957. This Coenzyme Q10 is the highest quality available and synergistically blended with Bioperinewhich has been demonstrated to aid in absorption.

Doctors commonly prescribe CoQ10 (coenzyme Q10) to treat heart disease in Japan, Sweden, Italy, Canada, and other countries.

Common Uses for CoQ10:

*

Improves the heart and circulation in those with congestive heart failure, a weakened heart muscle (cardiomyopathy), high blood pressure, heart rhythm disorders, chest pain (angina), or Raynaud's disease.
*

Treats gum disease and maintains health gums and teeth.
*

Protects the nerves and may help slow Alzheimer's or Parkinson's disease.
*

May help prevent cancer and heart disease, and play a role in slowing down age-related degenerative changes.
*

May improve the course of AIDS or cancer.
*

CoQ10 has shown small significant benefit in treating ALS, also known as Lou Gehrig's disease, and it has also been used to treat a range of rare pediatric neurological diseases.
*

Because any disease process that involves free radical damage could be treated with CoQ10, the theoretical therapeutic potential of this compound seems limitless. Cataracts, macular degeneration, side effects of chemotherapy and skin damage related to radiation exposure could all be helped by doses of CoQ10, proponents believe.

The primary function of CoQ10 (coenzyme Q10) is as a catalyst for metabolism - the complex chain of chemical reactions during which food is broken down into packets of energy that the body can use. Acting in conjunction with enzymes, the compound speeds up the vital metabolic process, providing the energy that the cells need to digest food, heal wounds, maintain healthy muscles, and perform countless other bodily functions. Because of the nutrient's essential role in energy production, it's not surprising that it is found in every cell in the body. It is especially abundant in the energy-intensive cells of the heart, helping this organ beat more than 100,000 times each day. In addition, coenzyme Q10 acts as an antioxidant, much like vitamin C and E, helping to neutralize the cell-damaging molecules known as free radicals.

CoQ10 (Coenzyme Q10) may play a role in preventing cancer, heart attacks, and other diseases linked to free-radical damage. It's also used as a general energy enhancer and anti-aging supplement. Because levels of the compound diminish with age (and with certain diseases), some doctors recommend daily supplementation beginning about age 40.

CoQ10 has generated much excitement as a possible therapy for heart disease, especially congestive heart failure or a weakened heart. In some studies, patients with a poorly functioning heart have been found to improve greatly after adding the supplement to their conventional drugs and therapies. Other studies have shown that people with cardiovascular disease have low levels of this substance in their heart. Further research suggest that CoQ10 may protect against blood clots, lower high blood pressure, diminish irregular heartbeats, treat mitral valve prolapse, lessen symptoms of Raynaud's disease (poor circulation in the extremities), and relieve chest pains (angina).

A few small studies suggest that CoQ10 may prolong survival in those with breast or prostate cancer, though results remain inconclusive. It also appears to aid healing and reduce pain and bleeding in those with gum disease, and speed recovery following oral surgery. CoQ10 shows some promise against Parkinson's and Alzheimer's Diseases and fibromyalgia, and it may improve stamina in those with AIDS. Certain practitioners believe the nutrient helps stabilize blood sugar levels in people with diabetes. There are many other claims make for CoQ10 that it slows aging, aids weight loss, enhances athletic performance, combats chronic fatigue syndrome, relieves multiple allergies, and boosts immunity.

Alpha-Lipoic acid

2007-09-10T15:47:00.000-05:00

Alpha-Lipoic acid:
Quite Possibly the "Universal" Antioxidant

This article originally appeared in the July 1996 issue of The Nutrition Reporter™ newsletter.

If it's essential role in health is any indication, alpha-lipoic acid may very well join the ranks of vitamins C and E as part of your first-line of defense against free radicals. Discovered in 1951, it serves as a coenzyme in the Krebs cycle and in the production of cellular energy. In the late 1980s, researchers realized that alpha-lipoic acid had been overlooked as a powerful antioxidant.

Over the past few years, the pace of research on lipoic acid has increased dramatically. Last year, Lester Packer, PhD, of the University of California, Berkeley, published a lengthy review article on alpha-lipoic acid in Free Radical Biology & Medicine (1995;19:227-50). In April 1996, he presented a short review of it in the same journal (FRBM;20:625-6).

Several qualities distinguish alpha-lipoic acid from other antioxidants, and Packer has described it at various times as the "universal," "ideal," and "metabolic" antioxidant. It neutralizes free radicals in both the fatty and watery regions of cells, in contrast to vitamin C (which is water soluble) and vitamin E (which is fat soluble).

The body routinely converts some alpha-lipoic acid to dihydrolipoic acid, which appears to be an even more powerful antioxidant. Both forms of lipoic acid quench peroxynitrite radicals, an especially dangerous type consisting of both oxygen and nitrogen, according to a recent paper in FEBS Letters (Whiteman M, et al., FEBS Letters, 1996; 379:74-6). Peroxynitrite radicals play a role in the development of atherosclerosis, lung disease, chronic inflammation, and neurological disorders.

Alpha-lipoic acid also plays an important role in the synergism of antioxidants, what Packer prefers to call the body's "antioxidant network." It directly recycles and extends the metabolic lifespans of vitamin C, glutathione, and coenzyme Q10, and it indirectly renews vitamin E.

In Germany, alpha-lipoic acid is an approved medical treatment for peripheral neuropathy, a common complication of diabetes. It speeds the removal of glucose from the bloodstream, at least partly by enhancing insulin function, and it reduces insulin resistance, an underpinning of many cases of coronary heart disease and obesity. The therapeutic dose for lipoic acid is 600 mg/day. In the United States, it is sold as a dietary supplement, usually as 50 mg tablets. (The richest food source of alpha-lipoic acid is red meat.)

"From a therapeutic viewpoint, few natural antioxidants are ideal," Packer recently explained in Free Radical Biology & Medicine. "An ideal therapeutic antioxidant would fulfill several criteria. These include absorption from the diet, conversion in cells and tissues into usable form, a variety of antioxidant actions (including interactions with other antioxidants) in both membrane and aqueous phases, and low toxicity."

"Alpha-lipoic acid...is unique among natural antioxidants in its ability to fulfill all of these requirements," he continued, "making it a potentially highly effective therapeutic agent in a number of conditions in which oxidative damage has been implicated."

Other research on alpha-lipoic acid has shown that it might:

* help people with genetic defects leading to muscle myopathies (Barbiroli B, et al., Journal of Neurology, 1995;242:472-7);

* reduce ischemia/reperfusion injury to the heart and brain. (Schonheit K, et al., Biochimica et Biophysica Acta, 1995;1271:335-42; and Cao X and Phillis JW, Free Radical Research, 1995;23:365-70); and

* inhibit the activation of "nuclear factor kappa-B," a protein complex involved in cancer and the progression of AIDS. (Suzuki YJ, et al., Biochemical & Biophysical Research Communications, 1992;189:1709-15).

"The therapeutic potential of alpha-lipoic acid is just beginning to be explored," observed Packer, "but this compound holds great promise."

Malic Acid, Energy, & Fibromyalgia

2007-09-10T15:41:00.000-05:00

Malic Acid, Energy, & Fibromyalgia

Primary fibromyalgia (FM) is a condition affecting principally middle-aged women, characterized by a syndrome of generalized musculoskeletal pain, aches, stiffness, and tenderness at specific anatomical sites. This condition is considered primary when there are no obvious causes. Since it was first described, FM has become recognized as a fairly common rheumatic complaint with a clinical prevalence of 6 to 20 percent. Additionally, FM has been associated with irritable bowel syndrome, tension headache, mitral valve prolapse, and chronic fatigue syndrome. Numerous treatment modalities have been attempted to treat patients with FM, but unfortunately the results have usually been poor. The primary reason for this lack of success was undoubtedly due to our lack of understanding FMs etiology.

In recent years, evidence has accumulated to suggest that FM is the result of local hypoxia in the muscles. For instance, patients with FM have low muscle-tissue oxygen pressure in affected muscles, and to a lesser degree
the same was found in other tissues. Muscle biopsies from affected areas showed muscle tissue breakdown and mitochondrial damage. Additionally, low levels of the high energy phosphates ATP, ADP, and phosphocreatine were found. It has been hypothesized that in hypoxic muscle tissues glycolysis is inhibited, reducing ATP synthesis. This stimulates the process of gluconeogenesis, which results in the breakdown of muscle proteins to amino acids that can be utilized as substrates for ATP synthesis. This muscle tissue breakdown, which has been observed in muscle biopsies taken from FM patients, is hypothesized to result in the muscle pain characteristic of FM.

Malic acid is both derived from food sources and synthesized in the body through the citric acid (Krebs) cycle. Its importance to the production of energy in the body during both aerobic and anaerobic conditions is well established. Under aerobic conditions, the oxidation of malate to oxaloacetate provides reducing equivalents to the mitochondria through the malate-aspartate redox shuttle. During anaerobic conditions, where a buildup of excess of reducing equivalents inhibits glycolysis, malic acids simultaneous reduction to succinate and oxidation to oxaloacetate is capable of removing the accumulating reducing equivalents. This allows malic acid to reverse hypoxias inhibition of glycolysis and energy production. This may allow malic acid to improve energy production in FM, reversing the negative effect of the relative hypoxia that has been found in these patients.

Because of its obvious relationship to energy depletion during exercise, malic acid may be of benefit to healthy individuals interested in maximizing their energy production, as well as those with FM. In the rat it has been found that only tissue malate is depleted following exhaustive physical activity. Other key metabolites from the citric acid cycle needed for energy production were found to be unchanged. Because of this, a deficiency of malic acid has been hypothesized to be a major cause of physical exhaustion. The administration of malic acid to rats has been shown to elevate mitochondrial malate and increase mitochondrial respiration and energy production. Surprisingly, relatively small amounts of exogenous malic acid were required to increase mitochondrial energy production and ATP formation. Under hypoxic conditions there is an increased demand and utilization of malic acid, and this demand is normally met by increasing the synthesis of malic acid through gluconeogenesis and muscle protein
breakdown. This ultimately results in muscle breakdown and damage.

In a study on the effect of the oral administration of malic acid to rats, a significant increase in anaerobic endurance was found. Interestingly, the improvement in endurance was not accompanied by an increase in
carbohydrate and oxygen utilization, suggesting that malic acid has carbohydrate and oxygen-sparing effects. In addition, malic acid is the only metabolite of the citric acid cycle positively correlated with physical activity. It has also been demonstrated that exercise-induced mitochondrial respiration is associated with an accumulation of malic acid. In humans, endurance training is associated with a significant increase in the enzymes involved with malic acid metabolism.

Because of the compelling evidence that malic acid plays a central role in energy production, especially during hypoxic conditions, malic acid supplements have been examined for their effects on FM. Subjective improvement in pain was observed within 48 hours of supplementation with 1200 - 2400 milligrams of malic acid, and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in FM, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with FM. The potential for malic acid supplements, however, reaches much farther than FM. In light of malic acids ability to improve animal exercise performance, its potential for human athletes is particularly exciting.

Additionally, many hypoxia related conditions, such as respiratory and circulatory insufficiency, are associated with deficient energy production. Therefore, malic acid supplements may be of benefit in these conditions. Chronic Fatigue Syndrome has also been found to be associated with FM, and malic acid supplementation may be of use in improving energy production in this condition as well. Lastly, malic acid may be of use as a general supplement aimed at ensuring an optimal level of malic acid within the cells, and thus, maintaining an optimal level of
energy production.

Reference:
G.E. Abraham and J.D. Flechas, J of Nutr Medicine 1992; 3: 49-59.
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Drink More Diet Soda, Gain More Weight?

2007-09-04T15:04:00.000-05:00

Overweight Risk Soars 41% With Each Daily Can of Diet Soft Drink
By Daniel J. DeNoon
WebMD Medical News
Reviewed by Charlotte Grayson Mathis, MD

People who drink diet soft drinks don't lose weight. In fact, they gain weight, a study shows.

The findings come from eight years of data collected by Sharon P. Fowler, MPH, and colleagues at the University of Texas Health Science Center, San Antonio.

"What didn't surprise us was that total soft drink use was linked to overweight and obesity," Fowler tells WebMD. "What was surprising was when we looked at people only drinking diet soft drinks, their risk of obesity was even higher."

In fact, when the researchers took a closer look at their data, they found that nearly all the obesity risk from soft drinks came from diet sodas.

"There was a 41% increase in risk of being overweight for every can or bottle of diet soft drink a person consumes each day," Fowler says.
More Diet Drinks, More Weight Gain

Fowler's team looked at seven to eight years of data on 1,550 Mexican-American and non-Hispanic white Americans aged 25 to 64. Of the 622 study participants who were of normal weight at the beginning of the study, about a third became overweight or obese.

For regular soft-drink drinkers, the risk of becoming overweight or obese was:

* 26% for up to 1/2 can each day
* 30.4% for 1/2 to one can each day
* 32.8% for 1 to 2 cans each day
* 47.2% for more than 2 cans each day.

For diet soft-drink drinkers, the risk of becoming overweight or obese was:

* 36.5% for up to 1/2 can each day
* 37.5% for 1/2 to one can each day
* 54.5% for 1 to 2 cans each day
* 57.1% for more than 2 cans each day.

For each can of diet soft drink consumed each day, a person's risk of obesity went up 41%.
Diet Soda No Smoking Gun

Fowler is quick to note that a study of this kind does not prove that diet soda causes obesity. More likely, she says, it shows that something linked to diet soda drinking is also linked to obesity.

"One possible part of the explanation is that people who see they are beginning to gain weight may be more likely to switch from regular to diet soda," Fowler suggests. "But despite their switching, their weight may continue to grow for other reasons. So diet soft-drink use is a marker for overweight and obesity."

Why? Nutrition expert Leslie Bonci, MPH, RD, puts it in a nutshell.

"You have to look at what's on your plate, not just what's in your glass," Bonci tells WebMD.

People often mistake diet drinks for diets, says Bonci, director of sports nutrition at the University of Pittsburgh Medical Center and nutrition consultant to college and professional sports teams and to the Pittsburgh Ballet.

"A lot of people say, 'I am drinking a diet soft drink because that is better for me. But soft drinks by themselves are not the root of America's obesity problem," she says. "You can't go into a fast-food restaurant and say, 'Oh, it's OK because I had diet soda.' If you don't do anything else but switch to a diet soft drink, you are not going to lose weight."
The Mad Hatter Theory

"Take some more tea," the March Hare said to Alice, very earnestly.
"I've had nothing yet," Alice replied in an offended tone, "so I can't take more."
"You mean you can't take less," said the Hatter: "It's very easy to take more than nothing." Lewis Carroll, Alice's Adventures in Wonderland

There is actually a way that diet drinks could contribute to weight gain, Fowler suggests.

She remembers being struck by the scene in Alice's Adventures in Wonderland in which Alice is offended because she is offered tea but is given none -- even though she hadn't asked for tea in the first place. So she helps herself to tea and bread and butter.

That may be just what happens when we offer our bodies the sweet taste of diet drinks, but give them no calories. Fowler points to a recent study in which feeding artificial sweeteners to rat pups made them crave more calories than animals fed real sugar.

"If you offer your body something that tastes like a lot of calories, but it isn't there, your body is alerted to the possibility that there is something there and it will search for the calories promised but not delivered," Fowler says.

Perhaps, Bonci says, our bodies are smarter than we think.

"People think they can just fool the body. But maybe the body isn't fooled," she says. "If you are not giving your body those calories you promised it, maybe your body will retaliate by wanting more calories. Some soft drink studies do suggest that diet drinks stimulate appetite.

Doctors and Statin Drugs

2007-08-29T13:06:00.000-05:00

Kaiser Daily Health Policy Report

Tuesday, August 28, 2007

Prescription Drugs

Physicians Often Ignore, Dismiss Patient Complaints About Possible Side Effects of Statins, Survey Finds

Physicians often ignore or dismiss patient complaints about possible side effects of statins, according to a study published last week in the journal Drug Safety, the Washington Post reports. For the study, researchers led by Beatrice Golomb, an associate professor of medicine at the University of California-San Diego, surveyed 650 patients, most of whom were in their early 60s and lived in the U.S.

Most participants said they complained to their physicians about muscle pain, memory loss, numbness in their hands and feet, or other possible side effects of statins, the study found. However, participants said in most cases their physicians attributed the symptoms to aging, denied their link with statins or dismissed them, according to the study. Golomb said, "Person after person spontaneously (told) us that their doctors told them that symptoms like muscle pain couldn't have come from the drug. We were surprised at how prevalent that experience was."

She attributed the results of the study in part to a lack of awareness about the side effects of statins. "Ad campaigns that preserve statins' miracle drug image are more powerful than education about side effects," Golomb said.

Implications
The study raises concerns about prescription drug safety because, when physicians fail to link symptoms with medications, they do not file adverse event reports with FDA. As a result, FDA might "underestimate the problem, and other doctors and patients may assume the drug is safer than it is," the Post reports.

Jerry Avorn -- a Harvard Medical School professor and author of the book "Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs" -- said that "there is horrendous underreporting of side effects," adding that 90% to 99% of "serious side effects are not reported by doctors."

The study "points out that doctor reports on side effects [are] a very unreliable means of learning about the true extent of problems," he said, adding, "We ought to have a (better) mechanism for gathering information from patients. A lot of it will be noise, but there may be important signals there as well" (Ganguli, Washington Post, 8/28).

Kidney Stones?

2007-08-28T10:58:00.001-05:00

The Role of Diet in the Prevention
Of Common Kidney Stones

Christy Krieg

Kidney stone formers may
feel doomed to a life of
unpredictable flank pain,periodic surgical intervention,
and concomitant loss of
work and daily pleasures. Indeed,
if untreated, those who have
formed one calcium oxalate stone
have a 50% chance of forming
additional stones within 10 years
(Menon & Resnick, 2002). With
appropriate education, patients
can exercise some control over
stone disease and reduce their
chances of forming stones
through dietary modifications
and medication.
General dietary recommendations
appropriate for patients
who form the most common
metabolic stone types — calcium
oxalate and uric acid — will be discussed
in this article. Patients with
a tendency to form cystine and
brushite stones may also benefit
from some of the same dietary recommendations,
but dietary management
is a small part of an even
more complex treatment regimen
in these instances. Regardless of
stone type, recommendations for
dietary modifications are most
accurate when tailored to the
results of urine stone risk profiles,
or “24-hour urine” studies.
These studies typically provide
total urine volume, urine
calcium, sodium, citrate and uric
Current dietary recommendations for patients who form kidney
stones are discussed. Focusing on the most common kidney stone
types, calcium oxalate and uric acid, the rationale for dietary changes
are described based on the renal and urine physiology.
Christy Krieg, BSN, RN, is a Clinical
Nurse, Methodist Urology, Indianapolis,
IN.
Note: CE Objectives and Evaluation
Form appear on page 457.
acid, as well as pH, and supersaturation
of critical compounds,
among other measurements. The
values, if properly interpreted,
allow the clinician to observe the
patient’s specific abnormalities,
recommend medication and/or
dietary modification, and track
progress through followup studies.
As with many bodily
processes, stone formation is a
complicated and multi-factorial
process. Yet, there is much still to
be understood about stone formation.
For example, we know that
stone formation runs in families,
but while all humans form calcium
oxalate crystals, most do not
form stones (Lemann, 2002). And
while for years calcium stone formers
were instructed to restrict
dietary calcium, there is now significant
evidence against this recommendation
(Borghi et al.,
2002). These observations illustrate
the sometimes counterintuitive
and always complex nature
of stone formation and the need
for ongoing investigation.
Stone recurrence is frustrating
for patients who have made
changes in their lives and yet still
form stones. While diet alone
cannot always control the disease,
dietary measures can
absolutely help supplement
other therapies, and for some
patients are the primary tool for
stone prevention. As a component
of the medical management
for stone disease, the goal of therapy
should be to improve those
factors thought to contribute to
stone formation in the urinary
tract, and thereby reduce the
chance of forming stones, even if
the disease is not eliminated.
Urine Supersaturation
And Stone Formation
Urine volume plays a pivotal
role in the process of stone formation.
In particular, low volume,
highly concentrated urine
contributes to the supersaturation
of elements normally found
in the urine, such as calcium
oxalate. Simply put, when the
solute exceeds the solvent’s ability
to dissolve it, precipitation of
crystals can occur. Consider an
attempt to dissolve sugar in
water: a tablespoon of sugar is
readily dissolved in a glass of
water, but eight tablespoons of
sugar in that same glass will not
completely dissolve, resulting in
the accumulation of crystals in
the bottom of the glass. In this
scenario, the water is saturated
with sugar; the solvent, water,
can dissolve no more solute. It
has exceeded the point of saturation,
and is supersaturated.
Fortunately, urine has the
unique quality of holding more
solute in suspension than does
water and so can accept large
concentrations of solute without
precipitation. The ability of urine
to keep such large concentrations
in solution is, in part, due to the
presence of protective organic
molecules like citrate, as well as
the presence of charged ions
which alter the solubility (Menon
& Resnick, 2002). Despite the fact
that calcium oxalate can be present
in urine in concentrations 7
to 11 times its solubility in water
(Menon & Resnick, 2002), the
point exists at which calcium
oxalate exceeds the unique properties
of urine; crystals will then
form and possibly aggregate to
form stones.
Understanding saturation principles
in the urine, is it not clear
that methods of prevention shall be
focused on both an increase in solvent
and a reduction of solute?
These two concepts are the basis
for the dietary changes described
below.

Assessment of Dietary
Patterns

As dietary history is not part
of the typical urologic patient
history forms, the nurse can
obtain this information through
patient interview. Important information
includes the patient’s
intake of fluids throughout the
day, environmental factors promoting
dehydration, special diets
such as now-popular high-protein
diets, and a propensity to
consume packaged or restaurant
foods which are typically very
high in sodium. What does the
patient drink, how much is consumed,
and how is fluid intake
distributed through the day?
Does he or she work in a hot or
dry environment (such as a hot
factory, outside work in the summer)?
Does he or she prepare
fresh foods at home or tend to eat
convenience foods?
Nurses’ dietary interview can
occur before or after metabolic
testing. Absent metabolic testing,
this interview has even greater
import as it is the only source of
information about dietary habits.
Asking patients to keep a 24-hour
diet record may help identify
patterns of which even the
patient was unaware. Sources of
dietary sodium can be obvious or
insidious. The excess intake of a
patient who consumes a bag of
microwave popcorn every night
is more apparent than the intake
of a patient who drinks sports
drinks after a daily workout;
these are both very high in sodium,
but the latter is less often
recognized.
If the nurse has at his or her
disposal a 24-hour urine study,
dietary anomalies may be more
specifically exposed and documented.
This author views 24-
hour urine studies as “vice recognition
software;” the numbers
show actual urine output, and
indicate dietary sodium, protein,
and oxalate excess. Patients with
low urine volumes may believe
their results are incorrect. They
may say “I drink all the time!”
and yet the output is low. Here
the role of dietary counseling is
critical; the insightful nurse
helps the patient identify volume
consumed, sources of insensible
loss, and ways to ensure
increased urine volume.

DIETARY CHANGES TO
PREVENT AND REDUCE
STONE FORMATION

Increase Fluid Intake
Increasing urine volume can
reduce supersaturation, and is
widely known to help prevent
stone formation. Recommendations
for urinary output vary, but there is
general agreement that it should
exceed two liters per day, while
some even encourage urinary
outputs in excess of three liters
per day (Menon & Resnick, 2002;
Sakhaee, Zerwekh, & Pak, 1980).
A key point is that the dilution of
urine is necessary “24/7,” or all
day, every day. A patient who
voids the recommended two
liters a day between the hours of
8 am and 10 pm, but only 300
milliliters during the remaining
10 hours of the day will have saturated
urine overnight, with the
possibility of precipitation and
aggregation during the sleeping
hours. Patients must accept the
necessity of getting up at least
twice at night to urinate, and
should consume more water each
time they rise to void.
Stress to patients that it is not
the quantity of fluid consumed
that is important, but rather the
fluid voided that should be measured.
Patients living in hot or
dry conditions, or who exercise
and perspire significantly, will
need to drink even more liquid to
maintain adequate urine output.
Many patients ask what fluids
are recommended, and which
are prohibited. The simple
answer is that water is best. For
those with excessive urinary
oxalates, black tea should be
eliminated because black tea is a
high-oxalate beverage. Curhan,
Willett, Rimm, Speizer, and
Stampfer (1998) found, in a retrospective
study of previously nonstone
forming women from the
Nurses’ Health Study, that the
type of beverages consumed
proved relevant for stone formers.
Of the 17 beverages studied,
and after correcting for other contributing
factors, those who
drank one daily 8 ounce glass of
grapefruit juice had a 44%
increased risk of a stone event in
the 8-year period, while the risk
was decreased by 8% to 10% for
each daily 8 ounce serving of coffee
(both caffeinated and non-caffeinated),
tea, or wine. A prospective study had similar
conclusions for men, additionally
showing that beer had a protective
effect and apple juice increased
the risk of stone events (Curhan,
Willett, Rimm, Speigelman, &
Stampfer, 1996). Also, a study published
by Massey and Sutton (2004)
showed a modest positive relationship
between caffeine intake and
urinary calcium levels in stone formers
and non-stone formers, so caffeinated
beverages should be limited
in stone formers. In summary,
stone formers should drink more
water and avoid excess caffeine,
black tea, and grapefruit and apple
juices.

What do these studies mean
for patient education?

Water is the
best beverage for stone formers. It is
non-caloric, non-caffeinated, and
contains insignificant amounts of
solutes. In initial attempts to
increase patients’ fluid intake, it
may be appropriate to advise them
to drink whatever they can consume
in large quantities. However,
warning them of side effects of sugared
and caffeinated beverages in
large quantities is important. The
results discussed above indicate
that consumption of alcoholic
beverages is unlikely to increase
stone risk. Water that tastes good
(filtered, reverse osmosis, bottled)
may be easier to consume than tap
water, so encourage patients to
seek a source of good-tasting
water. There is no clear agreement
on the impact of drinking water’s
mineral content on lithogenesis;
“hard water” may not be problematic
for most patients (Menon &
Resnick, 2002). Again, water in
large quantities should be the
focus of prevention. Lemonade is
often recommended, as it supplies
dietary citrate, a stone inhibitor
and pH buffer when excreted later
in the urine.
Encourage patients to set
consumption goals, carry water
with them at all times, and strive
for pale urine throughout the day
and night. Some patients describe
an initial physiologic
resistance to increased fluid
intake which eases as their bodies
and minds learn the new
habit of extra fluid intake and
output. According to Parks,
Goldfischer, and Coe (2003),
aims by clinicians to increase
patients’ urinary volumes often
fall short, and follow-up metabolic
studies showed an average
increase in urine output of only
0.3 liters per 24 hours. This
increase was associated with a
curious increase in sodium
intake. High urine volumes
should be the goal of all patients
who form stones. In this
instance, more is definitely better.
Most patients find that after
forcing fluids for a couple of
months, their bodies crave fluids
and their habit is to drink more.
Consume Adequate Calcium
High urine calcium, hypercalciuria,
is associated both with
formation of kidney stones and
with osteoporosis. Sufficient calcium
intake is required for the
growth and maintenance of the
skeleton in children and adults.
Reducing urine calcium should
be a goal for stone formers, but
not via dietary restriction. While
reduced dietary calcium can
decrease urine calcium (Lemann,
2002), calcium restriction is no
longer advisable for patients who
form calcium kidney stones as
this puts them at risk of bone disease,
namely osteoporosis. Recall
that bones are in a constant
process of resorption and formation;
adequate calcium is required
for the ongoing rebuilding of bone
material.
Several recent studies have
shown, in fact, that adequate calcium
intake is associated with
decreased stone formation.
Curhan, Willett, Knight, and
Stampfer (2004) found that in
previously non-stone forming
younger women, higher intake of
dietary calcium was related to
lower risk of kidney stone formation.
Additionally, a 5-year randomized
clinical trial of men
with a history of calcium oxalate
stones found that a normal calcium,
decreased sodium, and
decreased animal protein diet
was more effective for reducing
stone events than was a restricted
calcium diet (Borghi et al., 2002).
So, adequate calcium plus
decreased sodium and protein
intake had a significantly more
protective effect against stones
than decreased calcium intake
alone.
Why might increased dietary
calcium reduce the risk of calcium
stone formation? Calcium
and oxalate bind in the gut and
in the urine to form a nonabsorbable
compound. Low dietary
calcium permits greater free
oxalate to be absorbed in the gut
and excreted in the urine, which
may be counterproductive for
calcium oxalate stone formers.
Restricted calcium intake results
in increased urinary oxalates, a
risk for stone formation (Menon
& Resnick, 2002). This is a proposed
cause of the association
between reduced calcium intake
and increased supersaturation of
calcium oxalate (Lemann, 2002).
Clearly, strong research evidence
now supports adequate
calcium intake for patients who
form kidney stones. Low-fat
dairy products, green leafy vegetables,
broccoli, fortified foods,
and almonds are excellent
sources. Patients should consume
enough dietary calcium to
meet (but not exceed) the United
States Recommended Daily
Allowance (RDA) of calcium,
which ranges from 1,000 to 1,200
milligrams daily for adults. The
recommendations are the same
for men and women, but vary by
age group (see Table 1). Patients
should avoid calcium supplements
in favor of calcium-rich
foods; a patient with intolerance
to dairy products may supplement,
but should not exceed the
RDA for his/her age group.
Limit Dietary Oxalates
Oxalate is found in many
foods, but there is considerable
variability in the amount, which
depends upon where the food is
grown. Likewise, individual
absorption of oxalate also varies,
which makes adequate calcium
intake critically important.
Nonetheless, oxalate restriction
should be attempted. The highest
levels of oxalate are found in
chocolate, nuts, beans (including
soybeans), rhubarb, spinach,
beets, and black tea. A thorough
oxalate list can be found on the
Web site of the Oxalosis and
Hyperoxaluria Foundation (http://
www.ohf.org/diet.html). This list
is exhaustive and may be overwhelming
to patients. Stress that
reduction of high oxalate foods is
the goal for typical stone formers
rather than strict avoidance of all
oxalate-containing foods (which
would be very difficult). Followup
24-hour urine studies will demonstrate
the adequacy of patients’
restriction.
Though only 10% to 20% of
urinary oxalates come from
dietary sources (Morton, Iliescu,
& Wilson, 2002), dietary reduction
is commonly advised for calcium
oxalate stone formers. It has
been suggested that because
there is much less oxalate in the
urine than calcium in the urine,
urinary oxalate concentration is
much more critical to the formation
of calcium oxalate crystals
than is the urinary calcium concentration;
reducing urine oxalates
may have a more powerful effect
on stone formation than can reduction
of urine calcium (Morton et
al., 2002). Patients with calcium
oxalate stones, particularly those
with documented hyperoxaluria,
should avoid foods high in
oxalates. Vitamin C is a precursor
to endogenous production of
oxalates, so some clinicians recommend
avoiding mega-doses of
vitamin C. The rare genetic condition
of primary hyperoxaluria is
only slightly impacted by dietary
reduction, and causes serious
medical problems besides kidney
stones.
Limit Sodium Intake
Because calcium and sodium
compete for reabsorption in the
renal tubules, excess sodium
intake and consequent excretion
result in loss of calcium in the
urine. High-sodium diets are
associated with greater calcium
excretion in the urine (Lemann,
2002). Metabolic studies often
reveal exceptionally high urine
calcium over 24 hours, related to
patients’ exceptionally high sodium
excretion. Patients may deny
salt intake, stating, “I never salt
my food!” They quite likely are
ignorant of hidden sodium
sources in the diet. Sodium is a
common preservative in canned
and frozen foods, and is endemic
in restaurant foods. Instruction
on careful inspection of food
labels and wise food choices
helps patients identify and
reduce sodium in their diets.
A notable dietary “ah-ha!”
was the admission by one patient
that, on the day of 24-hour urine
testing, she ate a full jar of pickles
to reduce stress, and then
drank the brine; needless to say,
her urine sodium was very high
on the day of her stress mitigation.
The role of the nurse or dietician
in shedding light on sources
of sodium cannot be underestimated.
Repeated, persistent inquiry
into dietary habits may be necessary.
The goal of therapy should be
a “no added salt diet,” or the equivalent
of 2,000 mg per day or less of
dietary sodium. Reduction of
dietary sodium is difficult and disappointing
to patients. They may
believe they have made significant
reductions and sacrifices, while
their urine sodium remains high.
Consultation with a registered
dietician may help the patient
achieve the specific goal of a sodium
intake of 2,000 milligrams or
less per day.
Limit Animal Protein
The effect of excess animal
protein (purine) is most obvious
for the uric acid stone former.
Uric acid, a byproduct of purine
metabolism, is excreted in large
quantities in the urine. Excess
protein creates urine with high
total urine uric acid, potentially
high supersaturation of urine
uric acid, and a low pH, necessary
for formation of uric acid
stones. There is no inhibitor of
uric acid crystal formation
(Menon & Resnick, 2002), so
dietary measures focus on reducing
uric acid and increasing
urine volume. Reduction of animal
protein to 12 ounces per day
for adults is recommended. This
is plenty to meet the dietary
needs of most Americans, many
of whom typically consume several
more ounces of animal protein
daily than is recommended.
Protein from plant sources
(beans, legumes, etc.) can be substituted
as a dietary alternative
without negative consequences.
Calcium oxalate stone formers
reducing their animal protein
should note the oxalate content
of substitute proteins.
The role of excess protein in
promoting calcium stone formation
is less obvious, but equally
important. High dietary protein
is associated with increased urinary
calcium. Thus, there is a
link between meat consumption
and both uric acid and calcium
stone formation. In fact, vegetarians
form stones at one-third the
rate of those eating a mixed diet
(Lemann, 2002). A study of 18
hypercalciuric stone formers found
that a 15-day protein restriction
had many positive effects on urinary
markers of stone risk.
Namely, significant decreases
were seen in urine calcium, urine
uric acid, urine phosphate, and
urine oxalate. And, for unclear
reasons, a beneficial increase in
urinary citrate was observed
(Giannini et al., 1999). Citrate is a
known inhibitor of calcium
oxalate crystal formation and
also increases pH, which can prevent
uric acid stones. Clearly, the
benefits of protein restriction for
stone formers are many.

Weight Loss

A relationship between weight,
body mass index and risk of calcium
oxalate stone formation was
established in a retrospective
study of health professionals.
Curhan and colleagues (1998)
found that “the prevalence of
stone disease history and the
incidence of stone disease were
directly associated with weight
and body mass index. However,
the magnitude of the associations
was consistently greater among
women” (p. 1645). The value of
weight loss for stone prevention
has not been proven, but given
the benefits of weight loss for
general health, it is certainly
worth mentioning to overweight
patients who form stones.
Educational Resources
There are excellent resources
on the Internet for patients seeking
nutritional information. One stellar
example is NutritionData
(www.nutritiondata.com/). Here
patients can search by general food
category, like “pickle,” to view the
standard sodium content, as well
as a plethora of additional information
regarding vitamin and mineral
content, calories, suggested healthier
substitutes, and even the individual
amino acid compositions of
each protein. The site also provides
detailed information about
thousands of specific brand items
from grocery and fast food restaurants.
Under “Tools,” patients can
search within food categories like
“dairy products” for choices highest
in calcium and lowest in sodium.
This site is complex and may be
overwhelming to patients without
good computer and Web skills, but
is extraordinarily comprehensive;
unfortunately, this site does not list
oxalate content. For that purpose,
refer patients to www.ohf.org.
For patients without Web
access, nurses might find it helpful
to review a general nutrition
book for charts and diagrams to
help patients understand nutrition
content. Show patients a
sample food label from a can of
soup so they know where to find
sodium content on foods at home.
For a simple list of high-oxalate
foods, visit www.gicare.com/
pated/edtgs29.htm.
Conclusion
The dietary measures discussed
have value particularly
for patients who form the most
common types of kidney stones:
calcium oxalate and uric acid.
That said, they may be insufficient
to control the various metabolic
abnormalities present in
individual patients. The most
effective management of kidney
stones includes in-depth metabolic
studies, recommendations
tailored to patients regarding
medications and dietary changes,
and follow-up to ensure changes
are having the desired effect.
Urine studies should be repeated
to judge progress approximately
6 to 8 weeks after initial metabolic
testing recommendations are
implemented. Once a stable state
is reached in which the patient’s
urine demonstrates decreased
risk of stone formation, metabolic
testing should be performed
(along with an x-ray to check for
stone growth) at least annually to
monitor stone risk. The cycle of
stone formation can be altered,
and in some cases broken, with
the aid of effective dietary management.
Every patient need not make
all of these changes to his/her
diet, but in the absence of
patient-specific urine studies,
none of these recommendations
is harmful. Aside from oxalate
consumption, the dietary recommendations
for calcium oxalate
and uric acid stone formers are
the same. Assessing
patients’ dietary habits can shed
light on potential areas of
improvement. For example, a
receptive uric acid stone former
on a high-protein diet for weight
loss could benefit from counseling
on the effects of this diet on
his/her stone disease.
Of course, talking about
dietary changes is easier than actual
implementation. Encourage
patients to make changes at a realistic
pace. Praise even modest
progress and stress the value of
striving for improvement rather
than perfection.

The Bottom Line here is;

•Urinate more than two liters per day.
• Consume enough dietary calcium to meet the US RDA.
• Avoid dietary oxalates (for calcium oxalate stone-formers).
• Limit sodium to 2,000 milligrams per day.
• Limit protein to 12 ounces per day.
• If overweight, lose weight.

Diet and Kidney Stones

2007-08-28T10:58:00.000-05:00

The Role of Diet in the Prevention
Of Common Kidney Stones
Christy Krieg
Kidney stone formers may
feel doomed to a life of
unpredictable flank pain,periodic surgical intervention,
and concomitant loss of
work and daily pleasures. Indeed,
if untreated, those who have
formed one calcium oxalate stone
have a 50% chance of forming
additional stones within 10 years
(Menon & Resnick, 2002). With
appropriate education, patients
can exercise some control over
stone disease and reduce their
chances of forming stones
through dietary modifications
and medication.
General dietary recommendations
appropriate for patients
who form the most common
metabolic stone types — calcium
oxalate and uric acid — will be discussed
in this article. Patients with
a tendency to form cystine and
brushite stones may also benefit
from some of the same dietary recommendations,
but dietary management
is a small part of an even
more complex treatment regimen
in these instances. Regardless of
stone type, recommendations for
dietary modifications are most
accurate when tailored to the
results of urine stone risk profiles,
or “24-hour urine” studies.
These studies typically provide
total urine volume, urine
calcium, sodium, citrate and uric
Current dietary recommendations for patients who form kidney
stones are discussed. Focusing on the most common kidney stone
types, calcium oxalate and uric acid, the rationale for dietary changes
are described based on the renal and urine physiology.
Christy Krieg, BSN, RN, is a Clinical
Nurse, Methodist Urology, Indianapolis,
IN.
Note: CE Objectives and Evaluation
Form appear on page 457.
acid, as well as pH, and supersaturation
of critical compounds,
among other measurements. The
values, if properly interpreted,
allow the clinician to observe the
patient’s specific abnormalities,
recommend medication and/or
dietary modification, and track
progress through followup studies.
As with many bodily
processes, stone formation is a
complicated and multi-factorial
process. Yet, there is much still to
be understood about stone formation.
For example, we know that
stone formation runs in families,
but while all humans form calcium
oxalate crystals, most do not
form stones (Lemann, 2002). And
while for years calcium stone formers
were instructed to restrict
dietary calcium, there is now significant
evidence against this recommendation
(Borghi et al.,
2002). These observations illustrate
the sometimes counterintuitive
and always complex nature
of stone formation and the need
for ongoing investigation.
Stone recurrence is frustrating
for patients who have made
changes in their lives and yet still
form stones. While diet alone
cannot always control the disease,
dietary measures can
absolutely help supplement
other therapies, and for some
patients are the primary tool for
stone prevention. As a component
of the medical management
for stone disease, the goal of therapy
should be to improve those
factors thought to contribute to
stone formation in the urinary
tract, and thereby reduce the
chance of forming stones, even if
the disease is not eliminated.
Urine Supersaturation
And Stone Formation
Urine volume plays a pivotal
role in the process of stone formation.
In particular, low volume,
highly concentrated urine
contributes to the supersaturation
of elements normally found
in the urine, such as calcium
oxalate. Simply put, when the
solute exceeds the solvent’s ability
to dissolve it, precipitation of
crystals can occur. Consider an
attempt to dissolve sugar in
water: a tablespoon of sugar is
readily dissolved in a glass of
water, but eight tablespoons of
sugar in that same glass will not
completely dissolve, resulting in
the accumulation of crystals in
the bottom of the glass. In this
scenario, the water is saturated
with sugar; the solvent, water,
can dissolve no more solute. It
has exceeded the point of saturation,
and is supersaturated.
Fortunately, urine has the
unique quality of holding more
solute in suspension than does
water and so can accept large
concentrations of solute without
precipitation. The ability of urine
to keep such large concentrations
in solution is, in part, due to the
presence of protective organic
molecules like citrate, as well as
the presence of charged ions
which alter the solubility (Menon
& Resnick, 2002). Despite the fact
that calcium oxalate can be present
in urine in concentrations 7
to 11 times its solubility in water
(Menon & Resnick, 2002), the
point exists at which calcium
oxalate exceeds the unique properties
of urine; crystals will then
form and possibly aggregate to
form stones.
Understanding saturation principles
in the urine, is it not clear
that methods of prevention shall be
focused on both an increase in solvent
and a reduction of solute?
These two concepts are the basis
for the dietary changes described
below.

Assessment of Dietary
Patterns

As dietary history is not part
of the typical urologic patient
history forms, the nurse can
obtain this information through
patient interview. Important information
includes the patient’s
intake of fluids throughout the
day, environmental factors promoting
dehydration, special diets
such as now-popular high-protein
diets, and a propensity to
consume packaged or restaurant
foods which are typically very
high in sodium. What does the
patient drink, how much is consumed,
and how is fluid intake
distributed through the day?
Does he or she work in a hot or
dry environment (such as a hot
factory, outside work in the summer)?
Does he or she prepare
fresh foods at home or tend to eat
convenience foods?
Nurses’ dietary interview can
occur before or after metabolic
testing. Absent metabolic testing,
this interview has even greater
import as it is the only source of
information about dietary habits.
Asking patients to keep a 24-hour
diet record may help identify
patterns of which even the
patient was unaware. Sources of
dietary sodium can be obvious or
insidious. The excess intake of a
patient who consumes a bag of
microwave popcorn every night
is more apparent than the intake
of a patient who drinks sports
drinks after a daily workout;
these are both very high in sodium,
but the latter is less often
recognized.
If the nurse has at his or her
disposal a 24-hour urine study,
dietary anomalies may be more
specifically exposed and documented.
This author views 24-
hour urine studies as “vice recognition
software;” the numbers
show actual urine output, and
indicate dietary sodium, protein,
and oxalate excess. Patients with
low urine volumes may believe
their results are incorrect. They
may say “I drink all the time!”
and yet the output is low. Here
the role of dietary counseling is
critical; the insightful nurse
helps the patient identify volume
consumed, sources of insensible
loss, and ways to ensure
increased urine volume.

DIETARY CHANGES TO
PREVENT AND REDUCE
STONE FORMATION

Increase Fluid Intake
Increasing urine volume can
reduce supersaturation, and is
widely known to help prevent
stone formation. Recommendations
for urinary output vary, but there is
general agreement that it should
exceed two liters per day, while
some even encourage urinary
outputs in excess of three liters
per day (Menon & Resnick, 2002;
Sakhaee, Zerwekh, & Pak, 1980).
A key point is that the dilution of
urine is necessary “24/7,” or all
day, every day. A patient who
voids the recommended two
liters a day between the hours of
8 am and 10 pm, but only 300
milliliters during the remaining
10 hours of the day will have saturated
urine overnight, with the
possibility of precipitation and
aggregation during the sleeping
hours. Patients must accept the
necessity of getting up at least
twice at night to urinate, and
should consume more water each
time they rise to void.
Stress to patients that it is not
the quantity of fluid consumed
that is important, but rather the
fluid voided that should be measured.
Patients living in hot or
dry conditions, or who exercise
and perspire significantly, will
need to drink even more liquid to
maintain adequate urine output.
Many patients ask what fluids
are recommended, and which
are prohibited. The simple
answer is that water is best. For
those with excessive urinary
oxalates, black tea should be
eliminated because black tea is a
high-oxalate beverage. Curhan,
Willett, Rimm, Speizer, and
Stampfer (1998) found, in a retrospective
study of previously nonstone
forming women from the
Nurses’ Health Study, that the
type of beverages consumed
proved relevant for stone formers.
Of the 17 beverages studied,
and after correcting for other contributing
factors, those who
drank one daily 8 ounce glass of
grapefruit juice had a 44%
increased risk of a stone event in
the 8-year period, while the risk
was decreased by 8% to 10% for
each daily 8 ounce serving of coffee
(both caffeinated and non-caffeinated),
tea, or wine. A prospective study had similar
conclusions for men, additionally
showing that beer had a protective
effect and apple juice increased
the risk of stone events (Curhan,
Willett, Rimm, Speigelman, &
Stampfer, 1996). Also, a study published
by Massey and Sutton (2004)
showed a modest positive relationship
between caffeine intake and
urinary calcium levels in stone formers
and non-stone formers, so caffeinated
beverages should be limited
in stone formers. In summary,
stone formers should drink more
water and avoid excess caffeine,
black tea, and grapefruit and apple
juices.

What do these studies mean
for patient education?

Water is the
best beverage for stone formers. It is
non-caloric, non-caffeinated, and
contains insignificant amounts of
solutes. In initial attempts to
increase patients’ fluid intake, it
may be appropriate to advise them
to drink whatever they can consume
in large quantities. However,
warning them of side effects of sugared
and caffeinated beverages in
large quantities is important. The
results discussed above indicate
that consumption of alcoholic
beverages is unlikely to increase
stone risk. Water that tastes good
(filtered, reverse osmosis, bottled)
may be easier to consume than tap
water, so encourage patients to
seek a source of good-tasting
water. There is no clear agreement
on the impact of drinking water’s
mineral content on lithogenesis;
“hard water” may not be problematic
for most patients (Menon &
Resnick, 2002). Again, water in
large quantities should be the
focus of prevention. Lemonade is
often recommended, as it supplies
dietary citrate, a stone inhibitor
and pH buffer when excreted later
in the urine.
Encourage patients to set
consumption goals, carry water
with them at all times, and strive
for pale urine throughout the day
and night. Some patients describe
an initial physiologic
resistance to increased fluid
intake which eases as their bodies
and minds learn the new
habit of extra fluid intake and
output. According to Parks,
Goldfischer, and Coe (2003),
aims by clinicians to increase
patients’ urinary volumes often
fall short, and follow-up metabolic
studies showed an average
increase in urine output of only
0.3 liters per 24 hours. This
increase was associated with a
curious increase in sodium
intake. High urine volumes
should be the goal of all patients
who form stones. In this
instance, more is definitely better.
Most patients find that after
forcing fluids for a couple of
months, their bodies crave fluids
and their habit is to drink more.
Consume Adequate Calcium
High urine calcium, hypercalciuria,
is associated both with
formation of kidney stones and
with osteoporosis. Sufficient calcium
intake is required for the
growth and maintenance of the
skeleton in children and adults.
Reducing urine calcium should
be a goal for stone formers, but
not via dietary restriction. While
reduced dietary calcium can
decrease urine calcium (Lemann,
2002), calcium restriction is no
longer advisable for patients who
form calcium kidney stones as
this puts them at risk of bone disease,
namely osteoporosis. Recall
that bones are in a constant
process of resorption and formation;
adequate calcium is required
for the ongoing rebuilding of bone
material.
Several recent studies have
shown, in fact, that adequate calcium
intake is associated with
decreased stone formation.
Curhan, Willett, Knight, and
Stampfer (2004) found that in
previously non-stone forming
younger women, higher intake of
dietary calcium was related to
lower risk of kidney stone formation.
Additionally, a 5-year randomized
clinical trial of men
with a history of calcium oxalate
stones found that a normal calcium,
decreased sodium, and
decreased animal protein diet
was more effective for reducing
stone events than was a restricted
calcium diet (Borghi et al., 2002).
So, adequate calcium plus
decreased sodium and protein
intake had a significantly more
protective effect against stones
than decreased calcium intake
alone.
Why might increased dietary
calcium reduce the risk of calcium
stone formation? Calcium
and oxalate bind in the gut and
in the urine to form a nonabsorbable
compound. Low dietary
calcium permits greater free
oxalate to be absorbed in the gut
and excreted in the urine, which
may be counterproductive for
calcium oxalate stone formers.
Restricted calcium intake results
in increased urinary oxalates, a
risk for stone formation (Menon
& Resnick, 2002). This is a proposed
cause of the association
between reduced calcium intake
and increased supersaturation of
calcium oxalate (Lemann, 2002).
Clearly, strong research evidence
now supports adequate
calcium intake for patients who
form kidney stones. Low-fat
dairy products, green leafy vegetables,
broccoli, fortified foods,
and almonds are excellent
sources. Patients should consume
enough dietary calcium to
meet (but not exceed) the United
States Recommended Daily
Allowance (RDA) of calcium,
which ranges from 1,000 to 1,200
milligrams daily for adults. The
recommendations are the same
for men and women, but vary by
age group (see Table 1). Patients
should avoid calcium supplements
in favor of calcium-rich
foods; a patient with intolerance
to dairy products may supplement,
but should not exceed the
RDA for his/her age group.
Limit Dietary Oxalates
Oxalate is found in many
foods, but there is considerable
variability in the amount, which
depends upon where the food is
grown. Likewise, individual
absorption of oxalate also varies,
which makes adequate calcium
intake critically important.
Nonetheless, oxalate restriction
should be attempted. The highest
levels of oxalate are found in
chocolate, nuts, beans (including
soybeans), rhubarb, spinach,
beets, and black tea. A thorough
oxalate list can be found on the
Web site of the Oxalosis and
Hyperoxaluria Foundation (http://
www.ohf.org/diet.html). This list
is exhaustive and may be overwhelming
to patients. Stress that
reduction of high oxalate foods is
the goal for typical stone formers
rather than strict avoidance of all
oxalate-containing foods (which
would be very difficult). Followup
24-hour urine studies will demonstrate
the adequacy of patients’
restriction.
Though only 10% to 20% of
urinary oxalates come from
dietary sources (Morton, Iliescu,
& Wilson, 2002), dietary reduction
is commonly advised for calcium
oxalate stone formers. It has
been suggested that because
there is much less oxalate in the
urine than calcium in the urine,
urinary oxalate concentration is
much more critical to the formation
of calcium oxalate crystals
than is the urinary calcium concentration;
reducing urine oxalates
may have a more powerful effect
on stone formation than can reduction
of urine calcium (Morton et
al., 2002). Patients with calcium
oxalate stones, particularly those
with documented hyperoxaluria,
should avoid foods high in
oxalates. Vitamin C is a precursor
to endogenous production of
oxalates, so some clinicians recommend
avoiding mega-doses of
vitamin C. The rare genetic condition
of primary hyperoxaluria is
only slightly impacted by dietary
reduction, and causes serious
medical problems besides kidney
stones.
Limit Sodium Intake
Because calcium and sodium
compete for reabsorption in the
renal tubules, excess sodium
intake and consequent excretion
result in loss of calcium in the
urine. High-sodium diets are
associated with greater calcium
excretion in the urine (Lemann,
2002). Metabolic studies often
reveal exceptionally high urine
calcium over 24 hours, related to
patients’ exceptionally high sodium
excretion. Patients may deny
salt intake, stating, “I never salt
my food!” They quite likely are
ignorant of hidden sodium
sources in the diet. Sodium is a
common preservative in canned
and frozen foods, and is endemic
in restaurant foods. Instruction
on careful inspection of food
labels and wise food choices
helps patients identify and
reduce sodium in their diets.
A notable dietary “ah-ha!”
was the admission by one patient
that, on the day of 24-hour urine
testing, she ate a full jar of pickles
to reduce stress, and then
drank the brine; needless to say,
her urine sodium was very high
on the day of her stress mitigation.
The role of the nurse or dietician
in shedding light on sources
of sodium cannot be underestimated.
Repeated, persistent inquiry
into dietary habits may be necessary.
The goal of therapy should be
a “no added salt diet,” or the equivalent
of 2,000 mg per day or less of
dietary sodium. Reduction of
dietary sodium is difficult and disappointing
to patients. They may
believe they have made significant
reductions and sacrifices, while
their urine sodium remains high.
Consultation with a registered
dietician may help the patient
achieve the specific goal of a sodium
intake of 2,000 milligrams or
less per day.
Limit Animal Protein
The effect of excess animal
protein (purine) is most obvious
for the uric acid stone former.
Uric acid, a byproduct of purine
metabolism, is excreted in large
quantities in the urine. Excess
protein creates urine with high
total urine uric acid, potentially
high supersaturation of urine
uric acid, and a low pH, necessary
for formation of uric acid
stones. There is no inhibitor of
uric acid crystal formation
(Menon & Resnick, 2002), so
dietary measures focus on reducing
uric acid and increasing
urine volume. Reduction of animal
protein to 12 ounces per day
for adults is recommended. This
is plenty to meet the dietary
needs of most Americans, many
of whom typically consume several
more ounces of animal protein
daily than is recommended.
Protein from plant sources
(beans, legumes, etc.) can be substituted
as a dietary alternative
without negative consequences.
Calcium oxalate stone formers
reducing their animal protein
should note the oxalate content
of substitute proteins.
The role of excess protein in
promoting calcium stone formation
is less obvious, but equally
important. High dietary protein
is associated with increased urinary
calcium. Thus, there is a
link between meat consumption
and both uric acid and calcium
stone formation. In fact, vegetarians
form stones at one-third the
rate of those eating a mixed diet
(Lemann, 2002). A study of 18
hypercalciuric stone formers found
that a 15-day protein restriction
had many positive effects on urinary
markers of stone risk.
Namely, significant decreases
were seen in urine calcium, urine
uric acid, urine phosphate, and
urine oxalate. And, for unclear
reasons, a beneficial increase in
urinary citrate was observed
(Giannini et al., 1999). Citrate is a
known inhibitor of calcium
oxalate crystal formation and
also increases pH, which can prevent
uric acid stones. Clearly, the
benefits of protein restriction for
stone formers are many.

Weight Loss

A relationship between weight,
body mass index and risk of calcium
oxalate stone formation was
established in a retrospective
study of health professionals.
Curhan and colleagues (1998)
found that “the prevalence of
stone disease history and the
incidence of stone disease were
directly associated with weight
and body mass index. However,
the magnitude of the associations
was consistently greater among
women” (p. 1645). The value of
weight loss for stone prevention
has not been proven, but given
the benefits of weight loss for
general health, it is certainly
worth mentioning to overweight
patients who form stones.
Educational Resources
There are excellent resources
on the Internet for patients seeking
nutritional information. One stellar
example is NutritionData
(www.nutritiondata.com/). Here
patients can search by general food
category, like “pickle,” to view the
standard sodium content, as well
as a plethora of additional information
regarding vitamin and mineral
content, calories, suggested healthier
substitutes, and even the individual
amino acid compositions of
each protein. The site also provides
detailed information about
thousands of specific brand items
from grocery and fast food restaurants.
Under “Tools,” patients can
search within food categories like
“dairy products” for choices highest
in calcium and lowest in sodium.
This site is complex and may be
overwhelming to patients without
good computer and Web skills, but
is extraordinarily comprehensive;
unfortunately, this site does not list
oxalate content. For that purpose,
refer patients to www.ohf.org.
For patients without Web
access, nurses might find it helpful
to review a general nutrition
book for charts and diagrams to
help patients understand nutrition
content. Show patients a
sample food label from a can of
soup so they know where to find
sodium content on foods at home.
For a simple list of high-oxalate
foods, visit www.gicare.com/
pated/edtgs29.htm.
Conclusion
The dietary measures discussed
have value particularly
for patients who form the most
common types of kidney stones:
calcium oxalate and uric acid.
That said, they may be insufficient
to control the various metabolic
abnormalities present in
individual patients. The most
effective management of kidney
stones includes in-depth metabolic
studies, recommendations
tailored to patients regarding
medications and dietary changes,
and follow-up to ensure changes
are having the desired effect.
Urine studies should be repeated
to judge progress approximately
6 to 8 weeks after initial metabolic
testing recommendations are
implemented. Once a stable state
is reached in which the patient’s
urine demonstrates decreased
risk of stone formation, metabolic
testing should be performed
(along with an x-ray to check for
stone growth) at least annually to
monitor stone risk. The cycle of
stone formation can be altered,
and in some cases broken, with
the aid of effective dietary management.
Every patient need not make
all of these changes to his/her
diet, but in the absence of
patient-specific urine studies,
none of these recommendations
is harmful. Aside from oxalate
consumption, the dietary recommendations
for calcium oxalate
and uric acid stone formers are
the same. Assessing
patients’ dietary habits can shed
light on potential areas of
improvement. For example, a
receptive uric acid stone former
on a high-protein diet for weight
loss could benefit from counseling
on the effects of this diet on
his/her stone disease.
Of course, talking about
dietary changes is easier than actual
implementation. Encourage
patients to make changes at a realistic
pace. Praise even modest
progress and stress the value of
striving for improvement rather
than perfection.

The Bottom Line here is;

•Urinate more than two liters per day.
• Consume enough dietary calcium to meet the US RDA.
• Avoid dietary oxalates (for calcium oxalate stone-formers).
• Limit sodium to 2,000 milligrams per day.
• Limit protein to 12 ounces per day.
• If overweight, lose weight.

We Keep Getting Fatter

2007-08-27T14:49:00.000-05:00

Obesity rates climb in most states

By KEVIN FREKING, Associated Press

Loosen the belt buckle another notch: Obesity rates continued their climb in 31 states last year. No state showed a decline.

Mississippi became the first state to crack the 30 percent barrier for adult residents considered to be obese. West Virginia and Alabama are just slightly behind, according to the Trust for America's Health, a research group that focuses on disease prevention.

Colorado continued its reign as the leanest state in the nation with an obesity rate projected at 17.6 percent.

This year's report, for the first time, looked at rates of overweight children ages 10 to 17. The District of Columbia had the highest percentage — 22.8 percent. Utah had the lowest percentage of overweight youth — 8.5 percent.

Health officials say the latest state rankings provide evidence that the nation has a public health crisis on its hands.

Unfortunately, we're treating it like a mere inconvenience instead of the emergency that it is," said Dr. James Marks, senior vice president at the Robert Wood Johnson Foundation,a philanthropy devoted to improving health care.

Officials at the Trust for America's Health advocate for the government to play a larger role in preventing obesity. People who are overweight are at an increased risk for diabetes, heart problems and other chronic diseases that contribute to greater health care costs.

"It's one of those issues where everyone believes this is an epidemic, but it's not getting the level of political and policymaker attention that it ought to," said Jeffrey Levi, the organization's executive director. "As every candidate for president talks about health care reform and controlling health care cost costs, if we don't hone in on this issue, none of their proposals are going to be affordable."

At the same time, many believe weight is a personal choice and responsibility. Levi doesn't dispute that notion, but he said society can help people make good choices.

"If we want kids to eat healthier food, we have to invest the money for school nutrition programs so that school lunches are healthier," he said. "If we want people to be more physically active, then there have to be safe places to be active. That's not just a class issues. We've designed suburban communities where there are no sidewalks for anybody to go out and take a walk."

To measure obesity rates, Trust for America's Health compares data from 2003-2005 with 2004-2006. It combines data from three years to improve the accuracy of projections. The data come from a survey of height and weight taken over the telephone. Because the information comes from a personal estimate, some believe it is conservative.

Indeed, the Centers for Disease Control and Prevention released a study last year noting a national obesity rate of about 32 percent — a higher rate than was cited for any of the states in the Trust for America's Health report. The CDC's estimate came from weighing people rather than relying on telephone interviews, officials explained.

Generally, anyone with a body mass index greater than 30 is considered obese. The index is a ratio that takes into account height and weight. The overweight range is 25 to 29.9. Normal is 18.5 to 24.9. People with a large amount of lean muscle mass, such as athletes, can show a large body mass index without having an unhealthy level of fat.

A lack of exercise is a huge factor in obesity rates. The Centers for Disease Control and Prevention found last year that more than 22 percent of Americans did not engage in any physical activity in the past month. The percentage is greater than 30 percent in four states: Mississippi, Louisiana, Kentucky and Tennessee.

Meanwhile, Minnesotans led the way when it came to exercise. An estimated 15.4 percent of the state's residents did not engage an any physical exercise — the best rate in the nation. Still, the state ranked 28th overall when it came to the percentage of obese adults.

Another factor in obesity rates is poverty. The five poorest states were all in the top 10 when it came to obesity rates. An exception to that rule was the District of Columbia and New Mexico. Both had high poverty rates, but also one of the better obesity rates among adults.

Officials said the report is not designed to stigmatize states with high obesity rates but to stir them into action.

"These are the states where the urgency is the greatest. They need not to wait for others to lead. They need to become the leaders," Marks said. "It's the only way that they can restore the health of their children and their families. It's the only way that they can improve their economic competitiveness."

2007-08-17T14:29:00.000-05:00

Whole grains may lower odds of high blood pressure

Women who get plenty of whole grains in their diet may lower their risk of developing high blood pressure, a large study suggests.

Researchers found that middle-aged and older women who ate the most whole grains were less likely than those with the lowest intakes to develop high blood pressure over the next 10 years.

The benefit was modest. Women who consumed the most whole grains had an 11-percent lower risk of high blood pressure than those with the lowest intakes.

But the findings add to evidence of the cardiovascular benefits of whole grains such as oatmeal, bran and brown rice. Past studies have tied diets rich in these foods to lower risks of heart disease and stroke.

The fiber and other nutrients in whole grains may help lower cholesterol, blood sugar and insulin levels, as well as improve blood vessel functioning and reduce inflammation in the circulatory system. Whether whole grains benefit blood pressure has been unclear, however.

For the current study, researchers at Harvard University in Boston used data from the Women's Health Study, which has followed nearly 40,000 U.S. female health professionals since 1992. Upon entering the study, the women completed detailed questionnaires on their diet habits, including their usual intake of whole-grain foods like dark bread, popcorn, oatmeal and whole-grain breakfast cereals.

Of the nearly 30,000 women who were free of high blood pressure at the outset, those who ate the most whole grains had a lower risk of developing the condition. The apparent protective effect held when the researchers considered other factors, like weight, smoking and exercise habits.

In contrast, refined grains -- like pasta, white bread and other foods made from white flour -- were unrelated to high blood pressure risk, according to the researchers, led by Dr. Lu Wang.

Unlike whole grains, refined grains are largely stripped of the fiber- and nutrient-rich bran and germ components of the plant. This difference may explain why only whole grains were related to lower blood pressure, according to Wang's team.

The findings, the researchers conclude, suggest that people may do their blood pressure and heart health some good by replacing refined-grain foods with whole grains.

SOURCE: American Journal of Clinical Nutrition, August 2007.

Brain Food from Wikipedia

2007-08-15T16:07:00.000-05:00

Nootropic
Nootropics, popularly referred to as "smart drugs" and "smart nutrients", are substances which boost human cognitive abilities (the functions and capacities of the brain). The word nootropic was coined in 1964 by the Romanian Dr. Corneliu E. Giurgea, derived from the Greek words noos, or "mind," and tropein meaning "to bend/turn." Typically, nootropics are alleged to work by increasing the brain's supply of neurochemicals (neurotransmitters, enzymes, and hormones), by improving the brain's oxygen supply, or by stimulating nerve growth.
Most alleged nootropic substances are nutrients or plant components (herbs, roots, beans, bark, etc.), available over the counter at health food and grocery stores, and are used as nutritional supplements. Some nootropics are drugs, used to treat people with cognitive learning difficulties, neural degradation (Alzheimer's disease or Parkinson's disease), and for cases of oxygen deficit to prevent hypoxia. These drugs have a variety of human enhancement applications as well, are marketed heavily on the World Wide Web, and are used by many people in personal cognitive enhancement regimens.
While scientific studies support some of the claimed benefits, it is worth noting that many of the claims attributed to most nootropics have not been formally tested.
General strategies
Neurotransmitter support - supplying the body with the precursors and cofactors it needs to produce neurotransmitters.
Note that cardiovascular exercise performed on a regular basis also has nootropic effects, by increasing the body's capacity to supply brain cells with oxygen.
Nootropic substances
Nootropic drugs are generally only available by prescription or through personal importation. The other nootropic substances listed below are either nutritional supplements or plant components, and are generally available over the counter at health food and grocery stores. The term "drug" here is used as a legal designation, and does not indicate greater efficacy. With nootropics, the effects, effectiveness, and potency differ from substance to substance and from individual to individual. See the substance descriptions below for more detail.
Replenishing and increasing neurotransmitters
Thinking is a biologically demanding task. It involves the firing of neurons, which requires ample neurotransmitters, and even though these are reuseable to some extent, they do get depleted. Depletion of neurotransmitters generally results in reduced mental performance, which may include difficulty concentrating, slowed reasoning, decreased learning efficiency, impaired recall, reduced coordination, lowered moods, inability to cope, increased response times, and mental fatigue. This also generally increases the likelihood of human error on tasks and activities performed. Stress causes neurotransmitters to be depleted even faster. The brain's neurotransmitters need to be replenished frequently, made by the body from substances ingested in the diet. Maintaining neurochemicals at optimal levels has a corresponding effect on brain performance, supporting improved mental agility and stamina, even beyond the individual's normal limits.
As the brain ages, its ability to produce and maintain youthful levels of neurotransmitters declines. Thus, the theory is that providing the brain with ample raw materials necessary to make neurotransmitters can restore them to more youthful levels and thus help maintain cognitive function at vigorous youthful levels as well.
Cholinergics
Cholinergics are substances that affect the neurotransmitter acetylcholine or the components of the nervous system that use acetylcholine. Acetylcholine facilitates memory, concentration, focus, and high-order thought processes (abstract thought, calculation, innovation, etc.). Increasing the availability of this neurotransmitter in the brain may improve these functions and increase the duration in which they may be engaged without slowing down or stopping. Oversupplying the brain with acetylcholine may have the opposite effect, temporarily reducing rather than improving mental performance. Cholinergic nootropics include acetylcholine precursors and cofactors, and acetylcholinesterase inhibitors:
• Acetyl-L-carnitine (ALCAR) - Amino acid. Precursor of acetylcholine (donating the acetyl portion to the acetylcholine molecule). It is synergistic with lipoic acid.
• Centrophenoxine (Lucidril) - Drug. Cholinergic agent, enhances color perception.
• Choline - precursor to acetylcholine (an essential component of the acetylcholine molecule).
o Alpha-GPC (L-alpha glycerylphosphorylcholine, Choline alfoscerate) - most effective choline precursor, readily crosses the blood-brain barrier.
o CDP-Choline (Cytidine Diphosphate Choline) - choline precursor, tends to be less expensive and similar in effect to Alpha GPC.
o Choline bitartrate - precursor of acetylcholine, anti-depressant.
o Choline citrate - precursor of the neurotransmitter acetylcholine, anti-depressant.
• DMAE - approved treatment for ADD/ADHD, precursor of acetylcholine, cholinergic agent, removes lipofuscin from the brain, anti-depressant.
• Huperzine A - potent acetylcholinesterase inhibitor derived from Chinese club-moss.
• Lecithin - contains phosphatidylcholine, precursor of acetylcholine.
• Pyrrolidone derivatives:
o Piracetam (Nootropil) - Prescription drug (in Europe). The original (first), and most commonly taken nootropic drug. It is a cholinergic agent, synergistic with DMAE, centrophenoxine, choline, and Hydergine. Increases brain cell metabolism and energy levels, and speeds up interhemispheric flow of information (left-right brain hemisphere communication). Increases alertness, improves concentration, and enhances memory. Protects neurons from hypoxia, and stimulates growth of acetylcholine receptors. May also cause nerves to regenerate. Piracetam markedly decreases the formation of neuronal lipofuscin. It improves posture in elderly people. It is not regulated in the US.
o Aniracetam - Drug. Analog of piracetam, and 4 to 8 times more potent. Like piracetam, aniracetam protects against some memory impairing chemicals, such as diethyldithiocarbamate and clonidine. Also like piracetam, aniracetam may enhance memory in aging adults by increasing levels of brain biogenic monoamines, which are beneficial to learning and memory. Both racetams have possible therapeutic use in treating fetal alcohol syndrome. Aniracetam increases vigilance.
o Etiracetam - It increases vigilance.
o Nefiracetam - Drug. Analog of piracetam, and facilitates hippocampal neurotransmission.
o Oxiracetam - Drug. Analog of piracetam, and 2 to 4 times stronger. Improves memory, concentration, and vigilance. When fed to pregnant rats, the offspring of those rats were more intelligent than the offspring of rats fed a saline solution placebo.
o Pramiracetam - Drug. Fifteen times stronger than piracetam, of which it is an analog.
• Vitamin B5 - cofactor in the conversion of choline into acetylcholine, cholinergic agent, increases stamina (including mental stamina).
Excess acetylcholine is considered by many to be potentially harmful; see cholinesterase inhibitor.
Dopaminergics
Dopaminergics are substances that affect the neurotransmitter dopamine or the components of the nervous system that use dopamine. Dopamine is produced in the synthesis of all catecholamine neurotransmitters, and is the rate limiting step for this synthesis. Dopaminergic nootropics include dopamine precursors and cofactors, and dopamine reuptake inhibitors:
• L-dopa - Prescription drug. Precursor to the neurotransmitter dopamine, anti-depressant.
• Phenylalanine (requires Vitamin B6 and Vitamin C) - Essential amino acid. Precursor to dopamine, anti-depressant, sleep reducer.
• Theanine - Found in tea. Increases serotonin and dopamine levels in the brain. Increases alpha-wave based alert relaxation.
• Tyrosine (requires Vitamin B6 and Vitamin C) - Amino acid. Precursor to dopamine, anti-depressant, sleep reducer.
• Vitamin C- improves cardiovascular elasticity and integrity, membrane stabilizer and major anti-oxidant (protects brain cells and prevents brain cell death), cofactor in the production of the neurotransmitters dopamine and serotonin.
• Vitamin B6 - co-factor used by the body to produce dopamine.
• Yohimbe - Bark. Boosts dopamine levels as much as 80%, though how it does this is not yet understood. Aphrodisiac. Yohimbe poses some health risks through its side-effects: it is a neuro-paralytic which slows down breathing and induces acidosis, some symptoms of which are malaise, nausea, and vomiting. Contraindicated for users of megadoses of acidic vitamins or nutrients.
• Deprenyl - Inhibits MAO B (an enzyme that breaks down dopamine) thus raising dopamine by partially inhibiting its breakdown.
• Tolcapone - Inhibits COMT (an enzyme that breaks down the neurotransmitters dopamine, epinephrine, and norepinephrine) and increases performance in tasks depending on working memory in individuals with the val/val and val/met genotype of the val158Met polymorphism of the catechol-O-methyltransferase gene, while decreasing it in presence of the met/met version. Tolcapone presents the risk of deadly side effects.
Serotonergics
Serotonergics are substances that affect the neurotransmitter serotonin or the components of the nervous system that use serotonin. Serotonergic nootropics include serotonin precursors and cofactors, and serotonin reuptake inhibitors:
• 5-HTP - more bioavailable form of tryptophan, precursor to the neurotransmitter serotonin, promotes relaxed poise and sound sleep.
• Griffonia simplicifolia a natural source of 5-HTP (an alternative in countries where 5-HTP not legal, freely available.)
• Tryptophan (requires Vitamin B6 and Vitamin C) - Essential amino acid. Precursor to serotonin, found in high concentration in bananas and poultry (especially turkey), also in milk, promotes relaxed poise and sound sleep.
• 5HT2A agonists such as LSD and 2C-T-7 have been shown to produce nootropic effects when used at a dose much lower than a hallucinogenic dose. (e.g. 10 μg for LSD and 1 mg 2C-T-7, 1/25 of a normal recreational dose )
Anti-depression, adaptogenic and mood stabilization
Depression and depressed mood negatively affect cognitive performance. Feelings of sadness, guilt, helplessness, hopelessness, anxiety, and fear caused by depression detract from productive thought, while apathy (which is also induced by depression) is the lack of motivation and driving moods (like curiosity, interest, determination, etc.) Other symptoms include disturbed sleep patterns, mental fatigue and loss of energy, trouble concentrating or making decisions, and a generalized slowing and obtunding of cognition, including memory. Obviously, removing these effects improves intelligence and mental performance, and therefore, counteracting and preventing depression are effective nootropic strategies. There is a high correlation between depression and a reduction or depletion of neurotransmitters (dopamine, acetylcholine, and serotonin) in the brain, therefore it is no surprise that increasing the brain's supply of neurotransmitters alleviates (or at least reduces the symptoms of) most depressions. Stress is another major factor in neurotransmitter depletion, being both a cause and effect of it (creating a vicious downward spiral), therefore stress management and anti-stress substances are also very useful nootropic strategies.
All of the "nergics" listed above have been found to increase stress tolerance and alleviate depression (by replenishing or increasing the brain's supply of specific neurotransmitters)[citation needed], especially when used in precursor/co-factor combinations[citation needed].
Below are additional more nootropics which affect mood and stress:
• Ashwagandha (Withania somnifera) - Root. Also known as Indian ginseng. Adaptogen used as a tonic to normalize body processes and reduce stress and anxiety.
• Inositol - Is a B-vitamin like substance with anti-anxiety effects. It is believed to produce its anti-anxiety effects by improving the binding of gabaergics to GABAA receptors. Inositol is a sugar, and is therefore an alternative energy source for brain and muscle tissues. It produces a sugar high without a sugar low, making it especially suited for sweetening tea (instead of sugar). It is also a membrane stabilizer which can strengthen (and therefore help protect) neurons.
• Lemon Balm (Melissa officinalis) - Herb. Anti-depressant.
• Rhodiola Rosea - Herb. Adaptogen; elevates mood, alleviates depression. Promotes mental energy and stamina, reduces fatigue.
• St John's Wort - Herb. The active components: hypericin and hyperforin, are clinically indicated to be effective in cases of mild to medium depression.
• Ginseng, Siberian (Eleutherococcus senticosus) - Root. Anti-anxiety adaptogen that normalizes physical stress and mental consequences.
• Selegiline (Deprenyl) - Along with Piracetam and Meclofenoxate, Deprenyl decreases the amount of lipofuscin pigment and ceroid pigment accumulations in the brain by improving cellular recycling activities. Therefore, these nootropics may slow age-related diseases in the brain.
• Sutherlandia frutescens - Herb. Adaptogen, blood detoxifier.
• Tea - Herb. Contains theophylline and theanine. Increases alpha-wave based alert relaxation (relieves stress).
• Theanine - Amino acid. Found in tea. Increases serotonin and dopamine levels in the brain. Increases alpha-wave based alert relaxation.
• Vasopressin - Drug. Memory hormone produced by the pituitary gland which improves both memory encoding and recall. Rapidly counters chronic apathy syndrome and drug-induced vasopressin depletion.
• Nicotinic acid (vitamin B3) - Essential nutrient. Mild enhancer of concentration and memory. Vasodilator. Mood stabilizer, with a powerful anti-anxiety effect — perhaps the best and most immediate stress reliever available (note that other forms of vitamin B do not have this effect). Side effects: gastric upset (which is easily prevented and relieved with antacids), reduced blood pressure and flushing of the skin (caused by vasodilation), and itchy sensation in the skin caused by histamine release.
Brain energy and improved oxygen supply
• Acetyl-L-carnitine (ALCAR) - Amino acid. Transports fatty acids through cellular membranes and cytosol into cells' mitochondria, where the fats undergo oxidation to produce ATP, the universal energy molecule. Synergistic with lipoic acid.
• Chromium- stabilises blood sugar levels promoting concentration.
• Coenzyme q-10 syn. Ubiquinone - increases oxygen transport through the mitochondria of the cells. Appears to slow age-related dementia.
• Creatine - increases brain energy levels via ATP production.
• Inositol -
• Lipoic acid - synergistic with Acetyl-L-carnitine.
• Piracetam - improves alertness, blood flow, oxygen supply, and stroke recovery.
• Pyritinol (Enerbol) - Drug. Enhances oxygen and glucose uptake in the brain, and allows glucose to pass more easily through the blood-brain barrier. It is also a powerful anti-oxidant which scavenges hydroxyl radicals created in the very processes it is involved in.
• Vinpocetine - micro-circulation enhancer, improves oxygen supply to brain cells.
Mental agility, concentration, stamina, and focus
• Adrafinil (Olmifon) - Drug.
• Caffeine - improves concentration, idea production, but hinders memory encoding. Also produces the jitters. Caffeine is the most widely used psychoactive substance in the world, it may be susceptible to strong levels of tolerance.
• Coffee - Bean. Contains caffeine; brewed coffee is high in antioxidants.
• Nicergoline - Drug. Nicergoline is an ergoloid mesylate derivative used to treat senile dementia. It has also been found to increase mental agility and enhance clarity and perception. It increases vigilance. Increases arterial flow and use of oxygen and glucose in the brain.
• Nicotine - stimulus barrier (aids in concentration). Stimulus barrier rebound effect (an unpleasant side effect).
• Cocaine - Drug
• Methylphenidate (Ritalin) - Drug
• Dextroamphetamine - (Adderall, Dexedrine) - Drug
• Modafinil - (Provigil) - Drug.
• Piracetam - improves alertness, socialization, and co-operation in the brain impaired from age, dementia, and reduced blood flow.
• Phenibut -
• Theophylline -
• Amphetamine -
Purported memory enhancement and learning improvement
All of the "nergics" listed above are purported to improve memory (encoding and recall), As do all nootropics which improve general brain performance in categories such as the brain energy and oxygen supply, and nerve growth stimulantion and protection. Other agents purported to have these specific benefits are mentioned in their own sections.
Other nootropics with specific effects on memory encoding and recall include:
• Bacopa monniera (Brahmi) - Herb. Elevates curiosity, enhances memory and concentration. Brahmi also protects against amnesia inducing chemicals such as scopolamine or loss of memory due to electro convulsive shocks. It is a traditional ayurvedic medicine.
• Piracetam - improves memory, Alzheimer's, dementia, dyslexia and Down's syndrome
• Rosemary - Herb. Rosemary has a very old, albeit unverified, reputation for improving memory.
• Vasopressin - Hormone, prescription drug.
• Dextroamphetamine- Adderall, Dexedrine.[13]
Nerve growth stimulation and brain cell protection
• Acetyl-L-carnitine (ALCAR) - Amino acid. Inhibits lipofuscin formation.
• Bacopa monnieri (Brahmi) - Herb. Improves protein synthesis in brain cell repair and new dendritic growth.
• Selegiline (Deprenyl) - Drug. Brain cell protectant, delays senescence of brain cells, proven to increase maximum life span in laboratory rats.
• Ergoloid mesylates (Hydergine) - Drug. Mimics nerve growth factor (NGF), and is a powerful anti-oxidant capable of delaying brain death in cases of heart failure and stroke by several minutes with regular use. It increases vigilance.
• Idebenone - stimulates nerve growth, and has same effects as Coenzyme q-10 - boosters claim that CoQ10 has "harmful side-effects", a claim which has not been demonstrated in published peer-reviewed studies.
• Inositol - Membrane stabilizer. Strengthens neurons, making them less susceptible to damage.
• Pyritinol (Enerbol) - Drug. Powerful anti-oxidant which scavenges hydroxyl radicals. Also enhances oxygen and glucose uptake in the brain, and allows glucose to pass more easily through the blood-brain barrier. Improves general brain function.
• Rasagiline (Azilect) - Drug. Treats Parkinson’s disease either as monotherapy (by itself) or in addition to levodopa therapy. Promotes increased and sustained levels of dopamine by selectively inhibiting an enzyme, monoamine oxidase-B.
• Vitamin C - Membrane stabilizer, involved in collagen synthesis. Strengthens neurons, making them less susceptible to damage. Vitamin C is also a co-factor in the brain's production of dopamine.
Recreational drugs with purported nootropic effects
See also: Controlled substances act and Misuse of Drugs Act 1971
• Amphetamines (Adderall, Dexedrine) - Schedule II / Class B drugs. Prescribed for attention-deficit disorders, narcolepsy, and certain cases of obesity; and issued as an anti-fatigue pill for pilots in the armed forces. These also heighten alertness, mental focus, vigilance, stamina, and sex drive. They are highly addictive, and have many side effects. Personal importation is prohibited. Using these recreationally or for performance enhancement is illegal in most countries.
• Cannabis is reported to heighten the ability of the senses, as well as heighten alpha wave activity in the brain associated with creativity.
• LSD - Schedule I / Class A drug. At minuscule doses (1 μg) the drug has effects similar to Hydergine. The ability of the senses are expanded to such an overwhelming degree that what is being sensed seems qualitatively different. Left brain and right brain activity is heightened to produce an extremely heightened creativity. Also produces hallucinogenic and entheogenic effects at doses as low as 20–30 μg (micrograms), with the likelihood of having a bad trip increasing as dose is increased if these effects are undesired. May also cause cognitive shifts, synesthesia, and flashbacks. The drug sometimes spurs long-term or even permanent changes in a user's personality and life perspective. (For more details, see Albert Hofmann: LSD - My Problem Child.)
• 4-methylaminorex
• Pemoline
• Psilocybin and Psilocin
• MDPV
• Mescaline
Other nootropics
• Adafenoxate - Has an anti-anxiety effect for rats and possibly the same for humans.
• Butea frondosa - "The plant Butea frondosa has been indicated in the Indian system of medicine as a plant augmenting memory and as a rejuvenator. ... B. frondosa possesses anti-stress and weak nootropic activity."
• BMY 21502 - Injured animals treated with BMY-21502 at one week post-injury showed significant improvement in post-injury learning ability compared to injured animals treated with vehicle. Paradoxically, in uninjured control animals BMY-21502 treatment appeared to worsen learning scores. The results of this study indicate that BMY-21502 may be useful for attenuating the dysfunction in learning ability that occurs following TBI.
• Cabergoline (Dostinex) -
• Celastrus panicaltus - Herb.
• Cerebrolysin - A neuroprotective nootropic agent, might affect Alzheimer's disease pathology. Currently in clinical trials
• Coluracetam - It may also have potential use in prevention and treatment of ischemic retinopathy and retinal and optic nerve injury.
• Desmopressin (DDAVP) - Drug. Analog of vasopressin (the anti-diuretic and memory hormone)
• DHEA - Hormone created by the adrenal glands; Precursor to Estrogen and Testosterone
• Dostinex -
• Fasoracetam -
• Essential Fatty Acids- Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DPA) are the best known. EPA in particular, has an anti-depressant function and is positively indicated in trials with autism and learning difficulties.
• Fipexide (Vigilor) - It protects against some memory impairing chemicals, such as diethyldithiocarbamate and clonidine.
• Galantamine - Drug.
• Gerovital H3 -
• Ginkgo biloba - Root. Increases blood flow to the extremities and the brain, nootropic effects are disputed.
• Gotu Kola - Herb and root.
• Meclofenoxate - Has an anti-anxiety effect for rats and possibly the same for humans. Like Fipexide, it protects against some memory impairing chemicals, such as diethyldithiocarbamate and clonidine. Like many racetams, it may treat fetal alcohol syndrome.
• Milacemide - Drug.
• Nimodipine -
• Ondansetron -
• Oxiracetam (Neuromet) -
• Phenytoin (Dilantin) -
• Phosphatidylserine- reduces age-related memory loss and promotes concentration.
• Picamilon - Drug.
• Pikamilone -
• Pregnenolone - Hormone; Precursor to DHEA;
• Pyroglutamate -
• Semax - A neuropeptide (stimulator of the nervous system) developed from a short fragment of ACTH, Pro8-Gly9-Pro10 ACTH(4-10). Claims of significant increase in salvation of neurons are made
• Somatotropin -
• Sulbutiamine (Arcalion) - Drug.
• Xanthinol -

Brain foods
Some regular food items are rich sources of substances with alleged nootropic benefits:
• Nuts, in particular walnuts, are rich sources of alpha-linolenic acid (ALA), a type of omega-3 fatty acid. A mixture of walnuts served with dried fruit pieces is known in some regions as student food (orig. German: Studentenfutter) and is there popularily recommended as a snack for students and other mental workers.
• Oily fish, such as salmon or fresh tuna (not tuna canned in oil) are also good sources of omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid, whose lack in diet has been associated with increased risk of mental illnesses such as depression, aggressive behavior, schizophrenia, or hyper-activity in children.
Links
• BetterBrain Nootropics Index
• Business Week Online - "I Can't Remember" September 1, 2003
• CerebralHealth.com
• Slashdot |Cognitive Enhancement Drugs
• Brain Foods
• List of Nootropic drugs at Erowid.org
• The Scientist - Seeking Smart Drugs by Eugene Russo October 28, 2002
Psychoanaleptics: psychostimulants, agents used for ADHD and nootropics (N06B)

Centrally acting sympathomimetics
Amphetamine - Dexamphetamine - Dextromethamphetamine - Levomethamphetamine - Pemoline - Fencamfamin - Modafinil - Fenozolone - Atomoxetine - Fenetylline

Xanthine derivatives
Caffeine - Propentofylline

Other psychostimulants and nootropics Racetams (Piracetam, Oxiracetam, Aniracetam, Pramiracetam) - Meclofenoxate - Pyritinol - Deanol - Fipexide - Citicoline - Pirisudanol - Linopirdine - Nizofenone - Acetylcarnitine - Idebenone - Prolintane - Pipradrol - Adrafinil -

The Mens Health Article on Fish Oil

2007-08-15T10:25:00.000-05:00

Note to VitalChoice.com visitors: We have inserted our own comments between brackets [ ] in a few places. This article was accessed online August 7, 2007 at http://health.msn.com/general/articlepage.aspx?cp-documentid=100166680>1=10212

The Government's Big Fish Story
Scientists worldwide are praising a nutrient so powerful that it may help combat dozens of diseases. But don't expect an endorsement from our policy makers: They say we can do without.

By Sabrina Rubin Erdely and Denny Watkins, Men's Health.

When Randal McCloy was rushed to West Virginia University Ruby Memorial Hospital's intensive-care unit, he was practically dead. The 27-year-old coal miner had spent 41 hours buried 2 ½ miles underground after an explosion in the Sago, West Virginia, mine where he'd been working. His 12 oxygen-starved colleagues had all perished.

"As far as we know, he survived the longest exposure to carbon monoxide poisoning," says Julian Bailes, M.D., the neurosurgeon assigned to the case. McCloy was in a coma and in deep shock, his heart barely beating, one of his lungs collapsed, his liver and both kidneys shut down. Even if he somehow managed to pull through, doctors predicted McCloy would be severely brain damaged, since the carbon monoxide had stripped the protective myelin sheath from most of his brain's neurons. "It's very difficult to come back from a brain injury," says Dr. Bailes. "There's no drug that can help that."

While McCloy was being given oxygen infusions in a hyperbaric chamber, Dr. Bailes was struck by inspiration: He ordered a daily dose of 15,000 milligrams (mg) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) for the miner. In layman's terms?

"Fish oil," says Dr. Bailes.

Several weeks passed. Then, unexpectedly, McCloy emerged from his coma. This in itself was amazing, but he wasn't done. In the weeks that followed, he stunned even the most optimistic experts by recovering his memory and gradually regaining his ability to walk, talk, and see, a turnaround that many in the medical field called miraculous.

Although Dr. Bailes believes the hyperbaric chamber may have worked some magic on the myelin, he thinks much of the credit belongs elsewhere. "The omega-3s helped rebuild the damaged gray and white matter of his brain," says Dr. Bailes, who now takes his own medicine, swallowing a fish-oil supplement each morning. On his orders, McCloy, still recuperating at home, continues to take fish oil daily. "I would say he should be on it for a lifetime," says Dr. Bailes. "But then, I think everybody should."

Maybe what fish oil needed all along was a better publicist. After all, this isn't the medical community's first infatuation with omega-3s. Back in 1970, a pair of Danish researchers, Hans Olaf Bang and Jørn Dyerberg, traveled to Greenland to uncover why the Eskimo population there had a low incidence of heart disease despite subsisting on a high-fat diet. Their finding: The Eskimos' blood contained high levels of omega-3s, establishing the first link to heart health. But even though this discovery spurred additional omega-3 research throughout the '70s and '80s, the public remained more interested in other nutrients—none of which had the unfortunate words "fish" or "fatty" in their names.

There are three types of omega-3s: DHA and EPA, found in fish and marine algae (which is where the fish get them), and alpha-linolenic acid (ALA), which is found in plants, seeds, and nuts. All three have health benefits, but those attributed to DHA and EPA have sparked renewed interest in recent years. Studies show that this tag team may not only reduce a person's risk of heart disease and stroke but also possibly help prevent ailments as diverse as arthritis, Alzheimer's disease, asthma, autoimmune disorders, and attention-deficit/hyperactivity disorder—and those are just the A's. Researchers are now exploring if these multifunctional fats can, among other things, ward off cancer and even make prison inmates less violent. It's enough to make omega-3 geeks downright giddy.

"Omega-3s are fantastic!" says Jing X. Kang, M.D., Ph.D., a Harvard University researcher who made the news by genetically engineering pigs to produce omega-3s in their meat. "Not just for your heart but also for brain function, immunity function, women's health, children's health—I'm amazed at how important they are."

In fact, some experts argue that omega-3s should be labeled essential nutrients as necessary to health as, say, vitamins A and D. "They're involved in the metabolism of each individual cell," says Artemis P. Simopoulos, M.D., a physician and the president of the Center for Genetics, Nutrition and Health in Washington, D.C. "They're part of your body's basic nutrition."

But while some see omega-3s as a nutritional no-brainer, others find them surprisingly controversial. "Omega-3s are way, way overhyped," says Marion Nestle, Ph.D., M.P.H., a professor of nutrition and public health at New York University and the author of What to Eat. "The research so far has been mixed. I'll grant that they're healthy, but I don't think if you don't eat them you're going to die of a heart attack."

[Note: We respect Dr. Nestle’s public battle against junk food and in favor of whole food nutrition, so we were surprised by the thoughtless nature of her comment. The issue is not whether you need to eat omega-3s to avoid dying of a heart attack tomorrow, but whether you will be healthier overall by eating amounts greater than most Americans do, and there is little doubt of that.]

The government has been equally cautious. So far, the Food and Drug Administration has issued only a tepid statement that "supportive but not conclusive research" indicates that DHA and EPA are good for your heart. And the Food and Nutrition Board—the scientific panel that, funded mostly by federal money, creates Daily Recommended Intakes (DRI) for essential nutrients—has shrugged off the issue altogether. It crowned ALA essential, but ignored DHA and EPA. "We didn't feel the data were sufficient," says Linda Meyers, Ph.D., director of the board. It's precisely the sort of comment that leaves omega-3 researchers flabbergasted.

"They're in the Dark Ages," says Bill Lands, Ph.D., a retired National Institutes of Health (NIH) biochemist who has written extensively about omega-3s and is widely considered the field's elder statesman. "The science was very clear 15 years ago. But they're not interested in science. All they're interested in doing is preserving the status quo, when they could be saving lives."

[Note: Dr. Lands has been a science advisor to Vital Choice since 2005.]

I stare down at the fish lying on the laboratory countertop. It stares back with one dead eye. Hours ago it was swimming in the Chesapeake Bay with 2 million of its brethren; tomorrow they'll all be squashed in a giant screw press to make 10,000 gallons of oil destined for fish-oil capsules and omega-3 fortified foods.

"Not very glamorous, is he?" says Jane Crowther, senior director of Omega Protein's Health and Science Center. It's hard to disagree: I've come to the nation's largest fish-oil refinery, in Reedville, Virginia, and now that I'm face to fin with what a poster on the wall calls "MENHADEN...THE WONDERFISH!" I'm not exactly awestruck. Bony, oily, and without much meat, the menhaden isn't even considered edible by most people. And yet, hidden inside is a substance that some anthropologists claim was critical to our very evolution; without it, they say, we'd still have brains like chimps'.

Ask most scientists and they'll tell you that Stone Age man evolved on the African savannas, developing his big, complex brain as a result of all the animals he'd hunt and eat. But most scientists would be wrong, according to Michael Crawford, Ph.D., who, along with researchers from the USDA, conducted a 2002 study challenging the prevailing theory, which he calls "a load of rubbish."

Crawford, the director of London's Institute of Brain Chemistry and Human Nutrition, argues that many other savanna mammals also subsisted on meat, but none developed our megabrains. "And with their strong jaws and sharp teeth, they were far better equipped to eat flesh than we were," he says. Yet relative to their growing bodies, those animals' brains actually shrank, while man's brain expanded from a 1-pound processor to a 3-pound supercomputer.

What were we dining on that the rest of the Paleolithic crowd wasn't? Crawford has a three-letter answer: DHA. "The human brain is soaking in DHA," he says. "It is the only substance that supports that level of neural development and cognitive function."
And lo and behold, paleontologists have found evidence that early man lived along the coasts of southern Africa, leaving behind mounds of fossilized shells and other table scraps. Crawford points out that catching fish would have been a heck of a lot easier than snaring four-legged prey. Children and pregnant women could wade in and collect mollusks themselves, feeding young brains in the process. Studies show that DHA helps secure the connections between brain cells, especially in utero, when pregnant women can increase their babies' IQs by as many as six points.

While the savanna-versus-seashore debate will continue (Emory University researchers recently fired their own scientific salvo at Crawford's theory), no one can dispute that we're veritable meat-eating machines today. The average American ate only 16.2 pounds of fish in 2005, but consumed 195 pounds of meat. And although our livers can manufacture tiny amounts of DHA and EPA when we eat lots of ALA-rich nuts and seeds, these aren't exactly our favorite foods, either.

Changing agricultural techniques have worsened the situation. The natural omega-3 contents of meat, milk, and eggs have plummeted now that our livestock no longer graze on ALA-rich grass, instead consuming corn, wheat, and other grains that are loaded with another group of fatty acids, called omega-6s. In fact, the disappearance of omega-3s from our diets has coincided with an upsurge in omega-6s, mainly in the form of cereals, grains, and processed foods made with hydrogenated oils. Dr. Simopoulos estimates that in caveman days, we ate an equal amount of the two types, but that the average American now eats 16 times more omega-6s than omega-3s.

"That's what's really killing us," says Lands. "The balance of 6 and 3 got out of whack." These two types of fatty acids have a biochemical yin-and-yang relationship: While omega-3s reduce our body's inflammation response, omega-6s encourage it. Each fatty acid is crucial: For example, if your inflammatory response is too weak, you won't be able to fight infection properly. And in theory, the push and pull should create perfect balance. Instead, the excess of omega-6s in our diets may have left us in a perpetual state of inflammation.

"The reason you take ibuprofen and Celebrex and all those nonsteroidals is to prevent the manufacture of these inflammation molecules in the first place," says Joseph Hibbeln, M.D., a neuroscientist with the NIH. "The mental picture I have is of the Dutch boy with his finger in the dike, where the finger is expensive pharmacology, and the flood is omega-6s."

Andrew McGeehin had limped for the past half century. "Stupid football," mutters the 83-year-old resident of Allentown, Pennsylvania. He tore up his right knee in his 30s, and despite surgery and drugs, the pain gradually became enough to wake him at night. Finally, McGeehin's orthopedist, Thomas Meade, M.D., suggested that he take an omega-3 supplement.

"I wasn't expecting much. But I figured I'd tried everything else," says McGeehin, who began swallowing fish oil along with his usual dose of the anti-inflammatory drug Voltaren. One week later, McGeehin was startled to realize that the stiffness in his knee was gone. He was able to walk with the easy, fluid stride of a younger man.

"Dr. Meade must be a genius!" McGeehin says today, though Dr. Meade himself explains it more modestly: "I read the literature. There's a plethora of evidence supporting the benefit of omega-3s for joint pain." He cites a 2006 University of Pittsburgh study of 125 people with neck and back pain, in which 60 percent of participants reported having less pain after taking omega-3s. And clinical studies on rheumatoid arthritis suggest that patients who take a daily dose may be able to cut back on their meds.

Indeed, in the 2 years in which Dr. Meade has been recommending omega-3s to his patients, he's seen a major shift in his orthopedic practice. "I almost never prescribe anti-inflammatories now," he says. "My staff kids me that I'll put us out of business with fish oil."

Omega-3s act as a sort of internal ice pack, in part because they spur our bodies to produce several inflammation-lowering substances. "Omega-3s work along the same biochemical pathway as a COX-2 inhibitor, such as Vioxx, but farther upstream," says Dr. Meade, meaning that omega-3s treat the underlying problem rather than the symptoms. And emerging research indicates that this powerful ability to ease inflammation is one of the ways omega-3s may help prevent a number of ailments, including:

Heart attack and stroke.
Cardiologists now believe that chronic inflammation triggers the release of artery-blocking plaque. In the most definitive study to date, published in the Lancet, heart-attack survivors who took 900 mg fish oil daily were 30 percent less likely to die of a second heart attack, and 20 percent less likely to suffer a stroke, than those who skipped the supplement.

Omega-3s can guard your arteries in other ways, too, since they also lower triglycerides and make blood vessels more elastic. Add in their ability to improve electrical communication between cardiac cells, thereby preventing arrhythmia, and you can see why omega-3s are a standard part of cardiac care in Europe. If you have a heart attack in Italy, France, Britain, or Spain, the hospital will even send you home with a prescription for Omacor, a "medication" that's superpurified DHA and EPA.

Alzheimer's disease.
Though not yet conclusive, research suggests that runaway brain inflammation may cause Alzheimer's disease. In a 2007 study published in the American Journal of Clinical Nutrition, elderly men who consumed 350 mg DHA and EPA daily experienced less cognitive decline than those who swallowed only 15 mg a day. And researchers at the Rush Institute for Healthy Aging, in Chicago, found that people who ate fish at least once a week were significantly less likely to develop Alzheimer's disease than those who ate more turf than surf.

Prostate cancer.
It's estimated that chronic inflammation is the culprit in 20 percent of all cancers, and that may include many cases of prostate cancer. In a 2003 Harvard study that tracked nearly 48,000 men over 12 years, researchers discovered that the men who ate fish three times a week were 25 percent less likely to develop metastatic prostate cancer than those who dined on less. However, a recent (and hotly debated) study review in the Journal of the American Medical Association says clear proof of cancer protection is still lacking.

Depression.
Could fish be the ultimate mood food? Ohio State University researchers recently analyzed blood samples from 43 older adults and found that a high omega-6 to low omega-3 ratio corresponded to elevated inflammation and more symptoms of depression. This and previous research suggest that eating more fatty fish or supplementing with omega-3s could help us beat the blues.

In the world of nutrition, few events make a scientist's palms sweat as much as the release of a newly revised DRI list.

Before the Food and Nutrition Board announced its most recent DRI for fatty acids, in 2002, some experts were optimistic that omega-3s would make the cut, given the research strides made over the previous decade. Instead, DHA and EPA were nowhere to be found—snubbed yet again by the larger scientific community. Even worse, the new DRI recommended that adults continue eating 10 times as many omega-6s as omega-3s, a ratio that practically gave omega-3 researchers a heart attack.

But Alice Lichtenstein, D.Sc., a Tufts University public-health professor who was on the panel that voted DHA down, doesn't see what all the fuss is about. "There just wasn't enough data to go on," she says. "What's out there is a little difficult to interpret."

Part of the problem she's referring to is that some studies didn't account for the amount of omega-6s that research participants consumed (too much blunts the effects of omega-3s), and other supplement studies didn't adjust for how much fish their participants ate. The differences make the studies hard to compare.

"It's all over the place," says Sharon Akabas, Ph.D., codirector of the master's program at Columbia University's institute of human nutrition, which held a symposium on this very problem. "It's like dealing with a moving target." Also, since most omega-3 research has focused on curing the sick, no one has yet pinned down how much DHA and EPA keeps healthy people well. Without that magic number, the Food and Nutrition Board says, its hands are tied.

The board's cautious approach is typical of how slow our government is to accept scientific change, say advocates of omega-3s. For example, although the World Health Organization endorsed adding DHA to infant formula back in 1994, it took the FDA until 2002 to approve the move. "Fifty-nine countries added DHA to infant formula before we did," says Dr. Simopoulos. "Mexico and China were ahead of us! And that's because our government is 20 years behind when it comes to the science."

Nevertheless, Meyers insists that the Food and Nutrition Board is just being thorough. "Anything in nutrition is going to lead to controversy," she says. "No matter the issue, some people will say we don't go far enough and others will say we go too far."

Perhaps, but it's revealing that even though important studies have come out since the board's 2002 list, it has no plans to revisit the status of DHA, despite the fact that at least one panelist has changed her mind. "There's a growing consensus that we should be eating more DHA for sure, as well as EPA," says Penny Kris-Etherton, Ph.D., a Penn State University professor of nutrition. "I would like to see stronger dietary recommendations than we currently have."

Columbia's Akabas agrees, which is why her Institute of Nutrition has come out with a bold endorsement. "We think the whole U.S. population would benefit from an upward shift in omega-3 intake, and we don't see any downside," she says. "So our recommendation is to not wait until the research becomes definitive. It's time to examine the development of a DRI."

One group that isn't waiting around for the blessing of the Food and Nutrition Board is the food manufacturers. Companies are already adding fish oil—minus the fish odor—to everyday products such as yogurt, frozen pizza, and orange juice. Most recently, Hormel Foods announced that it was entering this arena by partnering with a North Carolina research firm. What this also means, however, is that our government's greatest nutrition minds are being scooped by the maker of Spam.

Pick the Perfect Fish-Oil Supplement

Purity
When Consumerlab.com tested 41 fish-oil supplements, none was found to contain unsafe levels of mercury, PCBs, or dioxins. One explanation is that many brands are now molecularly distilled to remove any possible contaminants.

[Note: Vital Choice Sockeye Salmon Oil is certified free of harmful levels of contaminants by NSF. It does not need to be distilled because Sockeye are naturally very pure fish, because they eat low on the food chain, and their diets are largely vegetarian.]

Dosage
Ignore the total milligrams (mg) of fish oil, and focus instead on the combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). You want a supplement that contains at least 500 mg per dose or serving. If you're on blood thinners, talk to your doctor about the best dosage.

[Note: High-dose fish oil is not needed to raise blood levels of omega-3s to the range recommend by experts. It just takes a few weeks longer to reach these levels when taking a “natural” dose fish oil like Vital Choice Sockeye Salmon Oil, which provides about 260 mg of DHA and EPA per capsule. We recommend taking two to four capsules per day, to reach the dose level recommended by experts.]

Form
Your choice is basically capsules or a liquid. They're equally effective at delivering omega-3s to your bloodstream, so go with the form you think you'll take on a daily basis.

[Note: Vital Choice offers Salmon Oil in fish-gelatin capsules and in liquid form.]

Fish Burp
Some people experience this as their stomachs dissolve the fish-oil capsule. Beat the burp by buying enteric-coated capsules or freezing regular capsules. Either strategy will cause the fish oil to be released in your intestine instead, says William Harris, Ph.D., a professor of medicine and biomedical sciences at the University of South Dakota.

[Note: Vital Choice Sockeye Salmon Oil is available with added lemon oil to reduce fishy burps.]

Ratio
The ratio of EPA to DHA used in research varies, but most supplements are made with a 3:2 split. This translates to 300 mg EPA and 200 mg DHA in a 500 mg supplement.

Source
Any fish oil will do, be it from mackerel or menhaden, salmon or sardines. Supplements made from algae oil contain only DHA, and those made from flaxseed oil have alpha-linolenic acid (ALA), only a little of which can be converted into EPA and DHA by your body.

Antioxidants
Once inside your body, omega-3s can quickly lose their power due to oxidation. Look for vitamin E, a.k.a. tocopherol, an antioxidant that can neutralize free radicals.

[Note: Vital Choice Sockeye Salmon Oil contains naturally occurring astaxanthin, the potent antioxidant pigment that makes salmon flesh red-orange. It is many times more powerful than vitamin E, so we do not need to add tocopherols to our oil to protect it.]

Very interesting fish oil article

2007-08-15T10:19:00.000-05:00

Article from Vital Choices Newsletter ()
August 13, 2007
Miner’s "Miracle" Leads Stellar Omega-3/Health Summary
Top researchers quoted as deploring authorities' failure to push for increased omega-3 intake
by Craig Weatherby

Click for full story © M.O. Ellis 2006 / West Virginia Univ. Alumni Magazine

We want to applaud Men’s Health magazine for publishing the best omega-3 article we’ve seen in any publication intended for non-scientists.

The article's key point is summarized in this excerpt: “Scientists worldwide are praising a nutrient so powerful that it may help combat dozens of diseases. But don't expect an endorsement from our policy makers: They say we can do without.”

The Men’s Health piece – titled “The Government's Big Fish Story” – begins dramatically, with the story of Randal McCloy, the sole survivor of last year’s Sago Coal Mine disaster in West Virginia. (He's pictured at left, between two of his doctors.)

Mr. McCloy suffered extreme carbon monoxide exposure, which normally results in severe brain damage. While Mr. MCloy received the standard interventions, including hyperbaric oxygen treatment, these were not expected to prevent serious disability.

Instead, his neurosurgeon – Julian Bailes, M.D. of West Virginia University – believes the miner was spared only by the unprecedented decision to administer very high doses of omega-3 fish oil.

Dr. Bailes said McCloy had almost no measurable brain activity until they started feeding him fish oil through a tube, which provided huge doses of the two key omega-3 fatty acids (EPA and DHA).

As the authors of the Men’s Health article wrote, “… unexpectedly, McCloy emerged from his coma. This in itself was amazing, but he wasn't done. In the weeks that followed, he stunned even the most optimistic experts by recovering his memory and gradually regaining his ability to walk, talk, and see, a turnaround that many in the medical field called miraculous.”

The conclusion of this part of the article is worth quoting: “’The omega-3s helped rebuild the damaged gray and white matter of his brain,’ says Dr. Bailes, who now takes his own medicine, swallowing a fish-oil supplement each morning. On his orders, McCloy, still recuperating at home, continues to take fish oil daily. ‘I would say he should be on it for a lifetime,’ says Dr. Bailes. ‘But then, I think everybody should.’”

(Large amounts of omega-3 DHA accumulate in the brain’s grey matter during fetal and infant development. And research supports its ongoing importance to the tissues of adult brains: see “Omega-3s Display More Brain-Mood Benefits” and “Mental Decline Slowed by Omega-3s”.)

Researchers interviewed by Men's Health deplored the failure of health authorities to advocate assertively for increased intake of omega-3s.

And unlike most popular articles on omega-3s, this one stresses the importance of decreasing Americans' intake of omega-6 fatty acids.

These pro-inflammatory, omega-3-blocking fats dominate American diets, thanks to their heavy presence in standard meats and poultry and in cheap vegetable oils (corn, soy, cottonseed, canola, sunflower, safflower) and the processed and prepared foods that contain them.

The only way you’d get more essential information would be by reading the recent, definitive book by New York Times science contributor Susan Allport, titled Queen of Fats (see “Queen of Fats Tells Exciting, Untold Omega-3 Story” and “The Queen of Fats: Part II of Our Review”) and by diving deep into our Vital Choices newsletter archives.

We urge you to read this incredibly informative, wonderfully written article (which we've posted online) and pass it on to friends and family. To access it, click on the article title above or below, and save or open it.

In addition to addressing some of the most fascinating aspects of omega-3s in human biology and evolution, the piece summarizes the adverse impacts of America’s gross omega-3/omega-6 intake imbalance, the evidence of omega-3s’ effects on major health conditions, and includes recommendations on supplemental omega-3s.

The only way you’d get more essential information about omega-3s would be to read the recent, definitive book by New York Times science contributor Susan Allport, titled Queen of Fats (see “Queen of Fats Tells Exciting, Untold Omega-3 Story” and “The Queen of Fats: Part II of Our Review”) and by diving deep into our Vital Choices newsletter archives.

The article features cogent quotes from interviews with a number of leading researchers, including renowned omega-3 scientist William E. Lands, Ph.D., who has responded graciously to our requests for guidance concerning omega-3 fatty acids in human health.

Dr. Lands discovered many of the basic functions of omega-3s as a former Professor at the Michigan Medical School and Director of Basic Research at the National Institute on Alcohol Abuse and Alcoholism. He also authored an indispensable reference book titled Fish, Omega-3s, and Human Health.

We hope you will get a chance to read “The Government's Big Fish Story”, and share it widely!

Sources

* Erdely SR, Watkins D. The Government's Big Fish Story. Accessed online August 7, 2007 at http://health.msn.com/general/articlepage.aspx?cp-documentid=100166680>1=10212
* Innis SM. Polyunsaturated fatty acids in human milk: an essential role in infant development. Adv Exp Med Biol. 2004;554:27-43. Review.
* Wainwright PE. Dietary essential fatty acids and brain function: a developmental perspective on mechanisms. Proc Nutr Soc. 2002 Feb;61(1):61-9. Review.
* United Press International. Omega-3 credited in miner's recovery. Accessed online August 10, 2007 at http://www.sciencedaily.com/upi/?feed=TopNews&article=UPI-1-20070727-01004600-bc-us-sagosurvivor.xml

Published by Vital Choice Seafood
Copyright © 2007 Vital Choice Seafood, Inc.. All rights reserved.
Information in this newsletter is not meant to substitute for the advice provided by medical professionals, nor is it intended to diagnose, treat, cure or prevent disease. Copyright is held by Vital Choice Seafood, to which all rights are reserved. Other than personal, non-commercial use or forwarding, no material in this newsletter may be copied, distributed, or published without the express permission of Vital Choice Seafood.
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A Study on Vitamin E and Hotflashes

2007-07-31T10:23:00.000-05:00

Hot flashes affect as many as 75% of menopausal women. Estrogen reliably reduces the severity of hot flashes and remain the single most effective treatment. Today, however, more and more women are seeking alternatives. Instead of hormonal therapy, women are turning to vitamins, and other over-the-counter products for relief from hot flashes. This study was undertaken to assess the effect of vitamin E on hot flashes. Method: A placebo double blind-controlled trial was conducted. After 1 week baseline period, the enrolled patients (n = 51) received placebo (identical in appearance to vitamin E softgel) daily for 4 weeks, followed by 1 week wash out and 400 IU vitamin E (softgel cap) daily for the next 4 weeks. Diary was used to measure hot flashes before and at the end of the study. Result: There were statistical significant differences in hot flashes severity score (2.37 ± 0.74, 1.80 ± 0.87) and their daily frequency (5.00 ± 3.34, 3.19 ± 2.74) after the treatments between the placebo and vitamin E therapies (p <>Conclusion: Based on our trial, vitamin E is recommended for the treatment of hot flashes.

Soft drinks are hard on the body

2007-07-27T15:35:00.000-05:00

NEW YORK (Reuters Health) - The prevalence of metabolic syndrome is increased among middle-aged adults who regularly drink carbonated soft drinks, even soda that is calorie-free, new research suggests.

The metabolic syndrome is a cluster of several cardiovascular risk factors, including high blood pressure, high cholesterol, excess fat around the abdomen and glucose intolerance, a condition in which the body can no longer process sugar in the blood that often precedes diabetes.

Up until now, theories relating soft-drink consumption and metabolic syndrome have been based primarily on the high sugar content, Dr. Ramachandran S. Vasan, at Boston University School of Medicine, and associates note in their report, published in the Circulation: Journal of the American Heart Association.

To further evaluate this relationship, the authors analyzed data from subjects in the Framingham Heart Study who were in their mid-50s participated in two evaluations between 1998 and 2001 and were free of cardiovascular disease when the study began.

In their analysis, the researchers found that the subjects who consumed one or more soft drinks per day had a 48-percent higher prevalence of metabolic syndrome compared to whose who drank less.

In the second analysis, subjects who drank soft drinks had 44-percent higher risk of metabolic syndrome. Drinking soft drinks also increased the incidence of each component of the metabolic syndrome.

Previous work has shown that consumption of soft drinks is associated with overall dietary behavior, with a diet high in calories and fat, and low in fiber. However, Vasan and associates point out, even after accounting for known risk factors such as diet, smoking and physical activity, the association between soft drink consumption and metabolic syndrome remained statistically significant.

However, because this was an observational study, Vasan's group could not discern any evidence that drinking soft drinks actually caused the metabolic syndrome.

"Public health policy measures to limit the rising consumption of soft drinks in the community may be associated with a lowering of the burden of metabolic risk factors in adults," they conclude.

SOURCE: Circulation, July 24, 2007.

Fishy Eyes?

2007-07-27T10:37:00.000-05:00

Study: Eating Fish Helps Protect Eyesight

By CARLA K. JOHNSON
The Associated Press
Monday, July 10, 2006; 11:49 PM

CHICAGO -- Two new studies give one more reason to eat a diet rich in fish: prevention of age-related macular degeneration, the leading cause of blindness in old age.

The omega-3 fatty acids found in fish such as salmon are already known to help the heart and brain stay healthy. The new studies, appearing Monday in the Archives of Ophthalmology, add to evidence that fish eaters also protect the eyes.

The new studies aren't the strongest level of scientific evidence, but they confirm the findings of previous studies that also link fish consumption with prevention of macular degeneration.

A study of 681 elderly American men showed that those who ate fish twice a week had a 36 percent lower risk of macular degeneration. In the other study, which followed 2,335 Australian men and women over five years, people who ate fish just once a week reduced their risk by 40 percent.

The U.S. study also found that smokers nearly doubled their risk of the eye condition compared to people who never smoked.

Macular degeneration starts with blurring in the center of what the eye sees. It progresses to blindness, slowly or quickly depending on the type of disease. Six to 8 percent of people age 75 and older have an advanced form of the disease.

"We have a longer life expectancy so the prevalence and burden related to age-related macular degeneration will continue to increase," said Dr. Johanna Seddon of the Massachusetts Eye and Ear Infirmary in Boston, lead author of the U.S. study.

The proper balance of essential fatty acids was crucial to preventing eye disease in the study, Seddon said. The men who ate not only more omega-3 fatty acids, but also fewer omega-6 fatty acids, found in vegetable oils and baked goods, got the most benefit.

Both studies on the effect of fish were based on participants' recall of what they ate. The studies were observational, meaning they observed people's behavior and health. Although the researchers tried to account for other risk factors, the people who ate more fish may have had other healthy habits that lowered their risk.

Stronger evidence may come in five or six years with results from a large, randomized study of how fish oil and another nutrient, lutein, affect macular degeneration, said Dr. Emily Chew of the National Eye Institute, who is heading that study.

Volunteers will be assigned randomly to get either fish oil, lutein, or both _ or placebos.

Researchers don't yet know why eating fish seems to protect the eyes. Omega-3 fatty acids may neutralize free radicals in the eye, preventing the formation of new blood vessels, reducing inflammation or all three, Chew said.

Dr. Yu Guang He of the University of Texas Southwestern Medical Center said the new studies confirm findings from other research and will give doctors even more confidence as they advise patients what they can eat to protect their eyesight.

"I always tell them if you like fish, if you enjoy fish, eat more fish. Some people don't like the flavor. I would encourage those people to take (fish oil) supplements," he said.

___

On the Net:

Archives of Ophthalmology: http://archopht.ama-assn.org/

Headaches a Big Headache for Sufferers

2007-07-27T10:27:00.000-05:00

Headaches a Big Headache for Sufferers

Ivanhoe Newswire

(Ivanhoe Newswire) -- Women who suffer from chronic headaches end up with more than just the pain associated with the headache.

According to University of Toledo researchers, women whose heads throb on a regular basis are four-times more likely than those who experience fewer headaches to report symptoms of major depression. They're also three-times more likely to report physical symptoms like low energy, difficulty sleeping, nausea, dizziness, sexual problems or bodily pains.

Researchers surveyed more than 1,000 women, 90 percent of whom were diagnosed with migraine. About 440 of the women reported chronic headache, which is defined as 15 or more headaches each month. The remainder suffered from episodic headache, defined as fewer than 15 headaches per month.

Women diagnosed with the most severe form of migraine headache were 32-times more likely to suffer from major depression if they were also experiencing some of the other physical symptoms noted in the study.

The investigators report they aren't sure how headaches may be causing depression or these other symptoms but suggest the link may lie in a dysfunction of serotonin in the central nervous system.

"Painful physical symptoms may provoke or be a manifestation of major depression in women with chronic headache, and depression may heighten pain perception," reports study author Gretchen Tietjen, M.D. "This relation between migraine and major depression suggests a common neurobiology."

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

SOURCE: Neurobiology, 2007;68:134-140

Fish oil may preserve thinking ability in elderly

2007-04-24T10:45:00.001-05:00

High blood levels of omega-3 highly unsaturated fatty acids, found in fish oil, may help preserve thinking ability in the elderly, according to the findings of two studies published in the American Journal of Clinical Nutrition.

The results were particularly striking among subjects with high blood pressure or high cholesterol levels.

Accumulating evidence suggests that diets that include omega-3 fatty acids, specifically, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), protect against the development of dementia and Alzheimer's disease, according to a Dutch research team. However, the effect of EPA+DHA consumption on thinking ability, or "cognitive function," has received less scrutiny.

So Dr. Boukje Maria van Gelder, from the National Institute for Public Health and the Environment in Bilthoven, and associates evaluated data for 210 healthy men in the "Zutphen Study," who were 79 to 89 years old in 1990 and had normal mental capacity. Their diets were assessed in 1990, and cognitive function was tested in 1990 and again in 1995.

Subjects who ate fish had a slower decline in cognitive function than subjects who did not eat fish.

The investigators conclude that "fish consumption and EPA+DHA intake are not significantly related to cognitive impairment but are significantly related to cognitive decline."

Van Gelder's team recommends the daily consumption of roughly 400 mg of EPA and DHA, found in fish, meat, eggs, leeks, and cereal products.

In the second study, which involved 2,251 older individuals, Dr. May A. Beydoun, at the University of North Carolina at Chapel Hill, and colleagues showed that high blood levels of EPA and DHA are associated with less decline in verbal ability.

In an accompanying editorial, Dr. William E. Connor and Dr. Sonja L. Connor suggest that EPA has anti-clotting and anti-inflammatory properties that work together to help preserve cognitive function.

SOURCE: American Journal of Clinical Nutrition, April 2007.

Regulating High Blood Pressure with Vitamins

2007-03-28T14:00:00.000-05:00

Regulating Blood Pressure Naturally with Vitamins
by Darrell Miller

High blood pressure, which is also called hypertension, affects about one in three adults. Although there are many causes of hypertension, there are not necessarily any symptoms, with 30% of people having high blood pressure not knowing it. Therefore, just because you don't have symptoms doesn't mean you don't have high blood pressure, which is why it is called "the silent killer." High blood pressure is very dangerous, being the number one cause of stroke, as well as the cause for heart attack and heart failure. Changing blood pressure numbers depends a great deal on the choices we make every day, such has how much we exercise, the foods we ear, and our overall lifestyle. However, for those times when extra help is needed, there is a new scientifically-studied supplement that will help us lower our blood pressure and give us better overall health.

Blood pressure is divided into two parts, systolic and diastolic. Systolic is the pressure of the heart beating; while diastolic is the pressure of the heart vessels when they are filling. Although a persons' blood pressure can vary naturally throughout the day, if numbers are consistently high after many visits to the doctor, it is possible that you have pre-hypertension or high blood pressure. Healthy blood pressure numbers are about 115/75 mm/Hg. Arteries that are kept young through healthy diet and exercise are usually more elastic and unclogged compared to those that have plaque buildup from diets high in saturated fat and sedentary lifestyles. These unclogged arteries are able to transport blood through them easily and without much effort. However, clogged arteries result in faster blood flow, all of the time, which can cause damages to heart tissue, arteries, kidney, and other major organs in the long run.

High blood pressure can be caused by a variety of lifestyle factors being: body type, sedentary lifestyle. Sodium intake, low potassium intake, heavy alcohol intake, unhealthy eating, and smoking. Although weight isn't always a reliable indicator of whether or not you'll have high blood pressure, the type of weight is. Lean body mass (muscle) doesn't increase blood pressure levels, but fat does, especially when it is around your mid-section. Many of our jobs require us to sit all day at work and then we continue to sit more when we get home. With time, this leads to weight gain, which makes your heart work harder to pump blood through the body. Inactivity usually leads to higher heart rates. Even though salt intake itself isn't necessarily bad, it leads to more water retention, which increases blood pressure. A moderate intake of salt, especially sea salt or Celtic salt, for healthy individuals is fine. Most Americans do not get enough potassium. It helps to regulate the amount of sodium in our cells and expels the rest to our kidneys. Low levels of potassium can lead to a build up of sodium in the body. Because having three or more alcoholic drinks a day doubles and individuals' chance of developing high blood pressure, it is important to limit the amount of alcohol intake. Drinking a large amount will eventually put a lot of stress on the heart, liver, pancreas, and brain. Eating a lot of processed and fatty foods can lead to high blood pressure as well. By adapting a diet rich in fruits and vegetables as well as whole grain products, fish, nuts, magnesium, and potassium, blood pressure can be brought back down. Smoking damages the heart and arteries, while the nicotine constricts blood vessels, increases heart rate, and raises blood pressure. The carbon monoxide in smoke replaces oxygen in the blood, which makes the heart work even harder to make up for the difference. It is important if you have high blood pressure that you do not smoke.

Along with the above diet and lifestyle changes, there are other natural ways to lower blood pressure. These supplements include: fish oil, CoQ10, and garlic. Although these are very effective, they usually lower systolic pressure much more than diastolic pressure. There is a blend of natural ingredients that lower systolic and diastolic blood pressure separately and work even better combined, dandelion leaf extract, lycopene, stevia extract, olive leaf extract, and hawthorn extract. Dandelion leaf extract provides a healthy supply of vitamins, including vitamins A, B, C, D, iron, silicon, magnesium, zinc, potassium, and manganese. This extract produces a diuretic effect in the body relieving hypertension in the body by drawing excess water and sodium from the body and releasing it through the kidneys as urine, which allows the blood vessels to relax and in turn lowers blood pressure. Lycopene, which is mostly found in tomatoes and processed tomato products, has great antioxidant abilities as well as free-radical scavenging properties. It also lowers LDL (bad) cholesterol, lowers homocysteine levels, and reduces blood platelet stickiness which leads to clogged arteries. Higher intakes of lycopene mean less thickening of arteries and a reduced risk of heart attack. Stevia extract, which is often used as a sweetener, relaxes arteries and helps to prevent the buildup of calcium on artery walls, which keeps them healthy and reduces blood pressure. Many scientific studies have proven that stevia controls blood sugar levels as well as has great potential in treating type 2 diabetes along with hypertension. Olive leaf extract relaxes blood vessels and prevents buildup of plaque in the arteries, which in turn lowers blood pressure. It also acts as an antioxidant. Hawthorn extract has been used to support heart health for many centuries. It improves blood pressure levels by increasing blood vessel elasticity, as well as improves coronary artery blood flow and contractions of the heart muscle. This supplement also has antioxidant properties, as well as the anti-anxiety abilities and blood sugar regulation properties.

After taking a combination of these herbs, you should notice both systolic and diastolic numbers lowering within two weeks. When you are taking herbs that support your blood pressure, it is important to keep it monitored so that you have an adequate reading of your numbers. To do so, you can purchase a home blood pressure monitoring device for thirty to two-hundred dollars. However, buying one in the thirty to fifty dollar range is sufficient and will be money well-spent. Although there are no side effects noted in the study, you may notice an increase in the number of trips you take to the bathroom do to the diuretic effect of the dandelion leaf extract. The vitamins mentioned above can be found at your friendly internet health food store.

More Migraine Help

2007-03-26T17:26:00.000-05:00

Re: CAM Remedies for Migraine Headaches Examined

Evans R, Taylor F. "Natural" or alternative medications for migraine prevention. Headache. June 2006;46(6):506-516.

Many people with migraines are concerned about the side effects of prescription medications and are interested in natural or alternative therapies to prevent migraine attacks. People who suffer from episodic migraine, in which they return to normal between migraines episodes, are at risk for progression to chronic (continuous) headaches. The overuse of medications to treat the symptoms of migraine may increase the risk of chronic headache conditions. Complementary and alternative medicine (CAM) can be a viable option in reducing the frequency of attacks and the risk of progression to a chronic condition. This "Expert Opinion" article reviews the effectiveness and safety of several CAM therapies for migraine prevention.

The leaves of feverfew (Tanacetum parthenium) are used to prevent migraines and to reduce migraine symptoms such as nausea and vomiting. A review of randomized, controlled trials (RCT) conducted before 1998 found five such trials involving 216 subjects. Two thirds of the subjects in these studies experienced greater benefit from feverfew than from placebo. A Cochrane review conducted in 2004 examined five double-blind trials involving 343 subjects and concluded that feverfew lacked convincing evidence of efficacy. Some of the inconsistent results may stem from different extraction techniques used for feverfew products and uncertainty regarding the active ingredients in the plant. A study published in 2005 reported that MIG-99, a highly enriched parthenolide extract, was more effective than placebo in reducing the number of migraine attacks per month. Feverfew side effects can include systematic sore mouth and tongue, swollen lips, loss of taste, abdominal pain, and intestinal disturbances. No long-term studies have been conducted to assess the safety of feverfew.

Butterbur (Petasites hybridus) is an herb native to Europe. Although parts of the butterbur plant contain toxic pyrrolizidine alkaloids, a patented, standardized extract of butterbur root (Petadolex®, Weber and Weber GmbH & Co. KG, Germany) is free of toxic substances and is marketed for the prevention of migraine headaches. Two RCTs have been published on Petadolex. In the first trial of 60 people, 45% of those taking 100 mg per day of Petadolex and 15% of those taking placebo experienced a 50% or greater reduction in migraine frequency. In the second trial of 245 people, the migraine frequency decreased an average of 48% in the group taking 150 mg per day of Petadolex while the migraine frequency decreased an average of 26% in the placebo group. The migraine frequency was not significantly different between the group taking 100 mg per day Petadolex and the placebo group. Side effects in the Petadolex groups and placebo group were comparable except for excess burping in people taking Petadolex. Short-term use of Petadolex appears to be safe; however, no long-term safety studies have been conducted.

Magnesium levels are reported to be lower in the brain, in the blood, or inside the cells of people who experience migraines. Several RCTs have been conducted to test the effects of magnesium supplements on migraine prevention. Two of the trials indicated a benefit for magnesium and the other two trials found no significant effect of magnesium over placebo. Magnesium is an essential mineral, and it is safe when consumed as a dietary supplement. However, diarrhea is a common side effect when magnesium is taken at very high doses.

Riboflavin (vitamin B2) is required for the production of energy in the cell. One RCT tested riboflavin in people with migraines. In this study, 55 subjects took 400 mg of riboflavin or a placebo daily for three months. Subjects taking riboflavin had significantly fewer migraines and fewer headache days than subjects taking placebo. In another study, subjects took a combination of 400 mg riboflavin, 300 mg magnesium, and 100 mg feverfew or a placebo (25 mg riboflavin) daily for 3 months. There were no significant differences in the frequency of migraine attacks or number of headache days between the two groups. It is possible that the riboflavin "placebo" (used to color the urine so subjects would not know which group they were in) had a treatment effect in this study. Riboflavin is safe and well tolerated even at very high doses.

Coenzyme Q10 is also essential for energy production in cells, and it is being tested in a variety of neurological conditions. One RCT involving 42 subjects found that by the fourth month of the study, migraine frequency had dropped by at least 50% in 48% of subjects taking coenzyme Q10 and 14% of subjects taking placebo. Side effects were similar between the two groups, and previous studies indicate coenzyme Q10 is safe and well tolerated.

Although several studies have reported an association between lower levels of melatonin and migraine, no RCTs have tested the effects of melatonin on migraine prevention or treatment.

The authors conclude by evaluating the strength of the evidence for these CAM therapies in migraine prevention. With the exception of melatonin, all the therapies are rated as "Grade B," which means there is limited evidence from a single randomized trial, from nonrandomized trials, or from multiple trials with inconsistent outcomes. Based on the evidence presented in the article, they rank Petadolex as the therapy with the relatively strongest evidence, followed by magnesium, feverfew, riboflavin, coenzyme Q10, and melatonin. This article reveals how few randomized, controlled trials have been conducted on CAM therapies for the prevention of migraine and points out the need for more well-designed trials in the future.

—Heather S. Oliff, PhD

Boost Your Energy

2007-03-26T15:18:00.000-05:00

Boost Energy and Reduce Stress Naturally
by Darrell Miller

These days, more and more Americans are feeling overworked and overtired, lacking the energy needed to meet the responsibilities required for everyday life. This constant feeling of fatigue has become a part of the American way of life. Research has proven that the same processes that cause lack of energy in Americans can also keep us from getting an adequate amount of sleep, cause weight gain, disrupt hormonal balance, and add a significant amount of stress to our daily lives. However, people do not have to accept the pain, insomnia, or fatigue associated with chronic fatigue syndrome and fibromyalgia thanks to the following three step process called "Vitality 101."

The first of the three steps is nutrition. Good overall nutrition is important for everyone. To obtain this, a foundation product that supports energy levels, such as a powdered drink mix, can ensure that you are getting all of the necessary vitamins, minerals, and amino acids that you need. This drink should include the following ingredients: vitamin A, C, D, and E; magnesium; malic acid; betaine; selenium; zinc; amino acids; and frutooligosaccharides. Vitamin A is essential for healthy skin, mucous membrane, immune system responses, bone growth, and reproductive processes. In the form of beta-carotene, vitamin A is an antioxidant and a free radical fighter. Vitamin C, which is necessary for the proper functioning of the immune system, is an antioxidant free radical fighter as well as an assistant in hormone synthesis and a supporter of healthy skin integrity and iron absorption. Vitamin D is essential for healthy calcium and phosphorus metabolism. It is also responsible for the absorption of vitamin A and supports bone mineralization. Vitamin E, which helps oxygen circulation, supports healthy nerve transmissions, leg nerves and muscles, and helps boost energy levels. Magnesium supports enzyme activity involved in energy productions and healthy nerve and muscle function, as well as supports the immune system functions, while malic acid acts as a catalyst to stimulate the complete burning of fuel for energy. It also supports healthy connective tissue and muscle functioning. Betaine, which works with B vitamins, may have an effect on overall mood elevation. Where as selenium works with vitamin E to maintain healthy cell membranes and support healthy thyroid functioning. Zinc supports a healthy immune system, enzyme processes, and immune response. Amino acids are essential for the production of energy in the body, which is essential for brain function. Finally, fructooligosacchardies provide nutrition for good bacteria in the intestinal tract which improves digestion and healthy microflora. In addition to the powdered energy drink mix, it is important to take a high potency vitamin B-complex supplement that includes riboflavin, vitamin B6, vitamin B12, pantothenic acid, and choline, which are each important in restoring the energy production needed in your body. It is also very important to get enough water.

The second step of the process is to rest your body. Because having trouble sleeping is one of the most troubling symptoms of stress and can cause pain and hormonal and immune dysfunction, it is important to break the stress/insomnia cycle early. It may be helpful to use herbal products in order to get the good quality sleep that will repair and re-energize the body. Although there are many formulas that are marketed for sleep, it is very important that the right ingredients are in the sleep formula that you buy. This formula should include herbs that promote deep sleep including: valerian, L-theanine, hops, passionflower, Jamaica dogwood and wild lettuce. Wild lettuce has been found to have sedative effects and similarly hops acts as a mild sedative and has a sleep inducing effect. Similar to hops and wild lettuce, Jamaica dogwood has been found to be mildly sedative and it is often used for anxiousness. L-theanine causes a significant increase of neurotransmitter concentrations in the brain which promotes muscle relaxation and improves sleep. Valerian has been clinically proven to improve sleep quality. Lastly, passionflower eases nervousness and insomnia. Each of these herbs addresses a different aspect of sleeplessness, making the combination very important.

The third step in this process is to manage excess stress levels. In the world we live in today, it is important to manage the stressors in our lives. Adrenal extract, as well as other glandular extracts, can offer natural support to help our bodies deal with the effects of stress. In turn, they can also boost your energy levels. Exercise is also a good way to reduce stress and is important for good health. Not only can stress cause you sleepless nights, it can also lead to adrenal burnout or adrenal fatigue, which occurs when the adrenal glands are constantly producing cortisol in response to chronic stress. However, when stress is decreased, changes in our hormone levels can return to normal. The key is learning how to deal with daily stress so that the body is able to return to its normal state.

In addition to stress control, it is important to provide yourself with an adrenal supplement to improve the health of your adrenal glands and repair them when they are malfunctioning. If your adrenal glands are stressed-out, great results can be seen from taking a raw adrenal supplement. Be sure to buy a supplement that contains whole adrenal and cortex adrenal as well as vitamin C, vitamin B6, pantothenic acid, and licorice. The adrenal glands use these nutrients to manufacture cortisone and other compounds. Liver extract also improves energy levels by providing an excellent source of nutrients such as iron, B vitamins, and other minerals. It has been shown to support healthy function of the liver and increase the energy levels inside our body. A high-quality liver extract supplement should be cold-processed and encapsulated to enhance speed and absorption of nutrients from the liver because heat will destroy the key components in the liver. Along with the above listed nutrients, there are many other natural alternatives that promote relaxation and increase energy levels during the day. Rhodiola rosea relieves stress and increases energy as well as lifts our moods, improves sexual satisfaction, and helps in certain nervous system disorders. Remember to consult your health care practitioner before changing any medications. The above mentioned vitamin supplements are available at your friendly internet health food store.

Magnesium and Malic acid in Fibromyalgia

2007-03-26T15:15:00.000-05:00

Magnesium & Malic Acid Supplementation Often Beneficial for CFS & FM Quality-of-Life Measures – Studies and Top Specialists Report by Editor
ImmuneSupport.com

08-18-2006

Clinical studies have consistently reported that Fibromyalgia and Chronic Fatigue Syndrome patients tend to be deficient in the essential mineral magnesium (Mg), and research indicates many may achieve quality-of-life benefits by adding supplemental Mg to their diets.^1,2,3 Leading CFS and FM specialists routinely recommend magnesium supplementation to their patients specifically for support of improved muscle pain and fatigue. And most favor a combination of Mg plus malic acid, an extract of tart apples, as a dietary supplement for individuals with below-normal Mg in the blood and tissues.^4,5,6

The importance of magnesium for energy and muscle comfort. Magnesium plays a role in at least 300 biochemical functions in the body. One of the most important is that it activates almost all the enzymes involved in transforming fat and sugar into high-energy adenosine triphosphate (ATP), the body’s energy source, reports Georges Ramalanjaona, MD, an expert on the benefits of Mg supplementation for FM patients based at Seton Hall University’s School of Graduate Medical Education.¹ A low level of Mg leads to a low level of ATP, which is especially crucial in the brain, where 20 percent of the body’s ATP is stored, he explains.

Magnesium is also an essential in muscle metabolism and function. Among the high-profile researchers emphasizing the importance of sufficient Mg in the tissues of FM/CFS patients is Paul Cheney, MD, whose highly publicized recent research involves studies of the association between ATP production and abnormal heart function in CFS.

Blood tests alone don’t tell the whole Mg story, says Dr. Cheney, because they are not sensitive to intra-cellular magnesium.¹ “Magnesium, like potassium, is pumped into the cell, so [there should be] a higher concentration inside the cell than there is in the blood,” he explains. “And that pump mechanism may not work very well in people with CFS, so their magnesium levels can be normal in the blood and low in the cell.”

Studies have also shown that Mg inhibits many nerve receptors related to the origins of certain types of pain in FM patients. As a result, when Mg is deficient in the body, it is borrowed from muscle cells, and “calcium [moves] in to replace it, causing the muscles to grow stiff and tense,” writes Richard Firshein, DO, author of The Nutraceutical Revolution.⁷

While magnesium helps activate production of ATP, malic acid allows the body to make the ATP more efficiently, even under low oxygen, or “hypoxic” conditions. Chemical analyses of tissues have identified low “oxygen pressure” in the muscles of many FM patients studied, and indicated that these patients’ “tender points” were often deficient in ATP.¹ Tender points are areas of muscle attachment to bone, ligaments, and tendons which may be painful when pressed in FM patients.

Jay Goldstein, MD – known for his CFS studies focused on disturbances in neurotransmitters, the chemical substances responsible for transmitting cell-to-cell information – indicated he found malic acid to be a safe, inexpensive nutritional supplement which he recommends for CFS and FM patients suffering continuing or recurring muscle soreness, discomfort, and fatigue.⁸

Other top CFS clinicians who recommend a combination of Mg and malic acid for improved quality-of-life measures include Dr. Cheney and Daniel L. Peterson, MD – who together earned their places in medical history by documenting the 1985 CFS outbreak in Incline Village, Nevada – and leading CFS clinician Dr. David Teitelbaum, as discussed in his book From Fatigued to Fantastic.⁹

In their 1999 book Making Sense of Fibromyalgia,¹⁰ noted rheumatologist Daniel J. Wallace, MD, and Janice Brock Wallace cite controlled studies in England and Texas supporting the success of a proprietary combination of malic acid and magnesium in FM patients with recurring soreness or tenderness in the muscles. “If subjects take a dose larger than recommended on the bottle… its effects become apparent within a week.…and side effects are uncommon,” they note, referring to a study that started doses of magnesium at 300 mg and increased them until symptoms were reduced or side effects appeared. “This combination may work as a result of interactions between magnesium and calcium channels within muscles and the generation of adenosine triphosphate (ATP).”

Jorge Flechas, MD, MPh, an FM specialist in Hendersonville, ND, has participated in two studies that have tested a combination of malic acid and magnesium for pain and fatigue. In these studies, subjects diagnosed with Fibromyalgia reported a significant reduction in discomfort and tenderness within 48 hours and without any side effects. Specifically, he says, his experience with about 500 individuals who used this combination was that “the results are positive 90 percent of the time.”¹¹

Billie J. Sahley, PhD, a San Antonio-based nutritional specialist and author, has also reported improved energy and comfort with the Mg/malic acid combination for FM and CFS patients.4 He reports prescribing doses ranging from 800 to 1200 mg per day, “using diarrhea as the limiting factor,” because “FM patients tend to be extremely low in magnesium… [and] the sooner malic acid and magnesium are started, the faster individuals begin to return to their normal lifestyles.”

Things to know about Mg supplementation. In addition to maintaining normal muscle and nerve function, “magnesium keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong” by aiding with calcium absorption, according to a National Institutes of Health fact sheet.¹² “It also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis. It is essential in the conversion of vitamin D to its biologically active form, which then helps the body absorb and utilize calcium.” And, especially important for CFS and FM patients, studies indicate that sleep deprivation is associated with low levels of magnesium in the red blood cells.¹³

The many sources of Mg range from milk and “hard” mineral-containing water to “sunshine” foods such as spinach, whole grains, and bananas. But with refined foods, magnesium-depleted soil, and the lack of Mg in commercial fertilizers, the vast majority of the U.S. population fails to obtain even 40 percent of the recommended dietary intake (RDI) of Mg from their diet, according to the USDA.¹⁴

A blood test may identify suboptimal Mg levels, though as noted this does not tell the whole story, since most of the body’s magnesium is found within the cell membranes and not in blood. The U.S. recommended RDI of Mg for an adult is 400 milligrams per day. Therapeutic doses used in clinical trials have typically been higher, ranging from 500 to 1500 mg per day, and “while many prescription medicines can cause side effects,” by comparison healthcare practitioners have found dietary magnesium supplements “extremely safe,” says Mg expert and author Alan R. Gaby, MD.¹⁵

Individuals with kidney disease are generally advised to avoid Mg supplementation. Anyone taking prescription or over-the-counter drugs should consult their doctor or a pharmacist: Certain diuretics, antibiotics, and other drugs may reduce Mg absorption. Laxatives and antacids often contain Mg. Diarrhea and loose stools are the most common side effects of Mg supplementation, and Mg “toxicity” is rare, as healthy kidneys excrete any reasonable excess.¹⁶

____

1. Go to ImmuneSupport.com to find a review summarizing the findings of 16 studies addressing Mg deficiencies in FM patients and benefits of supplementation, titled “Magnesium in the Treatment of Fibromyalgia,” by Georges Ramalanjaona, MD, DSc, FACEP, MBA, from Alternative Medicine Alert, March 2002.

2. Go to ImmuneSupport.com to find “A magnesium deficiency?” an abstract of “Review and hypothesis: Might patients with the Chronic Fatigue Syndrome have latent tetany of magnesium deficiency?” by Mildred Selig, MD, MPH, in the Journal of Chronic Fatigue Syndrome, Vol. 4, #2, 1998.

3. “NMR spectroscopy of muscle in Fibromyalgia Syndrome patients and sedentary controls,” R.W. Simms, et al., Arthritis and Rheumatism 1993.

4. Malic Acid and Magnesium for Fibromyalgia and Chronic Pain Syndrome, by Billie J. Sahley, PhD, Pain & Stress Therapy Center Publications, San Antonio 1995.

5. “Top CFIDS Researchers and Physicians Find Nutritional Supplement to Reduce Muscle Pain and Fatigue in Some Cases,” CFIDS Association of America, October 1994, ImmuneSupport.com

6. “Magnesium and Malic Acid: Partners in Muscle Health,” by Molly Hozschlag, December 1, 1994; and “American College of Physicians on Malic Acid, by ImmuneSupport.com Editor, June 6, 2006.

7. “Magnesium’s Profound Effect on CFS,” by Richard Firshein, DO, from The Nutraceutical Revolution, Riverhead Books, 1998.

8. Betrayal by the Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome, and Related Neural Network Disorders, by Jay Goldstein, MD, Haworth Medical Press, 1998.

9. From Fatigued to Fantastic, Dr. David Teitelbaum, Avery Penguin Putnam, 2001.

10. Dr. Wallace is Medical Director of the Wallace Rheumatic Study Center in Los Angeles, an Attending Physician at Cedars-Sinai Medical Center, and Clinical Professor of Medicine at UCLA’s David Geffen School of Medicine. He has written numerous books on “central pain syndromes.”

11. “Malic Acid and Magnesium for Fibromyalgia and Chronic Pain Syndrome,” by G.E. Abraham and J.D. Flechas, published in the March 1992 issue of the Journal of Nutritional Medicine, archived at http://www.immunesupport.com/message/malic.htm

12. NIH Clinical Center, Office of Dietary Supplements, at dietary-supplements.info.nih.gov/factsheets/magnesium.asp

13. “Erythrocyte magnesium and prostaglandin dynamics in chronic sleep deprivation,” K. Tanabe, et al., Clinical Cardiology, March 1997.

14. “Percentage of Individuals Meeting DRI - Magnesium” by state, USDA Community Nutrition Research Service site, at www.ba.ars.usda.gov/cnrg/services/magnesium.html

15. “Magnesium is the Missing Link in Many Chronic Ills,” from Magnesium, by Alan R. Gaby, MD, Keats Publishing, 1994.

16. Drug-Induced Nutrient Depletion Handbook, 2nd Edition, by Ross Pelton, RPh, PhD, CCN, et al., Lexi-Comp, Inc., 2001.

Many angioplasties are unnecessary

2007-03-26T15:01:00.000-05:00

By MARILYNN MARCHIONE, AP Medical Writer1 hour, 53 minutes ago

More than half a million people a year with chest pain are getting an unnecessary or premature procedure to unclog their arteries because drugs are just as effective, suggests a landmark study that challenges one of the most common practices in heart care.

The stunning results found that angioplasty did not save lives or prevent heart attacks in non-emergency heart patients.

An even bigger surprise: Angioplasty gave only slight and temporary relief from chest pain, the main reason it is done.

"By five years, there was really no significant difference" in symptoms, said Dr. William Boden of Buffalo General Hospital in New York. "Few would have expected such results."

He led the study and gave results Monday at a meeting of the American College of Cardiology. They also were published online by the New England Journal of Medicine and will be in the April 12 issue.

Angioplasty remains the top treatment for people having a heart attack or hospitalized with worsening symptoms. But most angioplasties are done on a non-emergency basis, to relieve chest pain caused by clogged arteries crimping the heart's blood supply.

Those patients now should try drugs first, experts say. If that does not help, they can consider angioplasty or bypass surgery, which unlike angioplasty, does save lives, prevent heart attacks and give lasting chest pain relief.

In the study, only one-third of the people treated with drugs ultimately needed angioplasty or a bypass.

"You are not putting yourself at risk of death or heart attack if you defer," and considering the safety worries about heart stents used to keep arteries open after angioplasty, it may be wise to wait, said Dr. Steven Nissen, a Cleveland Clinic heart specialist and president of the College of Cardiology.

Why did angioplasty not help more?

It fixes only one blockage at a time whereas drugs affect all the arteries, experts said. Also, the clogs treated with angioplasty are not the really dangerous kind.

"Even though it goes against intuition, the blockages that are severe that cause chest pain are less likely to be the source of a heart attack than segments in the artery that are not severely blocked," said Dr. David Maron, a Vanderbilt University cardiologist who helped lead the new study.

About 1.2 million angioplasties are done in the United States each year. Through a blood vessel in the groin, doctors snake a tube to a blocked heart artery. A tiny balloon is inflated to flatten the clog and a mesh scaffold stent is usually placed.

The procedure already has lost some popularity because of emerging evidence that popular drug-coated stents can raise the risk of blood clots months later. The new study shifts the argument from which type of stent to use to whether to do the procedure at all.

It involved 2,287 patients throughout the U.S. and Canada who had substantial blockages, typically in two arteries, but were medically stable. They had an average of 10 chest pain episodes a week — moderately severe.

About 40 percent had a prior heart attack more than three months previously.

"We deliberately chose to enroll a sicker, more symptomatic group" to give angioplasty a good chance to prove itself, Boden said.

All were treated with medicines that improve chest pain and heart and artery health such as aspirin, cholesterol-lowering statins, nitrates, ACE inhibitors, beta-blockers and calcium channel blockers. All also were counseled on healthy lifestyles — diet, exercise and smoking cessation.

Half of the participants also were assigned to get angioplasty.

After an average of 4 1/2 years, the groups had similar rates of death and heart attack: 211 in the angioplasty group and 202 in the medication group — about 19 percent of each.

Heart-related hospitalization rates were similar, too.

Neither treatment proved better for any subgroups like smokers, diabetics, or older or sicker people.

At the start of the study, 80 percent had chest pain. Three years into it, 72 percent of the angioplasty group was free of this symptom as was 67 percent of the drug group.

That means you would have to give angioplasties to 20 people for every one whose chest pain was better after three years — an unacceptably high ratio, Nissen said.

After five years, 74 percent of the angioplasty group and 72 percent of the medication group were free of chest pain - "no significant difference," Boden said.

The study was funded by the U.S. Department of Veterans Affairs, the Medical Research Council of Canada and a host of drug companies. Stent makers refused to help pay for the research, said scientists who led the study.

The study renewed a heated animosity between doctors who perform angioplasty and other heart specialists.

In fact, one who does the procedures and who spoke at a meeting in New Orleans sponsored by stent maker Boston Scientific Corp. was responsible for the early release of the study's results, which were not due out until Tuesday.

The study "was rigged to fail, and it did," the Wall Street Journal quoted Dr. Martin B. Leon of Columbia University telling several hundred of his colleagues Sunday night.

"A lot of people have been taking shots at us, and we need to go on the offense for awhile," the Journal reported Leon said.

He claimed to have inside knowledge of the results because he reviewed the study for the New England Journal. The journal would not comment, saying the identity of its reviewers is confidential.

The cardiology college issued a statement saying it was "extremely disappointed" results were released prematurely, "betraying the confidentiality of the scholarly process and the professional integrity of the scientific community."

The college "will be considering strong sanctions against the individual or individuals involved," the statement said.

Shares of Boston Scientific were down $1.15, or nearly 8 percent, to $14.07 in afternoon trading on the New York Stock Exchange. It was a nearly five-year low for the stock.

Dr. Spencer King of Piedmont Hospital in Atlanta, a leading cardiologist who does many angioplasties, said he was disappointed in the study results.

"How many patients have interventions in which the only expectation is to reduce the use of nitroglycerin or to walk a bit faster? Most patients anticipate a better prognosis and might opt for an extended course of medical therapy if they believe they are not putting their life at excess risk," he wrote in a recent editorial in an American Heart Association journal.

In an interview at the cardiology meeting, King said he recently had surgery for back pain and did not expect permanent relief but added, "If it only held up for five years, I wouldn't be happy about it."

The new study "should lead to changes in the treatment of patients with stable coronary artery disease, with expected substantial health care savings," Dr. Judith Hochman of New York University wrote in an editorial in the journal.

Angioplasty costs $30,000 to $40,000. The drugs used in the study are almost all available in generic form.

Maron, the Vanderbilt doctor who helped lead the study, said people should give the drugs a chance.

"Often I think that patients are under the impression that unless they have that procedure done, they're not getting the best of care and are at increased risk of having a heart attack and die," he said.

The study shows that is not true, he said.

___

On the Net:

New England Journal: http://www.nejm.org

Trans Fat

2007-03-21T15:51:00.000-05:00

Trans Fats Refresher

Posted: 3/13/2007

Posted Mar 13, 2007

Here's a refresher about trans fats: Artificial trans fats are made by adding hydrogen to vegetable oil to make it stable. Companies began using them to give certain foods a desirable taste, shape and texture (think flaky pie crust or perfect french fries). At home, you can find artificial trans fats in many crackers, cookies and frostings. Just look for words like "hydrogenated" or "partially hydrogenated" in the ingredients label. Health and nutrition groups including the American Heart Association say artificial trans fats can clog arteries and raise the body's level of LDL or "bad" cholesterol, setting the stage for heart disease and stroke. Thus, health departments across the country are pushing food companies and eateries to label trans fats or eliminate them from recipes as part of a larger effort to help consumers be better informed about what we're eating.

Q: If my cereal/cookies/frosting claims to be trans-fat free, how come there are still hydrogenated items on the ingredients list?

A: Since last year, the Food and Drug Administration has required most packaged foods to list trans-fat content in their ingredients list. Some products that say they are trans-fat free still list hydrogenated or partially hydrogenated oils as ingredients, which is allowed under FDA guidelines so long as the amount is less than 0.5 grams of trans fat per serving.

Q: What's this I hear about trans-fat alternatives that also could be harmful for my health?

A: Some restaurants searching for alternatives to artificial trans fats have turned to oils high in saturated fats, including palm and coconut oils. As any nutritionist will tell you, just because something is trans-fat free doesn't necessarily mean it's healthful.

Why Green Tea?

2007-03-21T15:23:00.000-05:00

7 Reasons to Drink Green Tea

Posted Tue, Feb 27, 2007, 11:54 am PST

High Energy Foods

2007-03-21T15:14:00.000-05:00

Wonder Foods

Posted Tue, Mar 06, 2007, 10:11 am PST

High blood pressure? Check your neck.

2007-03-19T08:32:00.000-05:00

Chiropractic Cuts Blood Pressure

Study Finds Special 'Atlas Adjustment' Lowers Blood Pressure

By Daniel J. DeNoon
WebMD Medical News

Reviewed by Louise Chang, MD

March 16, 2007 -- A special chiropractic adjustment can significantly lower high blood pressure, a placebo-controlled study suggests.

"This procedure has the effect of not one, but two blood-pressure medications given in combination," study leader George Bakris, MD, tells WebMD. "And it seems to be adverse-event free. We saw no side effects and no problems," adds Bakris, director of the University of Chicago hypertension center.

Eight weeks after undergoing the procedure, 25 patients with early-stage high blood pressure had significantly lower blood pressure than 25 similar patients who underwent a sham chiropractic adjustment. Because patients can't feel the technique, they were unable to tell which group they were in.

X-rays showed that the procedure realigned the Atlas vertebra -- the doughnut-like bone at the very top of the spine -- with the spine in the treated patients, but not in the sham-treated patients.

Compared to the sham-treated patients, those who got the real procedure saw an average 14 mm Hg greater drop in systolic blood pressure (the top number in a blood pressure count), and an average 8 mm Hg greater drop in diastolic blood pressure (the bottom blood pressure number).

None of the patients took blood pressure medicine during the eight-week study.

"When the statistician brought me the data, I actually didn't believe it. It was way too good to be true," Bakris says. "The statistician said, 'I don't even believe it.' But we checked for everything, and there it was."

Bakris and colleagues report their findings in the advance online issue of the Journal of Human Hypertension.

Supplements for Migraines

2007-03-17T09:14:00.000-05:00

Migraines: Much-needed relief from migraine attacks

When the big guns aren't effective, it may be time
to go back and give some simple tools a try. That's
the finding of a new study that tested dietary
supplements on patients who had been unsuccessful in
relieving migraines with a variety of drugs.

Migraines: Preliminary results look promising

Could free radical damage contribute to migraine
headaches? Dr. Sirichai Chayasirisobhon of Kaiser
Permanente Medical Center set out to address that
question when he recruited a dozen patients, each
with a long-term history of little or no success at
treating migraines with various drugs, including
antidepressants, beta-blockers and anticonvulsants.

At the outset of the study, subjects completed a
migraine disability assessment (MIDAS) questionnaire
to assess the impact of migraine flare-ups on
activities at home, at work and while interacting
with friends and family. For the three-month trial
period, each subject received daily supplements that
contained 600 mg of vitamin C, 300 IU of vitamin E
and 1,200 mg of a pine bark extract. Subjects were
allowed to continue using whatever medications they
were currently taking.

When subjects completed a second MIDAS questionnaire
at the end of the study period, their responses
indicated a marked improvement. And even though the
lack of a control group opens the possibility of
placebo effect, the results were promising:

* The overall MIDAS score improvement was more
than 50 percent

* Average Number of migraine days was reduced
from 44 days in the three months prior to
supplementation, to just 26 days during the trial
period

* Average migraine severity score was reduced
from 7.5 (out of 10) to 5.5

One subject dropped out of the trial. Of the
remaining 11, two reported no change in migraine
frequency, duration or severity. Among the other
nine, the overall MIDAS score improvement was nearly
68 percent.

Migraines: CoQ10 helps alleviate migraines

So...what's up with this pine bark extract?

Although not identified in the study, I believe the
extract is almost certainly Pycnogenol; a natural
antioxidant extracted from French maritime pine
bark. Pycnogenol contains a variety of polyphenols
with anti-inflammatory properties that have been
shown to benefit the cardiovascular system by
promoting proper blood flow. In a previous e-Alert
we compared the effectiveness of Pycnogenol's
antioxidant qualities to two of the most powerful
antioxidants: glutathione and coenzyme Q10 (CoQ10).

In fact, Dr. Chayasirisobhon might have produced

even more impressive migraine relief if he had added
CoQ10 to the supplement mix.

In a CoQ10 trial conducted in 2002, 32 migraine
patients each received 150 mg of the antioxidant
daily for three months. In the month before the
study began, the group experienced an average of
more than seven days of migraine each. But by the
end of the study that monthly average had dropped to
just under three days. About 60 percent of the
subjects reported that their frequency of migraines
dropped to less than half of what it had been before
the study.

And in another e-Alert I told you about a Swiss
study in which 42 migraine patients received either
100 mg of CoQ10 three times each day, or a placebo.
No other methods were used to prevent migraines.
After three months of supplementation, researchers
found that migraine frequency, total days with
migraine, and total days with nausea were all
significantly reduced in the CoQ10 group, compared
to placebo. Overall, the incidence of migraines was
almost cut in half in the CoQ10 group, while the
reduction of migraines in the placebo group was less
than 15 percent.

When this research was presented at the 2004 annual
meeting of the American Academy of Neurology, the
Swiss team noted that migraines might be triggered
by a breakdown in the production of cellular energy.
They theorised that CoQ10 helps prevent migraines by
promoting proper respiration in the powerhouses of
the cell: the mitochondria.

If you suffer from migraines, talk to your doctor or
a healthcare professional about these promising
antioxidant studies before expanding your supplement
regimen.

Sources:

"Use of a Pine Bark Extract and Antioxidant Vitamin
Combination Product as Therapy for Migraine in
Patients Refractory to Pharmacologic Medication"
Headache: The Journal of Head and Face Pain, Vol.
46, No. 5, May 2006, Blackwell-synergy.com
"Antioxidant Combo May Prevent Some Migraines"
Reuters Health, 6/1/06, reutershealth.com "Teen
Refuses Court-Ordered Test to Check Cancer Status"
Elizabeth Simpson, The Virginian-Pilot, 6/26/06,
home.hamptonroads.com "Judge OKs Alternative
Treatment for Teen" The Guardian, 6/2/06,
guardian.co.uk

Help for Retinoblastoma

2007-03-17T09:10:00.000-05:00

Tree bark extract might help treat rare eye cancer

By Julie SteenhuysenFri Mar 16, 1:07 AM ET

An extract from the bark of a South American tree might lead to better treatments for a rare but deadly childhood eye cancer called retinoblastoma, U.S. researchers reported on Friday.

Retinoblastoma affects 1 in 15,000 children, causing about 3 percent of all cancers in children. It forms when developing cells in the retina -- the eye's main light sensor -- go haywire and start reproducing out of control.

"The great majority of the cases exist in the developing world, where it is a fatal disease," said Dr. Joan O'Brien of the University of California, San Francisco, who led the study.

The cancer usually develops in children under age 6 and kills within two to four years after diagnosis if not treated.

If detected early and treated with a combination of chemotherapy agents or radiation, 90 to 95 percent of children live. But conventional treatment has significant side effects.

Combination chemotherapy can cause hearing loss, kidney failure and leukemia. Radiation therapy, which is now less commonly used, disfigures the child.

In children who have the cancer in only one eye, the eyeball is sometimes replaced with an implant.

"We can cure them, but at cost," said O'Brien. "It's important to find a cheap, easily administered, nontoxic therapy."

O'Brien and colleagues at UCSF wanted to see whether the tree bark extract beta-lapachone could cause the abnormal cells to commit suicide -- something it has been shown to do in a number of cancer types, including breast and prostate cells.

They tested the extract in the laboratory and found that beta-lapachone significantly blocked rapid cell growth of human tumor cells and that low doses could cause damaged cells to kill themselves in a process called apoptosis, or programmed cell death.

Writing in the journal Eye, the scientists said their findings support other studies of the extract in different human cancers and may lead to an effective treatment.

"The nice thing about the agent is that it kills at very low doses and it appears to be selective to cancer," O'Brien said.

Substances that zero in on cancer are less toxic because they do less harm to healthy cells, O'Brien said. Her lab is now testing the extract in mice with retinoblastoma to look for possible toxic side effects.

5-HTP; Help for mood and sleep

2007-03-14T11:25:00.000-05:00

5-Hydroxytryptophan (5-HTP)

	Overview
	Uses
	Dietary Sources
	Available Forms
	How to Take It
	Precautions
	Possible Interactions
	Supporting Research

Overview

5-hydroxytryptophan (5-HTP) is an amino acid. The body makes 5-HTP from tryptophan (an essential amino acid) and converts it to an important brain chemical known as serotonin. Tryptophan and 5-HTP dietary supplements help raise serotonin levels in the brain, which may have a positive effect on sleep, mood, anxiety, aggression, appetite, temperature, sexual behavior, and pain sensation.

It is important to note, however, that an outbreak of eosinophilic myalgia syndrome (EMS; a potentially fatal disorder that affects the skin, blood, muscles, and organs) caused by a contaminated batch of tryptophan led to the removal of all tryptophan supplements from the United States market in 1989. Although the manufacturing of 5-HTP is different from that of tryptophan, there is still concern that some 5-HTP supplements may contain similar contaminants. It is important to obtain dietary supplements from manufacturers that adhere to high quality standards. At least two organizations, NSF International and the United States Pharmacopeia (USP), offer programs that make sure manufacturers follow high quality practices. As a result, these manufacturers often indicate this information on their product labels.

Uses

5-HTP may be helpful in treating a wide variety of conditions related to low serotonin levels, including the following:

Depression

Low levels of serotonin in the brain can contribute to the development of depression. Many drugs prescribed for depression increase serotonin levels. Some studies indicate that 5-HTP may be as effective as certain antidepressant drugs in treating individuals with mild to moderate depression. Such individuals have shown improvements in mood, anxiety, insomnia, and physical symptoms.

Fibromyalgia

Although many factors can influence the stiffness, pain, and fatigue associated with fibromyalgia, evidence from several studies indicates that low serotonin levels may play a role in the development of this condition. 5-HTP has been shown to improve sleep quality and reduce pain, stiffness, anxiety, and depression in individuals with fibromyalgia.

Insomnia

Medical research indicates that supplementation with tryptophan before bedtime can induce sleepiness and delay wake times. Studies also suggest that 5-HTP may be useful in treating insomnia associated with depression.

Headaches

Some studies suggest that 5-HTP may be effective in children and adults with various types of headaches including migraines.

Obesity

There is some evidence that low tryptophan levels may contribute to excess fat and carbohydrate intake (which can result in weight gain). A study of overweight individuals with diabetes suggests that supplementation with 5-HTP may decrease fat and carbohydrate intake by promoting a feeling of satiety (fullness). Additional similar studies of obese men and women without diabetes found that supplementation with 5-HTP resulted in decreased food intake and weight loss.

Dietary Sources

5-HTP is not commonly available in food but the amino acid tryptophan, from which the body makes 5-HTP, can be found in turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and collard greens, and seaweed.

Available Forms

5-HTP can be obtained in the diet (from the conversion of tryptophan) or in supplement form. 5-HTP supplements are made from extracts of the seeds of the African tree Griffonia simplicifolia. 5-HTP can also be found in a variety of multivitamin and herbal preparations.

How to Take It

Pediatric

There are no known scientific reports on the pediatric use of 5-HTP. Therefore, it is not currently recommended for children.

Adult

50 mg of 5-HTP taken one, two, or three times per day is generally recommended for most of the conditions discussed in the Uses section.

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.

As mentioned previously, tryptophan use has been associated with the development of serious conditions such as liver and brain toxicity, and with eosinophilic myalgia syndrome (EMS), a potentially fatal disorder that affects the skin, blood, muscles, and organs. Such reports prompted the FDA to ban the sale of all tryptophan supplements in 1989. As with tryptophan, EMS has been reported in 10 people taking 5-HTP.

5-HTP may cause mild gastrointestinal disturbances including nausea, heartburn, flatulence, feelings of fullness, and rumbling sensations in some people. Pregnant or nursing women and individuals with high blood pressure or diabetes should consult a healthcare practitioner before taking 5-HTP.

In addition, as described in the Interactions section below, 5-HTP should not be taken at the same time as antidepressants.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use 5-HTP without first talking to your healthcare provider.

Antidepressant Medications

Individuals taking the antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) (such as fluoxetine, paroxetine, sertraline, and citalopram) and monoamine oxidase inhibitors (MAOIs) (such as phenelzine, isocarboxazid, selegiline, and tranylcypromine) should not use 5-HTP as these medications enhance the action of these drugs and may increase the risk for developing a dangerous condition known as "serotonin syndrome." Serotonin syndrome is characterized by mental status changes, rigidity, hot flashes, rapidly fluctuating blood pressure and heart rate, and possibly coma. Similarly, other drugs for depression that interfere with the uptake of the neurotransmitter serotonin, namely trazodone and venlafexine, may also lead to serotonin syndrome when used along with 5-HTP.

Carbidopa

Taking 5-HTP with carbidopa, a medication used to treat Parkinson's disease, has been associated with side effects including scleroderma-like illnesses (a condition in which the skin becomes hard, thick, and inflamed).

Sumatriptan
Similar to antidepressants, sumatriptan, a medication used for migraine headaches that works by stimulating serotonin receptors in the brain, should also not be used in combination with 5-HTP because of the risk for serotonin syndrome.

Tramadol

Tramadol, used for pain control, may also increase serotonin levels too much if taken in combination with 5-HTP. Serotoninsyndrome has been reported in some people taking the two together.

Zolpidem

Use of zolpidem, a medication for insomnia, can cause hallucinations when used with SSRI antidepressants. Because 5-HTP may work similarly to SSRIs, the combination of 5-HTP with zolpidem could, theoretically, lead to hallucinations as well.

Zinc Increases Immune Response

2007-03-14T10:56:00.001-05:00

ORIGINAL RESEARCH COMMUNICATION

Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress¹^,2^,3

Ananda S Prasad¹, Frances WJ Beck¹, Bin Bao¹, James T Fitzgerald¹, Diane C Snell¹, Joel D Steinberg¹ and Lavoisier J Cardozo¹

¹ From the Wayne State University School of Medicine, Detroit, MI (ASP, FWJB, BB, DCS, JDS, and LJC), and the University of Michigan, Ann Arbor, MI (JTF)

Background: Zinc deficiency, cell-mediated immune dysfunction,susceptibility to infections, and increased oxidative stresshave been observed in elderly subjects (ie, those >55 y old).Zinc is an effective antiinflammatory and antioxidant agent.

Objectives: The primary objective was to determine the effectof zinc on the incidence of total infections in healthy elderlysubjects. The secondary objective was to determine the effectof zinc on cytokines and oxidative stress markers.

Design: A randomized, double-blind, placebo-controlled trialof zinc supplementation was conducted in elderly subjects. Fiftyhealthy subjects of both sexes aged 55–87 y and inclusiveof all ethnic groups were recruited for this study from a seniorcenter. The zinc-supplemented group received zinc gluconate(45 mg elemental Zn/d) orally for 12 mo. Incidence of infectionsduring the supplementation period was documented. The generationof inflammatory cytokines, T helper 1 and T helper 2 cytokines,and oxidative stress markers and the plasma concentrations ofzinc were measured at baseline and after supplementation.

Results: Compared with a group of younger adults, at baselinethe older subjects had significantly lower plasma zinc, higherex vivo generation of inflammatory cytokines and interleukin10, and higher plasma oxidative stress markers and endothelialcell adhesion molecules. The incidence of infections and exvivo generation of tumor necrosis factor and plasma oxidativestress markers were significantly lower in the zinc-supplementedthan in the placebo group. Plasma zinc and phytohemagglutin-inducedinterleukin 2 mRNA in isolated mononuclear cells were significantlyhigher in the zinc-supplemented than in the placebo group.

Conclusions: After zinc supplementation, the incidence of infectionswas significantly lower, plasma zinc was significantly higher,and generation of tumor necrosis factor and oxidative stressmarkers was significantly lower in the zinc-supplemented thanin the placebo group.

Key Words: Elderly subjects • infections • interleukin 2 mRNA • zinc • oxidative stress • tumor necrosis factor • interleukin 1ß

The Cost of Untreated Insomnia

2007-03-14T09:44:00.000-05:00

Untreated Insomnia Has Exhausting Effect on Health Resources

Caroline Cassels

Medscape Medical News 2007. © 2007 Medscape

March 8, 2007 — The costs of untreated insomnia far outweigh the costs of not treating this common disorder, which affects 10% of the US population, a new study suggests.

Investigators from Cornell University found even the most expensive medications cost less than $200 per year for the typical insomnia patient vs $924 to $1143 more in medical expenses in the 6 months before treatment initiation.

"Our study suggests that it costs far less to treat insomnia than to ignore it. Untreated insomnia affects individuals' health, quality of life,and job performance — and increases their use of healthcare services substantially," said the study's lead author, Ronald Ozminkowski, PhD, from the Institute for Health and Productivity Studies, Cornell University, Washington, DC, in a statement from the American Academy of Sleep Medicine.

The study is published in the March issue of Sleep.

Using data from self-insured, employer-sponsored health insurance plans in the United States, investigators examined health and employment data from 214,378 patients with insomnia and looked at their health costs in the 6 months before diagnosis.

Unconventional Approach

According to the authors, the typical approach used to assess the burden of insomnia has been has been to focus on the current cost of treatment. However, they note, looking at costs of untreated insomnia may be more informative.

"Unlike many other medical conditions, insomnia is not an expensive condition to treat. . . . We therefore assumed that a more complete understanding of its burden of illness can be gained by estimating cost differences between similar insomnia and noninsomnia patients, shortly before diagnosis or treatment begins," they write.

Direct costs were investigated using information from medical claims for inpatient, outpatient, pharmacy, and emergency room expenses from July 1, 1999 to June 30, 2003. Expenditures for these services were all adjusted for inflation to reflect 2003 metrics.

Expenditures for 138,820 patients aged 18 to 64 years and 75,558 elderly insomnia patients older than 64 years were compared with 2 equal-sized, matched control groups who did not have insomnia.

To estimate indirect costs, absenteeism records and short-term disability program records were examined for matched workers who did and did not develop insomnia.

Insomnia Burden Underestimated?

The investigators found that combined direct and indirect medical expenses for younger patients were $1253 higher for those eventually diagnosed with insomnia compared with controls without insomnia. Similarly, combined costs for elderly patients diagnosed with insomnia were $1,143 higher that those of their counterparts without insomnia.

With approximately 25 million to 30 million Americans suffering from chronic insomnia, the authors point out that their findings have major implications for employers, health plans, government insurance programs, and individuals.

In addition, they note, the study did not take into account the impact of insomnia on psychosocial functioning, accident rates, or productivity at work and therefore the calculations in this study may be an underestimation of the insomnia burden in the United States.

Furthermore, it is known that many insomnia patients do not seek medical treatment and therefore it is likely that a proportion of the control groups had undiagnosed or untreated insomnia, which may also lead to a conservative estimate of cost burden.

Sleep. 2007;30:263-273.

2007-03-08T11:20:00.000-06:00

I find this study interesting but the practical applications are still a ways off. Cluster headaches can be a huge problem. Very difficult to control.

Brain stimulation may ease headaches

Stimulating the brain with implanted electrodes appears to help ease the pain of cluster headaches, two separate teams of researchers reported on Wednesday.

In one study, six out of eight patients said they got relief from cluster headaches, blindingly painful headaches that come back again and again.

Two out of eight patients in a second study said they were headache-free for more than a year using the device, and three more reported a 90-percent drop in the frequency of attacks.

Writing in the Lancet medical journal and its sister publication Lancet Neurology, the researchers said it was important to target the correct area -- the occipital nerve.

"Occipital nerve stimulation in cluster headache seems to offer a safe, effective treatment option that could begin a new era of neurostimulation therapy for primary headache symptoms," Peter Goadsby of University College London in Britain and the University of California, San Francisco, said in a statement.

Cluster headaches are marked by periods with many attacks of extremely severe headaches. Patients often must take preventive medication every day for years. But in some cases, drugs do no good.

Researchers have tried using brain stimulation before but it targeted a region called the posterior hypothalamus. Patients risk developing a fatal hemorrhage.

Techniques that stimulate the occipital nerve have been tested on other types of headaches.

Goadsby and colleagues tested the technique on eight patients with chronic cluster headaches that defied medications. After more than a year and a half, six of the eight said they would recommend the treatment to others.

Symptoms returned almost immediately when the device's battery wore down and it stopped working, the researchers said.

In the second report, Jean Schoenen and colleagues from the Headache Research Unit of Belgium's Liege University tested eight patients separately.

Two patients had no pain after 16 months and 22 months, respectively, and three more said they had 90 percent fewer headaches.

Only one patient switched off his stimulator after four months because he said it did not work.

In a commentary, Anna Ambrosini of the Headache Clinic at Neuromed in Pozzilli, Italy, said stimulating the hypothalamus got better results, but the new approach was worth testing in a larger group of patients.

2007-02-16T15:06:00.000-06:00

Migraines: Preliminary results look promising

Could free radical damage contribute to migraine
headaches? Dr. Sirichai Chayasirisobhon of Kaiser
Permanente Medical Center set out to address that
question when he recruited a dozen patients, each
with a long-term history of little or no success at
treating migraines with various drugs, including
antidepressants, beta-blockers and anticonvulsants.

At the outset of the study, subjects completed a
migraine disability assessment (MIDAS) questionnaire
to assess the impact of migraine flare-ups on
activities at home, at work and while interacting
with friends and family. For the three-month trial
period, each subject received daily supplements that
contained 600 mg of vitamin C, 300 IU of vitamin E
and 1,200 mg of a pine bark extract. Subjects were
allowed to continue using whatever medications they
were currently taking.

When subjects completed a second MIDAS questionnaire
at the end of the study period, their responses
indicated a marked improvement. And even though the
lack of a control group opens the possibility of
placebo effect, the results were promising:

* The overall MIDAS score improvement was more
than 50 percent

* Average Number of migraine days was reduced
from 44 days in the three months prior to
supplementation, to just 26 days during the trial
period

* Average migraine severity score was reduced
from 7.5 (out of 10) to 5.5

One subject dropped out of the trial. Of the
remaining 11, two reported no change in migraine
frequency, duration or severity. Among the other
nine, the overall MIDAS score improvement was nearly
68 percent.

Migraines: CoQ10 helps alleviate migraines

So...what's up with this pine bark extract?

Although not identified in the study, I believe the
extract is almost certainly Pycnogenol; a natural
antioxidant extracted from French maritime pine
bark. Pycnogenol contains a variety of polyphenols
with anti-inflammatory properties that have been
shown to benefit the cardiovascular system by
promoting proper blood flow.

In fact, Dr.Chayasirisobhon might have produced
even more impressive migraine relief if he had added
CoQ10 to the supplement mix.

In a CoQ10 trial conducted in 2002, 32 migraine
patients each received 150 mg of the antioxidant
daily for three months. In the month before the
study began, the group experienced an average of
more than seven days of migraine each. But by the
end of the study that monthly average had dropped to
just under three days. About 60 percent of the
subjects reported that their frequency of migraines
dropped to less than half of what it had been before
the study.

Also, there was a Swiss study in which 42 migraine patients received either
100 mg of CoQ10 three times each day, or a placebo.
No other methods were used to prevent migraines.
After three months of supplementation, researchers
found that migraine frequency, total days with
migraine, and total days with nausea were all
significantly reduced in the CoQ10 group, compared
to placebo. Overall, the incidence of migraines was
almost cut in half in the CoQ10 group, while the
reduction of migraines in the placebo group was less
than 15 percent.

When this research was presented at the 2004 annual
meeting of the American Academy of Neurology, the
Swiss team noted that migraines might be triggered
by a breakdown in the production of cellular energy.
They theorised that CoQ10 helps prevent migraines by
promoting proper respiration in the powerhouses of
the cell: the mitochondria.

If you suffer from migraines, talk to your doctor or
a healthcare professional about these promising
antioxidant studies before expanding your supplement
regimen.

Sources:

"Use of a Pine Bark Extract and Antioxidant Vitamin
Combination Product as Therapy for Migraine in
Patients Refractory to Pharmacologic Medication"
Headache: The Journal of Head and Face Pain, Vol.
46, No. 5, May 2006, Blackwell-synergy.com
"Antioxidant Combo May Prevent Some Migraines"
Reuters Health, 6/1/06, reutershealth.com "Teen
Refuses Court-Ordered Test to Check Cancer Status"
Elizabeth Simpson, The Virginian-Pilot, 6/26/06,
home.hamptonroads.com "Judge OKs Alternative
Treatment for Teen" The Guardian, 6/2/06,
guardian.co.uk

8 Herbal Remedies

2007-02-16T14:18:00.000-06:00

8 Herbal Remedies

Herbs are the most popular form of alternative medicine in the United States, according to a recent Harvard study which found that 38 million Americans collectively spend $4.2 billion on herbal medicine every year. Understanding more about how medicinal herbs work can help you treat common ailments more effectively.

HERBS FOR WELLNESS
Some herbs are beneficial to almost everyone when taken regularly. They include the following:

1. GARLIC FOR CHOLESTEROL CONTROL AND CANCER PREVENTION. The majority of garlic studies show that it reduces cholesterol and helps prevent heart disease. Garlic also helps prevent several types of cancer and helps prevent prostate, esophageal, stomach and bladder cancer.
Dosage: Most studies have used approximately the equivalent of one clove a day. Garlic works best when it's raw or only slightly cooked, and may also be taken in supplements.
Cautions: Garlic impairs blood clotting. If you notice increased bruising, stop taking it and consult a doctor. Stop taking medicinal doses of garlic two weeks before any planned surgery.

2. GINKGO FOR MENTAL SHARPNESS. Ginkgo increases blood circulation through the brain, and it is best known for its potential to slow the progression of Alzheimer's disease. Ginkgo also enhances memory in healthy adults of all ages, according to several studies.
Dosage: Use commercial preparations, which concentrate Ginkgo’s compounds. Look for standardized extracts that contain 24 percent flavonoid glycosides, and take 120 milligrams daily.
Cautions: Ginkgo has an anticoagulant effect, so stop taking it at least two weeks before any surgery or if you notice bruising.

HERBS TO TREAT COMMON COMPLAINTS
Although herbal medicine is not the answer for every ailment, herbs can be used effectively to treat many health conditions, including those below.

3. CRANBERRY FOR URINARY TRACT INFECTION. Cranberry juice - and the dried berries and extract - protect against infection by preventing bacteria from sticking to the bladder wall.
Dosage: If you use cranberry juice cocktail, drink at least three cups a day. If you use dried cranberries, munch on a handful or two a day. For commercial cranberry extract, follow the label directions.
Cautions: None.

4. ECHINACEA FOR COLDS. The root and sometimes the aboveground portions of this daisylike flower have been shown to bolster the immune system and help the body fight colds. Some studies have shown no treatment benefit, but most show that echinacea minimizes cold symptoms and speeds recovery.
Dosage: Take the dosage recommended on the product label. Typical directions are to take it several times a day at first, and then taper off as you begin to feel better.
Cautions: A mildly upset stomach is possible with the tincture. Echinacea is safe for most people, but because it stimulates the immune system, it is not recommended for those with auto-immune diseases (rheumatoid arthritis, lupus and several others), or for transplanted-organ recipients.

5. GINGER FOR MOTION SICKNESS AND MORNING SICKNESS. Studies show that pregnant women who take ginger have significantly less nausea associated with morning sickness. Several studies show that the herb also wards off motion sickness. To keep motion sickness at bay, take a capsule containing 1,000 milligrams of powdered ginger root about an hour before you embark, and every two hours during your journey.
Dosage: Start with 1,000 milligrams. If that doesn't provide sufficient relief, try 1,500 milligrams.
Cautions: Some people report heartburn after taking ginger capsules.

6. MILK THISTLE FOR LIVER DISEASE. Mainstream medicine doesn't have any miracle drugs for liver disease (hepatitis, cirrhosis), but milk thistle seeds can help. They contain three compounds, known collectively as silymarin, that have a remarkable ability to protect and heal the liver. Italian researchers have shown that milk thistle speeds recovery from hepatitis. Several studies have shown that the herb helps treat alcoholic cirrhosis. Milk thistle also helps prevent liver damage from powerful drugs.
Dosage: A typical recommended dosage is 140 milligrams of silymarin three times a day.
Cautions: Side effects are rare, but can include headache, stomach distress, nausea, hives, itching and joint pain.

7. ST. JOHN'S WORT FOR DEPRESSION. While some studies suggest otherwise, the majority show that St. John's wort, in capsules or tablets, works as well as Prozac and Zoloft for relieving mild to moderate depression, and causes fewer side effects.
Dosage: Follow label directions. Studies showing benefits have used 600 to 1,800 milligrams/day. Most studies have used 900 milligrams/day.
Cautions: St. John's wort can cause an upset stomach, increases sensitivity to sunlight and reduces the effectiveness of birth control pills. If you take medication regularly, it's important to consult your physician or pharmacist before using St. John's wort.

8. VALERIAN FOR INSOMNIA. Valerian's centuries-old reputation as a sleep aid has been validated by many studies. And unlike many sleeping pills, valerian is not addictive.
Dosage: Follow label directions.
Cautions: Raw valerian root smells and tastes terrible. Use a commercial preparation. Some include other safe tranquilizing herbs such as hops or lemon balm.

What is the High Energy Doctor all about

2007-02-16T10:41:00.000-06:00

What would you do if you had all the time and energy you could possibly want?

Start a new business? More time with the family? Write the great American novel? Travel?

I can't give you more time, however we can do something about your energy levels. We can do something about the way you feel.

My name is Rusty Dorn. I am a chiropractor in private practice. In addition to chiropractic I am a certified acupuncturist and have also done extensive postgraduate training in nutrition and anti aging medicine.

Over the course of my years in practice I have seen all sorts of complaints. Some of the more debilitating issues involved chronic fatigue syndrome and fibromyalgia. But as I went along, I also noticed that chronic fatigue was a problem with many people as a secondary issue, not the primary complaint.

What do I mean by that?

I mean that people who come to me for any number of complaints had issues with fatigue that was indirectly caused by their primary complaint. For instance, someone with horrible headaches or chronic pain that prevent restorative sleep would have issues with fatigue.

There is also the fatigue that sets in from our hectic work and family schedules.

There is fatigue secondary to lifestyle issues. Poor nutrition, being overweight, too many toxins and so on.

There is fatigue caused by anxiety, prolonged stress and depression.

There is also the decreased energy that many people assume is a natural part of aging.

My job is to fix these problems. To help people identify and correct the underlying issues and shortcomings so that they are able to fully enjoy and experience their life. To not just struggle through each day, barely making it to the end of the day, when they fall exhausted into bed only to get up and do it again the next day.

I have worked with labs to develop proprietary formulas for treatment of specific complaints, such as fibromyalgia , carpal tunnel and migraines. I am in touch with others who have unique treatment protocols for other issues. I spend a lot of time researching and reviewing the latest findings for the best new (and old) treatments.

I will be posting articles, recommendations and helpful links to things that can help overcome these problems and get on with living life, not just existing.

So until next time, heres to having a high energy life.

Rusty

The High Energy Doctor

Fibro and Inflammation

Bruce Lipton Describes Epigenetics in One Minute

GeneWize Press Release

Good News In Our DNA: Defects You Can Fix With Vitamins And Minerals

Interesting Thoughts on Weight Loss

Tough Talk about You and Weight Loss

The Healthy Way to Good Health

Malic Acid and Magnesium in Fibro

Key vitamin deficiency linked to tripled risk of dementia: study

Monthly fasting may help heart

By MARILYNN MARCHIONE

7 Reasons to Drink Green Tea

Do Diet Sodas Make You Fat?

The short answer(s) to this question is no and, maybe, yes. One recent study has shown that people who drink diet soda still have a 41 percent chance of being overweight.

Honey for Kids Coughs

Study: Try honey for children's coughs

Depressed? Get off the couch.

Aspartame Don't Even Consider It

Obesity and and Cancer

Report stresses link between obesity and cancer

Body Mass and Headaches

Acupuncture and Back Pain

Study: Acupuncture works for back pain

Still More on Malic Acid

Malic Acid: Top Up Your Body's Own Supplies Of Malic Acid To Increase Your Energy Levels And Overcome Fatigue

More on Malic Acid

Malic Acid and Magnesium in Fibro

The Super Triumvirate of Energy Supplements

Alpha-Lipoic acid

Malic Acid, Energy, & Fibromyalgia

Drink More Diet Soda, Gain More Weight?

Doctors and Statin Drugs

Kidney Stones?

Diet and Kidney Stones

We Keep Getting Fatter

Brain Food from Wikipedia

The Mens Health Article on Fish Oil

Very interesting fish oil article

A Study on Vitamin E and Hotflashes

Soft drinks are hard on the body

Fishy Eyes?

Headaches a Big Headache for Sufferers

Fish oil may preserve thinking ability in elderly

Regulating High Blood Pressure with Vitamins

More Migraine Help

Boost Your Energy

Magnesium and Malic acid in Fibromyalgia

Many angioplasties are unnecessary

Trans Fat

Why Green Tea?

7 Reasons to Drink Green Tea

High Energy Foods

Wonder Foods

High blood pressure? Check your neck.

Chiropractic Cuts Blood Pressure

Supplements for Migraines

Migraines: Much-needed relief from migraine attacks

Help for Retinoblastoma

Tree bark extract might help treat rare eye cancer

5-HTP; Help for mood and sleep

Zinc Increases Immune Response

ORIGINAL RESEARCH COMMUNICATION

Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress1,2,3

The Cost of Untreated Insomnia

8 Herbal Remedies

What is the High Energy Doctor all about

Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress¹^,2^,3