INTEGRATIVE HEALTH EDUCATION

             A monthly review of 100 medical journals

 

                                       Volume 10 � Number 7 � July 2009                        

                                                        EDITOR’S NOTE 

Last month I saw a patient who lost 200 lbs by simply (I don’t say it lightly) coming to terms with his refined sugar addiction. He is delighted and so am I.

Let’s compare him to the young woman I saw a few days ago: she demanded that I refill her amphetamine-like prescription (phentermine, which quits working after 3 months) and her thyroid hormone, both of which were erroneously prescribed by another provider. The fact that these two drugs had not worked was not obvious to her.  When I said that I was not going to comply with her refill request (which often earns me the reputation of “not listening” with these type of patient) she became angry and confrontational. Perhaps I was too direct, but I doubt it, since I have been doing this type of counseling for years now and I have a lot of gray hair to show for it.

What is really disturbing in her case was her statement that she will never eat veggies. Why won’t she? In my opinion, her addiction to sugar is so pronounced she is unable to taste the natural sugars found in veggies or any other natural food.

Such is the power of the addiction our society suffers. I compare it to an alcohol addiction. Before you say that this is a tortured analogy, let me remind you that alcohol is a fermented sugar. Alcohol and refined sugars in our diet have an active neurological effect on our neurotransmitter receptors, particularly in our brains’ thermostat. Also, these receptors are shared by opioids, endorphins and valium-like drugs. Do you get the picture?

Unfortunately, sexual/physical abuse in early childhood contributes to our thermostat dysfunction. And, believe it or not, toxins in the environment, including artificial sweeteners in diet soda pop and toxic microbes in our gut compound the addiction to sugar.

A final word of advice: quit relying on sale pitches (herbs, drugs, gadgets, fad diets, etc.) If you want to lose weight, look in the mirror and say: I am a sugar-holic. Also ask yourself if there is a history of childhood emotional trauma and work out 60 minutes a day. I sincerely wish you the success my first patient has seen.

Hugo Rodier, MD

“Doc, I can’t lose weight and I am tired: I need thyroid”

            If I had a dollar for each time I have heard this I would have a small fortune.

            Many of these patients come in, angry that other docs have not prescribed thyroid “because the blood levels were normal.” Most of them hope that I, as a bit of a maverick in the medical field, will produce the coveted prescription, only to be disappointed that I agree with the standard of care in this field, and for that matter, with the standards of prescribing practically all medications (I do not agree with the standards of care when it comes to non-pharmaceutical interventions, such as nutrition.)

            We have known for a while that people may develop “thyroid resistance,”[1] much like we may develop insulin resistance. In fact, “studies of insulin resistance in patients with clinical and subclinical hypothyroidism”[2] continue to appear, establishing the fact that most thyroid problems are due to our diets and environmental toxins;[3] the latter contribute to cell membrane toxicity and hormonal dysfunction. It is not just refined sugars that may trigger thyroid disease, but refined wheat.[4] (If you would like to study “resistance” at the cellular level take a look at the articles I have posted on my website.)

            So, stop blaming your thyroid and see if you might have a nutritional problem. Remember that insulin resistance is linked to obesity. The relationship between weight thyroid exists, but in most cases obesity is the cause of thyroid dysfunction, not the consequence: hyperinsulinemia diminishes the rate of conversion or activation of T4 to T3.[5]

            So, you may need to look in the mirror, again…
            [By the way, the “man in the mirror” passed away last month…]

Exercise tip

            Last month I stated that sometimes exercise advice from docs may fall on deaf ears, particularly if the patient is overworking just to make ends meet. Hopefully that statement was not interpreted as po-pooing exercise altogether. On the contrary, exercise is very well documented activity; its benefits are far reaching. It would be most beneficial for your insulin resistance issues (diabesity) if you could work out over 150 minutes a week and combine aerobic (i.e. running) and resistance training (weight-lifting.)[6]

Eat fiber!

            The epidemic of obesity began when Americans decreased the amount of fiber they consume. Most people now eat 5-10 grams a day, far below the recommended amounts:

            Men <50          38 grams

            Men >50          31

            Women <50     24

            Women >50     21

            How did this happen?   We turned to refined foods which are very low in fiber. This causes many problems, like increasing the rapid absorption of sugars from the gut. The result is a negative metabolic reaction that increases the addiction to sugar and the stress on the system that is then required to produce more insulin, faster and faster. Since the rising levels of insulin subsequently trigger hypoglycemia, we rush to eat more or the sweets that started the problem in the first place: we are then caught in a vicious cycle.

            Consuming fiber lowers your risk of gaining weight[7] by avoiding that vicious cycle. Remember that most fiber is in fruits and veggies, not grains. Also, remember guar gum fiber, arguably the best fiber to supplement for weight issues. I recommend 5 grams 1hour before each meal: it helps you reduce the absorption of sugars from the gut.

            There are many other benefits to fiber consumption. Let me tell you a story:

            Dr. Burkitt (a fearsome childhood cancer bears his name) did a lot of work in Africa, where he noted that the people with the biggest, bulkiest stools had less cancer. When he presented his observations he was not well received by his fellow physicians in the USA. However, time vindicated his astuteness; now we know that fiber does decrease the risk of many cancers. Remember the Nobel Prize winning research of Metchnikoff: 60% of our immune system is in the intestinal tract. A lot of it is the friendly bacteria that live therein, which needs good “prebiotics,” or fiber to thrive.

Low blood sugar

            When I first started practicing in SLC I had several patients tell me that the diagnosis of “hypoglycemia” was not well accepted elsewhere, despite their obvious improvement with dietary changes. It is not hard to understand that high sugar diets will trigger the release of a lot of insulin, which sticks around to lower sugar rather precipitously. This causes the release of several hormones, particularly epinephrine, which makes people shake, feel dizzy and speed up their hearts.

            This is why now we see that hypoglycemia increases mortality in hospitalized patients who have had a heart attack.[8] It may drive you crazy to read that hypoglycemia in type II diabetics also increases the risk of dementia.[9]

Confused about Homocysteine?

            Homocysteine goes up when we don’t have enough B vitamins in our diets.

            Initially, we saw a flurry of articles saying that this toxin is associated with heart disease and several other conditions, like strokes and dementia. Subsequent research cooled down the early enthusiasm. Some docs are now downright hostile if the “H” word comes up, fueling their dim views of anything non-pharmaceutical/nutritional.

            But, like we often see in nutritional research, negative studies about food are to be taken with a grain of salt. A significant proportion of these studies fail to take into account individual differences on how people process nutrients. Just like we see with “pharmacogenetics,” some of us do not process certain nutrients like the majority of people.

            Interestingly, the very principle that some are willing to concede to drug research (pharmacogenetics) is not easily applied to food science, despite the well documented fields of “nutrigenomics and nutrigenetics.”[10]

            So, I was happy to see yet another article saying that the reason some studies on homocysteine no longer show an association with heart disease is because researchers are not looking into 5-methyltetrahydrofolate genetic variances.[11] This simply means that some people cannot process B vitamins once ingested; they are the ones who will have more oxidation of the lining of their blood vessels. In other words, homocysteine is indeed toxic in those who have the mutation in the MTHF gene. If a study does not consider this genetic mutation, the toxic effect of homocysteine may not be apparent.

            And, wouldn’t you know it. The pharmaceutical industry has known about this for some time; they have marketed 5-mehtytetrahydrofolate (found OTC) as a drug, Deplin, to treat inflammation/oxidation of the brain: depression. Remember that we also need B vitamins to turn amino acids in our diet to neurotransmitters. For example, tryptophan is the substrate from which our body makes serotonin.

            All this may be a bit complicated, even unnecessary: just quit eating processed food! It is too low in B vitamins…

Telegraphed articles

Soy reduces the risk of colon cancer

            J. Nutrition 2009;139:474

Soy lowers the risk of gastric cancer

            J. Nutrition 2009;139:1008

Soy does not increase breast density in menopausal women

            J. Nutrition 2009;139:981

                        [Are you still  a soy-hater?]

Stress is the biggest factor in graying of hair

            J. Cell, June 2009

A stay in the slammer raises the risk of high blood pressure

            J. Archives of Internal Medicine 2009;169:687

Teen night owls have higher rates of depression

            NIH/Columbia University, June 2009

Seaweed improves sexual/hormonal balance in menopause

            J. Nutrition 2009;139:939        

Pre pregnancy obesity linked to postpartum depression

            J. Family Practice news, March 2009, page 19

Probiotics reduce liver inflammation seen with high fat diets

            J. Nutrition 2009;139:905

Cinnamon extract protects the liver against alcohol induced injury

            J. Nutrition 2009;139:5482

Moderate alcohol intake reduces insulin resistance

            J. Metabolism Clinical & Experimental 2009;58:387

The purple pill increases risk of hospital acquired pneumonia

            JAMA 2009;301:2120

Carotenoids in our diet lower risk of metabolic syndrome

            J. Nutrition 2009;139:987

CoQ10 improves arterial lining in diabetic patients on cholesterol drugs

            J. Diabetes Care 2009;32:810

Quercetin helps leaky gut symptoms

            J. Nutrition 2009;139:965

Green and Black tea lower the risk of strokes

            J. Stroke 2009 Feb 19: Epub

Higher overall adiposity, especially the beer-belly, is associated with more Restless Legs

            J. Neurology April 2009