INTEGRATIVE HEALTH EDUCATION

             A monthly review of 100 medical journals

                                       Volume 10 � Number 11 � November 2009                        

                                                         EDITOR’S NOTE 

            The 2009 Nobel Prize in Medicine was awarded to 3 American researchers working on the Telomere, the tail end of chromosomes; it controls gene copying. Their findings are likely to lead to new pharmaceutical products to lengthen the telomere, which could treat problems like prostate cancer. While this is a great accomplishment, I am disappointed, yet, not surprised, that the findings are automatically directed to the creation of a symptomatic treatment. The present paradigm driving our health care industry (yes, money) seems unable or unwilling to see past their narrow self-interests.

            We could focus on a more proactive angle; the articles “Multivitamin Use and Telomere Length in Women”[1] and “Leukocyte Telomere Length: the telomere tale continues”[2] tell us that the longer the telomere the longer we live; antioxidants keep the telomere from getting oxidized, or shortened. This means that a diet high in antioxidants and cleaner environments that don’t require as many antioxidants to detoxify, increase longevity by preserving the length of the telomere. In other words, our environment affects genetic expression.[3]

            The same may be said about emotional-spiritual stress, which also burns up antioxidants. The article “A Complex Relationship: psychosocial stress, pollution, and health”[4] tells us that psychosocial stress may exacerbate our susceptibility to adverse effects of pollutants such as lead, polychlorinated biphenyls, and combustion emissions.

            If we could educate people about these simple concepts they may assume more responsibility for their health;[5] we would then see longer lives and less atherosclerotic diseases. Dr. Ornish would agree; in the article “Increased Telomere Activity and Comprehensive Lifestyle Changes”[6] he showed that a longer telomere is associated with less prostate cancer. In another study, “Clinical Events in Prostate Cancer Lifestyle Trial: results from 2 years follow up,” Ornish proved that lifestyle changes for 2 years may be able to avoid or delay conventional prostate cancer treatment.[7] After all, conservative treatment of prostate cancer has better survival.[8]

            Will we pay attention to these articles as we continue to argue about financing our broken health care system? (See related blog, “Why We Hurt.”) Will we start looking at our health as a holistic concept that involves our entire communities?[9]                        Hugo Rodier, MD

Heart to Heart on Sugar

            “The American Heart Association is finally taking aim at our nation's sweet tooth, urging consumers to significantly cut back on the amount of sugar they get from such foods as soft drinks, cookies and ice cream. The AHA says most women should limit their sugar intake to 100 calories, or about six teaspoons, a day; for men, the recommendation is 150 calories, or nine teaspoons. The recommendations are likely to prove challenging for many consumers to meet. Just one 12-ounce can of cola has about 130 calories, or eight teaspoons of sugar. Data gathered during a national nutrition survey between 2001 and 2004 suggest that Americans consume on average 355 calories, or more than 22 teaspoons, of sugar a day.”[10]

            And why would it be hard to comply with the AHA’s suggestions? Our national addiction to refined sugars, which is made worse by stress, the Farm Bill, Big Food’s processing of food for profits and social contagion.[11]

“Therapeutic Uses of Magnesium”[12]

• 75% of Americans don’t get RDA. Poor nutrition, alcohol in excess and diuretics contribute to low levels and need for supplementation.

• Magnesium is needed for 300+ metabolic reactions in the body: protein synthesis, cellular energy production and storage, cell growth and reproduction, DNA/RNA synthesis,  stabilization of mitochondrial membranes, bone metabolism, nerve transmission, cardiac excitability, neuromuscular conduction, vasomotor tone, blood pressure and insulin metabolism

• Early signs of low magnesium: loss of appetite, nausea, vomiting, fatigue, weakness; then, numbness, tingling, muscle contractions, crams, seizures, personality changes, abnormal heart beats and coronary spasms.

• Diseases that contribute to low magnesium: diabetes, gut inflammation and malabsorption.

• Magnesium deficiency diagnosed by checking inside cells. Low CoQ10 levels may inhibit cell uptake of magnesium.

• Useful supplementation: eclampsia/preeclampsia, heart arrhythmias, asthma, indigestion, constipation, headaches, bone density, insulin resistance and dysmenorrhea.

• Contraindications: renal problems. Cautious use with prescription drugs (calcitonin, diuretics, calcium channel blockers, antibiotics and muscle relaxants) since magnesium may alter their blood levels.

• Dose: adults 350 mg; children 65 mg 1-3 yrs old, 110 mg < 8 yrs old.

“Zinc, an Essential Micronutrient”[13]
            This is another mineral found lacking in many people when they don’t eat enough veggies. There is good evidence that Zinc helps in the treatment of acute and chronic diarrhea, Wilson’s disease (liver problems due to copper,) and macular degeneration. The evidence that Zinc helps taste problems and colds is not as good. The

best dose is 20 mg and it should be coupled with 2-5 mg of Copper. Avoid Zinc in pregnant and lactating women and in patients taking penicillamine.

Update on the brain-gut connection 

            “Although many people are aware of the communication that occurs between the             gastrointestinal (GI) tract and the central nervous system, fewer know about the     ability of the central nervous system to influence the microbiota or of the    microbiota's influence on the brain and behavior. Within the GI tract, the             microbiota have a mutually beneficial relationship with their host that maintains   normal mucosal immune function, epithelial barrier integrity, motility, and     nutrient absorption. Disruption of this relationship alters GI function and disease   susceptibility.”

            “Animal studies suggest that perturbations of behavior, such as stress, can             change the composition of the microbiota; these changes are associated with   increased vulnerability to inflammatory stimuli in the GI tract. [See blog “Why We Hurt”] The mechanisms that underlie these alterations are likely to involve       stress-induced changes in GI physiology that alter the habitat of enteric bacteria.            Furthermore, experimental perturbation of the microbiota can alter behavior,    and the behavior of germ-free mice differs from that of colonized mice. Gaining a       better   understanding of the relationship between behavior and the microbiota             could   provide insight into the pathogenesis of functional and inflammatory          bowel   disorders.”                                          

            I quoted from the article “The Relationship Between Intestinal Microbiota and the Central nervous System in Normal Gastrointestinal Function and Disease”[14] so that readers may get a feeling for the strength of the scientific data on the brain-gut connection. This newsletter and many scientists have been highlighting this concept for sometime. Dr. Gershon pioneered this concept over 45 years.

            I can attest to the dramatic improvement my patients see in their cognitive and mood issues when they eat better and improve the quality of their intestinal environment. After all, our microbiota, which outnumber our 50 trillion body cells carry more genes than we do. Linus Pauling would like this article. He coined the term “Orthomolecular Psychiatry,” meaning that a significant number of psychological disorders may be treated with good nutrition.[15] Food for thought….

“Rethinking Screening for Breast Cancer and Prostate Cancer”[16]

                This is a game-changing article. Don’t shoot the messenger:

            “After 20 years of screening for breast and prostate cancer, several observations   can be made. First, the incidence of these cancers increased after the         introduction   of screening but has never returned to prescreening levels. Second,   the increase in the relative fraction of early stage cancers has increased.    Third, the incidence of regional cancers has not decreased at a commensurate rate. One      possible explanation is that screening may be increasing the burden of low-risk   cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer              mortality. To        reduce morbidity and mortality from prostate cancer and breast      cancer, new approaches for screening, early detection, and prevention for both        diseases should be considered.”

            Translation: screening may be discovering cancers that would have been OK to leave alone. This article vindicates doctors who maintain that the most reasonable approach to cancer is to boost one’s immune system. The rub is when to be more aggressive with screening and treatment: welcome to the world of uncertainty. No doctor will ever be able to give you 100% assurance on anything. The best we can do is to clearly outline your choices so that you decide and assume responsibility for that decision. Of course, some people may call such a discussion a “death panel…”

Telegraphed articles

“Half of Texas Physicians Don't Recommend HPV Vaccine,”
            J. Skin Allergy News 2009;40:23

“The Alzheimer’s Disease-Diabetes Angle: inevitable fate of aging or metabolic imbalance limiting successful aging.” Translation: high-sugar diets increase the risk of dementia

                J. Alzheimer’s Disease 2009;16:67

“Anti-RAGE and Immunoglobulin Levels Are Related to Dementia Level and Cognitive Performance” supports the above article

            J. Gerontology Biology Science Med Sci 2009;64:264

“Association Between 25-Hydroxy-Vitamin D Levels and Cognitive Performance in Middle Aged and Older European Men.” Get your levels above 80 for best function.

            J. Neurology Neurosurgery Psychiatry 2009;80:722

 “Lipid Peroxidation and Atherosclerosis.” The problem is oxidized cholesterol

            J. Lipids Research 2009;50:599

“Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive Hormones in Infertile Men,”

            J. Urology 2009;182:237

 “Acupuncture for Pain,”

            J. American Family Physician 2009;80:481      

“Sexual Abuse and Lifetime Diagnosis of Somatic Disorders,” like fibromyalgia, chronic pain and gut problems

            JAMA 2009;302:550

“Stimulant (ie Adderall) Linked to Sudden Death in Children Without Heart Problems,”

            JAMA 2009;302:613