Friday, January 29, 2016

Eating More Healthy Fats May Extend Life

For years, experts have preached the gospel of eating “healthy” fats and limiting “unhealthy” fats. Now, a new study contends that if people worldwide began to eat healthier fats, there might be more than a million fewer deaths from heart disease every year.

Although a great deal of attention has been focused on reducing saturated fats from the diet, the researchers said the focus should be two-fold: reducing unhealthy fats such as saturated fat and trans fats, and replacing them with healthy fats, such as polyunsaturated fats.

“Our findings highlight the importance of ending American fear of all fat. We estimate that nearly 50,000 Americans die of heart disease each year due to low intake of vegetable oils,” said Dr. Dariush Mozaffarian, senior author and dean of the Tufts Friedman School of Nutrition Science and Policy in Boston.
The study was published online Jan. 20 in the Journal of the American Heart Association.

Polyunsaturated fats are found in fatty fish (such as salmon, herring mackerel and trout), tofu, soybean oil, corn oil, sunflower oils and seeds, and walnuts. These fats help lower bad cholesterol, and have been linked to a lower risk of heart disease and stroke, according to the American Heart Association (AHA).

Saturated fats are found in meat and dairy products. Trans fats are found in processed, baked and fried foods, according the AHA.

Wednesday, January 27, 2016

Wisdom Wednesday: Annual Laboratory Testing

I highly recommend that you have annual lab work to access your current state of health, predict future health issues and hopefully avert them in the process.

My practice uses functional neurology as a framework. This requires physical testing of patients in the office. I then compare my findings against the patient history and laboratory testing. Laboratory testing is standardized and repeatable giving absolute benchmarks above and beyond the patient’s symptoms and their ability to convey them to the physician.

Here is a list of some of the more common tests I recommend and a brief explanation of why they are of value:
  • Comprehensive Metabolic Panel (CMP) – these fasting tests include the glucose, kidney indicators (uric acid, BUN, creatinine, & eGFR), electrolytes (sodium, potassium, chloride, carbon dioxide, calcium, phosphorus & magnesium), protein (albumin & globulin), bilirubin, alkaline phosphatase, LDL, liver enzymes, and iron indicators (iron binding capacity, UIBC, serum iron, iron saturation & ferritin). Abnormalities of any of these tests are related to metabolic issues like hepatitis, impaired kidney function or anemias.
  • Glycohemoglobin A1c – measures the glycosylation of the hemoglobin molecule on red blood cells. This test effectively measures your average blood glucose levels over the past two months. It is now considered the gold standard for diagnosing pre-diabetes and type 2 diabetes.
  • Serum Lipids – total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol and VLDL cholesterol. Traditionally, these tests are used as a basis to prescribe statin drugs. I use them as a measure of cholesterol metabolism as it relates to thyroid, liver, digestive, and endocrine function.
  • Thyroid Panel – the TSH (thyroid stimulating hormone) is the minimum test. I also like to run the T3 and T4. If I am concerned about autoimmune disease (Hashimoto’s thyroiditis), I also include the TPO (thyroid peroxidase) and thyroid autoantibodies.
  • Vitamin D – measures the serum level of 25-hydroxy vitamin D, the inactive form of vitamin D after conversion from either D2 or D3. Vitamin D is really a hormone and deficiency is very common. Adequate levels are vital to proper function of the immune system in addition to calcium and bone metabolism.
  • CBC (compete blood count) – includes white blood cells (WBCs), red blood cells (RBCs), hemoglobin, hematocrit, volume indices, and white blood cell types. This test shows anemias, infection fighting, and even vitamin B12 and/or folic acid deficiency.
  • C - reactive protein (CRP) – this is an inflammatory marker that is fairly specific for vascular inflammation. It is an important indicator of cardiac risk.
  • Homocysteine – an intermediate metabolite of sulfur amino acid metabolism. It is very dependent on vitamin B12, folic acid, and vitamin B6 status. It is also an important indicator of cardiac risk.
  • Urine Analysis – reveals signs of infection fighting (UTI), acid demand from the diet, and possible kidney stone formation.

Obviously, there are many more tests that can or should be run, depending on your history. I still believe the PSA (prostatic specific antigen) is a good test for men over the age of 40. If you have been advised to take or are taking a statin, then an L(p)a is highly recommended.

The Bottom Line:
Please have routine laboratory testing run annually.

Monday, January 25, 2016

Can Berries, Citrus Fruits, Boost Male Sexual Health?

Biochemicals found in berries, citrus fruit and red wine might help men maintain healthy erections, a new nutrition study suggests.

Foods rich in these flavonoids are associated with reduced risk of erectile dysfunction, researchers reported Jan. 13 in the American Journal of Clinical Nutrition.

Eating a flavonoid-rich diet may be as good for erectile function as briskly walking for two to five hours a week, researchers from Harvard University’s T.H. Chan School of Public Health and the University of East Anglia in England reported.

Flavonoids give fruits and vegetables their vibrant colors. The study found that three specific flavonoids – anthocyanins, flavanones and flavones – offered the greatest benefit in preventing erective dysfunction.
Anthocyanins are generally found in blueberries, cherries, blackberries, radishes and red wine. Flavanones and flavones are found in citrus fruits.

“Men who regularly consumed foods high in these flavonoids were 10% less likely to suffer erectile dysfunction,” lead researcher Aedin Cassidy, a professor of nutrition at the University of East Anglia, said in a university media release. “In terms of quantities, we’re talking just a few portions a week.”

Friday, January 22, 2016

High Uric-Acid Levels, Lower Risk of Parkinson’s?

Men with high levels of uric acid in their blood may be less likely to develop Parkinson’s disease, a new study suggests.

Researchers compared about 400 people in ongoing studies who developed Parkinson’s disease and more than 1,200 people in the same studies who did not develop the movement disorder.

Men with the highest levels of uric acid (urates) were nearly 40% less likely to develop Parkinson’s disease than those with the lowest levels, according to the study published online Jan. 13 in the journal Neurology.

“These results suggest that urate could protect against Parkinson’s or slow the progression of the disease in its very early stages before symptoms are seen,” study author Dr. Xiang Gao, of Pennsylvania State University, said in a news release from the American Academy of Neurology.

“The findings support more research on whether raising the level of urate in people with early Parkinson’s may slow the disease down,” Gao added.

There was no association between urate levels and Parkinson’s disease risk in women, the study found.

Urate is formed when chemical called purines – found in food – are broken down in the body. Previous research has suggested that urate may help protect brain cells.

It’s easy and inexpensive to boost people’s urate levels, but it must be done with care because extremely high levels can cause kidney stones and gout, Gao said.

Wednesday, January 20, 2016

Wisdom Wednesday: Schisandra

Schisandra chinensis is a deciduous woody climbing vine that bears flowers and small fruit of a deep red color. The plant is sometimes referred to as Chinese Magnolia Vine. The fruit is used in Traditional Chinese Medicine (TCM) and Russian medicine for treatment of asthma or as an expectorant, urinary and genital disorders, feminine health, sedative astringent, and as a general wellness tonic to counter fatigue.

The active compounds in Schisandra are thought to by the lignans but they are structurally unique, and quite different from other lignans such as Sesamin (from sesame seed oil). However, Schisandra fruit also contains unique triterpenoids but their exact role in supplementation is not currently known. Standardized extracts are based on the various lignans, specifically the schisandrins.

Quality Schisandra chinensis grows in Northern China and Western Russia. However, an inferior product from Southern China, Schisandra spenanthera is frequently substituted in herbal preparations resulting in a product that is ineffective.

Russian traditional medicine air dries the fruit then extracts the organic compounds with ethanol to create a tincture. The product I obtain from Australia is prepared by this method.

Schisandra lignans act as hormetic anti-oxidants. Hormesis is a phenomena similar to exercise where damage is induced only to subsequently protect and repair to a greater extent. The result of hormesis tends to be elevation of Heat Shock Proteins and increased expression of anti-oxidative enzymes in mitochondria such as Glutathione Reductase.

The therapeutic, preventative, and (theoretically, not yet demonstrated) life enhancing properties of Schisandra chinensis extends to most organ systems of the body. Schisandra has been demonstrated to reach the brain, liver, lungs, kidneys, spleen, heart, and adrenals.

Monday, January 18, 2016

Green, Leafy Vegetables Each Day May Help Keep Glaucoma at Bay

“We found those consuming the most green leafy vegetables had a 20-30% lower risk of glaucoma,” said study leader Jae Kang. Kang is an assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School in Boston.

Glaucoma is an eye condition that usually develops when fluid increases in the front part of the eye and causes pressure, damaging the optic nerve. It can lead to loss of vision, according to the U.S. National Eye Institute.

Kang’s team followed nearly 64,000 participants in the Nurses’ Health Study from 1984 through 2012, and more than 41,000 participants in the Health Professionals Follow-up Study from 1986 through 2014. The men and women were all 40 or older. None had glaucoma at the start of the study, and they had eye exams every two years.

Over the 25-year follow up, almost 1,500 people developed glaucoma. The research looked at the consumption of green leafy vegetables among the participants.

The investigators divided the participants into five groups, from the highest level of leafy green vegetable consumption to the lowest. Those who ate the most average about 1.5 servings a day, or about one and half cups a day, Kang said. Those in the group eating the least leafy greens ate about a serving every three days.

“In glaucoma, we think there is an impairment of blood flow to the optic nerve,” Kang said. “And an important factor that regulates blood flow to the eye is a substance called nitric oxide.” Green leafy vegetables contain nitrates, which are precursors to nitric oxide, the researchers said.

Friday, January 15, 2016

Pre-Pregnancy Potato Consumption Linked to Gestational Diabetes

A woman’s risk of gestational diabetes seemed to increase by 27% if she regularly consumed between two and four cups of potatoes a week before pregnancy. Five or more cups a week appeared to increase risk by 50%, even after researchers accounted for pre-pregnancy obesity and other potential risk factors, the study found.

“The more women consumed potatoes, the greater risk they had for gestational diabetes,” said senior author Dr. Cuilin Zhang, a senior investigator with the U.S. National institute of Child Health and Human Development. “Potatoes are regarded as a kind of vegetable, but not all vegetables are healthy.”

The findings from the study were released online Jan. 12 in the British Medical Journal.

Potatoes are the third most commonly consumed food crop in the world, after rice and wheat. About 35% of U.S. women in the childbearing years eat potatoes daily, according to the background information in the study.

Eating a cup of potatoes can send blood sugar levels skyrocketing, on par with swigging a can of cola or munching a handful of jelly beans, according to Harvard nutrition experts.

Elevated blood sugar levels can promote insulin resistance and contribute to the development of type 2 diabetes, Zhang said.

Wednesday, January 13, 2016

Wisdom Wednesday: High Cholesterol Revisited

I reference the fallacy of treating high cholesterol with statin drugs frequently. Maybe too frequently. However, for those of you taking a statin (soon to be 50% of the population over the age of 45) I would like to give some background information to discuss with your PCP.

These are the most common causes of high cholesterol:

  • The most common cause is a diet high in saturated fat or trans-fats. Saturated fats are found mostly in animal products and recent research indicates that in moderation, saturated fats are safe. Trans-fats are rare in nature but rather are the result of modifying fats to increase shelf life. The trans- bond is very difficult for the body to break. The half-life of a trans-fat in the body is 59 days and it takes five half-lives to eliminate a substance from the body. So the trans-fat oils in those French fries stay in your body for nine months.
  • The second most common cause is an underactive thyroid. Hypothyroidism is epidemic in the U.S., especially in women after menopause. Although almost immune to heart attack prior to menopause, the rate of heart attack in women exceeds that of men within five years of menopause. This and insulin resistance are major factors in metabolic syndrome. Laboratory testing for the thyroid begins with a TSH (thyroid stimulating hormone). Although the lab normal range runs from 0.4 to 4.5, the ideal range is 1-2. Running a T3 and T4 gives a better perspective of hormone production and the TPO (thyroid peroxidase) and thyroid auto-antibodies can reveal autoimmune disease of the thyroid (Hashimoto’s thyroiditis).
  • In third is dysbiosis. If the microbiome of the digestive tract is disturbed, harmful bacteria can liberate spent estrogen being discarded from the liver. They also produce estrogen analogs. These products are then resorbed in the lining of the large intestine and stimulate cholesterol production in the liver. A history of IBS (irritable bowel syndrome), GERD, acid-reflux or food sensitivities is usually evident but complete digestive stool analysis can identify offending organisms and evaluate the immune status of the gut.
  • Last and the least common is genetic, inherited over production of cholesterol in the liver. The lab test for this issue is an L(p)a, a portion of the LDL cholesterol. It is seldom run because there are no drugs currently available to lower the L(p)a. However, both niacin and Gingko leaf extract can often reduce the L(p)a by 50% in three months.

The bigger issue is artery inflammation. This is the ultimate cause of atherosclerosis. When an artery wall becomes inflamed. The inflammation triggers homocysteine to attract LDL cholesterol and attach it to the inflamed artery wall. On a small scale, this protects the inflamed wall. When excessive coronary artery disease is the result.

Monday, January 11, 2016

Try Home Remedies for Child’s Cough or Cold

Instead of turning to over-the-counter cough and cold remedies, parents should consider threating their children with home remedies, says a leading group of U.S. pediatricians.

Like all medications, even cold and cough remedies available without a prescription can cause serious side effects in young children, the American Academy of Pediatrics cautions.

Because of the risks, the U.S. Food and Drug Administration in 2008 recommended that children younger than 4 years old never be treated with over-the-counter cough and cold medicines.

Children between 4 and 6 years old should only take these remedies under the direction of their doctor, the academy said in a news release. But children older than 6 can safely take over-the-counter drugs if the dosage instructions on the package are followed correctly.

There are safer, more convenient and less costly ways to provide sick kids with some relief from such symptoms as a stuffy nose and coughing, the academy advised. Some suggestions include:
Runny nose: Grab a tissue. A runny nose can be stopped by suctioning it or blowing it. Although antihistamines are useful in treating nasal allergies, they don’t help relieve cold symptoms. The good news is that runny noses help the body get rid of the nasty viruses that make kids sick.

Stuffy nose: No medication can remove dried mucus or pus from the nose, but nasal washes can help. Saline nose spray or drops may loosen up mucus so that kids can blow their nose more easily. Saline solution can be made at home by adding 2 milliliters (mL) (0.4 teaspoon) of table salt to 240 mL (8 ounces) of warm tap water. If saline isn’t available, a few drops of warm water in each nostril also works. This can be repeated until the nose becomes clear. Very sticky mucus can also be removed with a wet cotton swab. If the air is dry, using a humidifier or running a warm shower can keep kids’ mucus from drying up.

Friday, January 8, 2016

Retract Study That Claimed Nitroglycerin Might Boost Bone Density

Some authors of a published study that claimed the heart medicine nitroglycerin might boost bone density in older women have asked that the study be retracted, saying the lead researcher falsified data in the the report.

The research was first published in February2011 in the Journal of the American Medical Association. The request for a retraction appeared online Dec. 28 on the journal’s website.

The researchers who published the retraction request said an investigation found that Dr. Sophie Jamal, formerly a researcher with Women’s College Hospital in Toronto, fabricated the data for the study. Jamal isn’t named as an author of the retraction request, which followed a hospital investigation that determined she had manipulated the data in the study.

When the study was published, it reported that applying a small amount of nitroglycerin ointment to the arm each day was linked to a modest increase in bone density. Roughly 240 women, average age 62, were involved in the study.

An October 2015 report in the Toronto Star said all the women in the study had been told the results weren’t accurate. Jamal has resigned as research director of the Centre for Osteoporosis & Bone Health a Women’s College Hospital, and as an associate professor of medicine at the University of Toronto, the newspaper reported.

Wednesday, January 6, 2016

Wisdom Wednesday: Set Some Goals for 2016

Everyone talks about New Year’s resolutions, mostly poking fun at how soon they will be broken. Many use this theme as a reason not to bother – “I’ll just break them in a week anyway”.

Of course you will break them and so will I, but New Year’s resolutions should not be about the absolutes. It’s all about changing patterns even if it the effort is sporadic. So when you break one of those resolutions, you just let it go and begin again. Over time, the resolutions will become habits.

So here are a few suggestions for this year:

  • Buy a water distiller. Clean water is the easiest, cheapest, and most important step you can take to support your health. A small distiller is relatively inexpensive (about $120). Over the past few years they have become more efficient, making a gallon in about three hours. Generally, 1-2 gallons per day is enough for our household. Buy a five-gallon glass dispenser to hold some reserve. I keep ours full during hurricane season. has several to chose from. Most come with a full one-year warranty. You can expect to get 2-3 years of good service from a unit. Set a goal to drink a half gallon each day.
  • Start an exercise program. I highly recommend “Couch to 5K”. This program takes you from walking to a walk-run and peaks with you participating in a 5K (3.2 mile) race. You can download an app for your smart phone or but the book, but many community centers offer classes for a minimal fee. You get coaching and teammates to help you through the rough spots.
  • If you are already exercising, add a new activity. Experiment with some classes at the gym. Many serious cyclists dismiss cycling classes, until they take one and then they’re hooked. If you are a runner or walker, try swimming or biking. I got my wife a paddleboard for Christmas. Just carrying it down the beach is a workout, but she loves her new activity – costal cruising on a board.
  • Try some baby steps to improve your diet. I recommend five vegetable servings, three protein servings, and two fruits per day. Maybe set a goal that you are going to eat two vegetables and one fruit every day. As you increase the healthy foods in your diet, the junk will begin to fall away. Just do a little better than you have been.
  • Plan an exercise based vacation. I love self guided cycling tours but there are unlimited options – hike a portion of the Appalachian Trial or one of hundreds of similar trails through out the country. Go on a ski vacation or a tennis vacation. Set training goals to be ready for the event. Your anticipation will increase as the date approaches and the training progresses.

This year one or my goals is to be consistent with weight training. I really don’t enjoy lifting weights but I love the effects. I feel the difference in my body each and every workout. This year I’m pairing it with spin classes. I’m very diligent in attending two classes per week. If I go a little early to lift weights that overcomes the biggest obstacle – getting there.

The Bottom Line:
There’s an ad on television for a home exercise machine that only takes 14 minutes a day. They claim that the biggest deterrent to exercise is finding the time. I disagree, it’s making the time. Make your plans for 2016.

Monday, January 4, 2016

Breast Ultrasound & Mammography May Be Equally Effective

A new study indicates they appear equally likely to detect breast cancer.

“It looks like ultrasound does better than mammography for node–negative invasive cancer,” said study leader Dr. Wendie Berg, professor of radiology at Magee-Women’s Hospital of UPMC in Pittsburgh. Node-negative invasive cancer is cancer that hasn’t invaded the lymph nodes, but has grown past the initial tumor, according to the U.S. National Cancer Institute.

The downside [to ultrasound] is, there were more false positives,” Berg said.

At least one expert doesn’t expect this study to change current screening practice in the United States.

“For U.S. patients, what [this study] really confirms is, ultrasound should be used as a supplemental screening exam in dense breast patients,” said Dr. Lusi Tumyan, a radiologist and assistant clinical professor at the City of Hope Cancer Center, in Duarte, Calif. She reviewed the findings but was not involved in the study. “At this time we do not have enough data to support or refute ultrasound as a screening tool for average-risk patients,” Tumyan said.

The study was published Dec. 28 in the Journal of the National Cancer Institute.

Ultrasound is generally used as a follow-up test once a potential breast tumor has been discovered through a mammogram or a physical exam, according to the American Cancer Society (ACS). The ACS says that ultrasound is a valuable tool that’s widely available and noninvasive.

The new study involved 2,600 women living in the United States, Canada and Argentina who had ultrasound and mammogram annually for three years. They had no symptoms of breast cancer at the study’s start, but they did have dense breast tissue – considered a risk factor for breast cancer – plus at least one other risk factor for breast cancer.