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Letter from Dr. Janson
St. John's Wort in the News
Junk Food Nation
Vitamins that Prevent Cataracts
Diet "As Good As"
Drugs (or better?)
In the Health News
Recipe of the Month: Whole
Grain Pasta with Pesto
Dear Friends,
Recently I had an online chat on a health forum
about the development and acceptance of “alternative”
or “complementary” medicine (which I call simply
“good medicine”) by mainstream medical professionals.
My correspondent was wondering in a plaintive
tone why it takes so long for such new ideas
to become accepted. She was also wondering about
the constant criticism from mainstream doctors
and medical researchers that this form of medicine
is not properly documented.
I pointed out that the statement that complementary
or natural medicine is not researched is simply
an opinion, and is neither a well-founded nor
researched statement, and it is a very unscientific
position. This attitude is usually the voice
of ignorance - just ask the medical researcher
if he or she has looked at the literature at
all, and if so, where and for what? For example,
have they done a Medline search on rutin in
the treatment of vascular disease and found
that there are no double-blind studies? If they
say yes, they’ve looked, then they have missed
those that have been done, if they say no, you
can point to ignorance as a poor basis for a
scientist to draw conclusions.
You could repeat this scenario for many other
treatments, including glucosamine sulfate for
osteoarthritis, horse chestnut and butcher’s
broom for varicose veins, folic acid and B12
for homocysteine reduction, or birth defect
prevention with folic acid, and I could go on
and on.
The next question, of course, is how much medicine
as it is practiced is based on the kind of studies
being demanded of alternative medicine. It is
easy to find examples of common practices with
little documentation, such as coronary bypass
surgery or angioplasty, amoxicillin for ear
infections, lidocaine for treatment of acute
MI, many blood pressure medications, the as
yet unproven value of regular mammograms, and
more. Just last month, I reported on the unnecessary
appendectomy that has been standard practice.
Most doctors are familiar with the overuse of
antibiotics for viral infections, and placing
tubes in children without adequate evidence
of benefits. Once a doctor is treating a patient
with more than one or two drugs, they are in
the realm of undocumented treatments.
Medicine does not depend on such research;
it uses it as a stepping off point, and then
applies research using the art of medicine,
whether it is in mainstream or complementary/natural
treatment.
I don’t doubt that there is quackery and ineffective
medicine being performed, but it is not exclusive
to unconventional treatments. I venture to say,
without much risk of error, that the unconventional
treatments, including those that may be ineffective,
are far less damaging than drugs and surgery,
and many of them are at least as well documented
as the mainstream treatments.
A report in the medical literature cited a large
study showing that St. John’s wort did not work
for patients with serious depression any better
than a placebo. In the study, from Vanderbilt
University and published in the Journal of the
AMA, they did not evaluate St. John’s wort for
treatment of mild to moderate depression, and
the researchers did note that many patients
do not respond well to any treatment.
Many prior (and larger) studies have shown
that St. John’s wort is valuable for depression
if it is mild to moderate, and that it is as
good as many medications, but better tolerated
and without drug side effects. Yet this researcher
was quoted as saying, “If someone is depressed
enough to be treated, the answer is ‘no’ for
treatment with St. John’s wort,” ignoring all
those people with mild to moderate depression
who could benefit from this safe and effective
remedy.
Needless to say, many in the medical community,
the media, and antagonists to natural remedies
and alternative medicine are using this study
to try to discredit all treatments outside of
the mainstream. They are ignoring (or ignorant
of) all the research that supports the many
non-drug therapies and alternatives to surgery.
This is but one study among many, and no doubt
it is important to the continuing evaluation
of this treatment, but it does not mean that
depressed people should not try St. John’s wort
as a treatment, nor that they should avoid other
natural remedies that may work with it or independently.
Science is made up of numerous studies that
need to be taken as a whole, looking at the
preponderance of the evidence, and then drawing
conclusions based on the current state of knowledge.
It is not wise to base decisions on one report.
Another study being done at Stanford, and sponsored
by the National Institute of Mental Health and
the National Center for Complementary and Alternative
Medicine is designed to show whether St. John’s
wort can help with depression. It is due to
be completed later this year.
Combining St. John’s wort with kava kava can
help depressed and anxious patients. SAMe, melatonin,
and 5-HTP (5-hydroxytryptophan) can help people
who may not respond to other natural treatments.
In addition, a comprehensive program of diet,
exercise, and other supplements (vitamin B complex
and C, for example) can also help with depression
without side effects.
The conclusion of the researchers was that
people would be better off using “established”
drugs, such as Prozac, Zoloft, and Paxil, and
it is true that some people do respond well
to those medications. However, it is also true
that they have frequent and significant side
effects, including serious agitation and aggressive
behavior, anxiety, insomnia, loss of appetite,
decreased libido, and tremors. It is no wonder
that people are looking for alternatives.
I was disheartened to see a report in Newsweek
called “United Snacks of America” listing the
sad situation of official glorification of dietary
junk (note that I don’t say junk food, because
it is not food!). Newsweek reported that in
Snohomish, Washington, they have an official
state candy; in Bell Buckle, Tennessee, they
have an official celebration of a cola and cookie
combo; in Sterling, Colorado, they have a celebration
of a cereal (700 bags of the stuff were a gift
to the town, containing 673,000 calories); Hastings,
Nebraska proclaimed the city the home town of
Kool-Aid (and annual U.S. consumption is more
than 2 gallons per person); and Salt Lake City,
Utah has made Jell-O the official snack.
How sad this is for anyone trying to educate
people to choose better health habits. Another
city has granted one cola exclusive rights to
sell in the city. Not that it matters which
cola someone drinks—what is unfortunate is this
further example of government support of dangerous
substances (all of these snacks and drinks are
more damaging to health than illegal drugs).
In one town, one school proclaimed a one-brand
cola day, and they actually sent a student home
for wearing a T-shirt with another brand label
emblazoned on it.
It makes me realize that those of us who teach
better eating habits will not be out of work
for a long time to come. Perhaps the American
obsession with junk has a silver lining for
me and my colleagues in this field.
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As people age, one of the most feared
problems that they may face is loss of vision.
Among the causes of visual deterioration is
cataract formation, or cloudiness of the lens
of the eye. The lens is exposed to light and
oxygen, both of which can lead to free radical
damage, which is one cause of cataracts. Dietary
sugar is another contributor to cataract formation.
Recent studies have shown that you can prevent
cataracts by choosing to eat properly and take
dietary supplements. You don’t have to simply
expect them to appear as a function of aging.
University of Wisconsin researchers followed
a group of people for five years, and they report
that people who had taken supplements containing
vitamins E and C for 10 years or more reduced
their risk of cataract by 60 percent. Neither
smoking nor dietary variation had any influence
on the benefits from the vitamin supplements.
Another study suggested that vitamins or the
foods (fresh fruits and vegetables) that contain
them are very important for cataract prevention.
The specific markers were lutein and zeaxanthin
(in the carotenoid family), and vitamin E, especially
gamma-tocopherol (the form found in mixed tocopherols
as opposed to just plain alpha-tocopherol).
You can find vitamin E supplements that are
particularly high in gamma tocopherol. Other
studies confirm that lutein and zeaxanthin as
well as other antioxidants are protective against
cataract formation.
Certain nutrient deficiencies lead to cataract
formation, particularly vitamin A, niacin, thiamin,
and riboflavin. These are readily available
from a healthy diet, as well as in multivitamin
supplements. Essential fatty acids also help,
such as gamma-linolenic acid and omega-3 oils.
A comprehensive approach to cataract prevention
means avoiding excessive exposure to ultraviolet
light, avoiding tobacco smoke (one ofthe most
serious sources of free radical damage in humans),
eating a healthy diet with lots of fruits and
vegetables, and taking various supplements to
control free radicals and oxidative damage.
These should include adequate amounts of minerals
that support free radical protection, such as
zinc, manganese, copper, and selenium.
Although you now see a lot of ads for statin
drugs to lower cholesterol (can’t escape those
for Pravastatin in most media), you don’t need
them to achieve the benefits of cholesterol
reduction. It turns out that a diet high in
fiber and rich in fruits, vegetables, and nuts
will have the same effect.
The highest fiber diet with nuts worked the
best, but the other two diets, with more cereal
grains and fewer nuts, had some beneficial effects.
The best diet contained 100 grams of fiber,
compared to 40 grams and 25 grams. The total
cholesterol reduction was 20 percent, while
the bad LDL cholesterol was lowered 30 percent.
The researchers thought it might be difficult
for people to stay on such diets with modern
lifestyles, but they can and do to avoid drug
side effects. I would also add antioxidant vitamins,
garlic, red yeast rice, and chromium for further
benefits.
•Air pollution can make it harder for people
with hypertension to lower their blood pressure.
A new German study has shown that pollution
may alter the part of the nervous system that
controls blood pressure. Particulate matter
in the air, as well as sulfur dioxides were
directly associated with blood pressure elevations.
Other studies have shown that pollutants from
cars and factories in U.S. cities were related
to the risk of death. (Ibald-Mulli A, et al.,
Effects of air pollution on blood pressure:
a population-based approach. Am J Public Health
2001 Apr;91(4):571-7.) It is possible that the
increased risk of death is related to chronic
lung inflammation, which appears to increase
the risk of heart disease.
•In February I reported on the risk of
excess mercury in fish, but since then I have
seen a report from the Environmental Working
Group and U.S. PIRG stating that the FDA Advisory
did not go far enough in its warnings. The FDA
guidelines do not account for the mercury already
present in women before becoming pregnant, and
they are based on levels considered acceptable
in a 150 pound man. The list of additional fish
to avoid includes tuna, sea bass, Gulf Coast
oysters, halibut, pike, and largemouth bass,
and reducing consumption of cod, pollock, mahi
mahi, blue mussel, Eastern oyster, and Great
Lakes salmon. (Brain Food: What Women Should
Know About Mercury Contamination in Fish, EWG,
April, 2001)
•Ginger can relieve nausea and vomiting of
pregnancy (morning sickness). Researchers have
shown that capsules of 1000 mg of ginger could
work within four days without side effects.
The same authors earlier reported that vitamin
B6 is helpful. (Vutyavanich T, et al., Ginger
for nausea and vomiting in pregnancy:.. Obstet
Gynecol 2001 Apr;97(4):577-82.)
I grow lots of basil in the garden, and I love
it fresh in salads, but I also make pesto sauce
for my pasta. This is a simple combination of
basil, garlic, and olive oil, with some pine
nuts or walnuts all blended together in a food
processor. I then boil whole grain noodles (I
like Kamut Soba from a company called Sobaya–they
are an organic noodle made with kamut and buckwheat;
ask your health food store to carry them), strain
out the water, and cover them with the pesto.
You can add an optional sprinkle of grated romano
sheep cheese. I also make ratatouille—a sauteed
mix of tomato, eggplant, peppers, zucchini,
yellow squash, garlic, and onions, and mix the
two different flavors over the same pasta dish.
Serve this with a small salad for a delicious
summer meal (or freeze the pesto for winter) |
